Slow virus diseases : past, present and future

L’auteur retrace l’évolution des connaissances concernant la trem blante et les autres maladies à virus lents de la fin du XIXe siècle à nos jours en insistant tout particulièrement sur les encephalopathies spongi formes de l’homme et des animaux. Il distingue trois périodes. La période initiale est marquée par les travaux de Guillé et C helle et ceux de Sigurds- son. La deuxième période est caractérisée par la prise en considération des maladies à virus lents en médecine humaine grâce au rapprochement effec tué entre la tremblante, le kuru et la maladie de Creutzfeldt-Jakob au sein du groupe des encéphalopathies spongiformes subaiguës. La troisième période est dominée par l’apport des techniques les plus modernes de la biologie qui permettent d’aboutir au concept unificateur de prion, alors qu’apparaît une nouvelle affection chez les bovins, l’encéphalopathie spon giforme bovine.The author summarise the evolution of knowledge about scrapie and other slow virus diseases from the end of xix century up to nowdays emphasing spongiform encephalopathies of man and animals. Three periods can be identified. Research works of Guillé and Chelle and those of Sigurdsson are the more important of the first period. During the second period human medicin was involved in slow virus diseases thanks to the neuropathological similiraties observed between Kuru, Creutzfeldt-Jakob disease and scrapie. Molecular biology allow the emergence of prion concept during the third period which see the emergence of bovine spongiform encephalopathy

European intensive care physicians’ experience of infections due to antibiotic-resistant bacteria

Background Antimicrobial resistance (AMR) compromises the treatment of patients with serious infections in intensive care units (ICUs), and intensive care physicians are increasingly facing patients with bacterial infections with limited or no adequate therapeutic options. A survey was conducted to assess the intensive care physicians' perception of the AMR situation in the European Union/European Economic Area (EU/EEA). Methods Between May and July 2017, physicians working in European ICUs were invited to complete an online questionnaire hosted by the European Society of Intensive Care Medicine. The survey included 20 questions on hospital and ICU characteristics, frequency of infections with multidrug-resistant (MDR) bacteria and relevance of AMR in the respondent's ICU, management of antimicrobial treatment as well as the use of last-line antibiotics in the six months preceding the survey. For the analysis of regional differences, EU/EEA countries were grouped into the four sub-regions of Eastern, Northern, Southern and Western Europe. Results Overall, 1062 responses from four European sub-regions were analysed. Infections with MDR bacteria in their ICU were rated as a major problem by 257 (24.2%), moderate problem by 360 (33.9%) and minor problem by 391 (36.8%) respondents. Third-generation cephalosporin-resistant Enterobacteriaceae were the most frequently encountered MDR bacteria followed by, in order of decreasing frequency, meticillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa and vancomycin-resistant enterococci. Perception of the relevance of the AMR problem and the frequency of specific MDR bacteria varied by European sub-region. Bacteria resistant to all or almost all available antibiotics were encountered by 132 (12.4%) respondents. Many physicians reported not having access to specific last-line antibiotics. Conclusions The percentage of European ICU physicians perceiving AMR as a substantial problem in their ICU is high with variation by sub-region in line with epidemiological studies. The reports of bacteria resistant to almost all available antibiotics and the limited availability of last-line antibiotics in ICUs in the EU/EEA are of concern

Recherche par une technique d'hémagglutination passive des traces sérologiques des principaux virus respiratoires des bovins et de Chlamydia psittaci dans un échantillon de la population des bovidés du Togo

D'après les résultats obtenus par la technique d'hémagglutination passive, le principal virus respiratoire des bovins du Togo est celui de la rhinotrachéite infectieuse bovine. Les autres virus et Chlamydia psittaci semblent avoir moins d'importanc

Molecular epidemiology of a hepatitis C virus epidemic in a haemodialysis unit: outbreak investigation and infection outcome

<p>Abstract</p> <p>Background</p> <p>HCV is a leading cause of liver chronic diseases all over the world. In developed countries the highest prevalence of infection is reported among intravenous drug users and haemodialysis (HD) patients. The present report is to identify the pathway of HCV transmission during an outbreak of HCV infection in a privately run haemodialysis (HD) unit in Italy in 2005.</p> <p>Methods</p> <p>Dynamics of the outbreak and infection clinical outcomes were defined through an ambi-directional cohort study. Molecular epidemiology techniques were used to define the relationships between the viral variants infecting the patients and confirm the outbreak. Risk analysis and auditing procedures were carried out to define the transmission pathway(s).</p> <p>Results</p> <p>Of the 50 patients treated in the HD unit 5 were already anti-HCV positive and 13 became positive during the study period (AR = 28.9%). Phylogenic analysis identified that, all the molecularly characterized incident cases (10 out of 13), were infected with the same viral variant of one of the prevalent cases. The multivariate analysis and the auditing procedure disclosed a single event of multi-dose vials heparin contamination as the cause of transmission of the infection in 11 out of the 13 incident cases; 2 additional incident cases occurred possibly as a result of inappropriate risk management.</p> <p>Discussion</p> <p>More than 30% of all HCV infections in developed countries results from poor application of standard precautions during percutaneous procedures. Comprehensive strategy which included: educational programmes, periodical auditing on standard precaution, use of single-dose vials whenever possible, prospective surveillance for blood-borne infections (including a system of prompt notification) and risk assessment/management dedicated staff are the cornerstone to contain and prevent outbreaks in HD</p> <p>Conclusions</p> <p>The outbreak described should serve as a reminder to HD providers that patients undergoing dialysis are at risk for HCV infection and that HCV may be easily transmitted whenever standard precautions are not strictly applied.</p