Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

RFID, les évolutions technologiques à venir

National audienc

Les technologies Chipless : intérêt et application à la lutte anti-contrefaçon

National audienc

Electromagnetic interference produced by printed dipole antennas for MCM wireless RF clock distribution

International audienc

Spectral detector for interference time blanking using quantized correlator

Given the large flow of data to be processed, quantized correlators are widely used in radio astronomy. Unfortunately, the occurrence of non-Gaussian interference combined with a coarse quantization can strongly alter the shape of the estimated spectra. The final spectral estimation can be preserved by blanking the correlator in real-time. A new interference detection criterion is proposed within this framework. It uses the real-time capabilities of correlators and compares contaminated and non-contaminated correlation functions. No a priori information on the interfering signals is required. Simulations, using synthetic and actual data, are presented. This new technique of real time detection can significantly improve the quality of spectral line observations

Detection par la PCR des begomovirus de la tomate (Solanum lycopersicum L.) dans les zones de production du Togo

Les maladies virales causées par les Begomovirus transmis par l’insecte vecteur Bemisia tabaci Gennadius sur la tomate (Solanum lycopersicum L.) constituent une contrainte biotique majeure pour la production de ce légume fruit. Les pertes de rendement causées par ces virus peuvent atteindre 100%. Au Togo, très peu de données moléculaires existent sur les Begomovirus de la tomate. Afin d’avoir plus d’information sur ces Begomovirus que la présente étude a été menée afin de déterminer les Begomovirus de la tomate au Togo et de mieux la protéger. Pour atteindre ces objectifs, une collecte d’échantillons géoréférencés de feuilles présentant des symptômes typiques de virose a été effectuée dans les champs sur des plants de tomate et autres plantes (sauvages et cultivées) dans les préfectures d’Assoli, de Bassar, de Binah, de Cinkassé, de Doufelgou, du Golfe, de la Kozah, de Kpendjal, des Lacs, de l’Ogou , de Sotouboua, de Tchaoudjo, de Tone et de Zio. Au total 307 échantillons ont été collectés et analysés par PCR. Les résultats de la PCR ont révélé la présence de Begomovirus sur 25,40% des échantillons analysés dont 4% sur les plantes sauvages et autres plantes cultivées à savoir: Euphorbia heterophylla, Physalis angulata, Ageratum conyzoides, Synedrella nodiflora, Clerodendron sp, Solanum macrocarpon, Glycine max, et Abelmoschus esculentus. Les analyses statistiques ont révélé dans l’ensemble que la préfecture de Tchaoudjo, avait le taux de contamination le plus élevé (100%). Ces résultats suggèrent que les Begomovirus seraient associés à une grande diversité de plantes sauvages non encore connues au Togo. Mots clés: Begomovirus, PCR, Plantes sauvages, Tomate, Virose

Diagnostic de Begomovirus associes aux systemes de cultures a base du manioc (Manihot esculenta Crantz) par la PCR (Polymerase Chain Reaction) au Togo

L’une des conséquences de la propagation des biotypes très polyphages de Bemisia tabaci, est probablement l’émergence de nouvelles espèces de Begomovirus associées aux changements climatiques. Cette étude a été initiée pour identifier ces agents pathogènes au sein des systèmes de cultures à base du manioc à travers tout le Togo afin d’avoir plus d’information sur les Begomovirus émergents. Ainsi des échantillons foliaires de manioc, de dix plantes associées au manioc en cultures mixtes et de diverses plantes sauvages collectés durant la période de 2013-2016, ont été soumis à un diagnostic PCR pour la détection des Begomovirus de façon générale et plus spécifiquement pour l’identification des Begomovirus de la mosaïque du manioc. À cet effet cinq couples d’amorces spécifiques ciblant le gène de la CP des Begomovirus ont été utilisés notamment JSP001/JSP002, JSP001/JSP003, JSP012/JSP013, ICMV-F2/ICMV-R2 et AC1048/AV494. Les résultats ont montré la présence effective de Begomovirus dans les cinq régions économiques du Togo. Avec l’amorce AC1048/AV494 des Begomovirus ont été identifié dans 50 % (soja), 26,31 % (piment), 19,15 % (manioc), 13,63 % (tomate), 9,09 % (corète potagère), et 5 % (plantes sauvages). Deux espèces de Begomovirus de la mosaïque du manioc ACMV et EACMV ont également été identifiées. Le taux d’incidence individuel de ACMV est de 36,17 % sur le manioc et celui de EACMV est de 20,21 % sur le manioc et 10.53 % sur le piment. C’est la première fois que des Begomovirus sont détectés dans des échantillons de la corète potagère et EACMV sur le piment au Togo. Cette étude contribuera à l’avancé des connaissances sur les maladies induites par des Begomovirus transmis par les mouches blanches, Bemisia tabaci.Mots clés:  Begomovirus, Bemisia tabaci, diagnostic, manioc, PCR, systèmeEnglish Title: Diagnosis of Begomoviruses associated with cassava  (Manihot esculenta Crantz)-based cropping systems by  PCR (Polymerase Chain Reaction) in TogoEnglish AbstractOne of the consequences of the spread of highly polyphagous Bemisia tabaci biotypes is probably the emergence of new begomovirus species associated with climate change. This study is conducted to identify theses pathogen agents within cassava based cropping systems throughout Togo in order to get more information about emerged begomoviruses. Thus, Foliar samples of cassava, ten intercropped plants with cassava in fields and various wild plants collected during the period 2013-2016 are submitted to PCR diagnosis for the detection of begomoviruses in general and more specifically for the detection of cassava mosaic begomoviruses. For this purpose, five specific primer pairs targeting begomoviruses CP gene were used, in particular JSP001/JSP002, JSP001/JSP003, JSP012/JSP013, ICMV-F2/ICMV-R2 and AC1048/AV494. Results showed the effective presence of begomoviruses in the five economic regions of Togo. With AC1048/AV494 primers begomoviruses are found in 50 % (soybean), 26.31 % (pepper), 19.15 % (cassava), 13.63 % (tomato), 9.09 % (jute), and 5 % (wild plants). Two species of cassava mosaic begomoviruses ACMV and EACMV are also identified. The individual incidence rate for ACMV is 36.17 % in cassava and EACMV is 20.21 % in cassava and 10.53 % in pepper. This is the first report of begomoviruses in jute samples and EACMV in pepper in Togo. This study will contribute to the advancement of knowledge on begomoviruses-induced diseases transmitted by whiteflies, Bemisia tabaci.Keywords: Begomovirus, Bemisia tabaci, diagnosis, cassava, PCR, syste