Navigating the World Wide Web in Search of Resources on Antimicrobial Resistance

This overview gives information on navigating for English-language Web sites on antimicrobial resistance. Web sites were gathered on the basis of personal files, articles, and an exhaustive Web search of cross-links from other Web pages. The Web sites were categorized according to users' needs into 5 broad categories, as follows: comprehensive Web sites, with information on all aspects of antimicrobial resistance-related issues; Web sites with patient information about antimicrobial resistance and about methicillin-resistant Staphylococcus aureus, in particular; Web sites covering current multinational surveillance programs; Web sites on prevention of antimicrobial resistance in health care facilities; and Web sites on control of antimicrobial resistance in the community. We compiled a selection of Web sites that seemed to be useful as starting points for physicians, epidemiologists, researchers, or patients interested in this topi

Atypical Infections in Tsunami Survivors

After a tsunami hit Asia in December 2004, 2 survivors had severe infections due to multidrug-resistant and atypical bacteria and rare fungi weeks afterwards. Treating these infections is challenging from a clinical and microbiologic point of view

Increase of invasive meningococcal serogroup W disease in Europe, 2013 to 2017

Background: The total incidence of invasive meningococcal disease (IMD) in Europe has been declining in recent years; however, a rising incidence due to serogroup W (MenW), predominantly sequence type 11 (ST-11), clonal complex 11 (cc11), was reported in some European countries. Aim: The aim of this study was to compile the most recent laboratory surveillance data on MenW IMD from several European countries to assess recent trends in Europe. Methods: In this observational, retrospective study, IMD surveillance data collected from 2013–17 by national reference laboratories and surveillance units from 13 European countries were analysed using descriptive statistics. Results: The overall incidence of IMD has been stable during the study period. Incidence of MenW IMD per 100,000 population (2013: 0.03; 2014: 0.05; 2015: 0.08; 2016: 0.11; 2017: 0.11) and the proportion of this serogroup among all invasive cases (2013: 5% (116/2,216); 2014: 9% (161/1,761); 2015: 13% (271/2,074); 2016: 17% (388/2,222); 2017: 19% (393/2,112)) continuously increased. The most affected countries were England, the Netherlands, Switzerland and Sweden. MenW was more frequent in older age groups (≥ 45 years), while the proportion in children (< 15 years) was lower than in other age groups. Of the culture-confirmed MenW IMD cases, 80% (615/767) were caused by hypervirulent cc11. Conclusion: During the years 2013–17, an increase in MenW IMD, mainly caused by MenW cc11, was observed in the majority of European countries. Given the unpredictable nature of meningococcal spread and the epidemiological potential of cc11, European countries may consider preventive strategies adapted to their contexts.info:eu-repo/semantics/publishedVersio

Rapid Clinical Microbiology for Antibiomicrobial Stewardship

The tremendous development of Medicine with the advent of transplants, chemotherapies and immunotherapies has made our patient population more vulnerable to infections. For a long time, we could treat them with broad spectrum antimicrobials without the risk of “missing the target”, and adapt our treatment to the results of the microbiological analysis, when it was finally available. This approach has come and gone. The emergence and rapid dissemination of multidrug resistant (MDR) pathogens parallel to the difficulties encountered to provide new antimicrobials, has led today’s clinicians in a difficult situation. They need to limit their usage of large spectrum antibiotics, despite being confronted to a higher risk of MDR pathogen. Antimicrobial stewardship (AMS) programs have been intensively developed during the last decades in hospitals, in an attempt to spare our “last-resource” antimicrobials and avoid the continuous spread of MDR bacteria. Microbiology has continually improved by providing clinicians with an accurate diagnosis of the pathogen and its susceptibility to antimicrobials. However, the long delay between sampling and results has limited its ability to influence the choice of antimicrobial in the first week, an unacceptable situation for AMS. Several revolutions took place in our microbiology labs in recent decades with the advent of mass spectrometry and automated bacterial and viral DNA detection systems that have significantly reduced the “time to results”. The line of research described in this thesis reflects a ongoing attempt to improve the “lead time” in our lab, by evaluating some of these new rapid diagnostic tests for their accuracy, reliability and potential impact on patient care. Those tests that convinced us based on these criteria were finally introduced inside our laboratory

Application et utilisation de différentes méthodes de spectrométrie de masse en microbiologie clinique

L'attente des résultats de culture peut être un supplice pour les cliniciens confrontés à un patient septique ou une épidémie naissante. Diverses applications de spectrométrie de masse (MS) pourraient répondre à leurs attentes. La 1ère permet l'identification rapide (1-2 min au lieu de 24-72h) d'une culture de microbes. Elle est basée sur l'analyse de signatures moléculaires plutôt que de traits phénotypiques, et se nomme "Matrix-Assisted Laser Désorption / Ionisation Time-of-Flight Mass Spectrometry" (MALDI-TOF MS). La 2ème, nommée "MALDI-Resequencing" (MALDI-RE), permet le génotypage d'un germe avec une précision comparable au "multilocus sequence typing" (MLST) mais dans un délai bien plus court. La 3ème devrait permettre l'identification directe, avant culture, de pathogènes dans les liquides biologiques, grâce au couplage PCR - analyse des amplicons par MS (PCR-ESI-MS). Ce travail de thèse analyse une révolution : l'entrée de la spectrométrie de masse en bactériologie clinique

Infections à méningocoques en Suisse : changements épidémiologiques, cliniques et de prophylaxie

In the last decade, the epidemiology of meningococcal infections in Switzerland and Europe has changed. The prevalence of Y and W serogroups augmented, with more atypical clinical manifestations such as pharyngitis, pneumonia and arthritis. A hypervirulent clonal serogroup W strain of Neisseria meningitidis has emerged in Europe and Switzerland, with a noticeable potential for epidemics as evidenced by its clonality. In this context, vaccinal recommendations for risk groups have and will continue to evolve towards the use of novel conjugated vaccines

Diagnostic de la gastroentérite bactérienne

The etiologic agents of acute gastroenteritis are diverse. The diagnosis of bacterial pathogens is particularly challenging given the large amount of vastly diverse indigenous gastrointestinal organisms present in stool. Multiple methods must be used by the clinical microbiology laboratories to diagnose the cause of acute gastroenteritis, including bacterial cultures, ELISA, and microscopy. Due to the limitations of conventional methods, there is still room for improvement in the detection of pathogens by using the molecular methods. This paper discusses these different diagnostic approaches and limitations

Characteristics of multidrug-resistant Acinetobacter baumannii strains isolated in Geneva during colonization or infection

This study determined the antibiotic susceptibility profile and genetic mechanisms of β-lactam resistance in 27 clinical strains of Acinetobacter baumannii isolated at the University Hospitals of Geneva, Switzerland. The antimicrobial susceptibility testing was performed using Etest and the disc diffusion method in accordance with CLSI guidelines. All of the strains were defined as multi-drug resistant (MDR) and were susceptible to colistin and moderately susceptible to tigecycline. Uniplex PCR assays were used to detect the following β-lactamase genes: four class D carbapenem-hydrolysing oxacillinases (blaOXA-51, blaOXA-23, blaOXA-24 and blaOXA-58), four class B metallo-β-lactamases genes (blaIMP, blaVIM, blaSPM and blaNDM) and two class A carbapenemases (blaKPC and blaGES). All of the strains were positive for blaOXA-51 (intrinsic resistance), 14/27 strains carried blaOXA-23, 2/27 strains carried a blaOXA-24-like gene, and 4/27 strains had a blaOXA-58 gene. blaGES-11 was found in three strains, and NDM-1-harbouring strains were identified in three patients. All of the A. baumannii isolates were typed by rep-PCR (DiversiLab) and excluded any clonality. Altogether, this analysis suggests a very high genetic diversity of imported MDR A. baumannii