Healthcare-associated infections in a tunisian university hospital: From analysis to action

Introduction: our study was conducted, in university hospital center (UHC) Farhat Hached of Sousse (city in Tunisian center-east), within healthcare-associated infections (HAI) epidemiological surveillance (ES) program,  based, among others, on HAI regular prevalence surveys. Our objectives are to resituate HAI prevalence rate and to identify their risk factors (RF) in order to adjust, in our hospital, prevention programs.Methods: it is a transversal descriptive study, including all patients who had been hospitalized for at least 48 hours, measuring prevalence of HAI a “given day”, with only one passage by service. Risk factors were  determined using Epiinfo 6.0, by uni-varied analysis, then, logistic  regression stepwise descending for the variables whose pResults: the study focused on 312 patients. Infected patients prevalence was 12.5% and that of HAI was 14.5 %. Infections on peripheral venous catheter (PVC)  dominated (42.2%) among all HAI identified. HAI significant RF were neutropenia (p<10-4) for intrinsic factors, and PVC for extrinsic factors (p=0,003). Conclusion: predominance of infections on PVC should be subject of specific prevention actions, including retro-information strategy, prospective ES, professional practices evaluation and finally training and increasing awareness of health personnel with hygiene measures. Finally,  development of a patient safety culture with personnel ensures best adherence to hygiene measures and HAI prevention

Coxiella burnetii in Humans and Ticks in Rural Senegal

Q fever is a zoonotic disease known since 1937. The disease may be severe, causing pneumonia, hepatitis and endocarditis. Q fever agent has been described as a possible biological weapon. Animals—especially domestic cows, goats and sheep—are considered reservoirs for this infection. They are capable of sustaining the infection for long periods and excreting viable bacteria, infecting other animals and, occasionally, humans. Here we studied the distribution of Q fever in a poorly studied region, Senegal. We studied the agent of Q fever both in ticks parasitizing domestic animals and in humans (antibodies in serum, bacteria in feces, saliva and milk). We found from the studied regions the bacterium is highly prevalent in rural Senegal. Up to 37.6% of five different and most prevalent tick species may carry the bacterium. Humans living in such areas, as other mammals, may occasionally excrete Q fever agent through feces and milk

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral

Topological Requirements for CI-M6PR-Mediated Cell Uptake

International audienceThe 300 kDa cation-independent M6P receptor (CI-MPR) mediates ligand internalization and trafficking to the endolysosomal compartments. Because of its endocytotic nature, it has been recognized as a promising class of receptors for target component delivery. Its cellular uptake involves the simultaneous binding of two protein units resulting in the formation of receptor dimers. While many multivalent glycoconjugates have been reported to date, little is known about the topological requests to induce an effective recruitment of CI-MPRs. We herein describe the synthesis and cell uptake ability of a set of highly organized glycoclusters bearing one to three saccharide units. The spatial arrangement of carbohydrate ligands is ensured by a heterocyclic γ-peptide central core