[New antibiotics to deal with antibiotic resistance]. / Nouveaux antibiotiques pour faire face à l'antibiorésistance.

NEW ANTIBIOTICS TO DEAL WITH ANTIBIOTIC RESISTANCE. The current increase in antibiotic resistance exposes to the risk of therapeutic impasse. To deal with this public health problem, developing new antibiotics that are effective (directly or in combination with older drugs) against these multi-resistant bacteria seems important. Over the last 10 years, new drugs (beta-lactams, beta-lactamase inhibitors, cyclin and carbapenems) have been developed against Gram-negative bacteria. A new oxazolidinone, two glycopeptides and a quinolone have been developed against Gram-positive bacteria. Their use must absolutely be controlled to avoid resistance mechanisms emergence.

NOUVEAUX ANTIBIOTIQUES POUR FAIRE FACE. À L'ANTIBIORÉSISTANCE L'augmentation actuelle de l'antibiorésistance expose au risque d'impasse thérapeutique. Face à ce problème de santé publique, développer de nouveaux antibiotiques actifs (directement ou en association avec d'anciennes molécules) contre ces bactéries multirésistantes semble essentiel. Au cours des dix dernières années, de nouvelles molécules (bêtalactamines, inhibiteurs de bêtalactamases, cycline et carbapénèmes) efficaces contre les bactéries à Gram négatif ont ainsi été développées. Une nouvelle oxazolidinone, deux glycopeptides et une quinolone ont été ajoutés à l'arsenal thérapeutique anti-Gram positif. Leur utilisation doit absolument être contrôlée pour éviter l'apparition de mécanismes de résistance.

Infectious Complications of Targeted Therapies for Solid Cancers or Leukemias/Lymphomas.

BACKGROUND: Infections are well known complications of some targeted drugs used to treat solid organ cancer and hematological malignancies. Furthermore, Individual patient risk factors are associated with underlying pathologies, concomitant immunosuppressive treatment, prior treatment and use of anti-infective prophylaxis. Immune-related adverse events (irAEs) are frequent among patients treated with new targeted drugs. OBJECTIVES: In this narrative review, we present the current state of knowledge concerning the infectious complications occurring in patients treated with immune checkpoint inhibitors (ICIs), Bruton's tyrosine kinase (BTK) inhibitors, phosphatidylinositol 3-kinase (PI3K) inhibitors, antiapoptotic protein BCL-2 inhibitors, Janus kinase inhibitors or CAR-T cell infusion. SOURCES: We searched for studies treating infectious complications of ICIs, BTK inhibitors, PI3K inhibitors, antiapoptotic protein BCL-2 inhibitors and CAR-T cell therapy. We included randomized, observational studies and case reports. CONTENT: Immune-related adverse events (irAEs) are frequent among patients treated with new targeted drugs. Treatment of irAEs with corticosteroids and other immunosuppressive agents can lead to opportunistic infections. Bruton's tyrosine kinase (BTK) inhibitors are associated with higher rate of infections, including invasive fungal infections. IMPLICATIONS: Infections, particularly fungal ones, are common in patients treated with BTK inhibitors even though most of the complications occurring among patients treated by ICIs or CART-cells infusion are associated with the treatment of side effects related to the use of these new treatments. The diagnosis of these infectious complications can be difficult and may require extensive investigations.

Frequency of surface bacterial contamination in family physicians' offices.

OBJECTIVES: The environment is perceived as a potential source of healthcare-associated infections. While this infection source has been well studied in hospital settings, little data on the risk of contamination in general medical practice is available. We aimed to assess the frequency of environmental contamination in family practice (FP), and to describe pathogens isolated, at-risk surfaces, and factors associated with this contamination. PATIENTS AND METHODS: We conducted a cross-sectional point prevalence study over six months in 51 FP offices. In each office, six environmental samples were collected after and before consultations on high-touch surfaces (stethoscope, examination table, physician's desktop, blood pressure cuff, medical equipment tray, computer keyboard and mouse). RESULTS: A total of 580 samples were obtained. All offices were contaminated at any time with at least 2.5 colony forming units. The median rate of examination room bio-cleaning was twice a week. For all equipment and surfaces, a lower bacterial load was found before consultations when the last cleaning had occurred less than 24hours prior to testing. CONCLUSION: High environmental contamination was observed in FP offices. Less than one practice in five used an effective cleaning agent; family physicians' awareness of practice hygiene is an important step for prevention.