Prevention of nosocomial infections by biological safety in veterinary healthcare settings

Probablement sous-estimées en médecine vétérinaire, les infections nosocomiales ont des conséquences sanitaires mais aussi économiques ; en outre elles peuvent ternir la réputation des établissements. Elles sont associées à des facteurs de risque variés, intéressant plusieurs aspects de la médecine vétérinaire. Elles peuvent être d’origine endogène ou exogène, et dues à des agents pathogènes ou opportunistes divers. La maîtrise des infections nosocomiales vise à interrompre la chaîne de transmission et à réduire la vulnérabilité de l’hôte. Elle repose sur une approche globale, intégrant l’ensemble de l’organisation de l’établissement vétérinaire. La maîtrise des risques d’infection d’origine exogène repose essentiellement sur l’isolement des animaux infectés ou colonisés, la gestion des flux, les pratiques d’asepsie adaptées et les mesures d’hygiène. Elle concerne également l’utilisation d’équipements adaptés afin de limiter les infections liées aux contaminants de l’environnement. Le contrôle de la qualité de l’environnement permet la surveillance de points critiques et la recherche des sources de contamination. Des procédures doivent décrire les règles de biosécurité dans l’établissement.Nosocomial infections are probably underestimated in veterinary medicine. Yet, they generate both health and economic consequences. In addition, they may tarnish the reputation of establishments. They are of endogenous or exogenous origin, produced by extremely varied pathogens or opportunists microorganisms. Several aspects of veterinary medicine can be considered as risk factors. The control of nosocomial infections is intended to interrupt the transmission chain and reduce the vulnerability of the host. It therefore relies on a comprehensive approach, considering the whole organization of the veterinary practice. The control of exogenous risks of infection depends to a large extent on the isolation of infected or colonized animals, management of flows and hygiene measures. Appropriate equipment should also be used to limit infections caused by actual microorganisms in the veterinary practice environment. Quality control of the environment allows monitoring of critical points or search for the source of contamination. Procedures should describe the biosecurity rules in the veterinary facilities

Specific capture and whole‑genome phylogeography of Dolphin morbillivirus

Dolphin morbillivirus (DMV) is considered an emerging threat having caused several epidemics worldwide. Only few DMV genomes are publicly available. Here, we report the use of target enrichment directly from cetacean tissues to obtain novel DMV genome sequences, with sequence comparison and phylodynamic analysis. RNA from 15 tissue samples of cetaceans stranded along the Italian and French coasts (2008–2017) was purified and processed using custom probes (by bait hybridization) for target enrichment and sequenced on Illumina MiSeq. Data were mapped against the reference genome, and the novel sequences were aligned to the available genome sequences. The alignment was then used for phylogenetic and phylogeographic analysis using MrBayes and BEAST. We herein report that target enrichment by specific capture may be a successful strategy for whole-genome sequencing of DMV directly from field samples. By this strategy, 14 complete and one partially complete genomes were obtained, with reads mapping to the virus up to 98% and coverage up to 7800X. The phylogenetic tree well discriminated the Mediterranean and the NE-Atlantic strains, circulating in the Mediterranean Sea and causing two different epidemics (2008–2015 and 2014–2017, respectively), with a limited time overlap of the two strains, sharing a common ancestor approximately in 1998

Hanging out at the club: Breeding status and territoriality affect individual space use, multi‐species overlap and pathogen transmission risk at a seabird colony

1. Wildlife movement ecology often focuses on breeders, whose territorial attachments facilitate trapping and following individuals over time. This leads to incomplete understanding of movements of individuals not actively breeding due to age, breeding failure, subordinance, and other factors. These individuals are often present in breeding populations and contribute to processes such as competition and pathogen spread. Therefore, excluding them from movement ecology studies could bias or mask important spatial dynamics. 2. Loafing areas offer an alternative to breeding sites for capturing and tracking individuals. Such sites may allow for sampling individuals regardless of breeding status, while also avoiding disturbance of sensitive breeding areas. However, little is known about the breeding status of individuals attending loafing sites, or how their movements compare to those of breeders captured at nests. 3. We captured a seabird, the brown skua, attending either nests or loafing areas (‘clubs’) at a multi-species seabird breeding site on Amsterdam Island (southern Indian Ocean). We outfitted skuas with GPS-UHF transmitters and inferred breeding statuses of individuals captured at clubs using movement patterns of breeders captured at nests. We then compared space use and activity patterns between breeders and nonbreeders. 4. Both breeding and nonbreeding skuas attended clubs. Nonbreeders ranged more widely, were more active, and overlapped more with other seabirds and marine mammals than did breeders. Moreover, some nonbreeders occupied fixed territories and displayed more restricted movements than those without territories. Nonbreeders became less active over the breeding season, while activity of breeders remained stable. Nonbreeding skuas were exposed to the agent of avian cholera at similar rates to breeders but were more likely to forage in breeding areas of the endangered endemic Amsterdam albatross, increasing opportunities for interspecific pathogen transmission. 5. Our results show that inference based only on breeders fails to capture important aspects of population-wide movement patterns. Capturing nonbreeders as well as breeders would help to improve population-level representation of movement patterns, elucidate and predict effects of external changes and conservation interventions (e.g. rat eradication) on movement patterns and pathogen spread, and develop strategies to manage outbreaks of diseases such as highly pathogenic avian influenza

Surgical and Oncological Outcomes After Preoperative FOLFIRINOX Chemotherapy in Resected Pancreatic Cancer : An International Multicenter Cohort Study

Background. Preoperative FOLFIRINOX chemotherapy is increasingly administered to patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) to improve overall survival (OS). Multicenter studies reporting on the impact from the number of preoperative cycles and the use of adjuvant chemotherapy in relation to outcomes in this setting are lacking. This study aimed to assess the outcome of pancreatectomy after preoperative FOLFIRINOX, including predictors of OS.Methods. This international multicenter retrospective cohort study included patients from 31 centers in 19 European countries and the United States undergoing pancreatectomy after preoperative FOLFIRINOX chemotherapy (2012-2016). The primary end point was OS from diagnosis. Survival was assessed using Kaplan-Meier analysis and Cox regression.Results. The study included 423 patients who underwent pancreatectomy after a median of six (IQR 5-8) preoperative cycles of FOLFIRINOX. Postoperative major morbidity occurred for 88 (20.8%) patients and 90-day mortality for 12 (2.8%) patients. An R0 resection was achieved for 243 (57.4%) patients, and 259 (61.2%) patients received adjuvant chemotherapy. The median OS was 38 months (95% confidence interval [CI] 34-42 months) for BRPC and 33 months (95% CI 27-45 months) for LAPC. Overall survival was significantly associated with R0 resection (hazard ratio [HR] 1.63; 95% CI 1.20-2.20) and tumor differentiation (HR 1.43; 95% CI 1.08-1.91). Neither the number of preoperative chemotherapy cycles nor the use adjuvant chemotherapy was associated with OS.Conclusions. This international multicenter study found that pancreatectomy after FOLFIRINOX chemotherapy is associated with favorable outcomes for patients with BRPC and those with LAPC. Future studies should confirm that the number of neoadjuvant cycles and the use adjuvant chemotherapy have no relation to OS after resection.Peer reviewe

In vivo combination of human anti-envelope glycoprotein E2 and -Claudin-1 monoclonal antibodies for prevention of hepatitis C virus infection

Despite the development of direct-acting antivirals (DAAs), hepatitis C virus (HCV) infection remains a major cause for liver disease and cancer worldwide. Entry inhibitors block virus host cell entry and, therefore, prevent establishment of chronic infection and liver disease. Due to their unique mechanism of action, entry inhibitors provide an attractive antiviral strategy in organ transplantation. In this study, we developed an innovative approach in preventing HCV infection using a synergistic combination of a broadly neutralizing human monoclonal antibody (HMAb) targeting the HCV E2 protein and a host-targeting anti-claudin 1 (CLDN1) humanized monoclonal antibody. An in vivo proof-of-concept study in human liver-chimeric FRG-NOD mice proved the efficacy of the combination therapy at preventing infection by an HCV genotype 1b infectious serum. While administration of individual antibodies at lower doses only showed a delay in HCV infection, the combination therapy was highly protective. Furthermore, the combination proved to be effective in preventing infection of primary human hepatocytes by neutralization-resistant HCV escape variants selected during liver transplantation, suggesting that a combination therapy is suited for the neutralization of difficult-to-treat variants. In conclusion, our findings suggest that the combination of two HMAbs targeting different steps of virus entry improves treatment efficacy while simultaneously reducing treatment duration and costs. Our approach not only provides a clinical perspective to employ HMAb combination therapies to prevent graft re-infection and its associated liver disease but may also help to alleviate the urgent demand for organ transplants by allowing the transplantation of organs from HCV-positive donors

Are Child and Adolescent Responses to Placebo Higher in Major Depression than in Anxiety Disorders? A Systematic Review of Placebo-Controlled Trials

BACKGROUND: In a previous report, we hypothesized that responses to placebo were high in child and adolescent depression because of specific psychopathological factors associated with youth major depression. The purpose of this study was to compare the placebo response rates in pharmacological trials for major depressive disorder (MDD), obsessive compulsive disorder (OCD) and other anxiety disorders (AD-non-OCD). METHODOLOGY AND PRINCIPAL FINDINGS: We reviewed the literature relevant to the use of psychotropic medication in children and adolescents with internalized disorders, restricting our review to double-blind studies including a placebo arm. Placebo response rates were pooled and compared according to diagnosis (MDD vs. OCD vs. AD-non-OCD), age (adolescent vs. child), and date of publication. From 1972 to 2007, we found 23 trials that evaluated the efficacy of psychotropic medication (mainly non-tricyclic antidepressants) involving youth with MDD, 7 pertaining to youth with OCD, and 10 pertaining to youth with other anxiety disorders (N = 2533 patients in placebo arms). As hypothesized, the placebo response rate was significantly higher in studies on MDD, than in those examining OCD and AD-non-OCD (49.6% [range: 17-90%] vs. 31% [range: 4-41%] vs. 39.6% [range: 9-53], respectively, ANOVA F = 7.1, p = 0.002). Children showed a higher stable placebo response within all three diagnoses than adolescents, though this difference was not significant. Finally, no significant effects were found with respect to the year of publication. CONCLUSION: MDD in children and adolescents appears to be more responsive to placebo than other internalized conditions, which highlights differential psychopathology

Planck pre-launch status : The Planck mission

Peer reviewe