Nosocomial outbreak of neonatal Salmonella enterica serotype Enteritidis meningitis in a rural hospital in northern Tanzania

BACKGROUND: Clinicians at Haydom Lutheran Hospital, a rural hospital in northern Tanzania noted an unusually high case-fatality rate of pediatric meningitis and suspected an outbreak of an unknown agent or an organism resistant to the empirical therapy. METHODS: We established a provisional microbiology laboratory to investigate the suspected outbreak. Blood and spinal fluid specimens were taken from children below the age of seven years with suspected meningitis. The blood and spinal fluid specimens were inoculated in commercial blood culture bottles and locally prepared Thayer-Martin medium in slanted tubes, respectively. The bacterial isolates were sent to Norway for further investigation, including susceptibility testing and pulsed-field gel-electrophoresis (PFGE). RESULTS: Among 24 children with suspected meningitis and/or septicemia, five neonates had meningitis caused by Salmonella enterica serotype Enteritidis, all of whom died. Two children had S. Enteritidis septicemia without meningitis and both survived. Genotyping with PFGE suggested a clonal outbreak. The salmonella strain was resistant to ampicillin and sensitive to gentamicin, the two drugs commonly used to treat neonatal meningitis at the hospital. CONCLUSION: The investigation reminds us that nontyphoidal salmonellae can cause meningitis associated with very high case-fatality rates. Resistance to multiple antimicrobial agents increases the risk of treatment failure and may have contributed to the fatal outcome in all of the five patients with salmonella meningitis. The investigation indicated that the outbreak was nosocomial and the outbreak subsided after hygienic measures were instituted. Establishing a provisional microbiological laboratory is a valuable and affordable tool to investigate and control outbreaks even in remote rural areas

La pseudogestation chez la chevre : observations preliminaires

National audienc

La pseudogestation chez la chevre : observations preliminaires

National audienc

Broad modulation of gene expression in CD4+ lymphocyte subpopulations in response to low doses of ionizing radiation

To compare me responses of the different lymphocyte sub-types after an exposure of whole blood to low doses of ionizing radiation, we examined variations in gene expression in different lymphocyte subpopulations using microarray technology. Blood samples from five healthy donors were independently exposed to 0 (sham irradiation), 0.05 and 0.5 Gy of ionizing radiation. Three and 24 h after exposure, CD56+, CD4+ and CD8+ cells were negatively isolated. RNA from each set of experimental conditions was competitively hybridized on 25k oligonucleotide microarrays. Modifications of gene expression were measured after both intervals and in all cell types. Twenty-four hours after exposure to 0.5 Gy, we observed an induction of the expression of BAX, PCNA, GADD45, DDB2 and CDKNIA. However, the numbers of modulated genes greatly differed between cell types. In particular, 3 h after exposure to doses as low as 0.05 Gy, the number of down-modulated genes was 10 times greater for CD4+ cells than for all other cell types. Moreover, most of these repressed genes were taking part in the cell processes of protein biosynthesis and oxidative phosphorylation. The results suggest that several biological pathways in CD4+ cells could be sensitive to low doses of radiation. Therefore, specifically studying CD4+ cells could help to understand the mechanisms involved in low-dose response and allow their detection

ECOVIR : mise en place d’une cohorte en soins primaires, un exemple de coopération pluri-professionnelle ville-hôpital

Acute Respiratory Infections (ARI) need be better understood and more effectively treated, especially insofar as they are of pivotal importance in public health, particularly during a crisis such as the SARS-CoV2 pandemic. The prospective, multicentric cohort study of viral codetections in respiratory samples study known as ECOVIR was conducted in Normandy, France during two winters (2018-2019, 2019-2020). The objective of the project was to create a biobank of respiratory tract samples from patients consulting their general practitioner (GP) for ARI symptoms. ECOVIR involved 36 GP investigators (GPI), from 8 health care centers throughout Normandy. Six hundred and eighty-five patients with ARI symptoms were included; naso-pharyngeal samples were taken by the GPIs and subsequently analyzed in virology laboratories for the purposes of viral codetection. The median of inclusions was 16 patients for each of the 31 actively participating GPIs over the two winters (CI25-75% [4.75; 27]). By D7, 92% of the patients contacted had responded to our call for participation, enabling us to obtain clinical, environmental and socio-demographic data. Through this study, we created an original functional network, thereby establishing a viable link between research and primary care, which is generally underrepresented in research protocols, even though it constitutes the cornerstone of the French health care system, especially during this prolonged period of sanitary crisis.Comprendre et traiter les infections respiratoires aiguës (IRA) sont un enjeu majeur de santé publique, particulièrement en cette période de pandémie à SARS-CoV2. ECOVIR (Étude des co-détections virales dans les prélèvements respiratoires), est une étude prospective, multicentrique, en Normandie, sur deux saisons hivernales (2018–2019 et 2019–2020). L’objectif de ce projet était de créer une biothèque de prélèvements respiratoires à partir d’une cohorte de patients consultant leur médecin traitant pour des symptômes d’IRA, permettant d’étudier les co-détections virales. Trente-six médecins généralistes investigateurs (MGI), dans 8 maisons de santé normandes, ont participé à l’étude. Au total, 685 patients ont été inclus, présentant des symptômes d’IRA, et ont bénéficié d’un prélèvement nasopharyngé au cabinet médical par les MGI pour analyse virologique. Trente et un MGI/36 ont inclus des patients. La médiane d’inclusion était de 16 patients par MGI sur les 2 saisons (IC25–75 % [4,75 ; 27]). De plus, 92 % des patients ont répondu à l’appel à j7, recueillant des données cliniques, environnementales, et sociodémographiques. Nous avons donc créé un vrai réseau, original, permettant d’assurer un lien entre la recherche et les soins primaires, peu représentés dans les protocoles de recherche mais qui sont la pierre angulaire de notre système de santé en France, comme nous le constatons actuellement avec la crise sanitaire