The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use

A standardised methodology for a combined point prevalence survey (PPS) on healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals developed by the European Centre for Disease Prevention and Control was piloted across Europe. Variables were collected at national, hospital and patient level in 66 hospitals from 23 countries. A patient-based and a unit-based protocol were available. Feasibility was assessed via national and hospital questionnaires. Of 19,888 surveyed patients, 7.1% had an HAI and 34.6% were receiving at least one antimicrobial agent. Prevalence results were highest in intensive care units, with 28.1% patients with HAI, and 61.4% patients with antimicrobial use. Pneumonia and other lower respiratory tract infections (2.0% of patients; 95% confidence interval (CI): 1.8-2.2%) represented the most common type (25.7%) of HAI. Surgical prophylaxis was the indication for 17.3% of used antimicrobials and exceeded one day in 60.7% of cases. Risk factors in the patient-based protocol were provided for 98% or more of the included patients and all were independently associated with both presence of HAI and receiving an antimicrobial agent. The patient-based protocol required more work than the unit-based protocol, but allowed collecting detailed data and analysis of risk factors for HAI and antimicrobial use.peer-reviewe

Consensus on Severity for Ocular Emergency: The BAsic SEverity Score for Common OculaR Emergencies [BaSe SCOrE]

Purpose. To weigh ocular emergency events according to their severity. Methods. A group of ophthalmologists and researchers rated the severity of 86 common ocular emergencies using a Delphi consensus method. The ratings were attributed on a 7-point scale throughout a first-round survey. Then, the experts were provided with the median and quartiles of the ratings of each item to reevaluate the severity levels being aware of the group’s first-round responses. The final severity rating for each item corresponded to the median rating provided by the last Delphi round. Results. We invited 398 experts, and 80 (20%) of them, from 18 different countries, agreed to participate. A consensus was reached in the second round, completed by 24 experts (43%). The severity ranged from subconjunctival hemorrhages (median = 1, Q1 = 0; Q3 = 1) to penetrating eye injuries collapsing the eyeball with intraocular foreign body or panophthalmitis with infection following surgery (median = 5, Q1 = 5; Q3 = 6). The ratings did not differ according to the practice of the experts. Conclusion. These ratings could be used to assess the severity of ocular emergency events, to serve in composite algorithms for emergency triage and standardizing research in ocular emergencies

Anterior segment optical coherence tomography imaging in peripheral ulcerative keratitis, a corneal structural description

BackgroundAnterior segment optical coherence tomography (AS OCT) is a helpful tool used to diagnose and manage many corneal conditions, but its use has not been reported in case of peripheral ulcerative keratitis (PUK). The aim of this study is to describe AS OCT findings in cases of PUK.MethodsRetrospective observational case series of six eyes presenting with a PUK and proven systemic vasculitis. Clinical course, slit lamp photographs, and AS OCT findings were the main outcomes.ResultsThe AS OCT findings were found to correlate with the ocular disease's level of activity. In the acute stage, an absence of corneal epithelium, a scrambled appearance of the anterior stroma and a heterogeneous stromal reflectivity were observed. During the reduction of disease level activity, an irregular hyporeflective epithelium, a smoother anterior stroma, and a homogenous hyperreflective stroma were seen. At the healed stage, a filling of the corneal defect by a hyporeflective thick epithelium, the persistence of the hyperreflective underlying stroma, and a demarcation line were observed. The mean total corneal thickness at last follow-up was significantly thicker (509 ± 147 μm) compared with the mean corneal thickness at onset (408 ± 131 μm; P = 0.03).ConclusionsAS OCT provides an assessment of structural changes occurring in PUK, useful for its diagnosis and monitoring

Birdshot Chorioretinopathy: A Review

Birdshot chorioretinopathy (BSCR) is a bilateral chronic inflammation of the eye with no extraocular manifestations. BSCR affects middle-aged individuals from European descent and is strongly associated with the human leucocyte antigen (HLA)-A29 allele. The immune mechanisms involved are not fully understood, but recent advances have shown the role of Endoplasmic Reticulum Aminopeptidase 2 (ERAP2) in disease pathogenesis. Multimodal imaging, including fluorescein angiography, indocyanine angiography, fundus autofluorescence, and optical coherence tomography, are useful in confirming the diagnosis and monitoring disease activity. Visual field testing is also important to assess the disease progression. To date, there is no consensus for optimal treatment regimen and duration. Local and systemic corticosteroids can be used for short periods, but immunosuppressive or biological therapies are usually needed for the long-term management of the disease. Here, we will review publications focused on birdshot chorioretinopathy to give an update on the pathophysiology, the multimodal imaging, and the treatment of the disease

Relationship between Antibiotic Use and Incidence of MexXY-OprM Overproducers among Clinical Isolates of Pseudomonas aeruginosa▿

In a university hospital, time-series analysis revealed a significant relationship between antibiotic (aminoglycoside, fluoroquinolone, and cefepime) use and incidence of MexXY-OprM-overproducing Pseudomonas aeruginosa. In vitro experiments confirm that such mutants were readily selected from both PAO1 and clinical strains when grown in the presence of these antibiotics

Infarctus cérébral par dissection des artères vertébrales (trois nouvelles observations chez l'enfant)

Nous rapportons trois observations d'infarctus cérébral par dissection de l'artère vertébrale chez l'enfant. L'une d'elle était post-traumatique. Dans les deux observations de dissection spontanée, il existait d'autres facteurs de risque : le plus jeune enfant avait eu une infection récente et portait la mutation G20210A du gène de la prothrombine à l'état hétérozygote, une autre a développé ultérieurement des migraines ophtalmiques. L'imagerie n'a pas permis d'affirmer le diagnostic initialement. Il a été confirmé 1,5 à 7 mois après les premiers signes : par artériographie de contraste à deux reprises, et par une nouvelle imagerie par résonance magnétique dans un cas. Les dissections sont considérées comme des artériopathies aiguës, pourtant, ces trois enfants ont rechuté sur plusieurs mois, justifiant une prolongation du traitement antithrombotique. L'évolution a été néanmoins favorable avec un recul de 6 à 16 mois : un seul enfant garde une discrète ataxie. Les dissections sont désormais reconnues comme une étiologie importante d'accident vasculaire cérébral ischémique chez l'adulte jeune. Elle pourrait l'être également chez l'enfant. La pathogénie n'est toujours pas élucidée pour les formes spontanées . La rareté de cette pathologie et les difficultés de sa prise en charge thérapeutique justifieraient d'un enregistrement des cas observés sur le territoire national.ST ETIENNE-BU Médecine (422182102) / SudocSudocFranceF

Report of the Consensus Conference on Antibiotic Resistance; Prevention and Control (ARPAC)

SCOPUS: cp.jinfo:eu-repo/semantics/publishe

La logistisation du monde

Moins médiatisée que la révolution digitale, une autre révolution, plus discrète et pourtant tout aussi bouleversante pour notre monde, s’est opérée au cours des dernières décennies : celle de la logistique. L’ouvrage revient sur cette « logistisation » du monde, à travers 56 chroniques. Destinées à un grand public, elles ont été écrites par des chercheurs du CRET-LOG, qui constitue le principal centre de recherche en logistique en France. Rédigées dans un langage clair, ces courtes chroniques donnent au lecteur les clefs pour comprendre de manière globale et systémique la révolution logistique. Les chroniques sont réunies en huit parties, qui couvrent tout le spectre de la logistique contemporaine : son omniprésence et son universalité son rôle stratégique pour les entreprises sa place de support à la consommation l’industrie logistique qui la sous-tend la façon dont elle crée de la valeur son rôle de levier vers un développement plus durable les enjeux politiques de la logistique les liens industrie-recherche en logistique. L’ouvrage a l’ambition de médiatiser et diffuser largement la pensée logistique auprès du grand public et intéressera tous ceux qui veulent comprendre les évolutions de notre monde