Risk perception of antimicrobial resistance by infection control specialists in Europe: a case-vignette study

Background Using case-vignettes, we assessed the perception of European infection control (IC) specialists regarding the individual and collective risk associated with antimicrobial resistance (AMR) among inpatients. Methods In this study, sixteen case-vignettes were developed to simulate hospitalised patient scenarios in the field of AMR and IC. A total of 245 IC specialists working in different hospitals from 15 European countries were contacted, among which 149 agreed to participate in the study. Using an online database, each participant scored five randomly-assigned case-vignettes, regarding the perceived risk associated with six different multidrug resistant organisms (MDRO). The intra-class correlation coefficient (ICC), varying from 0 (poor) to 1 (perfect), was used to assess the agreement for the risk on a 7-point Likert scale. High risk and low/neutral risk scorers were compared regarding their national, organisational and individual characteristics. Results Between January and May 2017, 149 participants scored 655 case-vignettes. The perceptions of the individual (clinical outcome) and collective (spread) risks were consistently lower than other MDRO for extended spectrum beta-lactamase producing Enterobacteriaceae cases and higher for carbapenemase producing Enterobacteriaceae (CPE) cases. Regarding CPE cases, answers were influenced more by the resistance pattern (93%) than for other MDRO. The risk associated with vancomycin resistant Enterococci cases was considered higher for the collective impact than for the individual outcome (63% vs 40%). The intra-country agreement regarding the individual risk was globally poor varying from 0.00 (ICC: 0–0.25) to 0.51 (0.18–0.85). The overall agreement across countries was poor at 0.20 (0.07–0.33). IC specialists working in hospitals preserved from MDROs perceived a higher individual (local, p = 0.01; national, p < 0.01) and collective risk (local and national p < 0.01) than those frequently exposed to bacteraemia. Conversely, IC specialists working in hospitals with a high MDRO clinical burden had a decreased risk perception. Conclusions The perception of the risk associated with AMR varied greatly across IC specialists and countries, relying on contextual factors including the epidemiology. IC specialists working in high prevalence areas may underestimate both the individual and collective risks, and might further negatively promote the MDRO spread. These finding highlight the need to shape local and national control strategies according to risk perceptions and contextual factors

Microbiological characteristics of subgingival microbiota in adult periodontitis, localized juvenile periodontitis and rapidly progressive periodontitis subjects

Objective To describe the prevalence of the cultivable subgingival microbiota in periodontal diseases and to draw attention to the polymicrobial nature of periodontic infections.Methods The study population consisted of 95 patients, 51 females and 44 males, aged 14-62 years. Twenty-nine patients exhibited adult periodontitis (AP), six localized juvenile periodontitis (LJP), and 60 rapidly progressive periodontitis (RPP). Two to four pooled bacterial samples were obtained from each patient. Samples were collected with sterile paper points from the deepest periodontal pockets. The samples were cultured under anaerobic and microaerophilic conditions using selective and non-selective media. Isolates were characterized to species level by conventional biochemical tests and by a commercial rapid test system.Results Prevotella intermedia and Capnocytophaga spp. were the most frequently detected microorganisms in all diagnostic groups. Porphyromonas gingivalis and Peptostreptococcus micros were found more frequently in AP and RPP patients, while Actinohacillus actinomycetemcomitans and Eikenella corrodens were associated with AP, LJP and RPP patients. The other bacterial species, including Actinomyces spp., Streptococcus spp. and Euhacterium spp., were detected at different levels in the three disease groups.Conclusions The data show the complexity of the subgingival microbiota associated with different periodontal disease groups, indicating that the detection frequency and levels of recovery of some periodontal pathogens are different in teeth affected by different forms of periodontal disease

Cellular carbohydrate patterns of the avian Pasteurella haemolytica like "Actinobacillus salpingitidis" complex

Des souches repr&eacute;sentant les diff&eacute;rents ph&eacute;notypes du complexe pseudo Pasteurella haemolytica aviaire/ "Actinobacillus salpingitidis" (PPHAAS) ont &eacute;t&eacute; &eacute;tudi&eacute;es via l'analyse de leurs profils en glucides, d&eacute;riv&eacute;s en aldonitriles p&eacute;rac&eacute;tyl&eacute;s et en m&eacute;thyloximes, par chromatographie capillaire gazeuse et par spectrom&eacute;trie de masse. L'analyse a permis de reconna&icirc;tre 13 ch&eacute;motypes confirmant ainsi l'h&eacute;t&eacute;rog&eacute;n&eacute;it&eacute; observ&eacute;e par la caract&eacute;risation ph&eacute;notypique conventionnelle, et par l'hybridation de l'acide d&eacute;oxyribonucl&eacute;ique-acide d&eacute;oxyribon ucl&eacute;ique.Cellular carbohydrate patterns of the avian Pasteurella haemolytic like "Actinobacillus salpingitidis" complexStrains representing the phenotypic different types of the avian Pasteurella haemolytica like ''Actinobacillus salpingitidis" (APHLAS) complex were analyzed for their cellular carbohydrate contents by capillary gaschromatography-mass spectrometry ofthe peracetylated aldononitrile and O-methyloxime derivatives. Analysis of the carbohydrate patterns allowed the recognition of 13 chemotypes confirming the heterogeneity observed by conventional phenotypic characteriz ation with biochemical reactions and by deoxyribonucleic aciddeoxyribonucleic acid hybridization

Efficacy of five ‘sporicidal’ surface disinfectants against Clostridioides difficile spores in suspension tests and 4-field tests

Background: A sporicidal surface disinfection is recommended both for the outbreak and the endemic setting but a comparative evaluation on the efficacy of ‘sporicidal’ surface disinfectants using suspension tests and 4-field tests has not been performed. Aim: To determine the efficacy of five ‘sporicidal’ surface disinfectants (three ready-to-use wipes (A, B, E), two concentrates (C, D) based on peroxides or aldehydes against C. difficile spores. Methods: The efficacy was determined under clean conditions using a suspension test and the 4-field test. Each test was performed in duplicate in two separate laboratories. Wipes were wrung to collect the solution for the suspension tests. Results: Product A (peracetic acid; 5 min), product C (peracetic acid; 2% solution in 15 min or 1% solution in 30 min) and product D (peracetic acid; only 2% solution in 15 min) were effective with at least a 4 log10-reduction of C. difficile spores in suspension and on surfaces. Product B (hydrogen peroxide) was not effective in suspension (0.9 log10 after 15 min; 3.2 log10 after 1 h) and on surfaces (2.8 log10 after 15 and 60 min). Product E based on glutaraldehyde, (ethylendioxy)dimethanol and DDAC demonstrated 0.9 log10 after 4 h in suspension and 4.5 log10 after 4 h on surfaces. Conclusions: Not all surface disinfectants with a sporicidal claim were effective against C. difficile spores in standardized suspension tests and in the 4-field test. In clinical practice preference should be given to products that reliably pass the efficacy criteria of both types of tests.Peer Reviewe

Systematic determination of the reproductive growth stage most sensitive to high night temperature stress in rice ( Oryza sativa )

High night‐temperature (HNT) stress during the reproductive stage of rice (Oryza sativa L.) reduces spikelet fertility and yield by inhibiting important physiological processes. However, specifics such as the period of time that is most sensitive to HNT, is unknown. To investigate this, we conducted four controlled‐environment experiments with two rice cultivars, N22 (HNT tolerant) and WAB56–104 (HNT susceptible). These cultivars were exposed to varying durations and intensities of night temperatures (control, 24°C; HNT, 30 and 35°C) during the reproductive stage. The effect of HNT on spikelet fertility and grain weight varied with duration: spikelet fertility reduced by 47–77% when exposed to HNT for 15 nights, 6–29% when exposed for four nights, and 9–15% when exposed for 5.5 h (pre‐midnight, 1830–0000 h or post‐midnight, 0000–0530 h) for four nights. Spikelet fertility and grain weight were most sensitive to HNT during the first 4 d of anthesis, compared with 1–4, 5–8, and 9–12 d before anthesis. At anthesis, reduction in spikelet fertility did not differ significantly between pre‐ and post‐midnight high‐temperature treatments. Our results suggest that greatest sensitivity to HNT during the reproductive stage occurs during the first 4 d of anthesis, providing a reference for future studies involving HNT tolerance in rice

Nanolitre real-time PCR detection of bacterial, parasitic, and viral agents from patients with diarrhoea in Nunavut, Canada

Background. Little is known about the microbiology of diarrhoeal disease in Canada&#x0027;s Arctic regions. There are a number of limitations of conventional microbiology testing techniques for diarrhoeal pathogens, and these may be further compromised in the Arctic, given the often long distances for specimen transport. Objective. To develop a novel multiple-target nanolitre real-time reverse transcriptase (RT)-PCR platform to simultaneously test diarrhoeal specimens collected from residents of the Qikiqtani (Baffin Island) Region of Nunavut, Canada, for a wide range of bacterial, parasitic and viral agents. Study design/methods. Diarrhoeal stool samples submitted for bacterial culture to Qikiqtani General Hospital in Nunavut over an 18-month period were tested with a multiple-target nanolitre real-time PCR panel for major diarrhoeal pathogens including 8 bacterial, 6 viral and 2 parasitic targets. Results. Among 86 stool specimens tested by PCR, a total of 50 pathogens were detected with 1 or more pathogens found in 40 (46.5%) stool specimens. The organisms detected comprised 17 Cryptosporidium spp., 5 Clostridium difficile with toxin B, 6 Campylobacter spp., 6 Salmonella spp., 4 astroviruses, 3 noroviruses, 1 rotavirus, 1 Shigella spp. and 1 Giardia spp. The frequency of detection by PCR and bacterial culture was similar for Salmonella spp., but discrepant for Campylobacter spp., as Campylobacter was detected by culture from only 1/86 specimens. Similarly, Cryptosporidium spp. was detected in multiple samples by PCR but was not detected by microscopy or enzyme immunoassay. Conclusions. Cryptosporidium spp., Campylobacter spp. and Clostridium difficile may be relatively common but possibly under-recognised pathogens in this region. Further study is needed to determine the regional epidemiology and clinical significance of these organisms. This method appears to be a useful tool for gastrointestinal pathogen research and may also be helpful for clinical diagnostics and outbreak investigation in remote regions where the yield of routine testing may be compromised