Zoonotic pathogens and antimicrobial resistance in ‘animal-friendly’ pig production systems in Switzerland

In a cross-sectional study, the impact of ‘animal-friendly’ housing systems on the prevalence of Salmonella species, Campylobacter species, and Yersinia enterocolitica in finishing pigs and pork was investigated. Furthermore, antimicrobial resistance patterns of isolated campylobacter strains were analysed. In faecal samples of two out of 88 fattening pig farms salmonellae were isolated. All 865 samples of pork were found to be negative. Campylobacter was isolated on 98.9 % of the farms but only from 0.2 % of the pork samples. Yersiniae were found in samples of 63.3 % of the farms and in 15.4 % of pork samples. For all three bacteria, there was no statistically significant difference in the prevalence between conventional and ‘animal-friendly’ housing systems. In ‘animal-friendly’ farms, antimicrobial resistance of campylobacter isolates to fluoroquinolones and streptomycin was significantly less frequent than in conventional farms. Furthermore, fewer isolates had resistance to three or more antimicrobials in ‘animal-friendly’ farms

Prevalence and Predictors for Homo- and Heterosubtypic Antibodies Against Influenza A Virus

Heterosubtypic antibodies to influenza A virus will be crucial for the development of a pan-influenza vaccine. Here we show that most individuals already possess heterosubtypic antibodies and that their generation is favored both by vaccination and ag

Predictors for the Emergence of the 2 Multi-nucleoside/nucleotide Resistance Mutations 69 Insertion and Q151M and their Impact on Clinical Outcome in the Swiss HIV Cohort Study

The 69 insertion and Q151M mutations are multi-nucleoside/nucleotide resistance mutations (MNR). The prevalence among 4078 antiretroviral therapy (ART)-experienced individuals was <1.3%. Combined ART fully prevented MNR in subtype B infections. Case-control studies were performed to identify risk factors. Control subjects were patients with ≥3 thymidine-analogue mutations. The 69 insertion study (27 control subjects, 14 case patients) identified didanosine exposure as a risk (odds ratio, 5.0 per year; P = .019), whereas the Q151M study (which included 44 control subjects and 25 case patients) detected no associations. Following detection, individuals with Q151M tended to have lower suppression rates and higher mortality rates, relative to control subjects. Additional studies are needed to verify these findings in non-subtype B infection

Improved Virological Outcome in White Patients Infected With HIV-1 Non-B Subtypes Compared to Subtype B

Patients infected with HIV type 1 non-B subtypes had a decreased probability for a virological failure while receiving combination antiretroviral therapy compared with individuals infected with subtype B. Subtypes A and CRF02_AG, in particular, revealed improved outcome

Prevalence and predictors for homo- and heterosubtypic antibodies against influenza a virus

Background: The effectiveness of trivalent influenza vaccination has been confirmed in several studies. To date, it is not known whether repeated exposure and vaccination to influenza promote production of cross-reactive anti-bodies. Furthermore, how strains encountered earlier in life imprint the immune response is currently poorly understood. Methods: To determine the prevalence for human homo- and heterosubtypic antibody responses, we scruti-nized serum samples from 305 healthy volunteers for hemagglutinin-binding and -neutralizing antibodies against several strains and subtypes of influenza A. Statistical analyses were then performed to establish the association of measured values with potential predictors. Results: It was found that vaccination not only promoted higher binding and neutralizing antibody titers to homosubtypic in fluenza isolates but also increased heterosubtypic human immune responses. Both binding and neutralizing antibody titers in relation with age of the donors mirrored the course of the different influenza strain circulation during the last century. Advanced age appeared to be of advantage for both binding and neutralizing titers to most subtypes. In contrast, the first virus subtype encountered was found to imprint to some degree subsequent antibody responses. Antibodies to recent strains, however, primarily seemed to be promoted by vaccination. Conclusions: We provide evidence that vaccinations stimulate both homo- and heterosubtypic immune responses in young and middle-aged as well as more senior individuals. Our analyses suggest that influenza vaccinations not only prevent infection against currently circulating strains but can also stimulate broader humoral immune responses that potentially attenuate infections with zoonotic or antigenically shifted strains

Characterization method of dielectric properties of free falling drops in a microwave processing cavity and its application in microwave internal gelation

[EN] Microwave internal gelation (MIG) is a chemical process proposed for the production of nuclear particle fuel. The internal gelation reaction is triggered by a temperature increase of aqueous droplets falling by gravity by means of non-contact microwave heating. Due to the short residence time of a solution droplet in a microwave heating cavity, a detailed knowledge of the interaction between microwaves and chemical solution (shaped in small drops) is required. This paper describes a procedure that enables the measurement of the dielectric properties of aqueous droplets that freely fall through a microwave cavity. These measurements provide the information to determine the optimal values of the parameters (such as frequency and power) that dictate the heating of such a material under microwaves.This work is a part of the PINE (Platform for Innovative Nuclear FuEls) project which targets the development of an advanced production method for Sphere-Pac fuel and is financed by the Swiss Competence Center for Energy and Mobility. The work has been also financed by the European Commission through contract no 295664 regarding the FP7 PELGRIMM Project, as well as contract no 295825 regarding the FP7-ASGARD Project. MC-S would like to thank the ITACA research team (UPV Valencia, Spain) and the EMPA Thun (Switzerland) for their support in the measurements and Carl Beard (PSI, Switzerland) for the help provided in respect with CST simulations. The work of FLP-F was supported by the Conselleria d'Educacio of the Generalitat Valenciana for economic support (BEST/2012/010).Cabanes Sempere, M.; Catalá Civera, JM.; Penaranda-Foix, FL.; Cozzo, C.; Vaucher, S.; Pouchon, MA. (2013). Characterization method of dielectric properties of free falling drops in a microwave processing cavity and its application in microwave internal gelation. Measurement Science and Technology. 24(9). https://doi.org/10.1088/0957-0233/24/9/095009S24

Population pharmacokinetic modelling and evaluation of different dosage regimens for darunavir and ritonavir in HIV-infected individuals

Objectives Darunavir is a protease inhibitor that is administered with low-dose ritonavir to enhance its bioavailability. It is prescribed at standard dosage regimens of 600/100 mg twice daily in treatment-experienced patients and 800/100 mg once daily in naive patients. A population pharmacokinetic approach was used to characterize the pharmacokinetics of both drugs and their interaction in a cohort of unselected patients and to compare darunavir exposure expected under alternative dosage regimens. Methods The study population included 105 HIV-infected individuals who provided darunavir and ritonavir plasma concentrations. Firstly, a population pharmacokinetic analysis for darunavir and ritonavir was conducted, with inclusion of patients' demographic, clinical and genetic characteristics as potential covariates (NONMEM®). Then, the interaction between darunavir and ritonavir was studied while incorporating levels of both drugs into different inhibitory models. Finally, model-based simulations were performed to compare trough concentrations (Cmin) between the recommended dosage regimen and alternative combinations of darunavir and ritonavir. Results A one-compartment model with first-order absorption adequately characterized darunavir and ritonavir pharmacokinetics. The between-subject variability in both compounds was important [coefficient of variation (CV%) 34% and 47% for darunavir and ritonavir clearance, respectively]. Lopinavir and ritonavir exposure (AUC) affected darunavir clearance, while body weight and darunavir AUC influenced ritonavir elimination. None of the tested genetic variants showed any influence on darunavir or ritonavir pharmacokinetics. The simulations predicted darunavir Cmin much higher than the IC50 thresholds for wild-type and protease inhibitor-resistant HIV-1 strains (55 and 550 ng/mL, respectively) under standard dosing in >98% of experienced and naive patients. Alternative regimens of darunavir/ritonavir 1200/100 or 1200/200 mg once daily also had predicted adequate Cmin (>550 ng/mL) in 84% and 93% of patients, respectively. Reduction of darunavir/ritonavir dosage to 600/50 mg twice daily led to a 23% reduction in average Cmin, still with only 3.8% of patients having concentrations below the IC50 for resistant strains. Conclusions The important variability in darunavir and ritonavir pharmacokinetics is poorly explained by clinical covariates and genetic influences. In experienced patients, treatment simplification strategies guided by drug level measurements and adherence monitoring could be propose

Early severe morbidity and resource utilization in South African adults on antiretroviral therapy

BACKGROUND:High rates of mortality and morbidity have been described in sub-Saharan African patients within the first few months of starting highly active antiretroviral therapy (HAART). There is limited data on the causes of early morbidity on HAART and the associated resource utilization. METHODS: A cross-sectional study was conducted of medical admissions at a secondary-level hospital in Cape Town, South Africa. Patients on HAART were identified from a register and HIV-infected patients not on HAART were matched by gender, month of admission, and age group to correspond with the first admission of each case. Primary reasons for admission were determined by chart review. Direct health care costs were determined from the provider's perspective. RESULTS: There were 53 in the HAART group with 70 admissions and 53 in the no-HAART group with 60 admissions. The median duration of HAART was 1 month (interquartile range 1-3 months). Median baseline CD4 count in the HAART group was 57 x 106 cells/L (IQR 15-115). The primary reasons for admission in the HAART group were more likely to be due to adverse drug reactions and less likely to be due to AIDS events than the no-HAART group (34% versus 7%; p < 0.001 and 39% versus 63%; p = 0.005 respectively). Immune reconstitution inflammatory syndrome was the primary reason for admission in 10% of the HAART group. Lengths of hospital stay per admission and inpatient survival were not significantly different between the two groups. Five of the 15 deaths in the HAART group were due to IRIS or adverse drug reactions. Median costs per admission of diagnostic and therapeutic services (laboratory investigations, radiology, intravenous fluids and blood, and non-ART medications) were higher in the HAART group compared with the no-HAART group (US$190 versus US$111; p = 0.001), but the more expensive non-curative costs (overhead, capital, and clinical staff) were not significantly different (US$1199 versus US$1128; p = 0.525). CONCLUSIONS: Causes of early morbidity are different and more complex in HIV-infected patients on HAART. This results in greater resource utilization of diagnostic and therapeutic services