Flurin, Laure

Hydrogen peroxide (H 2 O 2 ) and hypochlorous acid (HOCl) are biocides used for cleaning and debriding chronic wound infections, which often harbor drug-resistant bacteria. Here, we evaluated the in vitro activity of H 2 O 2 and HOCl against 27 isolates of eight bacterial species involved in wound infections.

Abstract Introduction Guadeloupe, a French West Indies island, has been fiercely affected by two large waves of COVID.Therapeutic approach was different between the two waves in the intensive care unit (ICU). We aimed to compare the two different periods in terms of characteristics and outcomes and to evaluate risk factors associated with 60-day mortality in our overall cohort. Methods All consecutive patients with laboratory confirmed COVID-19 pneumonia and requiring oxygen support admitted in our ICU unit of University Hospital of Guadeloupe were prospectively included. Patients were treated during the first wave with a combination of Hydroxychloroquine and Azithromycin and during the second wave with dexamethasone and reinforced anticoagulation. Results In our cohort, 187 patients were included, 31 during the first one and 156 during the second. Patients were mostly male (69%) with a median age of 64years old. Patients tend to be younger during the second wave and body mass index was higher (respectively 31 vs 27kg/m2, p=0.01). Overall mortality at Day 60 was high (45%) and not different between the two waves. Among patients under mechanical ventilation risk factors associated with death in a multivariate analysis were a high number of comorbidities, a high level of SOFA score and the delay of invasive mechanical ventilation (IMV) onset after admission in ICU (OR=1.6 (95% CI 1.2 – 2.4). Conclusion Although therapeutics approach evolve, COVID-19 severe pneumonia is still associated with a high mortality rate in ICU.

Oxidizing agents like hypochlorous acid (HOCl) have antimicrobial activity. We developed an integrated electrochemical scaffold, or e-scaffold, that delivers a continuous low dose of HOCl aimed at targeting microbial biofilms without exceeding concentrations toxic to humans as a prototype of a device being developed to treat wound infections in humans.

Abstract Background With a reported incidence of up to 12%, periprosthetic joint infection (PJI) is a frequent complication of total elbow arthroplasty (TEA). Its microbiologic diagnosis is usually based on periprosthetic tissue culture (hereafter referred to as tissue culture), despite the poor sensitivity of this technique. Although implant sonication cultures have been shown to be superior to tissue cultures for hip and knee PJI diagnosis, only a single small study (including fewer than 10 infected implants) has assessed sonication of elbow arthroplasties. Methods We retrospectively analysed 116 sonicate fluid cultures from patients who underwent revision of a TEA at our Institution between 2007 and 2019, comparing results to tissue cultures. Nine elbows who had fewer than 2 tissue samples obtained during surgery were excluded. Using the IDSA guidelines to define PJI, there were 46 infected cases and 61 aseptic failures. We reviewed clinical characteristics and calculated the sensitivity and specificity of periprosthetic tissue culture compared to culture of samples obtained by implant sonication. In addition, we compared the sensitivity of tissue culture to the combination of tissue and sonicate fluid culture. Results A total of 107 elbows were included. Median ages in the aseptic failure and PJI groups were 60 and 67 years, respectively. Gender distribution was similar for both groups (PJI group 62% females; aseptic group 65% females). The most common pathogens were coagulase negative Staphylococcus species (66%), followed by Staphylococcus aureus (18%). The sensitivity of tissue culture was 63% and the sensitivity of sonicate fluid culture was 76% (p=0.14). The specificity of tissue culture was 86% and the specificity of sonicate fluid culture was 100%. Sensitivity of sonicate fluid culture in combination with tissue culture was 91% (p=0.045). Table. Comparison of tests for microbiologic diagnosis of PJI Conclusion The combination of sonicate fluid culture and tissue culture had a greater sensitivity than tissue culture alone for microbiologic diagnosis of elbow TEA infection. Disclosures Joachin Sanchez-Sotelo, M.D, PhD, Elsevier (Other Financial or Material Support, Publishing Royalties)Exactech (Consultant)Oxford Univerity Press (Other Financial or Material Support, Publishing Royalties)Stryker (Grant/Research Support)Wright (Consultant) Robin Patel, MD, Accelerate Diagnostics (Grant/Research Support)CD Diagnostics (Grant/Research Support)Contrafect (Grant/Research Support)Curetis (Consultant)GenMark Diagnostics (Consultant)Heraeus Medical (Consultant)Hutchison Biofilm Medical Solutions (Grant/Research Support)Merck (Grant/Research Support)Next Gen Diagnostics (Consultant)PathoQuest (Consultant)Qvella (Consultant)Samsung (Other Financial or Material Support, Dr. Patel has a patent on Bordetella pertussis/parapertussis PCR issued, a patent on a device/method for sonication with royalties paid by Samsung to Mayo Clinic, and a patent on an anti-biofilm substance issued.)Selux Dx (Consultant)Shionogi (Grant/Research Support)Specific Technologies (Consultant)