Treatment of domestic wastewater by anaerobic denitrification: Influence of the type of support media on the production of extracellular polymer substances

Eighteen Erlenmeyer flask containing six different support media [pozzolan, polyvinyl chloride1 (PVC1), polyvinyl chloride2 (PVC2), foam, polyethylene terephthalate (PET) and polystyrene (PS)] were subject to identical volumetric organic loadings and hydraulic retention time in treating synthetic protein ± carbohydrate waste. The objective was to examine the influence of support media on performance of anaerobic denitrification and retention and their resulting impact on system performance and failure. According to the results relative to every control support media, it was noticed that the best support media were the ones in PVC1 and PVC2, with successive reduction rates of 68.33 and 61.93% for chemical oxygen demand (COD), and 55 and 49% for nitrate. On the other hand, in two submerged anaerobic biofilter reactor packed with the support media of PVC1 and PVC2, the reactor with PVC1 media exhibited 89.93% COD and 78.75% nitrate removal efficiency attributable to its higher production of EPSp and EPSc.Key words: Wastewater, anaerobic biofilm, extracellular polymeric substances (EPS), extraction, support media

Les invaginations intestinales chez l’adulte : A propos de 19 cas

Le cathétérisme veineux central occupe une place considérable dans le traitement de l’insuffisance rénale terminale dans l’attente de la création d’une fistule artério-veineuse. Cependant il n’est pas dénué de complications. Nous rapportons un cas de pneumomédiastin tardif révélé par un œdème aigu du poumon chez une jeune patiente en hémodialyse, et nous discutons ses particularités. L'invagination intestinale est une affection rare chez l’adulte. Elle conduit le plus souvent à la découverte d’une cause organique pouvant être tumorale. Le but de notre travail est de dégager les particularités épidémiologiques diagnostiques et thérapeutiques de cette affection; à travers une étude descriptive rétrospective, ayant portée sur 19 cas d'invagination intestinale de l'adulte opérés dans le service des Urgences Chirurgicales Viscérales du CHU Hassan II de Fès du 1er janvier 2009 au Mars 2016.La douleur abdominale était présente chez tous les patients; L'échographie abdominale pratiquée chez neuf patients; elle a montré une image en cocarde dans cinq cas, une  masse abdominale dans un cas,  et un épaississement grélique pour un seul patient. La tomodensitométrie abdominale faite chez 15 patients a objectivé l’invagination intestinale dans tous les cas.Le traitement chirurgical a été adopté chez 18 patients; il a permis de faire la résection des segments intestinaux invaginé dans 16 cas opérés (87,5%). Le résultat anatomopathologique de la pièce de résection a retrouvé une cause organique de l’invagination dans 17 cas (89,47%).L’invagination intestinale chez l’adulte est souvent secondaire à une lésion organique : tumorale ou inflammatoire. Elle se caractérise par son polymorphisme clinique. Il s’agit essentiellement de phénomènes subocclusifs à répétition. Concernant le traitement de l’invagination intestinale de l’adulte, la résection du segment invaginé est toujours nécessaire car dans 80% des cas, cette affection est secondaire à une lésion organique qui doit être traitée

Association of C-Reactive Protein With Bacterial and Respiratory Syncytial Virus-Associated Pneumonia Among Children Aged <5 Years in the PERCH Study.

BACKGROUND.: Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) multicenter case-control study. METHODS.: We measured serum CRP levels in cases with World Health Organization-defined severe or very severe pneumonia and a subset of community controls. We evaluated the sensitivity and specificity of elevated CRP for "confirmed" bacterial pneumonia (positive blood culture or positive lung aspirate or pleural fluid culture or polymerase chain reaction [PCR]) compared to "RSV pneumonia" (nasopharyngeal/oropharyngeal or induced sputum PCR-positive without confirmed/suspected bacterial pneumonia). Receiver operating characteristic (ROC) curves were constructed to assess the performance of elevated CRP in distinguishing these cases. RESULTS.: Among 601 human immunodeficiency virus (HIV)-negative tested controls, 3% had CRP ≥40 mg/L. Among 119 HIV-negative cases with confirmed bacterial pneumonia, 77% had CRP ≥40 mg/L compared with 17% of 556 RSV pneumonia cases. The ROC analysis produced an area under the curve of 0.87, indicating very good discrimination; a cut-point of 37.1 mg/L best discriminated confirmed bacterial pneumonia (sensitivity 77%) from RSV pneumonia (specificity 82%). CRP ≥100 mg/L substantially improved specificity over CRP ≥40 mg/L, though at a loss to sensitivity. CONCLUSIONS.: Elevated CRP was positively associated with confirmed bacterial pneumonia and negatively associated with RSV pneumonia in PERCH. CRP may be useful for distinguishing bacterial from RSV-associated pneumonia, although its role in discriminating against other respiratory viral-associated pneumonia needs further study

High-throughput barcoding method for the genetic surveillance of insecticide resistance and species identification in Anopheles gambiae complex malaria vectors.

Surveillance of malaria vector species and the monitoring of insecticide resistance are essential to inform malaria control strategies and support the reduction of infections and disease. Genetic barcoding of mosquitoes is a useful tool to assist the high-throughput surveillance of insecticide resistance, discriminate between sibling species and to detect the presence of Plasmodium infections. In this study, we combined multiplex PCR, custom designed dual indexing, and Illumina next generation sequencing for high throughput single nucleotide polymorphism (SNP)-profiling of four species from the Anopheles (An.) gambiae complex (An. gambiae sensu stricto, An. coluzzii, An. arabiensis and An. melas). By amplifying and sequencing only 14 genetic fragments (500 bp each), we were able to simultaneously detect Plasmodium infection; insecticide resistance-conferring SNPs in ace1, gste2, vgsc and rdl genes; the partial sequences of nuclear ribosomal internal transcribed spacers (ITS1 and ITS2) and intergenic spacers (IGS), Short INterspersed Elements (SINE), as well as mitochondrial genes (cox1 and nd4) for species identification and genetic diversity. Using this amplicon sequencing approach with the four selected An. gambiae complex species, we identified a total of 15 non-synonymous mutations in the insecticide target genes, including previously described mutations associated with resistance and two new mutations (F1525L in vgsc and D148E in gste2). Overall, we present a reliable and cost-effective high-throughput panel for surveillance of An. gambiae complex mosquitoes in malaria endemic regions

LAMP4yaws: Treponema pallidum, Haemophilus ducreyi loop mediated isothermal amplification - protocol for a cross-sectional, observational, diagnostic accuracy study.

INTRODUCTION: Yaws, caused by the bacterium Treponema pallidum subsp. pertenue, is a neglected tropical disease targeted for eradication by 2030. Improved diagnostics will be essential to meet this goal. Diagnosis of yaws has relied heavily on clinical and serological tools. However, the presence of coendemic cutaneous skin ulcer diseases, such as lesions caused by Haemophilus ducreyi (HD), means these techniques do not provide a reliable diagnosis. Thus, new diagnostic tools are needed. Molecular tools such as PCR are ideal, but often expensive as they require trained technicians and laboratory facilities, which are often not available to national yaws programmes. METHODS AND ANALYSIS: The LAMP4yaws project is a cross-sectional, observational, diagnostic accuracy study of a combined Treponema pallidum (TP) and HD loop mediated isothermal amplification (TPHD-LAMP) test performed under real world conditions in three endemic countries in West Africa. Individuals with serologically confirmed yaws will be recruited in Cameroon, Côte d'Ivoire and Ghana. Each participant will provide paired swabs, one of which will be sent to the respective national reference laboratory for yaws quantitative PCR and the other will be tested for both TP and HD using the TPHD-LAMP test at local district laboratories. Sensitivity and specificity of the TPHD-LAMP test will be calculated against the reference standard qPCR. We will also assess the acceptability, feasibility and cost-effectiveness of the test. We anticipate that results from this study will support the adoption of the TPHD-LAMP test for use in global yaws eradication efforts. ETHICS AND DISSEMINATION: We have received ethical approval from all relevant institutional and national ethical committees. All participants, or their parents or guardians, must provide written informed consent prior to study enrolment. Study results will be published in an open access journal and disseminated with partners and the World Health Organization. TRIAL REGISTRATION NUMBER: NCT04753788

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Association of C-reactive protein with bacterial and respiratory syncytial virus-associated pneumonia among children aged <5 years in the PERCH study

Background. Lack of a gold standard for identifying bacterial and viral etiologies of pneumonia has limited evaluation of C-reactive protein (CRP) for identifying bacterial pneumonia. We evaluated the sensitivity and specificity of CRP for identifying bacterial vs respiratory syncytial virus (RSV) pneumonia in the Pneumonia Etiology Research for Child Health (PERCH) multicenter case-control study. Methods. We measured serum CRP levels in cases with World Health Organization-defined severe or very severe pneumonia and a subset of community controls. We evaluated the sensitivity and specificity of elevated CRP for "confirmed" bacterial pneumonia (positive blood culture or positive lung aspirate or pleural fluid culture or polymerase chain reaction [PCR]) compared to "RSV pneumonia" (nasopharyngeal/oropharyngeal or induced sputum PCR-positive without confirmed/suspected bacterial pneumonia). Receiver operating characteristic (ROC) curves were constructed to assess the performance of elevated CRP in distinguishing these cases. Results. Among 601 human immunodeficiency virus (HIV)-negative tested controls, 3% had CRP ≥40 mg/L. Among 119 HIVnegative cases with confirmed bacterial pneumonia, 77% had CRP ≥40 mg/L compared with 17% of 556 RSV pneumonia cases. The ROC analysis produced an area under the curve of 0.87, indicating very good discrimination; a cut-point of 37.1 mg/L best discriminated confirmed bacterial pneumonia (sensitivity 77%) from RSV pneumonia (specificity 82%). CRP ≥100 mg/L substantially improved specificity over CRP ≥40 mg/L, though at a loss to sensitivity. Conclusions. Elevated CRP was positively associated with confirmed bacterial pneumonia and negatively associated with RSV pneumonia in PERCH. CRP may be useful for distinguishing bacterial from RSV-associated pneumonia, although its role in discriminating against other respiratory viral-associated pneumonia needs further study

Surgical site infections (SSI) rates, risk factors and post discharge surveillance (PDS) methods: A narrative review

Introduction One of the most challenging outcomes after surgery is site infection, the consequences of which include the cost burden on hospitals, contributions to patient morbidity and readmissions. A shift to shorter hospital stays requires closer monitoring of surgical site infections (SSI) after discharge. This paper reviews post-discharge surveillance (PDS) methods on SSI identification, a comparison of some of these methods, SSI rates during and after hospitalization, and associated risk factors for SSI