Standardised surveillance of Clostridium Difficile Infection in European acute care hospitals: A pilot study, 2013

Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a ‘minimal’ option (aggregated hospital data), a ‘light’ option (including patient data for CDI cases) and an ‘enhanced’ option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe

Nest-site competition between bumblebees (Bombidae), social wasps (Vespidae) and cavity-nesting birds in Britain and the Western Palearctic

Capsule: There is no evidence of widespread significant nest-site competition in Britain or the Western Palearctic between cavity-nesting birds and bumblebees or social wasps. Aims: To investigate competition between cavity-nesting birds and bumblebees and wasps, particularly the range-expanding Tree Bumblebee, Saxon Wasp and European Hornet in Britain, and review evidence throughout the Western Palearctic. Methods: We compared field data from English and Polish studies of tits and woodpeckers breeding in nest-boxes and/or tree holes to assess nest-site competition with bumblebees and wasps. We reviewed the literature quantifying nest-site competition between birds and these insects in the Western Palearctic. Results: Bumblebees and wasps are capable of usurping small passerines from nests. In England, these insects commandeered a mean annual 4.1% of tit nests initiated in nest-boxes; occurrence of hornets showed a long-term increase, but not other wasps or bumblebees. Across the Western Palearctic, insect occupation of nest-boxes was generally low, and was lower in England than in Poland. No insects were discovered in tree cavities, including those created by woodpeckers (Picidae). Conclusion: Nest-site competition between cavity-nesting birds and bumblebees and wasps appears to be a ‘nest-box phenomenon’, which may occasionally interfere with nest-box studies, but appears negligible in natural nest-sites

Prebiotic feeding elevates central brain derived neurotrophic factor, N-methyl-D-aspartate receptor subunits and D-serine

The influence of the gut microbiota on brain chemistry has been convincingly demonstrated in rodents. In the absence of gut bacteria, the central expression of brain derived neurotropic factor, (BDNF), and N-methyl-d-aspartate receptor (NMDAR) subunits are reduced, whereas, oral probiotics increase brain BDNF, and impart significant anxiolytic effects. We tested whether prebiotic compounds, which increase intrinsic enteric microbiota, also affected brain BDNF and NMDARs. In addition, we examined whether plasma from prebiotic treated rats released BDNF from human SH-SY5Y neuroblastoma cells, to provide an initial indication of mechanism of action. Rats were gavaged with fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS) or water for five weeks, prior to measurements of brain BDNF, NMDAR subunits and amino acids associated with glutamate neurotransmission (glutamate, glutamine, and serine and alanine enantiomers). Prebiotics increased hippocampal BDNF and NR1 subunit expression relative to controls. The intake of GOS also increased hippocampal NR2A subunits, and frontal cortex NR1 and d-serine. Prebiotics did not alter glutamate, glutamine, l-serine, l-alanine or d-alanine concentrations in the brain, though GOSfeeding raised plasma d-alanine. Elevated levels of plasma peptide YY (PYY) after GOS intake was observed. Plasma from GOS rats increased the release of BDNF from SH-SY5Y cells, but not in the presence of PYY antisera. The addition of synthetic PYY to SH-SY5Y cell cultures, also elevated BDNF secretion. We conclude that prebiotic-mediated proliferation of gut microbiota in rats, like probiotics, increases brain BDNF expression, possibly through the involvement of gut hormones. The effect of GOS on components of central NMDAR signalling was greater than FOS, and may reflect the proliferative potency of GOS on microbiota. Our data therefore, provide a sound basis to further investigate the utility of prebiotics in the maintenance of brain health and adjunctive treatment of neuropsychiatric disorders

Bacterial Colonization of Low‐Wettable Surfaces is Driven by Culture Conditions and Topography

Effect of surface low‐wettability on bacterial colonization has become a prominent subject for the development of antibacterial coatings. However, bacteria's fate on such surfaces immersed in liquid as well as causal factors is poorly understood. This question is addressed by using a range of coatings with increasing hydrophobicity, to superhydrophobic, obtained by an atmospheric plasma polymer method allowing series production. Chemistry, wettability, and topography are thoroughly described, as well as bacterial colonization by in situ live imaging up to 24 h culture time in different liquid media. In the extreme case of superhydrophobic coating, substrates are significantly less colonized in biomolecule‐poor liquids and for short‐term culture only. Complex statistical analysis demonstrates that bacterial colonization on these low‐wettable substrates is predominantly controlled by the culture conditions and only secondary by topographic coating's properties (variation in surface structuration with almost constant mean height). Wettability is less responsible for bacterial colonization reduction in these conditions, but allows the coatings to preserve colonization‐prevention properties in nutritive media when topography is masked by fouling. Even after long‐term culture in rich medium, many large places of the superhydrophobic coating are completely free of bacteria in relation to their capacity to preserve air trapping

Clostridium-difficile Colitis - Recent Therapeutic and Immunological Considerations

Clostridium difficile is the main etiological agent of antibiotic associated diarrhoea and pseudomembranous colitis (PMC), It is considered as the most frequent agent of infectious diarrhoea occuring in hospitalized patients, in whom it is responsible for a high morbidity and occasional mortality even when the diagnosis and the treatment are pursued aggressively (1), The pathology is due to the production of at least two toxins: toxin A is an enterotoxin which induces intestinal tissue damage and a fluid response and toxin a Is a cytotoxin which lacks any enterotoxic activity but is believed to exert an additive effect in vivo (2) (Acta gastroenterol. belg., 1995, 58, 313-317)