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Garbaccio S.,Instituto Nacional de Tecnologia Agropecuaria | Macias A.,National University of Rio Cuarto | Shimizu E.,Bacteriology Laboratory | Paolicchi F.,Bacteriology Laboratory | And 10 more authors.
Virulence | Year: 2014

Mycobacterium bovis is the causative agent of bovine tuberculosis, a disease that affects approximately 5% of Argentine cattle. The aim of this research was to study if it is possible to infer the degree of virulence of different M. bovis genotypes based on scorified observations of tuberculosis lesions in cattle. In this study, we performed association analyses between several parameters with tuberculosis lesions: M. bovis genotype, degree of progression of tuberculosis, and animal age. For this purpose, the genotype was determined by spoligotyping and the degree of bovine tuberculosis gross lesion was quantified with a score based on clinical observations (number, size, and location of granulomas along with histopathologic features). This study was performed with naturally infected cattle of slaughterhouses from three provinces in Argentina. A total of 265 M. bovis isolates were obtained from 378 pathological lesion samples and 192 spoligotyping and VNTR (based on ETR sequences) typing patterns were obtained. SB0140 was the most predominant spoligotype, followed by SB0145. The spoligotype with the highest lesion score was SB0273 (median score of 27 ± 4.46), followed by SB0520 (18 ± 5.8). Furthermore, the most common spoligotype, SB0140, had a median score of 11 ± 0.74. Finally, the spoligotype with the lowest score was SB0145 (8 ± 1.0). ETR typing of SB0140, SB0145, SB0273, and SB0520 did not subdivide the lesion scores in those spoligotypes. In conclusion, SB0273 and SB0520 were the spoligotypes with the strongest association with hypervirulence and both spoligotypes were only found in Río Cuarto at the south of Córdoba province. Interestingly, there is no other report of any of these spoligotyes in Latin America. © 2014 Landes Bioscience.


Allyn J.,Intensive Care Unit | Angue M.,Intensive Care Unit | Belmonte O.,Bacteriology Laboratory | Lugagne N.,Infection Control Unit | And 4 more authors.
Journal of Travel Medicine | Year: 2015

We report three cases of high drug-resistant microorganisms (HDRMO) carriage by patients repatriated from a foreign country. National recommendations suggest systematic screening and contact isolation pending results of admission screening of all patients recently hospitalized abroad. HDRMO carriage (carbapenem-resistant Acinetobacter baumanii and carbapenemase-producing Enterobacteriaceae) was not isolated on admission screening swabs, but later between 3 and 8-days after admission. In absence of cross-transmission, two hypotheses seem possible: a false-negative test on admission, or a late onset favored by antibiotic pressure. Prolonged isolation may be discussed even in case of negative screening on admission from high-risk patients. © 2015 International Society of Travel Medicine.


Angue M.,Intensive Care Unit | Allou N.,Intensive Care Unit | Belmonte O.,Bacteriology Laboratory | Lefort Y.,Intensive Care Unit | And 5 more authors.
Journal of Travel Medicine | Year: 2015

Background Few national recommendations exist on management of patients returning from abroad and all focus on hospitalized patients. Our purpose was to compare, in an intensive care unit (ICU), the admission prevalence and acquisition of multidrug-resistant (MDR) bacteria carriage in patients with ("Abroad") or without ("Local") a recent stay abroad, and then identify the risk factors in "Abroad" patients. Methods In this retrospective study, we reviewed charts of all the patients hospitalized in the ICU unit from January 2011 through July 2013 with hygiene samplings performed. We identified all patients who had stayed abroad ("Abroad") within 6months prior to ICU admission. Results Of 1,842 ICU patients, 129 (7%) "Abroad" patients were reported. In the "Abroad" group, the rate of MDR strain carriage was higher at admission (33% vs 6.7%, p<0.001) and also more often diagnosed during the ICU stay (acquisition rate: 17% vs 5.2%, p<0.001) than in "Local" patients. Risk factors associated with MDR bacteria carriage at admission in "Abroad" patients were diabetes mellitus [odds ratio (OR) 5.1 (1.7-14.8), p=0.003] and "hospitalization abroad with antibiotic treatment" [OR 10.7 (4.2-27.3), p<0.001]. Hospitalization abroad without antibiotic treatment was not identified as a risk factor. Conclusions The main factor associated with MDR bacteria carriage after a stay abroad seems to be a hospitalization abroad only in case of antibiotic treatment abroad. Screening and isolation of "Abroad" patients should be recommended, even in case of a first negative screening. © 2015 International Society of Travel Medicine.


PubMed | Bacteriology Laboratory, Intensive Care Unit, Infection Control Unit and AP HP
Type: Journal Article | Journal: Journal of travel medicine | Year: 2015

Few national recommendations exist on management of patients returning from abroad and all focus on hospitalized patients. Our purpose was to compare, in an intensive care unit (ICU), the admission prevalence and acquisition of multidrug-resistant (MDR) bacteria carriage in patients with (Abroad) or without (Local) a recent stay abroad, and then identify the risk factors in Abroad patients.In this retrospective study, we reviewed charts of all the patients hospitalized in the ICU unit from January 2011 through July 2013 with hygiene samplings performed. We identified all patients who had stayed abroad (Abroad) within 6 months prior to ICU admission.Of 1,842 ICU patients, 129 (7%) Abroad patients were reported. In the Abroad group, the rate of MDR strain carriage was higher at admission (33% vs 6.7%, p < 0.001) and also more often diagnosed during the ICU stay (acquisition rate: 17% vs 5.2%, p < 0.001) than in Local patients. Risk factors associated with MDR bacteria carriage at admission in Abroad patients were diabetes mellitus [odds ratio (OR) 5.1 (1.7-14.8), p = 0.003] and hospitalization abroad with antibiotic treatment [OR 10.7 (4.2-27.3), p < 0.001]. Hospitalization abroad without antibiotic treatment was not identified as a risk factor.The main factor associated with MDR bacteria carriage after a stay abroad seems to be a hospitalization abroad only in case of antibiotic treatment abroad. Screening and isolation of Abroad patients should be recommended, even in case of a first negative screening.


Mokrousov I.,St Petersburg Pasteur Institute | Vyazovaya A.,St Petersburg Pasteur Institute | Otten T.,Research Institute of Phthisiopulmonology | Zhuravlev V.,Research Institute of Phthisiopulmonology | And 5 more authors.
PLoS ONE | Year: 2012

This study aimed to characterize the population structure of Mycobacterium tuberculosis in Pskov oblast in northwestern Russia, to view it in the geographical context, to compare drug resistance properties across major genetic families. Ninety M. tuberculosis strains from tuberculosis (TB) patients, permanent residents in Pskov oblast were subjected to LAM-specific IS6110-PCR and spoligotyping, followed by comparison with SITVITWEB and MIRU-VNTRplus databases. The Beijing genotype (n = 40) was found the most prevalent followed by LAM (n = 18), T (n = 13), Haarlem (n = 10), Ural (n = 5), and Manu2 (n = 1); the family status remained unknown for 3 isolates. The high rate of Beijing genotype and prevalence of LAM family are similar to those in the other Russian settings. A feature specific for M. tuberculosis population in Pskov is a relatively higher rate of Haarlem and T types. Beijing strains were further typed with 12-MIRU (followed by comparison with proprietary global database) and 3 hypervariable loci QUB-3232, VNTR-3820, VNTR-4120. The 12-MIRU typing differentiated 40 Beijing strains into 14 types (HGI = 0.82) while two largest types were M2 (223325153533) prevalent throughout former USSR and M11 (223325173533) prevalent in Russia and East Asia. The use of 3 hypervariable loci increased a discrimination of the Beijing strains (18 profiles, HGI = 0.89). Both major families Beijing and LAM had similar rate of MDR strains (62.5 and 55.6%, respectively) that was significantly higher than in other strains (21.9%; P = 0.001 and 0.03, respectively). The rpoB531 mutations were more frequently found in Beijing strains while LAM drug resistant strains mainly harbored rpoB516 and inhA -15 mutations. Taken together with a high rate of multidrug resistance among Beijing strains from new TB cases (79.3% versus 44.4% in LAM), these findings suggest the critical impact of the Beijing genotype on the current situation with MDR-TB in the Pskov region in northwestern Russia. © 2012 Mokrousov et al.


Farooq S.,Sher-e-Kashmir University of Agricultural Sciences and Technology | Wani S.A.,Sher-e-Kashmir University of Agricultural Sciences and Technology | Hussain I.,Sher-e-Kashmir University of Agricultural Sciences and Technology | Bhat M.A.,Sher-e-Kashmir University of Agricultural Sciences and Technology | Bhat M.A.,Bacteriology Laboratory
Indian Journal of Animal Sciences | Year: 2010

In a study conducted in 4 districts of south Kashmir the prevalence of ovine footrot was found to be 16.41 %, with the highest prevalence of 19.43% in district Kulgam and lowest of 12.21% in district Pulwama. While 18.65 and 17.45% prevalence of footrot was observed in districts Anantnag and Shopian respectively. Overall economic impact of footrot was estimated to the tune of Rs 36.79 million annually to the sheep production in south Kashmir. Out of 400 samples collected from footrot lesions of naturally infected, sheep, 224 (56%) samples were detected D. nodosus positive. Out of these, 185 (82.58%) isolates were belonging to serogroup B of D. nodosus, 3 (1.33%) serogroup C, 21 (9.37%) serogroup E, 5 (2.23%) serogroup I and. 10 (4.46%) had mixed infection of 2 serogroups B and E. Serogroup C was detected for the first time in India. Out of 224 D. nodosus isolates, 138 (61.60%) possessed. intA gene, thus were considered, as virulent strains. Serogroup-wise, intA. gene was found, in 123 (66.48%) isolates of serogroup B, 11 (52.38%) of E and 4 (80.0%) of I. It was interesting to note that none of the sample from serogroup C was positive for intA. gene, indicating benign status of disease.


Diamantis S.,Antibiotic Management Team | Rioux C.,University Paris Diderot | Bonnal C.,University Paris Diderot | Farfour E.,University Paris Diderot | And 5 more authors.
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2012

Hospital antibiotic management teams (AMTs) have been recommended, but, in France, their concrete implementation remains scarce and their effectiveness largely unevaluated. The objective of this investigation was to evaluate the appropriateness of antibiotic therapy (AT) for bloodstream infections (BSIs) at a 950-bed university teaching hospital, and assess the role of an AMT in improving it. A prospective analysis of all significant BSIs occurring outside of the intensive care unit (ICU) during an 18-month period was carried out. AT was deemed effective if at least one prescribed antibiotic was effective in vitro, and appropriate if it was consistent with local recommendations. Out of 574 BSIs, 512 were evaluated: 231 community-acquired, 206 nosocomial, and 75 healthcare-associated. For 219 (42.8%) BSIs, the AT initiated prior to AMT intervention proved to be effective and appropriate, inappropriate but effective in 136 (26.5%), and ineffective or absent in 157 (30.7%). In the multivariate analysis, hospital-acquired and other healthcare-associated BSIs, as well as catheter-borne (CB) infections, were associated with inappropriate or absent AT. A recommendation from the AMT was given and followed in 233 (94%) out of 249 BSIs requiring intervention. Initially, two-thirds of BSIs outside the ICU did not receive appropriate AT. Healthcare-associated BSIs should, therefore, be the priority target of AMTs. © Springer-Verlag 2011.


Mallet M.,Dron Hospital | Loiez C.,Bacteriology Laboratory | Melliez H.,Dron Hospital | Yazdanpanah Y.,Dron Hospital | And 2 more authors.
Infection | Year: 2011

Objectives: To evaluate the role of Staphylococcus simulans in bone and joint infections (BJI) and determine their main characteristics. Methods: A search of the database of the microbiology laboratories of Lille hospital and Tourcoing hospital was performed. Only results from blood, bone, and orthopedic device cultures were taken into account for hospitalized patients between January 2004 and January 2009. We considered cases in which S. simulans was the only bacteria isolated in all of the patients' biological samples with clinical and laboratory signs of infection. For patients with complete medical records, we recorded the clinical and epidemiological data. Results: Six cases of BJI due to S. simulans were recorded, with five cases related to orthopedic devices infections. Three patients lived in rural areas. In four out of six patients, S. simulans was isolated in intraoperative biopsy material. In one patient, S. simulans grew in synovial fluid and in another in blood cultures only. The latter patient had a spondylodiscitis, and chronic foot ulcers due to gout disease were suspected to be the origin of the infection. All patients were healed after a mean follow up of 9 ± 3 months. Orthopedic devices were removed in four of the five patients concerned. The combination of rifampicin plus levofloxacin was used in four patients. Conclusion: The present data suggest that, even though S. simulans remains rarely observed in clinical pathology, its role in osteoarticular infections, especially in the case of infected orthopedic devices, is not exceptional. As for the antibiotic treatment, the combination of rifampicin and levofloxacin seems to be an effective strategy according to our clinical results. © 2011 Springer-Verlag.


PubMed | Bacteriology Laboratory, Infection Control Unit, AP HP and University Paris Diderot
Type: Journal Article | Journal: BMJ open | Year: 2016

To assess costs associated with implementation of a strict search and isolate strategy for controlling highly drug-resistant organisms (HDRO).Review of data from 2-year prospective surveillance (01/2012 to 12/2013) of HDRO.Three university hospitals located in northern Paris.Episodes were defined as single cases or outbreaks of glycopeptide-resistant enterococci (GRE) or carbapenemase-producing Enterobacteriacae (CPE) colonisation. Costs were related to staff reinforcement, costs of screening cultures, contact precautions and interruption of new admissions. Univariate analysis, along with simple and multiple linear regression analyses, was conducted to determine variables associated with cost of HDRO management.Overall, 41 consecutive episodes were included, 28 single cases and 13 outbreaks. The cost (mean SD) associated with management of a single case identified within and/or 48 h after admission was 4443 11,552 and 11,445 15,743, respectively (p<0.01). In an outbreak, the total cost varied from 14,864 17,734 for an episode with one secondary case (7432 8867 per case) to 136,525 151,231 (12,845 5129 per case) when more than one secondary case occurred. In episodes of single cases, contact precautions and microbiological analyses represented 51% and 30% of overall cost, respectively. In outbreaks, cost related to interruption of new admissions represented 77-94% of total costs, and had the greatest financial impact (R(2)=0.98, p<0.01).In HDRO episodes occurring at three university hospitals, interruption of new admissions constituted the most costly measure in an outbreak situation.


PubMed | Bacteriology laboratory and Intensive Care Unit and
Type: Comparative Study | Journal: Journal of travel medicine | Year: 2016

To our knowledge, there is no data on the epidemiology of patients hospitalized in intensive care unit (ICU) after a stay in Madagascar or other low-income countries. It is possible that such data may improve transfer delays and care quality for these patients.In a retrospective study, we reviewed the charts of all patients admitted to ICU of the Reunion Island Felix Guyon University Hospital from January 2011 through July 2013. We identified all patients who had stayed in Madagascar during the 6 months prior to ICU admission.Of 1842 ICU patients, 62 (3.4%) had stayed in Madagascar during the 6 months prior to ICU admission. Patients were 76% male and the median age was 60.5 (48.25-64.75) years; patients were more frequently residents of Madagascar than travellers (56.5%). In most cases, patients were not hospitalized or given antibiotics in Madagascar. The most frequent causes of hospitalization were infections including malaria (21%) and lower respiratory infection (11%). Carriage and infection with multidrug resistant (MDR) bacteria on ICU admission were frequent (37% and 9.7%, respectively). The mortality rate in ICU was 21%, and severity acute physiological Score II was 53.5 (37-68).Patients admitted to ICU after a stay to Madagascar are mainly elderly patients with chronic illnesses, and often foreign residents. The admission causes are specific of the country like malaria, or specific to the population concerned such as cardiovascular accidents that could be prevented.

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