Investigation of a Cluster of Candida albicans Invasive Candidiasis in a Neonatal Intensive Care Unit by Pulsed-Field Gel Electrophoresis

Nosocomial invasive candidiasis (IC) has emerged as a major problem in neonatal intensive care units (NICUs). We investigated herein the temporal clustering of six cases of neonatal IC due to Candida albicans in an NICU. Eighteen isolates obtained from the six neonates and two isolates from two health care workers (HCWs) working at the same unit and suffering from fingers' onychomycosis were genotyped by electrophoretic karyotyping (EK) and restriction endonuclease analysis of genomic DNA by using Sfi I (PFGE-Sfi I). PFGE-Sfi I was more effective in discriminating between temporally related isolates. It showed that (i) both HCWs had specific strains excluding them as a source of infections in neonates. (ii) Isolates collected from three neonates were identical providing evidence of their clonal origin and the occurrence of a horizontal transmission of C. albicans in the unit. (iii) The three remaining neonates had specific strains confirming that the IC cases were coincidental. (iv) Microevolution occurred in one catheter-related candidemia case. Our results illustrate the relevance of the molecular approach to investigate suspected outbreaks in hospital surveys and the effectiveness of PFGE-Sfi I for typing of epidemiologically related C. albicans isolates

Agriculteurs tunisiens face avx impératifs de l'intensification : diversité des systèmes de production et des comportements des agriculteurs de la région céréalière de Borj-el-Amri

[fre] Partant d'une hypothèse de diversité dans les situations des agriculteurs dans une région donnée et d'une hypothèse de rationnante sous-jacente à leur comportement économique, cet article se propose de mettre au point une méthodologie appropriée à l'identification des diverses situations, pour ensuite ébaucher une analyse de comportement. . La méthodologie repose sur l'analyse multidimensionnelle des données ; c'est ainsi que l'analyse en composantes principales a été appliquée aux critères de structures. Quant aux systèmes de cultures, ils ont été dégagés par le recours à une représentation graphique à trois dimensions. . Des Groupes homogènes d'exploitations ont pu ainsi être identifiés. . Pour chacun de ces groupes l'ensemble des données structurelles et technico-économiques a permis de définir un système de distinct des autres ; une typologie des exploitations agricoles a ainsi été établie dans la région de Borj-EI-Amri au Nord de la . Les systèmes de production ainsi définis, ont ensuite servi de cadre à une analyse de comportement, principalement orientée vers la mise en évidence des différents niveaux d'intensification auxquels se placent les exploitants ; les variations observées dans les niveaux de production ont du être expliquées à l'aide soit de données internes au SP (la capacité de production intervient tant par son importance que par sa composition interne) soit de données relatives à l'environnement géographique et socio-économique (encadrement accès au crédit sous toutes ses formes, etc.).

A new IgG immunoblot kit for diagnosis of toxoplasmosis in pregnant women.

International audienceThe determination of the accurate immune status of pregnant women is crucial in order to prevent congenital toxoplasmosis. Equivocal results with conventional serological techniques are not uncommon when IgG titers are close to the cut-off value of the test, so that a confirmatory technique is needed. For this purpose, we developed a homemade immunoblot (IB) using soluble extract of Toxoplasma gondii tachyzoites and assessed it by testing 154 positive, 100 negative, and 123 equivocal sera obtained from pregnant women. In order to select the more valuable bands in terms of sensitivity and specificity, we used the Youden Index (YI). The highest YIs were those given by the 32, 36, 98, 21, and 33 bands. The simultaneous presence on the same blot of at least 3 bands showed a much higher YI (0.964) and was adapted as the positivity criterion. The analysis of results showed that our homemade IB correlated well with the commercial LDBIO Toxo II IgG® kit recently recommended as a confirmatory test (96.7% of concordance)

Microsatellite Typing of Aspergillus flavus Strains in a Tunisian Onco-hematology Unit

International audienceAspergillus flavus is the most common species associated with invasive aspergillosis in Tunisia. The molecular epidemiology of the species is poorly documented. We used five highly discriminative microsatellite markers for the genotyping of clinical and hospital environmental A. flavus strains to assess whether IA could be hospital-acquired in the onco-hematology unit of the Farhat Hached teaching hospital of Sousse, Tunisia. The genotyping of 18 clinical isolates, collected from sputa of 17 acute leukemia patients, and 81 isolates, collected in these patients' hospital environment and food, identified 57 isolates that were grouped in 10 clones, each of them including 2-17 isolates. The remaining 42 isolates showed a unique genotype. Two main transmission scenarios were observed: (1) the same clone was isolated from different patients; (2) the same clone was isolated from a patient, its hospital environment and/or food. These findings strongly suggest the occurrence of hospital-acquired A. flavus infection/colonization in the investigated onco-hematology unit

Follicular fluid and supernatant from cultured cumulus-granulosa cells improve in vitro maturation in patients with polycystic ovarian syndrome

International audienceObjective : To study the effectiveness of a new in vitro maturation (IVM) approach based on heterologous follicularfluid (HFF) andsupernatant of cumulus-granulosa cells (CGCs) mimicking the intact follicular microenvironment to rescue immature denudedoocytes (IDOs) of patients with polycystic ovary syndrome (PCOS) whose IVM or IVF outcomes remain poor.Design : Randomized controlled trial. Setting : University-affiliated private center.Patient(s) :One hundred fifty-nine IDOs were obtained from 47 patients with PCOS. First, a simple IVM system (S-IVM; 40 IDOs;control group) was compared with different protocols based on the addition of autologous follicularfluid (AFF-IVM; 44 IDOs), HFF(HFF-IVM; 42 IDO), or HFF with CGC isolated from seven women without PCOS and presenting 100% in vivo oocyte maturation(HFF/CGC-IVM; 33 IDOs).Intervention(s) : None.Main Outcome Measure(s) : IVM outcomes were compared among the four groups (S-IVM, AFF-IVM, HFF-IVM, HFF/CGC-IVM); then the vitro and in vivo maturation results (from controlled ovarian stimulation of PCOS patients) were compared for each group.Result(s) : The HFF/CGC-IVM method gave the best yield of developed blastocysts per IDO compared with S-IVM, AFF-IVM, and HFF-IVM (27% vs. 2%, 2%, and 12%, respectively). The IVM rate with the HFF/CGC-IVM method was even higher than that compared with the in vivo maturation rate (79% vs. 42%), with significant improvement in the cleavage rate (71% vs. 61%).Conclusion(s) : This adapted IVM system could be used to reach an acceptable result in meiotic competence and competent metaphaseII oocytes capable of developing into intact embryos after fertilization and before transfer.El líquido folicular y el sobrenadante de cultivos de células del cúmulo-granulosa mejoran la maduración in vitro en pacientes con síndrome de ovario poliquístico.ObjetivoEstudiar la efectividad de un nuevo abordaje de maduración in vitro (IVM) basado en líquido folicular heterólogo (HFF) y sobrenandante de cultivo de cumulus-células de la granulosa (CGCs) imitando el microambiente folicular intacto para rescatar ovocitos inmaduros denudados (IDOs) de pacientes con síndrome de ovario poliquístico (PCOS) cuyos resultados en IVM o IVF son pobres.DiseñoEstudio aleatorizado controlado.EntornoCentro privado afiliado universidad.Paciente(s)Se obtuvieron 159 IDOs de 47 pacientes con PCOS. Primero, un sistema de IVM simple (grupo control: S-IVM; 40 IDOs) se comparó con diferentes protocolos basados en la adición de líquido folicular autólogo (AFF-IVM; 44 IDOs), HHF (HHF-IVM; 42 IDO), o HFF con CGC aislado de siete mujeres sin PCOS y que presentaron una maduración ovocitaria in vivo del 100% (HFF/CGC-IVM; 33 IDOs).Intervención(es)ninguna.Medida(s) de la variable principalLos resultados de la IVM se compararon entre los cuatro grupos (S-IVM, AFF-IVM, HFF-IVM, HFF/CGC-IVM); posteriormente, se compararon, para cada grupo, los resultados de la maduración in vitro e in vivo.Resultado(s)El método HFF/CGC-IVM produjo el mejor rendimiento de blastoscistos desarrollados por IDO comparado con S-IVM, AFF-IVM y HFF-IVM (27% vs. 2%, 2% y 12%, respectivamente). La tasa de IVM con el método HFF/CGC-IVM fue incluso mayor comparada con la tasa de maduración in vivo (79% vs. 42%), con una mejora significativa en la tasa de división embrionaria en dia 3 (71% vs 61%).Conclusión(es)Este sistema de IVM adaptado podría ser utilizado para alcanzar un resultado aceptable en competencia meiótica y en ovocitos metafase II competentes capaces de desarrollar embriones intactos tras la fecundación y antes de la transferencia

Alternaria alternata peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis

Fungal peritonitis is a serious complication of peritoneal dialysis (PD) leading to loss of ultrafiltration and discontinuation of PD treatment. The most frequently isolated fungi are Candida albicans and, filamentous fungi such Alternaria alternata species are found only rarely. We report the case of a 75-year-old woman who developed peritonitis due to this black fungus

Paternal age: Negative impact on sperm genome decays and IVF outcomes after 40 years

International audienceThis study assessed sperm quality declining on relation to paternal age and its impact on in vitro fertilization (IVF) outcomes in order to estimate the APA (Advanced Paternal Age) cutoff. For this, 83 couples undergoing IVF treatment for male factor infertility were enrolled. The women age was ≤39 years, whereas the men were divided in two groups: APA (n = 41; age ≥ 40 years) and young (Y) (n = 42; age < 40 years). Conventional semen parameters (volume, concentration, motility, vitality, and morphology) were analyzed in the collected sperm samples. Furthermore, sperm genome decays (SGD) was assessed by TUNEL assay (DNA fragmentation), aniline blue staining (chromatin decondensation), and fluorescent in situ hybridization (aneuploidy). No significant difference was found concerning the conventional semen parameters between APA and Y groups. Conversely, SGD analysis showed increased DNA fragmentation; chromatin decondensation and sperm aneuploidy rates in the APA group (respectively, 41%, 43%, and 14% vs. 25%, 23%, and 4% in Y group). IVF outcomes also were affected by paternal age as indicated by the rates of cancelled embryo transfers, clinical pregnancy and miscarriage in the two groups APA and Y (29%, 17%, and 60% vs. 10%, 32%, and 42%). Finally, statistical analysis of the results suggests that the age of 40 should be considered as the APA cutoff during ART attempts