L'aérosolisation préférentielle de différentes souches de Streptococcus suis, un microorganisme pathogène du porc

Streptococcus suis est un agent pathogène porcin causant des pneumonies, des septicémies et des méningites. Il est aussi un agent de zoonose responsable de plusieurs éclosions en Asie. Les souches de S. suis sont classifiées en 35 sérotypes basés sur la composition de leur capsule polysaccharidique. S. suis sérotype 2 cause la majorité des infections sévères et est sous-divisé en séquence types (ST). Le ST1 est associé avec des souches hautement virulentes. En Amérique du Nord, les souches communément isolées appartiennent aux ST25 et ST28, respectivement modérément et faiblement virulentes dans un modèle animal. La présence de S. suis sous forme de bioaérosols dans l’air des bâtiments porcins a été démontré. Le but de ce projet est d’étudier l’aérosolisation préférentielle de différentes souches de S. suis en utilisant une chambre expérimentale et un nébuliseur développés pour ce projet. Bien qu’un nombre supérieur de souches doivent être étudiées, les résultats du projet suggèrent que les souches hautement virulentes du sérotype 2 de ST1 semblent être préférentiellement aérosolisées et que l’aérosolisation préférentielle de S. suis semble être un processus souche dépendant. Cette étude est une preuve de concept et améliore nos connaissances sur la potentielle transmission de S. suis via les bioaérosols.Streptococcus suis is a swine pathogen that causes pneumonia, septicaemia and meningitis. It is also a zoonotic agent responsible for outbreaks in Asia. S. suis strains are classified into 35 serotypes based on the composition of their polysaccharide capsule. S. suis serotype 2 causes the majority of severe infections and it is subdivided into sequence types (STs). The ST1 is associated with highly virulent strains. In North America, the strains most commonly isolated belong to ST25 and ST28, which are respectively moderately and weakly virulent in animal model. The presence of S. suis bioaerosols in the air of swine confinement buildings has been demonstrated. The aim of this study was to better understand the aerosolization behaviour of S. suis by investigating preferential aerosolization of different S. suis strains using in-house developed environmental chamber and nebulizer. Although more strains should be studied, the results suggest that the highly virulent serotype 2 ST1 strains seem to be preferentially aerosolized and that the S. suis preferential aerosolization is a strain-dependant process. This study is a proof of concept and increases our knowledge on the potential aerosol transmission of S. suis

Preferential aerosolization of Streptococcus suis

Streptococcus suis is a swine pathogen that causes pneumonia, septicaemia and meningitis. It is also an important zoonotic agent responsible of several outbreaks in China. S. suis strains are classified into 35 serotypes based on the composition of their polysaccharide capsule. S. suis serotype 2 causes the majority of severe infections and it is subdivided into sequence types (STs) based on multilocus sequence typing. The ST1 is associated with highly virulent strains. In North America, the strains most commonly isolated belong to ST25 and ST28, which are respectively moderately and weakly virulent in a mouse model. The presence of S. suis bioaerosols in the air of swine confinement buildings has been previously demonstrated. The aim of this study was to better understand the aerosolization behaviour of S. suis by investigating of the preferential aerosolization of different strains of S. suis. The highly virulent serotype 2 ST1 strains appeared to be preferentially aerosolized. This study increases our knowledge on the potential aerosol transmission of S. suis and emphasises the importance of developing an exposure prevention strategy to protect the swine and the swine producers

Characteristics, management, and prognosis of elderly patients with COVID-19 admitted in the ICU during the first wave: insights from the COVID-ICU study

International audienceBackground: The COVID-19 pandemic is a heavy burden in terms of health care resources. Future decision-making policies require consistent data on the management and prognosis of the older patients (> 70 years old) with COVID-19 admitted in the intensive care unit (ICU). Methods: Characteristics, management, and prognosis of critically ill old patients (> 70 years) were extracted from the international prospective COVID-ICU database. A propensity score weighted-comparison evaluated the impact of intubation upon admission on Day-90 mortality. Results: The analysis included 1199 (28% of the COVID-ICU cohort) patients (median [interquartile] age 74 [72–78] years). Fifty-three percent, 31%, and 16% were 70–74, 75–79, and over 80 years old, respectively. The most frequent comorbidities were chronic hypertension (62%), diabetes (30%), and chronic respiratory disease (25%). Median Clinical Frailty Scale was 3 (2–3). Upon admission, the PaO2/FiO2 ratio was 154 (105–222). 740 (62%) patients were intubated on Day-1 and eventually 938 (78%) during their ICU stay. Overall Day-90 mortality was 46% and reached 67% among the 193 patients over 80 years old. Mortality was higher in older patients, diabetics, and those with a lower PaO2/FiO2 ratio upon admission, cardiovascular dysfunction, and a shorter time between first symptoms and ICU admission. In propensity analysis, early intubation at ICU admission was associated with a significantly higher Day-90 mortality (42% vs 28%; hazard ratio 1.68; 95% CI 1.24–2.27; p < 0·001). Conclusion: Patients over 70 years old represented more than a quarter of the COVID-19 population admitted in the participating ICUs during the first wave. Day-90 mortality was 46%, with dismal outcomes reported for patients older than 80 years or those intubated upon ICU admission