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Systemic Gordonia spp. infections are rare and occur mostly among immunocompromised patients. We analyzed 10 cases of Gordonia bacteremia diagnosed in 3 tertiary care centers in France to assess risk factors, treatment, and clinical outcomes. Most patients were cured within 10 days by using β-lactam antimicrobial therapy and removing central catheters.

To the Editor: In their review article, Vannier and Krause (June 21 issue) 1 describe the classic form of Babesia divergens infections. B. divergens is responsible for most infections in Europe (approximately 40 reported cases); these are mainly severe infections in persons who have undergone splenectomy. In 2009, we diagnosed two cases of babesiosis in northeastern France in two young, healthy people, 15 days after they received tick bites. They had a marked flulike syndrome and a low level of parasitemia. 2 Both patients had a suggestive positive blood smear, though only one was clearly identified as being infected with B. divergens . . .

Human granulocytic anaplasmosis (HGA), caused by Anaplasma phagocytophilum transmitted through tick bites, remains poorly documented in France. We conducted a retrospective, multicenter study of cases in Alsace during 2012-2024, including 39 HGA episodes in 38 patients PCR positive for A. phagocytophilum. Most (63.2%) patients were men, median age was 60.5 years, and 76.3% lived in rural areas. A tick bite was reported in 61.6% of cases. Frequent symptoms included fever (97.4%), fatigue (61.5%), and headache (61.5%). Laboratory findings showed elevated C-reactive protein (100%), thrombocytopenia (94.9%), leukopenia (59.0%), and cytolysis (66.7%). One patient had secondary hemophagocytic lymphohistiocytosis. Most (87.2%) patients were hospitalized; none required intensive care unit admission. Doxycycline was administered in 29 cases, and all patients recovered. HGA should be considered in febrile patients with recent tick exposure and cytopenia. Although often benign, rare severe HGA forms can occur and justify increased clinical awareness, especially in A. phagocytophilum-endemic areas.

Background European guidelines recommend that susceptibility tests be routinely performed, even before prescribing first‐line treatment of Helicobacter pylori infection. However, empirical treatments are the rule in France, and susceptibility‐guided treatments are the exception. Objective We aimed to report our experience of systematic antibiotic susceptibility testing before first‐line treatment. Methods Prospective registration of all esofagogastroduodenoscopies performed in a community hospital from December 2023 to December 2024. Antral and fundic biopsies were performed, at the discretion of the endoscopist, for histological examination, polymerase chain reaction (PCR) and culture without any freezing. Results Overall, 3566 adults underwent esofagogastroduodenoscopy, 1785 (50.1%) were tested and H. pylori infection was diagnosed in 308 (17.3%) [95% confidence interval (CI): 15.5%–19.0%] individuals. The sensitivity of PCR for the diagnosis of H. pylori infection was 99.7%, significantly higher than those of histology (94.1%) and culture (95.2%) (p < 0.01). Clarithromycin resistance was observed in 22.6% [95% CI: 17.9%–27.3%] and levofloxacin resistance in 18.6% [95% CI: 14.1%–23.2%] of cases. Among 285 patients treated, susceptibility‐guided triple therapy was prescribed in 84.9% of cases (73.3% amoxicillin‐clarithromycin, 11.6% amoxicillin‐levofloxacin) and quadruple bismuth therapy in 14.4% of cases. The eradication rates were 98.1% [95% CI: 96.0%–100%] for triple therapy amoxicillin‐clarithromycin and 100% [95% CI: 100%–100%] for amoxicillin‐levofloxacin, significantly higher than 81.3% [95% CI: 67.7%–94.8%] for quadruple bismuth therapy (p < 0.01 and p = 0.03, respectively). Overall, of 218 (70.8%) patients evaluated by the C13 urea breath test, H. pylori was eradicated in 209 (95.9%) [95% CI: 93.2%–98.5%] patients. The PCR‐based diagnostic and therapeutic strategy was more cost‐effective than the immunohistochemistry‐based strategy. Conclusion A PCR‐based susceptibility‐guided strategy is easy to implement in routine clinical practice. In more than 7 in 10 patients, PCR enabled the offer of a susceptibility‐guided triple therapy that was more effective and less costly than empirical quadruple bismuth therapy. Culture enabled one additional patient in 10 to be offered a susceptibility‐guided triple therapy. Key Summary Summarise the established knowledge on this subject ◦ Owing to an increase in antibiotic resistance, the eradication rate of Helicobacter pylori with empirical therapy has declined. ◦ European guidelines recommend that susceptibility tests are routinely performed, even before prescribing first‐line treatment. ◦ Evidence for the superiority of susceptibility‐guided therapy over empirical therapy is still limited and varies by region and treatment regimen. ◦ Almost all studies evaluating the efficacy of a susceptibility‐guided tailored first‐line treatment have been carried out in Asia, with very few in Europe. What are the significant and/or new findings of this study? ◦ A PCR‐based susceptibility‐guided strategy is easy to implement in routine clinical practice. ◦ In more than seven in 10 patients, PCR enabled susceptibility‐guided triple therapy to be proposed that was more effective and less costly than empirical quadruple bismuth therapy. ◦ Culture enabled one additional patient in 10 to be offered a susceptibility‐guided triple therapy. ◦ The PCR‐based diagnostic and therapeutic strategy was more cost‐effective than immunohistochemistry‐based strategy.

Abstract The significance of low leukocyte counts in cerebrospinal fluid (CSF) remains unclear. We performed a 2-year retrospective study to examine microbiological outcomes associated with CSF leukocytes at 6–10/mm3. Of the 178 samples examined, we detected positive results for 11 samples, including 5 cases of tick-borne encephalitis virus infection.

During the 2017–2018 flu epidemic, the point-of-care Alere-i (n = 72) and reverse transcription polymerase chain reaction (n = 106) tests were compared. Patients in the point-of-care group were administered oseltamivir significantly more rapidly (9 hours vs 23 hours), they spent less time in the emergency department, and they had lower rates of antibiotic administration and hospitalization.

Antibiotic stewardship programmes (ASP) are essential to tackle antibiotic resistance. Clinical microbiologists (CMs) play a key role in these programmes; however, few studies describe their actual involvement. Our objective was to explore CMs’ involvement in French hospital ASP. In 2018, we conducted a survey among CMs working in large public French hospitals (600 acute care beds or more). The questionnaire focused on the following topics: microbiology department’s characteristics, hospital ASP, and CMs’ involvement in this programme, including their use of rapid diagnostic tests (RDT). Fifty/74 CMs answered (response rate 68%), with 68% working in a teaching hospital. CMs were leading the ASP in 6% of cases, and 57% of hospitals had a multidisciplinary antibiotic stewardship team. Most microbiology departments (92%) were using specific PCR, processed 24/7 in 74% of hospitals. More than half (58%) were using syndromic panel-based testing, 94% mass spectrometry, and 96% immunochromatographic/colorimetric RDT. Blood cultures were processed 24/7 in 44% of hospitals. CMs were involved in this. Finally, 42% of CMs wished to be more involved in their hospital’s ASP, the most frequently reported barrier being lack of time (36%). CMs should be more involved in ASP. RDT are widely used, but not implemented in an optimal way.

From 1962 to 1965, in perhaps the most important religious event of the twentieth century, the Second Vatican Council met to plot a course for the future of the Roman Catholic Church. After thousands of speeches, resolutions, and votes, the Council issued sixteen official documents on topics ranging from divine revelation to relations with non-Christians. In many ways, though, the real challenges began after the council was over and Catholics began to argue over the interpretation of the documents. Many analysts perceived the Council’s far-reaching changes as breaks with Church tradition, and soon this became the dominant bias in the American and other media, which lacked the theological background to approach the documents on their own terms. In Vatican II: Renewal Within Tradition, an international team of theologians offers a different reading of the documents from Vatican II. The Council was indeed putting forth a vision for the future of the Church, but that vision was grounded in two millennia of tradition. Taken together, these essays demonstrate that Vatican II’s documents are a development from an established antecedent in the Roman Catholic Church. Each chapter contextualizes Vatican II teachings within that rich tradition. The resulting book is an indispensable and accessible companion to the Council’s developments, one that focuses on theology and transcends the mass-media storyline of “liberal” versus “conservative.”