Cybele A. Renault, MD, DTM&H

All Publications

• Persistent bacteraemia caused by Staphylococcus aureus in the gall bladder. BMJ case reports Yu, A. T., Cun, T., Benamu, E., Renault, C. 2017; 2017

  Abstract

  Staphylococcus aureusbacteraemia (SAB) remains a complex disease with a high associated morbidity and mortality, especially when it is able to establish an occult nidus safe from antimicrobial eradication. Without rapid identification and intervention, the nidus can cause persistent relapse of disease, morbidity and mortality. Having a high clinical suspicion for the foci of occult S. aureus is important, and awareness of potential sites of infection is critical and can be life-saving.We present a unique case of a 65-year-old man with end-stage renal disease receiving haemodialysis who developed septic shock from SAB. Despite 18 days of appropriate antibiotics, the patient had persistent high-grade bacteraemia until his gall bladder was ultimately percutaneously drained. The day after drainage, he cleared his blood cultures, although he ultimately passed away as he decided to transition his care to focus on comfort measures.

  View details for DOI 10.1136/bcr-2017-220656

  View details for PubMedID 29122896

• A high value care curriculum for interns: a description of curricular design, implementation and housestaff feedback. Postgraduate medical journal Hom, J., Kumar, A., Evans, K. H., Svec, D., Richman, I., Fang, D., Smeraglio, A., Holubar, M., Johnson, T., Shah, N., Renault, C., Ahuja, N., Witteles, R., Harman, S., Shieh, L. 2017

  Abstract

  Most residency programmes do not have a formal high value care curriculum. Our goal was to design and implement a multidisciplinary high value care curriculum specifically targeted at interns.Our curriculum was designed with multidisciplinary input from attendings, fellows and residents at Stanford. Curricular topics were inspired by the American Board of Internal Medicine's Choosing Wisely campaign, Alliance for Academic Internal Medicine, American College of Physicians and Society of Hospital Medicine. Our topics were as follows: introduction to value-based care; telemetry utilisation; lab ordering; optimal approach to thrombophilia work-ups and fresh frozen plasma use; optimal approach to palliative care referrals; antibiotic stewardship; and optimal approach to imaging for low back pain. Our curriculum was implemented at the Stanford Internal Medicine residency programme over the course of two academic years (2014 and 2015), during which 100 interns participated in our high value care curriculum. After each high value care session, interns were offered the opportunity to complete surveys regarding feedback on the curriculum, self-reported improvements in knowledge, skills and attitudinal module objectives, and quiz-based knowledge assessments.The overall survey response rate was 67.1%. Overall, the material was rated as highly useful on a 5-point Likert scale (mean 4.4, SD 0.6). On average, interns reported a significant improvement in their self-rated knowledge, skills and attitudes after the six seminars (mean improvement 1.6 points, SD 0.4 (95% CI 1.5 to 1.7), p<0.001).We successfully implemented a novel high value care curriculum that specifically targets intern physicians.

  View details for DOI 10.1136/postgradmedj-2016-134617

  View details for PubMedID 28663352

• Mycobacterium leprae In: Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases, 8th edition Renault, C. A., Ernst, J. D. 2014
• Time to clearance of Chlamydia trachomatis ribosomal RNA in women treated for chlamydial infection SEXUAL HEALTH Renault, C. A., Israelski, D. M., Levy, V., Fujikawa, B. K., Kellogg, T. A., Klausner, J. D. 2011; 8 (1): 69-73

  Abstract

  The dynamics of chlamydia clearance after treatment administration for chlamydial urogenital infection are unknown. We estimated the time to clearance of Chlamydia trachomatis (CT) ribosomal RNA (rRNA) after administration of azithromycin for cervical chlamydial infection using APTIMA Combo 2 (Gen-Probe, Inc., San Diego, CA, USA).A total of 115 women diagnosed with urogenital chlamydial infection, defined as a positive APTIMA urine or endocervical specimen, were enrolled in the present study. Vaginal swabs on the day of treatment (Day 0) and on Days 3, 7, 10 and 14 after treatment with 1 g of azithromycin were self-obtained by participants. Specimens were tested in a single laboratory. Our analysis was limited to women who were CT-confirmed by vaginal swab at baseline, who returned all follow-up swabs, and who reported sexual abstinence during the follow-up period (n = 61).Among 61 participants, 48 (79%) had a negative APTIMA at Day 14. Subjects with a negative APTIMA at each time-point were as follows: 0/61 (0%) on Day 0, 7/61 (12%) on Day 3, 28/61 (46%) on Day 7, 40/61 (66%) on Day 10, and 48/61 (79%) on Day 14. Multiple linear regression analysis predicted time to clearance at 17 days (95% confidence interval, 16-18 days) after administration of azithromycin. Seventeen of the 94 participants (18.1%) who screened positive for chlamydia had a negative vaginal swab on Day 0, indicating possible spontaneous clearance of CT.After treatment, CT rRNA declined with time. As rRNA was still detectable in 21% of the women 14 days after treatment, APTIMA should not be used as a test-of-cure in the 14-day period following azithromycin administration.

  View details for DOI 10.1071/SH10030

  View details for Web of Science ID 000286518400013

  View details for PubMedID 21371385

• Trypanosoma brucei infection in a HIV positive Ugandan male Clinical Laboratory Science Dill, E., Renault C, Kirkpatrick BD 2011; 24 (2): 85-88
• Is spinal tuberculosis contagious? INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Schirmer, P., Renault, C. A., Holodniy, M. 2010; 14 (8): E659-E666

  Abstract

  While pulmonary Mycobacterium tuberculosis infections are recognized for their public health implications, less is known about the infectiousness of extrapulmonary tuberculosis, specifically, spinal tuberculosis or Pott's disease. We present a case of spinal tuberculosis with concomitant active pulmonary tuberculosis in the absence of chest radiographic abnormalities or symptoms, and review the literature regarding infectiousness of concomitant spinal and pulmonary tuberculosis.

  View details for DOI 10.1016/j.ijid.2009.11.009

  View details for Web of Science ID 000282662100003

  View details for PubMedID 20181507

• Validation of Microcapillary Flow Cytometry for Community-Based CD4+ T Lymphocyte Enumeration in Remote Burkina Faso The Open AIDS Journal Renault CA, Traore A, Machekano RN, Israelski DM 2010; 4: 171-175
• Mycobacterium leprae In: Mandell G, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases, 7th edition Renault, C. A., Ernst, J. D. 2010
• Lower-Cost Laboratory Monitoring for CD4 T-Lymphocyte Enumeration, HIV RNA Quantitation and Drug Resistance. In: Marlink RG, Teitelman SJ, eds., From the Ground Up: Building Comprehensive HIV/AIDS Care Programs in Resource-Limited Settings Kassaye, S., Renault, C. A., Israelski, D. M. 2009
• Use of NAATs for STD diagnosis of GC and CT in non-FDA -cleared anatomic specimens. MLO: medical laboratory observer Renault, C. A., Hall, C., Kent, C. K., Klausner, J. D. 2006; 38 (7): 10-?

  View details for PubMedID 16918168

• Avian influenza in humans: A practical review for clinicians INFECTIONS IN MEDICINE Eckburg, P. B., Schneider, J. J., Renault, C. A. 2005; 22 (11): 535-?

  View details for Web of Science ID 000233659700004