Epidemiology of airway colonization by Scedosporium apiospermum during cystic fibrosis

With a frequency of about 10%, species of the Scedosporium apiospermum complex (which comprises at least five distinct species with different antifungal susceptibility patterns) rank the second among the filamentous fungi colonizing the airways in cystic fibrosis (CF). Additionally, it is clearly established that these fungi may disseminate in case of immunodeficiency and that a chronic colonization of the airways by these pathogens may hinder the success of lung transplantation. In this study, we develop a new genotyping method to investigate the epidemiology of the airway colonization by these fungi. 63 multiple and sequential isolates of S. apiospermum collected from 9 CF patients, and selected among those previously studied by random amplification of polymorphic DNA (RAPD), were analyzed using the automated typing system DiversiLab (bioMérieux) based on PCR amplification of repetitive sequences. The DiversiLab Aspergillus rep-PCR kit which uses specific primers designed for Aspergillus fumigatus, was compared with the pan-fungus DiversiLab Fungal kit. Amplification products were separated by capillary electrophoresis on Agilent B2100 bioanalyzer, leading to single profiles for each isolate which were then compared using the DiversiLab software. In addition, species identification of these isolates was clarified by sequencing the betatubulin gene. Results obtained with both kits were comparable. Nevertheless, differentiation was easier using the DiversiLab Fungal kit. Additionally, rep-PCR usually confirmed the colonization patterns described by RAPD. Only two patients showed distinct genotypes. For Patient 2, two isolates were analyzed which were undistinguishable by RAPD, but rep-PCR revealed that they belonged to distinct genotypes, suggesting a transient colonization. For Patient 8 which showed by RAPD two distinct genotypes, 5 genotypes were found by rep-PCR with a dominant one represented by 5 isolates and two very close genotypes (corresponding to 3 isolates), while 4 other isolates belonged to two distant genotypes. In conclusion, the automated typing system DiversiLab proved to be an easy and efficient method to investigate the molecular epidemiology of the airway colonization by S. apiospermum in CF. Our results also confirm the capacity of the different species from the S. apiospermum complex to chronically colonize the airways of CF patients

Successful treatment of Trichosporon asahii fungemia with isavuconazole in a patient with hematologic malignancies

International audienceTrichosporon spp. are yeast-like microorganisms responsible for skin, urinary, pulmonary, or bloodstream infections. Due to intrinsic resistance to echinocandins, poor susceptibility to polyenes, and preferred occurrence in immunocompromised patients, such infections are often of poor prognosis. Yet no consensual therapeutic guidelines are presently available. Several clinical cases of Trichosporon infections have been successfully treated with azole therapy, including voriconazole which appeared frequently effective against Trichosporon both in vitro and in vivo. However, the low efficacy associated with some Trichosporon genotypes, complex pharmacokinetics, and the side effects of voriconazole represent limitations for its use and has prompted a search for other therapeutic options. Here, we report a case of T. asahii fungemia in a patient with B-cell acute lymphoblastic leukemia which was successfully treated with isavuconazole consecutive to stopping voriconazole therapy due to severe side effects. This observation suggests that isavuconazole with a similar spectrum to voriconazole, fewer pharmacology interactions, and side effects may be considered as a valuable therapeutic option against Trichosporon infections

Common occurrence of Cryptosporidium hominis in asymptomatic and symptomatic calves in France

International audienceSymptomatic infection by the Apicomplexan Cryptosporidium spp. is presently considered the most frequent parasitic cause of acute diarrhea in both humans (especially severe in immunocompromised individuals and infants in both developed and developing countries) and cattle (calves), while asymptomatic infections are less often documented. Cryptosporidium (C.) hominis once considered to be restricted to humans accounts for the majority of pediatric cases in several countries. C. parvum can also infect cattle as well as C. bovis, C. andersoni, and C. ryanae. Recently, cattle C. hominis cryptosporidiosis has been reported, suggesting that the presence of C. hominis in calves was previously underestimated. The aim of this work was to characterize Cryptosporidium spp. infection in both asymptomatic and symptomatic dairy and beef calves from Metropolitan France. From February to November 2015, C. parvum or C. hominis infected calves were detected in farms from 5 geographic regions of France. Surprisingly, C. hominis was present in about one fifth of Cryptosporidium spp. infected calves, and exhibited genotypes which were previously reported in human and nonhuman primate. Further investigations are aimed at documenting direct or indirect C. hominis transmissions between and among livestock and humans

Semi-automated repetitive sequence-based PCR amplification for species of the Scedosporium apiospermum complex

International audiencePurpose: The Scedosporium apiospermum species complex usually ranks second among the filamentous fungi colonizing the airways of patients with cystic fibrosis (CF), but little is known about the molecular epidemiology of the airway colonization.Methods: Polymerase chain reaction (PCR) amplification of repetitive sequences (rep-PCR) was applied to the retrospective analysis of a panel of isolates already studied by random amplification of polymorphic DNA (RAPD) and comprising 63 isolates recovered from sputa from 9 CF patients. Results were compared to those obtained previously by RAPD, and herein by beta-tubulin (TUB) gene sequencing and Multilocus Sequence Typing (MLST).Results: Within the panel of isolates studied, S. apiospermum sensu stricto and Sce-dosporium boydii, as expected, were the predominant species with 21 and 36 isolates, respectively. Four isolates from one patient were identified as Scedosporium auranti-acum, whereas two isolates belonged to the Pseudallescheria ellipsoidea subgroup of S. boydii. rep-PCR analysis of these isolates clearly differentiated the three species and P. ellipsoidea isolates, whatever the rep-PCR kit used, and also permitted strain differentiation. When using the mold primer kit, results from rep-PCR were in close agreement with those obtained by MLST. For both S. apiospermum and S. boydii, 8 genotypes were differentiated by rep-PCR and MLST compared to 10 by RAPD. All S. aurantiacum isolates shared the same RAPD genotype and exhibited the same rep-PCR profile and sequence type.Conclusions: These results illustrate the efficacy of rep-PCR for both species identification within the S. apiospermum complex and genotyping for the two major species of this comple

Human cryptosporidiosis in immunodeficient patients in France (2015-2017)

Cryptosporidiosis is a common disease in children and immunodeficient individuals. In 2006, a national network was set up on the surveillance of human cryptosporidiosis in France. Since January 2015, the 41 tertiary care hospitals and the 3 private laboratories of the French National Network on the surveillance of human cryptosporidiosis have been able to declare confirmed cases of cryptosporidiosis online. Between 2015 and 2017, 210 cases of cryptosporidiosis were declared in immunodeficient patients in France; Cryptosporidium parvum and Cryptosporidium hominis represented 66% and 22% of cases, respectively. A peak was observed in autumn. Cryptosporidiosis occurred mainly in a context of solid organ transplantation (SOT) (49%) and of HIV infection (30%). In SOT recipients, cryptosporidiosis appeared more frequently in the first 6 months post transplantation. Regarding cases declared in SOT recipients, mycophenolate mofetil was used in 68%. A mortality rate of 6% was observed. Present results underline the importance of screening for cryptosporidiosis in immunocompromised patients suffering from diarrhea, especially in the course of major cell mediated immunodeficiency or even systematic screening before SOT. Exclusive Cryptosporidium free water feeding could be suggested during major cell mediated immunodeficiency

Telehealth experiences in Canadian veterans: associations, strengths and barriers to care during the COVID-19 pandemic.

INTRODUCTION: Identifying barriers to care in veteran populations is critical, as veterans face increased social isolation, relationship strains and financial insecurities. For Canadian veterans experiencing barriers to accessing healthcare, telehealth may be a promising alternative with comparable effectiveness to in-person services; however, the potential benefits and limitations of telehealth require further examination to determine its long-term utility, and to inform health policy and planning. The goal of the present research was to identify predictors and barriers to telehealth usage in Canadian veterans in the context of the COVID-19 pandemic. METHODS: Data were drawn from baseline data of a longitudinal survey examining the psychological functioning of Canadian veterans during the COVID-19 pandemic. Participants were 1144 Canadian veterans aged 18-93 years (M RESULTS: Findings suggest that sociodemographic factors and previous telehealth use were significantly associated with telehealth use during the COVID-19 pandemic. Qualitative evidence highlighted both the benefits (eg, reducing barriers of access) and drawbacks (eg, not all services can be delivered) of telehealth services. CONCLUSIONS: This paper provided a deeper understanding of Canadian veterans\u27 experiences with accessing telehealth care during the COVID-19 pandemic. While for some, the use of telehealth mitigated perceived barriers (eg, safety concerns of leaving home), others felt that not all health services could be appropriately carried out through telehealth. Altogether, findings support the use of telehealth services in increasing care accessibility for Canadian veterans. Continued use of quality telehealth services may be a valuable form of care that extends the reach of healthcare professionals

Clinical and microbiological efficacy of micafungin on Geosmithia argillacea infection in a cystic fibrosis patient

Cystic fibrosis are at risk of colonization by a number of fungi, including Geosmithiaargillacea which appears to be an emerging pathogen in these patients. This pathogen has been recently reported as a cause of invasive/systemic mycosis in immunocompromized patients such as colonized patients who are immunosuppressed for lung transplantation. In this context, we report here a case of clinical and microbiological efficacy of micafungin in a French cystic fibrosis patient chronically colonized with G. argillacea. O.D., a female F508Del-CFTR homozygous patient was diagnosed at birth with cystic fibrosis in January 1996. She was found chronically colonised with multi-resistant Staphylococcus aureus (MRSA) from 1997 to 2011, and with Aspergillus fumigatus from 2001 to 2006. She was treated alternatively with oral voriconazole and itraconazole from 2004 to 2008, and with posaconazole since february 2008. Geosmithia argillacea was first diagnosed in May 2007, and chronic colonisation was persistent from this date to August 2010 with 23/28 fungus positive sputum samples, in spite of posaconazole therapy. For an isolate obtained in October 2008, minimal inhibitory/effective concentrations (MIC/MEC, mg/ml) determined using the Eucast method were 2.0, 2.0, 16.0, 2,0, 0.25 and 0.015 for amphotericin B, itraconazole, voriconazole, posaconazole, caspofungin and micafungin, respectively. The FEV1 predicted value was 73% at the time of first fungus isolation and was decreased to 47% in October 2009. She then was given caspofungin for 21 days ((70 mg/day, later reduced to 50 mg) which resulted in clinical improvement (FEV1 = 64% in January 2010) without eradication of G. argillacea. In June 2010, treatment with micafungin (75 mg, 21days) was realized owing to deterioration of the respiratory function (FEV1 = 56%),without clinical improvement ( FEV1 = 47% in August 2010). O.D. was then treated from September, 23 to November 3, 2010 with micafungin (100mg bid for 21 days and 100mg/day for the following 21 days) which resulted in clinical and microbiological improvement. FEV1 predicted ranged 67-68% in October and December 2010, and February and May 2011, and from the end of treatment to December 2010, 5/6 sputum samples were found negative for G. argillacea. The positive sample contained fungus of the same genotype as previous isolates. The present case is to our knowledge the first description of G. argillacea eradication in a chronically colonized cystic fibrosis patient. Similar to previous studies, G. argillacea colonization was detected in the presence of chronic MRSA after A. fumigatus eradication. Since no change in bacterial colonization was observed before, during, and after G. argillacea colonization, the present case is consistent with a pathogenic role of the fungus in cystic fibrosis patients. In vitro antifungal susceptibility assays suggested that echinocandins are most effective agents against this fungus with a lowest MEC for micafungin (7 isolates studied, MEC range: 0.015-0.03), although eradication could only be obtained with high dose micafungin for a long time (6 weeks)

Unfair competition in the field of intellectual property

Швець, Г. О. Недобросовісна конкуренція в сфері інтелектуальної власності / Г. О. Швець, К. М. Гаргала // Вісник Приазовського державного технічного університету : зб. наукових праць / ПДТУ. – Маріуполь, 2016. – Вип. 31, Т. 1. – С. 267–271. – (Серія : Економічні науки).В статті розглянуто визначення поняття «недобросовісна конкуренція» відповідно до норм міжнародного права та чинного Закону України «Про захист від недобросовісної конкуренції». Перераховано та охарактеризовано відповідно до чинного законодавства дії, що розглядаються як недобросовісна конкуренція. Зазначено погляд науковців, щодо недоліків законодавства в сфері недобросовісної конкуренції. Наведено дії, які пов’язані із дискредитацією конкурента (дискредитація конкурента; купівля-продаж товарів, виконання робіт, надання послуг із примусовим асортиментом; порівняльна реклама; схилення до бойкоту господарюючого суб’єкта та інше). Зазначено, що проблеми, пов'язані з недобросовісною конкуренцією найбільше на ринку інтелектуальних продуктів. Представлено аналіз порушень в сфері інтелектуальної власності. Вказано чинники впливу на вибір методів захисту підприємства від недобросовісної конкуренції, а саме: розробленість законодавства щодо захисту від недобросовісної конкуренції; наявність добросовісних конкурентних відносин на ринку; проінформованість суб’єктів господарювання про права щодо захисту від проявів недобросовісної конкуренції; прагнення учасників ринку до отримання надприбутків; надійність захисту прав суб’єктів господарювання; налагодження стабільних ділових стосунків з партнерами; ступінь сформованості конкурентного середовища; недоліки в управлінській системі; залежність від постачальників сировини з-за кордону. Наведено напрями щодо вдосконалення системи захисту інтересів суб'єктів господарювання від недобросовісної конкуренції в Україні.В статье рассмотрено определение понятия «недобросовестная конкуренция» в соответствии с нормами международного права и действующего Закона Украины «О защите от недобросовестной конкуренции». Перечислены и охарактеризованы действия в соответствии с действующим законодательством, которые рассматриваются как недобросовестная конкуренция. Представлен взгляд ученых, относительно недостатков законодательства в сфере недобросовестной конкуренции. Приведены действия, связанные с дискредитацией конкурента (дискредитация конкурента купля-продажа товаров, выполнение работ, оказание услуг с принудительным ассортиментом, сравнительная реклама; склонение к бойкоту хозяйствующего субъекта и т.д.). Отмечено, что проблем, связанных с недобросовестной конкуренцией больше всего на рынке интеллектуальных продуктов. Представлен анализ нарушений в сфере интеллектуальной собственности, связанных с недобросовестной конкуренцией. Указаны факторы влияния на выбор методов защиты предприятия от недобросовестной конкуренции, а именно: степень разработки законодательства о защите от недобросовестной конкуренции; наличие добросовестных конкурентных отношений на рынке; осведомленность субъектов хозяйствования о правах по защите от проявлений недобросовестной конкуренции; стремление участников рынка к получению сверхприбылей; надежность защиты прав субъектов хозяйствования; налаживание стабильных деловых отношений с партнерами; степень сформированности конкурентной среды; недостатки в управленческой системе; зависимость от поставщиков сырья из-за рубежа. Приведены направления по совершенствованию системы защиты интересов субъектов хозяйствования от недобросовестной конкуренции в Украине.In the article the definition of "unfair competition" in accordance with international law and the current Law of Ukraine "On protection against unfair competition". Lists and describes actions in accordance with applicable law, which are seen as unfair competition. Shows the view of scholars regarding the shortcomings of the legislation in the sphere of unfair competition. Given the action. associated with the discrediting of a competitor (the discrediting of a competitor, the purchase and sale of goods, performance of works, rendering services with compulsory assortment, comparative advertising; inducing others to boycott a business entity, etc.). It is noted that the problems associated with unfair competition than anything else on the market of intellectual products. The analysis of violations in the sphere of intellectual property-related unfair competition. Shows the factors influencing the choice of methods of protection of enterprises against unfair competition, namely: the development of legislation on protection from unfair competition; the availability of fair competitive relations in the market; the awareness of business entities on the rights for protection against unfair competition; the desire of market participants to seek excessive profits; the protection of rights of business entities; establishing sustainable business relationship with partners; the degree of formation of the competitive environment; weaknesses in the management system; dependence on suppliers of raw materials from abroad. Provides direction for improving the system of protection of interests of businesses from unfair competition in Ukraine