Observation et étude expérimentale de mycobactéries atypiques en aquariums d'eau douce et d'eau de mer

L'eau des aquariums est source de Mycobactéries atypiques qui peuvent être pathogènes pour l'homme et les poissons.Une étude a été réalisée à l'aquarium du Musée de Zoologie de Nancy. La recherche de Mycobactéries a été effectuée dans 40 aquariums équipés de lampes germicides à UV : 11 bassins étaient alimentés en eau douce et 29 en eau de mer. Deux aquariums non équipés de système de désinfection ont également été analysés, les propriétaires de ces derniers ayant présenté un granulome cutané à M. marinum. L'action des UV sur M. marinum en suspension dans l'eau a été testée expérimentalement dans des bassins d'eau douce peuplés de Cichlidés.Pour chaque aquarium, un échantillon de 250 ml a été prélevé. Les cultures après décontamination au lauryl sulfate de soude ont été réalisées sur milieu de Loewenstein.Les résultats indiquent que, quel que soit l'aquarium, la présence de mycobactéries est constante. L'isolement des mycobactéries peut être gêné par la présence d'une flore bactérienne ou fongique importante (≥ 103 U.F.C./ml).Les espèces les plus fréquemment isolées sont M. gordonae et M. fortuitum ; M. kansasii et M. marinum ont rarement été isolées (6140 aquariums). Différents facteurs peuvent intervenir sur la sélection des espèces. La salinité de l'eau limite le développement de certaines espèces, alors qu'elle permet la croissance de M. fortuitum. Dans notre étude, la température de l'eau n'a pas été un facteur sélectif. L'utilisation de lampes UV limite le nombre de Mycobactéries. Dans les bassins expérimentaux, les radiations UV se sont révélées très actives sur M. marinum en présence ou en l'absence de poissons. A l'inverse de M. gordonae, M. fortuitum est rarement isolée en présence d'UV. Un nombre important de poissons par aquarium augmente la flore bactérienne et mycobactérienne.La prévention des infections à Mycobactéries atypiques chez l'homme comme chez les poissons devrait pouvoir être assurée par des mesures d'hygiène élémentaire.Water is a natural habitat of mycobacteria. In aquaria 3 species of atypical mycobacteria are frequently present : M. marinera, M. kansasitand M. fortuitum. They are potential pathogen for fishes and men. Tuberculosis has been recognized as the cause of mortality in marine and fresh water fishes. Clinical signs of fish tuberculosis are variable : ascites, skin ulcerations, skeletal deformities. The human infection is cutaneous granuloma occuring after in jury in aquaria.In the aquaria, of which two patients with cutaneous lesions due to M. marinum were analysed, UV lamps were not used. Many factors have an influence on the number of mycobacterial organisms in aquaria waters : number of fishes per tank, decontamination system, salinity, temperature.To determine the consequence of each factor, a study has been conducted at the “Aquarium du Musée de Zoologie de Nancy”. Research of mycobacteria was carried out in the water of 40 tanks : 11 were supplied with fresh water and 29 with salt water. Each tank was equipped with germicide UV (λ : 253,7 nm) : the intensity was 15 watts for aquaria smaller than 1 000 liters and 36 watts for aquaria larger than 5 000 liters. The effectiveness of UV radiation against M. marinum was tested in 3 experimental fresh water tanks of 280 liters. The first part of the experiment was tested without fish. Tank n° 1 was a control, lamp was switched on during the complete study, M. marinum was not added. In tank n° 2 (with UV) and n° 3 (without UV), 2 ml of M. marinum (of suspension 107 CF/ml) was added. Samples of water were analysed every two weeks. After six weeks tanks n° 2 and n° 3, were prepared for the next study : UV lamps were switched on in n° 2 and switched off in n° 3 both of which were contaminated by M. marinum. After 4 weeks 27 fishes, Cichlids, were introduced in the three aquaria. The day after, M. marinum was added to tanks n° 2 and n° 3. Every week water analysis was done, as well as an identification and quantification of all species of mycobacteria.From each tank 250 ml of water were collected. The water was passed through a 0,2 mµ membrane. The filters were introduced in distilled water and decontaminated by lauryl sulfate. The culture of mycobacteria was grown with Loewenstein medium at 30 and 37 °C. Each colony type was identified by cultural and biochemical characteristics.This study shows the richness in aquaria of mycobacteria; whatever the tanks, mycobacteria presence was constant. In non-treated home aquaria, the presence of mycobacteria was very important, 4 to 6 species per tank, (but in this case M. marinum was not found). In aquaria with UV lamps, the number of species per tank was lower (1 to 3).The growth of mycobacleria could be prevented when the samples were contaminated by fungi and bacteria. However, inability to recover mycobacteria from water occurred only when a massive over-growth by non-mycobacterial contaminant was present (103 CFU/ml). This was the case of non-treated tanks, belonging to patients who developed a chronic granuloma on their hands, M. marinum was not isolated in these aquaria. The evaluation of slowly growing mycobacteria could be altered by the important development of fast growing mycobacteria on the same culture tube. Among isolated species, M. fortuitum and M. gordonae saprophytic strains were frequent; M. kansasii and M. marinum involved in human cutaneous granuloma were unusual, as were the non-pigmented strains of groupe III of Runyon ; M. avium was not isolated.During this study, we observed a relationship between the mycobacteria presence and the cleanness of tank and the fishes population. A great number of fishes per tank was a factor which increased the bacterial and mycobacterial contamination. During this experiment fishes didn't present tubercular-lesions but when a dead fish was examinated, the culture from post-modem samples revealed the presence of M. marinum. The microbiological examination of skip and viscera was negative.The comparison of results in non-treated home tanks and UV treated tanks of the Museum indicates the role of water treatment by UV lamps on the number of isolated mycobacteria.The germicide UV camps are frequently used for the decontamination of tanks. The efficiency is good for bacteria, but unknown for mycobacteria. This study shows that UV radiation decreased the mycobacterial contamination. The species of mycobacteria differ in their sensitivity to UV radiation. In experimental tanks, the results showed the great susceptibility of M. marinum to UV lamps such they were used in aquaria. Presence of fish dues not change the results. If the addition of M. marinum and the lighting of lamps were simultaneous, M. marinum was not isolated in water. If the contamination by M. marinum preceded the lighting of UV lamps, must of bacteria was eliminated in one week and the totality in 4 weeks. For the other species, we observed that the mycobacterial sensitivity to UV light decreases in the following order : quickly growing mycobacteria, photochromogen and scotochromogen strains. During our experimental study, M. gordonae was isolated more frequently when UV lamps were switched on. The results obtained in the 40 tanks with UV lamps allowed the evaluation of the influence of salinity and temperature of water on mycobacterial survival and the selection of species. We did not observed a difference in the concentration of mycobacteria in two types of aquaria, fresh water and salt water. Na Cl is known as an inhibitor of the mycobacterial growth. The sensitivity of strains differs. The salinity of water appears to be a selection factor. M. forfuitum was isolated more frequently in salt water.M. marinum was isolated only in salt water and M. kansasii in fresh water. These results are surprising, as these strains have about the same metabolism. The temperature of water can also be a selection factor for mycobacteria, but in our study the temperature was similar in each aquarium (25°-26°). In this study, we did not observe thermophile strains such as M. avium.Aquarists must be informed of the aquarium contamination by atypical mycobacteria and their role in the evolution of skin lesions after injury of hands and arms. The use of germicide UV lamps improves the bacteriological quality of water

Occurrence of nontuberculous mycobacteria in aquatic sources of Sri Lanka

AbstractNontuberculous mycobacteria (NTM) have been reported to cause opportunistic infections with increasing frequency, especially in immunocompromised patients. Water plays a major role in the epidemiology of nontuberculous mycobacterial infection in humans, as it is one of the natural sources for transmission of this group of organisms. The current study focused on determining the occurrence of NTM in different aquatic sources of Sri Lanka by using phenotypic tests and polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) analysis of the rpoβ gene. Of 290 water samples, 45 (15%) were positive for NTM on culture. The percentage of mycobacteria identified at species level by phenotypic tests and PCR–RFLP analysis were 44% (20/45) and 73% (33/45), respectively. The frequency of isolation of mycobacteria from aquarium water, surface water, ground water and chlorinated water were 29% (20/70), 26% (20/76), 5% (4/76) and 1% (1/68), respectively. Eleven different NTM species were identified by PCR–RFLP analysis. M. fortuitum type I was the most frequently isolated species from all the four water sources. The current study suggests that water is an environmental source harboring NTM, a potential public health hazard especially for those with immunodeficiency

Mycobacterium xenopi Clinical Relevance and Determinants, the Netherlands

Clinical isolation of M. xenopi represents true infection in 51% of cases; genotype is a major determinant

Isolation of non-tuberculous mycobacteria from pastoral ecosystems of Uganda: Public Health significance

<p>Abstract</p> <p>Background</p> <p>The importance of non-tuberculous mycobacteria (NTM) infections in humans and animals in sub-Saharan Africa at the human-environment-livestock-wildlife interface has recently received increased attention. NTM are environmental opportunistic pathogens of humans and animals. Recent studies in pastoral ecosystems of Uganda detected NTM in humans with cervical lymphadenitis and cattle with lesions compatible with bovine tuberculosis. However, little is known about the source of these mycobacteria in Uganda. The aim of this study was to isolate and identify NTM in the environment of pastoral communities in Uganda, as well as assess the potential risk factors and the public health significance of NTM in these ecosystems.</p> <p>Method</p> <p>A total of 310 samples (soil, water and faecal from cattle and pigs) were examined for mycobacteria. Isolates were identified by the INNO-Lipa test and by 16S rDNA sequencing. Additionally, a questionnaire survey involving 231 pastoralists was conducted during sample collection. Data were analysed using descriptive statistics followed by a multivariable logistic regression analysis.</p> <p>Results</p> <p>Forty-eight isolates of NTM were detected; 25.3% of soil samples, 11.8% of water and 9.1% from animal faecal samples contained mycobacteria. Soils around water sources were the most contaminated with NTM (29.8%). Of these samples, <it>M. fortuitum-peregrinum </it>complex, <it>M. avium </it>complex, <it>M. gordonae</it>, and <it>M. nonchromogenicum </it>were the most frequently detected mycobacteria. Drinking untreated compared to treated water (OR = 33), use of valley dam versus stream water for drinking and other domestic use (OR = 20), sharing of water sources with wild primates compared to antelopes (OR = 4.6), sharing of water sources with domestic animals (OR = 5.3), and close contact with cattle or other domestic animals (OR = 13.8) were the most plausible risk factors for humans to come in contact with NTM in the environment.</p> <p>Conclusions</p> <p>The study detected a wide range of potentially pathogenic NTM from the environment around the pastoral communities in Uganda. Drinking untreated water and living in close contact with cattle or other domestic animals may be risk factors associated with the possibility of humans and animals acquiring NTM infections from these ecosystems.</p

An overview on the reactors to study drinking water biofilms

The development of biofilms in drinking water distribution systems (DWDS) can cause pipe degradation, changes in the water organoleptic properties but the main problem is related to the public health. Biofilms are the main responsible for the microbial presence in drinking water (DW) and can be reservoirs for pathogens. Therefore, the understanding of the mechanisms underlying biofilm formation and behavior is of utmost importance in order to create effective control strategies. As the study of biofilms in real DWDS is difficult, several devices have been developed. These devices allow biofilm formation under controlled conditions of physical (flow velocity, shear stress, temperature, type of pipe material, etc), chemical (type and amount of nutrients, type of disinfectant and residuals, organic and inorganic particles, ions, etc) and biological (composition of microbial community e type of microorganism and characteristics) parameters, ensuring that the operational conditions are similar as possible to the DWDS conditions in order to achieve results that can be applied to the real scenarios. The devices used in DW biofilm studies can be divided essentially in two groups, those usually applied in situ and the bench top laboratorial reactors. The selection of a device should be obviously in accordance with the aim of the study and its advantages and limitations should be evaluated to obtain reproducible results that can be transposed into the reality of the DWDS. The aim of this review is to provide an overview on the main reactors used in DW biofilm studies, describing their characteristics and applications, taking into account their main advantages and limitations.This work was supported by the Operational Programme for Competitiveness Factors COMPETE and by Portuguese Foundation for Science and Technology through Project Phyto disinfectants - PTDC/DTPSAP/1078/2012 (COMPETE: FCOMP-01-0124-FEDER-028765), the Post-Doc grant awarded to Lucia Simoes (SFRH/BPD/81982/2011). Also, this work was undertaken as part of the European Research Project SUS-CLEAN (Contract n_FP7-KBBE-2011-5, project number: 287514) and the COST Action FA1202. The authors are solely responsible for this work. It does not represent the opinion of the Community, and the Community is not responsible for any use that might be made of data appearing herein

Epidemiology and Clinical Features of Pulmonary Nontuberculous Mycobacteriosis in Nagasaki, Japan

Background and Objectives: Recent reports indicate that the incidence of nontuberculous mycobacterial-lung disease (NTM-LD) is increasing. This study aimed to investigate the epidemiology and clinical features of NTM-LD patients in Nagasaki prefecture, Japan to identify the negative prognostic factors for NTM-LD in Japan. Methods: The medical records of patients newly diagnosed with NTM-LD in eleven hospitals in Nagasaki prefecture between January 2001 and February 2010 were reviewed. Data regarding the annual population of each region and the incidence of all forms of tuberculosis were collected to assess geographic variations in NTM-LD incidence, isolates, and radiological features. Results: A total 975 patients were diagnosed with NTM-LD. The incidence increased over the study period and reached 11.0 and 10.1 per 100,000 population in 2008 and 2009, respectively. M. intracellulare was the most common pathogen in the southern region, and M. avium most common in other regions. The most common radiographic pattern was the nodular-bronchiectatic pattern. Age >60 years, body mass index <18.5 kg/m2, underlying lung disease, and cavitary pattern were the negative prognostic factors at the 1-year follow-up. Conclusions: The incidence of NTM-LD has been increasing in Nagasaki prefecture. The isolates and radiographic features of patients vary markedly by region

The inheritance laws of the French Revolution : an anticipation of the evolution of the family

Les historiens du Droit ont longtemps fait peu de cas du droit civil de la Révolution française qualifié péjorativement de droit intermédiaire. Mais depuis le bicentenaire de la Révolution française, ils ont révisé leur appréciation et davantage mis en exergue la modernité de cette législation que l’on peut désormais considérer comme une anticipation du droit contemporain de la famille. Cette thèse est une contribution à cette œuvre de réhabilitation. Le droit des successions de l’ancien régime était caractérisé par l’inégalité de ses règles. La proclamation de l’égalité civile dans la Déclaration des droits de l’homme et du citoyen de 1789 impliquait une refonte complète de cette matière. Les deux premières assemblées, la Constituante et la Législative n’avaient fait qu’entamer ce travail en supprimant les inégalités les plus manifestes, les privilèges d’aînesse et de masculinité, ce qui fut l’occasion de discussions sur le droit de tester. Ce fut la Convention qui réalisa les réformes les plus considérables et les plus célèbres à l’apogée de la Révolution, au moment où les tensions idéologiques étaient exacerbées. Un premier projet de Code civil fut discuté mais n’aboutit pas. En attendant la rédaction d’un second projet amendé, il fut résolu de mettre en application quelques parties du premier sur des questions qui semblaient particulièrement urgentes. C’est ainsi que des « articles d’appendice » du premier Code, furent mis en application au moyen de deux lois. La première est celle du 12 brumaire an II sur les droits des enfants naturels qui étaient essentiellement des droits successoraux, la seconde est la loi du 17 nivôse an II, sur la dévolution successorale et l’égalité des partages.Leur caractéristique commune était d’introduire la rétroactivité dans le règlement des successions ouvertes depuis le 14 juillet 1789, date symbolique de l’avènement de la liberté, pour hâter la mise en application des principes nouveaux. Cet effet rétroactif fut ensuite violemment critiqué, dès que la situation politique se retourna avec l’élimination des Robespierristes. De nombreuses plaintes affluèrent pour montrer les graves inconvénients pratiques de cette situation. Les législateurs postérieurs revinrent sur cet effet au moyen de lois qui s’échelonnent du 9 fructidor an III au 3 vendémiaire an IV. Les rédacteurs du Code civil maintinrent le principe d’égalité dans la famille fondée sur le mariage. Mais en ce qui concerne les enfants nés hors mariage, le code de 1804 consacre les solutions les plus dures qu’il était possible d’imaginer à leur encontre. Il n’est plus question d’égalité même tempérée. La situation de ces enfants ne fut améliorée que très lentement pendant 150 ans. Ce mouvement s’est néanmoins accéléré à partir de 1972 pour aboutir à la situation actuelle.Law historians have long ignored the civil law of the French Revolution, pejoratively termed as “intermediate right”. But since the bicentennial of the French Revolution, they have revised their appreciation and highlighted the modernity of this legislation that can now be considered as an anticipation of the contemporary law of the family. This thesis is a contribution to this rehabilitation work.The inheritance law of the old regime was characterized by the inequality of hits rules. The proclamation of civil equality in the Declaration of the Rights of Man of 1789 implied a complete overhaul of this subject. The first two assemblies, the Constituent Assembly and the Legislative Assembly, had only begun this work, removing the most obvious inequalities, the privileges of aeness and masculinity, which was the occasion for discussions on the right to test. It was the Convention that carried out the most important reforms at the height of the Revolution, at a time when ideological tensions were exacerbated. A first draft of the Civil Code was discussed but did not succeed.Pending the drafting of a second amended draft, it was resolved to implement some parts of the first, on matters which seemed particularly urgent. Thus, “appendix articles” of the first Code were implemented by means of two laws. The first is that of 12 Brumaire year II on the rights of natural children, which were essentially inheritance rights. The second is the law of 17 Nivôse year II, on the devolution of inheritance and the equality of shares.Their common feature was to introduce retroactivity into the settlement of estates opened since July 14, 1789, the symbolic date of the advent of freedom, to hasten the implementation of the new principles. . This retroactive effect was then violently criticized , as soon as the political situation tuned around with the elimination of the Robespierrists. Many complaints poured out to show the serious practical inconvenience of this situation.The later legislators returned to this effect, by means of laws which extended from the 9th Fructidor year III, to the 3rd Vendemiaire year IV. The drafters of the Civil Code maintained the principle of equality in the family based on the marriage. But with regard to the children born out of the wedlock, the Code of 1804 devotes the harshest solutions that could be imagined against them. It is no longer a question of even moderate equality. The situation of these children was only very slowly improved for 150 years. However, this movement accelerated from 1972 onwards to current situation

Place du Médecin traitant dans le suivi de patients atteints par le VIH

TOURS-BU Médecine (372612103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Vidéo quantification appliquée a la topographie de la plage intertidale

La mise en place d'une gestion durable et pérenne de la problématique d'érosion nécessite d'appréhender toutes les échelles spatio-temporelles d'évolution morpho-sédimentaire. Depuis quelques années, l'utilisation de systèmes vidéo numériques pour quantifier ces évolutions constitue une alternative autonome et peu coûteuse [Holman and Stanley, 2007] aux méthodes traditionnelles telles que la topographie. Cet article présente une technique de mesure topographique basée sur la détection vidéo du trait de côte dans un environnement méso-tidal. Le principe de la vidéo quantification appliquée au suivi des environnements côtiers est basé sur une technique de photogrammétrie qui permet de transformer une " image oblique brute " en une " image métrique plan " [Trucco, 1998]. Une fois les images sélectionnées, une région d'intérêt est définie manuellement. Les pixels contenus à l'intérieur de cette zone vont être traités à partir d'un algorithme de détection de contour, basé sur une technique de segmentation [Morichon et al., 2007], qui va permettre de séparer les pixels en deux groupes distincts : un groupe concernant les pixels " secs " de la partie sableuse et un groupe concernant les pixels " humides " de la partie océanique. Il est ensuite possible de détecter de façon précise la position du trait de côte. Les coordonnées 2D du trait de côte sur l'image initiale vont ensuite être transformées en coordonnées 3D du monde réel. Cet article présente l'application de cette technique dans un environnement méso-tidal, la grande plage de Biarritz. La détection horaire de la position du trait de côte au cours d'un demi cycle de marée permet alors de mesurer la topographie de la zone intertidale. Cette mesure est ensuite comparée à un relevé topographique réalisé au DGPS centimétrique. La précision de la méthode, ses limitations et les perspectives de développement sont alors discutées