Outbreak of Corynebacterium pseudodiphtheriticum Infection in Cystic Fibrosis Patients, France

Respiratory tract colonization with these bacteria may be common in this population

Genomic analysis of an emerging multiresistant Staphylococcus aureus strain rapidly spreading in cystic fibrosis patients revealed the presence of an antibiotic inducible bacteriophage

BACKGROUND: Staphylococcus aureus is a major human pathogen responsible for a variety of nosocomial and community-acquired infections. Recent reports show that the prevalence of Methicillin-Resistant S. aureus (MRSA) infections in cystic fibrosis (CF) patients is increasing. In 2006 in Marseille, France, we have detected an atypical MRSA strain with a specific antibiotic susceptibility profile and a unique growth phenotype. Because of the clinical importance of the spread of such strain among CF patients we decided to sequence the genome of one representative isolate (strain CF-Marseille) to compare this to the published genome sequences. We also conducted a retrospective epidemiological analysis on all S. aureus isolated from 2002 to 2007 in CF patients from our institution. RESULTS: CF-Marseille is multidrug resistant, has a hetero-Glycopeptide-Intermediate resistance S. aureus phenotype, grows on Cepacia agar with intense orange pigmentation and has a thickened cell wall. Phylogenetic analyses using Complete Genome Hybridization and Multi Locus VNTR Assay showed that CF-Marseille was closely related to strain Mu50, representing vancomycin-resistant S. aureus. Analysis of CF-Marseille shows a similar core genome to that of previously sequenced MRSA strains but with a different genomic organization due to the presence of specific mobile genetic elements i.e. a new SCCmec type IV mosaic cassette that has integrated the pUB110 plasmid, and a new phage closely related to phiETA3. Moreover this phage could be seen by electron microscopy when mobilized with several antibiotics commonly used in CF patients including, tobramycin, ciprofloxacin, cotrimoxazole, or imipenem. Phylogenetic analysis of phenotypically similar h-GISA in our study also suggests that CF patients are colonized by polyclonal populations of MRSA that represents an incredible reservoir for lateral gene transfer. CONCLUSION: In conclusion, we demonstrated the emergence and spreading of a new isolate of MRSA in CF patients in Marseille, France, that has probably been selected in the airways by antibiotic pressure. Antibiotic-mediated phage induction may result in high-frequency transfer and the unintended consequence of promoting the spread of virulence and/or antibiotic resistance determinants. The emergence of well-adapted MRSA is worrying in such population chronically colonized and receiving many antibiotics and represents a model for emergence of uncontrollable super bugs in a specific niche. REVIEWERS: This article was reviewed by Eric Bapteste, Pierre Pontarotti, and Igor Zhulin. For the full reviews, please go to the Reviewers' comments section

Inquilinus limosus and Cystic Fibrosis

International audienc

Tropheryma whipplei in Children with Gastroenteritis

This bacterium may be an etiologic agent of gastroenteritis

BCG et nourrissons à risque de tuberculose (Etude de couverture vaccinale après la levée d'obligation vaccinale)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Importance du dépistage familial dans la coqueluche du nourrisson

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Connaissances parentales sur la rougeole et sa vaccination en 2013

INTRODUCTION: La rougeole est une maladie contagieuse dont les complications et la mortalité justifient une prévention vaccinale. L'objectif de notre étude était d'évaluer et de caractériser les connaissances parentales sur la rougeole et sa vaccination après l'épidémie de 2008-2011 en France. MATERIEL ET METHODE: Il s'agissait d'une étude transversale, par questionnaires anonymes distribués aux urgences pédiatriques du CHU Timone à Marseille du 21 au 28 janvier puis du 4 au 11 février 2013. RESULTATS: Pour les parents (n=658)n la rougeole consistait en une fièvre éruptive (62%), contagieuse (69%), source de complications dans 47% des cas (pulmonaires 18%, neurologiques 17%, décès 4%). La vaccin était connu (87%) mais ses modalités beaucoup moins. Plus de la moitié n'avaient pas entendu parlé de l'épidémie de 2011 (n=366, 556%) ni vu la campagne médiatique la concernant (n=454, 69%). La classification sur facteurs issus de l'analyse des correspondances multiples trouvait 4 classes de parents selon leurs connaissances sur la rougeole et son vaccin. Les plus informés étaient les mères, ceux dont l'enfant était suivi par un pédiatre et non un généraliste et ceux avisés de l'épidémie de rougeole. Une connaissance parentale parfaite ou correcte entraînait une meilleure couverture vaccinale des enfants. CONCLUSION: L'état des connaissances des parents est primordial pour une vaccination adéquate des enfants. Une information via le médecin semblerait avoir plus d'impact d'une campagne médiatique.INTRODUCTION: Measles is a contagious disease for which complications and mortality justify preventive vaccine. The aim of our study was to evalute and characterize parental knowledge about measles and its vaccination after the epidemic of 2008-2011 in France. MATERIALS AND METHODS: This study was a cross-sectorial descriptive and analytical, by anonymous questionnaires distributed to pediatric emergencies CHU Timone in Marseille for two weeks (from 21 to 28 january and from 4 to 11 february 2013). RESULTS: For parents (n=658), measles was an eruptive fever (62%), a contagious disease (69%) and source of complications in 47% of cases (pumonary 18%, neurological 17%, death 44%). The vaccine was well know (87%) but the terms were much less. More than half of parents had not heard of the epidemic in 2011 (n=366, 56%), or seen the media campaign about it (n=454, 69%). the classification of factors derived from multiple correspondence analysis found four classes according to the parent's knowledge about measles and vaccination. The more informed were the mothers, those whose child was followed by a pediatrician and those notified by the measles epidemic. A perfect or correct parental knowledge led to a better vaccination coverage oh children. CONCLUSION: The state of knowledge of parents is essential for proper immunization of children. Information via the doctor seeems to have more impact than a media camapaign.AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Développement de l'anticipation posturale chez l'enfant sain et pathologique: revue de travaux

International audienc