Jean-Ralph Zahar

Learn More
BACKGROUND AND OBJECTIVES Cyst infection is a complex diagnostic and therapeutic issue in patients with autosomal dominant polycystic kidney disease (ADPKD); however, published data regarding the diagnosis and the management of cyst infections in patients with ADPKD are sparse. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A retrospective study was(More)
The clinical pulmonary infection score-original or modified-has been proposed for the diagnosis and management of ventilator-associated pneumonia. In 79 episodes of suspected pneumonia, we prospectively assessed the diagnostic accuracy of the physicians' clinical assessment of probability and of the modified clinical pulmonary infection score, both measured(More)
BACKGROUND Recovery of Candida from the respiratory tract of a critically ill patient receiving mechanical ventilation (MV) usually indicates colonization rather than infection of the respiratory tract. However, interactions between Candida and bacteria, particularly Pseudomonas, have been reported. Thus, Candida colonization of the respiratory tract may(More)
CONTEXT Use of a chlorhexidine gluconate-impregnated sponge (CHGIS) in intravascular catheter dressings may reduce catheter-related infections (CRIs). Changing catheter dressings every 3 days may be more frequent than necessary. OBJECTIVE To assess superiority of CHGIS dressings regarding the rate of major CRIs (clinical sepsis with or without bloodstream(More)
OBJECTIVES We evaluated the respective influence of the causative pathogen and infection site on hospital mortality from severe sepsis related to community-, hospital-, and intensive care unit-acquired infections. DESIGN We used a prospective observational cohort 10-yr database. We built a subdistribution hazards model with corrections for competing risks(More)
BACKGROUND Overall rates of bloodstream infection (BSI) are often used as quality indicators in intensive care units (ICUs). We investigated whether ICU-acquired BSI increased mortality (by > or = 10%) after adjustment for severity of infection at ICU admission and during the pre-BSI stay. METHODS We conducted a matched, risk-adjusted (1:n),(More)
BACKGROUND Thrombocytopenia is common in ICU patients. The objective of this study was to evaluate possible links between declining platelet counts early in the ICU stay and survival. METHODS All patients who were admitted to the ICU for at least 5 days and had no thrombocytopenia at the time of admission were included in the study. A multivariable(More)
STUDY OBJECTIVES More than two thirds of family members visiting intensive care unit (ICU) patients have symptoms of anxiety or depression during the first days of hospitalization. Identifying determinants of these symptoms would help caregivers support families at patient discharge or when death is imminent. DESIGN AND SETTING Prospective multicenter(More)
The recent increase in drug-resistant micro-organisms complicates the management of hospital-acquired bloodstream infections (HA-BSIs). We investigated the epidemiology of HA-BSI and evaluated the impact of drug resistance on outcomes of critically ill patients, controlling for patient characteristics and infection management. A prospective, multicentre(More)
RATIONALE Most vascular catheter-related infections (CRIs) occur extraluminally in patients in the intensive care unit (ICU). Chlorhexidine-impregnated and strongly adherent dressings may decrease catheter colonization and CRI rates. OBJECTIVES To determine if chlorhexidine-impregnated and strongly adherent dressings decrease catheter colonization and CRI(More)