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Master Thesis

Caractéristiques épidémiologiques, bactériologiques et prise en charge des infections à gonocoque en Ille-et-Vilaine et dans le Morbihan entre 2014 et 2016

Abstract : Introduction : Gonococcal infections are emerging in France, in parallel with an increase in antibiotic-resistant strains. Material & Methods : This is a retrospective multicenter observational study. We included all cases of gonococcal infections, diagnosed by Neisseria gonorrhoeae positive PCR, documented in the hospitals and laboratories participating in the RENAGO biological sentinel network as well as health professionals, liberals, participating in the Resist clinical sentinel network in hospitals, in Ille-et-Vilaine and Morbihan departments. The case description is based on a standardized collection of clinical and biological data. Results : From January 1, 2014 to December 31, 2016, 245 cases of patients with gonococcal infection were studied. The patients had the following characteristics : the median age was 25 years with a male-to-female sex ratio of 1.55. The main places of recruitment were General Practitioners Office for 122 patients, Gynecological Emergencies for 45 patients and the Emergency Department for 17 patients. The infections diagnosed were : Urethritis (59 cases), Upper Genital Tract Infection (40 cases), Cervicitis (12 cases), Anitis-Rectitis (11 cases), Arthritis (4 cases), Asymptomatic Form (3 cases), Orchyepididymitis (2 cases), Endocarditis (1 case), Conjunctivitis (1 case) and Pyelonephritis (1 case). HIV co-infection was found in 3.3% of cases. Co-infection with Chlamydia trachomatis was found in 16.3% of cases. The culture was positive for N. gonorrhoeae in 60% of patients. The Minimal Inhibitory Concentration (MIC) of CEFTRIAXONE was < 0.12 mg/l in 99.4% of cases. In one case, it was > 0.12 mg/l. The CEFIXIME MIC was < 0.12 mg/l in 98.1% of cases. 70.2% of patients received effective treatment and 59.5% of patients received treatment adapted to current recommendations. Conclusion : This study confirms that general practitioners play a major role in the management of gonococcal infections, whose emergence remains worrying. The risk of emerging resistance justifies ongoing microbiological surveillance in order to adjust therapeutic recommendations.
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Master Thesis
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Adrien Loncle. Caractéristiques épidémiologiques, bactériologiques et prise en charge des infections à gonocoque en Ille-et-Vilaine et dans le Morbihan entre 2014 et 2016. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02139487⟩

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