Secondary bacterial infections of buruli ulcer lesions before and after chemotherapy with streptomycin and rifampicin

Buruli ulcer (BU), caused by Mycobacterium ulcerans is a chronic necrotizing skin disease. It usually starts with a subcutaneous nodule or plaque containing large clusters of extracellular acid-fast bacilli. Surrounding tissue is destroyed by the cytotoxic macrolide toxin mycolactone produced by microcolonies of M. ulcerans. Skin covering the destroyed subcutaneous fat and soft tissue may eventually break down leading to the formation of large ulcers that progress, if untreated, over months and years. Here we have analyzed the bacterial flora of BU lesions of three different groups of patients before, during and after daily treatment with streptomycin and rifampicin for eight weeks (SR8) and determined drug resistance of the bacteria isolated from the lesions. Before SR8 treatment, more than 60% of the examined BU lesions were infected with other bacteria, with Staphylococcus aureus and Pseudomonas aeruginosa being the most prominent ones. During treatment, 65% of all lesions were still infected, mainly with P. aeruginosa. After completion of SR8 treatment, still more than 75% of lesions clinically suspected to be infected were microbiologically confirmed as infected, mainly with P. aeruginosa or Proteus miriabilis. Drug susceptibility tests revealed especially for S. aureus a high frequency of resistance to the first line drugs used in Ghana. Our results show that secondary infection of BU lesions is common. This could lead to delayed healing and should therefore be further investigated

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

R. R. Bolgar, Classical Influences on European Culture. A.D. 1500- 1700

Isaac Marie-Thérèse. R. R. Bolgar, Classical Influences on European Culture. A.D. 1500- 1700. In: L'antiquité classique, Tome 46, fasc. 1, 1977. pp. 374-375

Annabel M. Patterson, Hermogenes and the Renaissance. Seven Ideas of Style

Isaac Marie-Thérèse. Annabel M. Patterson, Hermogenes and the Renaissance. Seven Ideas of Style. In: L'antiquité classique, Tome 40, fasc. 2, 1971. pp. 825-826

Les livres manuscrits de l'abbaye des Dunes d'après le catalogue du XVIIe siècle

Isaac Marie-Thérèse. Les livres manuscrits de l'abbaye des Dunes d'après le catalogue du XVIIe siècle. In: Scriptorium, Tome 37 n°1, 1983. pp. 129-133

Carl Wendel, Kleine Schriften zum antiken Buch- und Bibliothekswesen. Herausgegeben von Werner Krieg

Isaac Marie-Thérèse. Carl Wendel, Kleine Schriften zum antiken Buch- und Bibliothekswesen. Herausgegeben von Werner Krieg. In: L'antiquité classique, Tome 45, fasc. 1, 1976. pp. 416-418

Cristina Noacco et al. (Dir.), Figures du maître. De l’autorité à l’autonomie. Rennes, Presses universitaires, 2013 (Interférences)

Isaac Marie-Thérèse. Cristina Noacco et al. (Dir.), Figures du maître. De l’autorité à l’autonomie. Rennes, Presses universitaires, 2013 (Interférences). In: L'antiquité classique, Tome 83, 2014. pp. 603-604

Annabel M. Patterson, Hermogenes and the Renaissance. Seven Ideas of Style

Isaac Marie-Thérèse. Annabel M. Patterson, Hermogenes and the Renaissance. Seven Ideas of Style. In: L'antiquité classique, Tome 40, fasc. 2, 1971. pp. 825-826

Donald A. RUSSELL (Ed.), Quintilian. The Orator 's Education.

Isaac Marie-Thérèse. Donald A. RUSSELL (Ed.), Quintilian. The Orator 's Education. . In: L'antiquité classique, Tome 72, 2003. pp. 411-412

R. R. Bolgar (ed.), Classical Influences on Western Thoughts A.D. 1650-1870

Isaac Marie-Thérèse. R. R. Bolgar (ed.), Classical Influences on Western Thoughts A.D. 1650-1870. In: L'antiquité classique, Tome 49, 1980. pp. 662-663