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Master Thesis

Évaluation d'une nouvelle méthode de détection des Campylobacters dans les selles au laboratoire et impact en pratique clinique aux urgences pédiatriques

Abstract : Objectives: campylobacter spp. is the leading cause of bacterial diarrhea in children under five years of age. Antibiotic therapy is indicated for severe forms and its interest is higher when it is started within the first three days of diarrhea. The objectives of this study are to evaluate the performance of a new EIA to detect the presence of Campylobacters in stools and the impact of its implementation at the Bordeaux pediatric emergency department on the appropriate antibiotic prescription. Method: we used a composite reference criterion with stool culture, an ELISA test and a PCR, to evaluate the EIA. Then it was performed systematically on children’s stools sent from emergency department to the laboratory for culture. We conducted a retrospective study comparing the appropriate antibiotic prescription before and after the implementation of the EIA among children for whom stool culture was performed. Results: EIA sensitivity was 96.2% and specificity was 94.5%. After implementation of the test, a significant increase in inappropriate antibiotic prescribing was found and was mainly related to an increase in antibiotic prescribing for non-severe Campylobacter spp. infections. Conclusion: we validated the EIA to be used routinely. Its implementation is associated in our study with an increase in the rate of inappropriate antibiotic prescribing, according to current recommendations. It appears essential to associate the implementation of the EIA with a reminder of the recommendations on the indications of antibiotic therapy and its benefit-risk ratio in order to limit inappropriate antibiotics prescriptions. In view of the increasingly frequent use in laboratories of Syndromic multiplex PCRs that also offer rapid results, vigilance must be exercised to ensure compliance with antibiotic therapy recommendations.
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https://dumas.ccsd.cnrs.fr/dumas-03011640
Contributor : Médecine Ub <>
Submitted on : Wednesday, November 18, 2020 - 11:09:50 AM
Last modification on : Saturday, December 19, 2020 - 3:12:50 AM

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Justine Franco. Évaluation d'une nouvelle méthode de détection des Campylobacters dans les selles au laboratoire et impact en pratique clinique aux urgences pédiatriques. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03011640⟩

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