Evolution particulière de variants cytogénétiques complexes de leucémies myéloïdes chroniques traitées par l’Imatinib

Les variants cytogénétiques simples et complexes constituent 5 à 10% de tous les cas de leucémie myéloïde chronique. Le mécanisme de leur formation a été proposé par certains auteurs. Les aspects clinique, thérapeutique et pronostique ne sont pas différents des formes classiques à l’aire des anti-tyrosines kinases. Nous rapportons deux cas traités par Imatinib dont l’évolution cytogénétique a été particulière. Les deux patients ont été inclus dans le programme GIPAP après signature d’un consentement éclairé. Chaque patient a bénéficié d’un examen clinique, d’un hémogramme, d’un myélogramme, d’un caryotype et ou d’une hybridation intra-génique avec fluorescence avant inclusion dans le programme. Chaque patient après inclusion a été traité avec l’Imatinib à la dose quotidienne de 400mg. La surveillance clinique, hématologique et cytogénétique et moléculaire a été faite selon les recommandations de LeukemiaNet.Key words: Leucémie myéloïde chronique, complexe variant, évolution cytogénétiqu

Faecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in healthy volunteers and hospitalized patients in Ouagadougou, Burkina Faso: prevalence, resistance profile, and associated risk factors

Background: Extended spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) are a serious challenge to patients’ treatment. The aim of this study is to determine the prevalence of ESBL-PE, investigate the associated resistance, and analyze the associated risk factors for acquisition of ESBL-PE.Methodology: A cross-sectional study was conducted on healthy volunteers and inpatients. After obtaining informed consent, rectal swabs were collected from each participant for isolation of Enterobacteriaceae on Hektoen enteric agar containing 4µg/L cefotaxime. The Enterobacteriaceae isolates were identified using biochemical tests and ESBL production was confirmed by the double-disc synergy test of amoxicillin and clavulanic acid. Antibiotic susceptibility test of each isolate was done by the disc diffusion method and interpreted using the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical  breakpoints version 5.0.Results: During the study period, prevalence of faecal ESBL-PE among the study participants was 54.5% (103/189); 53.5% among healthy volunteers and 55.7% among inpatients (p=0.87). The major ESBL-PE isolates was Escherichia coli (71%) followed by Klebsiella pneumoniae (16%). The isolates in hospitalized patients were resistant to norfloxacin (84.2%), cotrimoxazole (89.5%), and gentamicin (7.0%). The isolates from healthy volunteers were resistant to norfloxacin (86.2%), cotrimoxazole (82.8%), and gentamicin (1.7%).Gender, age, and previous antibiotic use were not significantly associated with carriage of ESBL-PE (p=0.51).Conclusion: The high prevalence of ESBL-PE in this study is worrying. There is an urgent need to develop measures to monitor and limit the spread of these multidrug-resistant organisms in healthcare facilities and the community in Burkina Faso. Keywords: faecal carriage, ESBL-PE, healthy volunteers, inpatients, Burkina Fas

Epstein-Barr virus: clinical and epidemiological revisits and genetic basis of oncogenesis

Epstein-Barr virus (EBV) is classified as a member in the order herpesvirales, family herpesviridae, subfamily gammaherpesvirinae and the genus lymphocytovirus. The virus is an exclusively human pathogen and thus also termed as human herpesvirus 4 (HHV4). It was the first oncogenic virus recognized and has been incriminated in the causation of tumors of both lymphatic and epithelial nature. It was reported in some previous studies that 95% of the population worldwide are serologically positive to the virus. Clinically, EBV primary infection is almost silent, persisting as a life-long asymptomatic latent infection in B cells although it may be responsible for a transient clinical syndrome called infectious mononucleosis. Following reactivation of the virus from latency due to immunocompromised status, EBV was found to be associated with several tumors. EBV linked to oncogenesis as detected in lymphoid tumors such as Burkitt's lymphoma (BL), Hodgkin's disease (HD), post-transplant lymphoproliferative disorders (PTLD) and T-cell lymphomas (e.g. Peripheral T-cell lymphomas; PTCL and Anaplastic large cell lymphomas; ALCL). It is also linked to epithelial tumors such as nasopharyngeal carcinoma (NPC), gastric carcinomas and oral hairy leukoplakia (OHL). In vitro, EBV many studies have demonstrated its ability to transform B cells into lymphoblastoid cell lines (LCLs). Despite these malignancies showing different clinical and epidemiological patterns when studied, genetic studies have suggested that these EBV- associated transformations were characterized generally by low level of virus gene expression with only the latent virus proteins (LVPs) upregulated in both tumors and LCLs. In this review, we summarize some clinical and epidemiological features of EBV- associated tumors. We also discuss how EBV latent genes may lead to oncogenesis in the different clinical malignancie