Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Neonatal infection constitutes one of Senegal’s most important public health problems, with amortality rate of 41 deaths per 1,000 live births.Methods: Between January 2007 and March 2008, 242 neonates with suspected infection were recruited at threeneonatal intensive care units in three major tertiary care centers in Dakar, the capital of Senegal. Neonatal infections wereconfirmed by positive bacterial blood or cerebrospinal fluid culture. The microbiological pattern of neonatal infectionsand the antibiotic susceptibility of the isolates were characterized. In addition, the genetic basis for antibiotic resistanceand the genetic background of third-generation cephalosporin-resistant (3GC-R) Enterobacteriaceae were studied.Results: A bacteriological infection was confirmed in 36.4 % (88/242) of neonates: 22.7 % (30/132) during the early-onsetand 52.7 % (58/110) during the late-onset periods (p > 0.20). Group B streptococci accounted for 6.8 % of the 88 collectedbacterial isolates, while most of them were Enterobacteriaceae (n = 69, 78.4 %). Of these, 55/69 (79.7 %) were 3GC-R. TheblaCTX-M-15 allele, the blaSHV and the blaTEM were highly prevalent (63.5, 65.4 and 53.8 %, respectively), usually associatedwith qnr genes (65.4 %). Clonally related strains of 3GC-R Klebsiella pneumoniae and 3GC-R Enterobacter cloacae, the twomost commonly recovered 3GC-R Enterobacteriaceae (48/55), were detected at the three hospitals, underlining the roleof cross-transmission in their spread. The overall case fatality rate was 18.6 %.Conclusions:Measures should be taken to prevent nosocomial infections and the selection of resistant bacteria
ISSN: 1471-2334

Droits : http://creativecommons.org/licenses/by/
hal-01473613
https://hal.archives-ouvertes.fr/hal-01473613
https://hal.archives-ouvertes.fr/hal-01473613/document
https://hal.archives-ouvertes.fr/hal-01473613/file/High%20third-generation%20cephalosporin%20resistant%20Enterobacteriaceae%20prevalence%20rate%20among%20neonatal%20infections%20in%20Dakar%2C%20Senegal.pdf
DOI : 10.1186/s12879-016-1935-y

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Urinary tract infections are bacterial infections most commonly encountered in the community. The resistance rate of uropathogens to commonly prescribed antibiotics has increased worldwide but there are no published data concerning the resistance of strains isolated from community-acquired UTI in Guadeloupe. To assess the susceptibility patterns of Enterobacteriaceae strains isolated from outpatients in Guadeloupe we conducted a prospective study from December 2012 to May 2014 among outpatients consulting at private and public laboratories for urine analysis. Risk factors for E. coli resistance to amoxicillin, third-generation cephalosporin, and ciprofloxacin were also determined. To study the trends of E. coli resistance rates over the past 10 years, data on the susceptibility patterns of E. coli from 2003 to 2014 were also collected from three major laboratories for a retrospective study. During the prospective study, we isolated 1293 bacterial strains from the urine of outpatients presenting for urine analysis. The most commonly isolated bacteria were E. coli (57 %) and Klebsiella pneumoniae (15.5 %). Thirty seven per cent of the E. coli strains were resistant to amoxicillin. Resistance rates to third generation cephalosporin were low for E. coli and other Enterobacteriaceae (3.1 and 12.2 % respectively) and mostly due to the presence of an Extended Spectrum Beta-lactamase. Resistance to cotrimoxazole and ciprofloxacin was moderate (17.8 and 15.6 % respectively). However, the resistance rate of E. coli to ciprofloxacin has significantly increased during the last 10 years. Risk factors were consistent with previously reported data, especially for the increasing ciprofloxacin resistance with age. General practitioners in Guadeloupe need to be better informed to favor the prescription of fosfomycin-trometamol to reduce the risk of resistance to fluoroquinolones.
ISSN: 1471-2180

Droits : http://creativecommons.org/licenses/by/
pasteur-01351191
https://hal-riip.archives-ouvertes.fr/pasteur-01351191
https://hal-riip.archives-ouvertes.fr/pasteur-01351191/document
https://hal-riip.archives-ouvertes.fr/pasteur-01351191/file/art%253A10.1186%252Fs12866-016-0749-9.pdf
PUBMED : 27342199

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Objective: The first aim of this study was to evaluate the antimicrobial resistance of Enterobacteriaceae in different water environments of Guadeloupe and especially those impacted by waste water treatment plants (WWTP) effluents. The second objective was to characterize the genetic basis for antibiotic resistance of extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase producing Enterobacteriaceae isolates (ESBLE and AmpCE).Methods: We have collected 70 surface waters (river and sea samples) impacted or not by WWTP and 18 waste waters from 2 WWTPs in 2012 and 2013. We i) determined the total and resistant bacterial counts and ii) tested isolated Enterobacteriaceae for their antimicrobial susceptibility. We also studied the genetic basis for antibiotic resistance of ESBLE and AmpCE, and the genetic background of Escherichia coli.Results: In rivers, contamination with Escherichia coli and antibiotic resistant coliforms (ARC) increased from the source to the mouth. Highest levels of river contamination with E. coli (9.26 x 105 MPN/100mL) and ARC (2.26 x 108 CFU/mL) were observed in surface water sampled near the discharge. A total of 246 Enterobacteriaceae strains resistant to antibiotics were isolated, mostly from waste waters and from river water collected near the discharge. Among these strains, 33 were Extended Spectrum Beta Lactamase (ESBLE) and 8 E. coli were AmpC beta-lactamase producers. All the ESBLE were isolated from waste waters or from river water collected near the discharge. The blaCTX-M gene was present in 29 of the 33 ESBLE strains, with 24 belonging to group 1. Numerous strains (68.7%) showed more than one acquired antibiotic resistance mechanism. E. coli strains belonged to different phylogenetic groups; among the B2 group, most strains belonged to the ST131 clone.Conclusion: Our results demonstrated that many human activities can supply antibiotic-resistant bacteria in surface water. Nevertheless, WWTPs were the most important supplier of ESBLE in water environment of Guadeloupe.
ISSN: 1932-6203

Droits : http://creativecommons.org/licenses/by/
hal-01485327
http://hal.upmc.fr/hal-01485327
http://hal.upmc.fr/hal-01485327/document
http://hal.upmc.fr/hal-01485327/file/journal.pone.0173155.pdf
DOI : 10.1371/journal.pone.0173155.t002

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
BACKGROUND: Evidence of human sexual transmission during Zika virus emergence is a matter of concern, particularly in procreation, but to date, kinetics of seminal shedding and the effects of infection on human reproductive function have not been described. To investigate the effects of Zika virus infection on semen and clearance of Zika virus from semen and body fluids, we aimed to study a cohort of Zika virus-infected men. METHODS: This prospective observational study recruited men presenting with acute Zika virus infection at Pointe-à-Pitre University Hospital in Guadeloupe, French Caribbean, where a Zika virus outbreak occurred between April and November, 2016. Blood, urine, and semen were collected at days 7, 11, 20, 30, 60, 90, and 120 after symptom onset, and semen characteristics, such as total sperm count, sperm motility, vitality, and morphology, and reproductive hormone concentrations, such as testosterone, inhibin, follicle-stimulating hormone, and luteinising hormone, were assessed. At days 7, 11, and 20, semen was processed to isolate motile spermatozoa. Zika virus RNA was detected by RT-PCR using whole blood, serum, urine, seminal plasma, semen cells, and motile spermatozoa fractions. Zika virus was isolated from different sperm fractions on Vero E6 cultures. FINDINGS: 15 male volunteers (mean age 35 years [SD 5; range 25-44) with acute Zika virus infection and positive Zika virus RNA detection in blood or urine were enrolled. Total sperm count was decreased from median 119 × 10(6) spermatozoa (IQR 22-234) at day 7 to 45·2 × 10(6) (16·5-89·6) at day 30 and 70 × 10(6) (28·5-81·4) at day 60, respectively, after Zika virus infection. Inhibin values increased from 93·5 pg/mL (IQR 55-162) at day 7 to 150 pg/mL (78-209) at day 120 when total sperm count recovered. In motile spermatozoa obtained after density gradient separation, Zika virus RNA was found in three of 14 patients at day 7, four of 15 at day 11, and four of 15 at day 20, and replication-competent virus was found in the tested patient. Seminal shedding kinetics seemed heterogeneous among patients. Whole blood was the fluid most frequently positive for Zika virus RNA (62 of 92 samples) and three patients remained positive at day 120. INTERPRETATION: Semen alterations early after acute Zika virus infection might affect fertility and could be explained by virus effects on the testis and epididymis. Frequency of shedding and high viral load in semen, together with the presence of replicative virus in a motile spermatozoa fraction, can lead to Zika virus transmission during sexual contact and assisted reproduction procedures. Whole blood seems to be the best specimen for Zika virus RNA detection, diagnosis, and follow-up. FUNDING: Agence de la Biomédecine/Agence Régionale de Santé de la Guadeloupe/Inserm-REACTing.
ISSN: 0140-6736

hal-01647078
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01647078
DOI : 10.1016/S1473-3099(17)30444-9
PUBMED : 28838639

Éditeur(s) : HAL CCSD
Résumé : International audience
Background Mycobacterium ulcerans infection is the third most common mycobacterial disease in the world after tuberculosis and leprosy. To date, transmission pathways from its environmental reservoir to humans are still unknown. In South America, French Guiana has the highest reported number of M ulcerans infections across the continent. This empirical study aimed to characterise the epidemiology of M ulcerans infection in French Guiana between 1969 and 2013.MethodsData were collected prospectively mainly by two dermatologists at Cayenne Hospital’s dermatologydepartment between Jan 1, 1969, and Dec 31, 2013, for age, date of diagnosis, sex, residence, location of the lesion,type of lesion, associated symptoms, and diagnostic method (smear, culture, PCR, or histology) for all confirmed andsuspected cases of M ulcerans. We obtained population data from censuses. We calculated mean M ulcerans infectionincidences, presented as the number of cases per 100 000 person-years.Findings 245 patients with M ulcerans infections were reported at Cayenne Hospital’s dermatology department duringthe study period. M ulcerans infection incidence decreased over time, from 6·07 infections per 100 000 person-years(95% CI 4·46–7·67) in 1969–83 to 4·77 infections per 100 000 person-years (3·75–5·79) in 1984–98 and to3·49 infections per 100 000 person-years (2·83–4·16) in 1999–2013. The proportion of children with infections alsodeclined with time, from 42 (76%) of 55 patients in 1969–83 to 26 (31%) of 84 in 1984–98 and to 22 (21%) of 106 in1999–2013. Most cases occurred in coastal areas surrounded by marshy savannah (incidence of 21·08 per100 000 person-years in Sinnamary and 21·18 per 100 000 person-years in Mana). Lesions mainly affected limbs (lowerlimbs 161 [66%] patients; upper limbs 60 [24%] patients). We diagnosed no bone infections.Interpretation The decrease of M ulcerans infection incidence and the proportion of children with infections over a45 year period in this ultra-peripheral French territory might have been mostly driven by improving living conditions,prophylactic recommendations, and access to health care.
The Lancet Planetary Health

inserm-01545603
http://www.hal.inserm.fr/inserm-01545603
http://www.hal.inserm.fr/inserm-01545603/document
http://www.hal.inserm.fr/inserm-01545603/file/2017%2C%20Douine%20-%20Mycobacterium%20ulcerans%20infection%20%28Buruli%20ulcer%29.pdf
http://www.hal.inserm.fr/inserm-01545603/file/Comments.pdf

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Local variation in the density of Anopheles mosquitoes and the risk of exposure to bites are essential to explain the spatial and temporal heterogeneities in the transmission of malaria. Vector distribution is driven by environmental factors. Based on variables derived from satellite imagery and meteorological observations, this study aimed to dynamically model and map the densities of Anopheles darlingi in the municipality of Saint-Georges de l’Oyapock (French Guiana). Longitudinal sampling sessions of An. darlingi densities were conducted between September 2012 and October 2014. Landscape and meteorological data were collected and processed to extract a panel of variables that were potentially related to An. darlingi ecology. Based on these data, a robust methodology was formed to estimate a statistical predictive model of the spatial-temporal variations in the densities of An. darlingi in Saint-Georges de l’Oyapock. The final cross-validated model integrated two landscape variables—dense forest surface and built surface—together with four meteorological variables related to rainfall, evapotranspiration, and the minimal and maximal temperatures. Extrapolation of the model allowed the generation of predictive weekly maps of An. darlingi densities at a resolution of 10-m. Our results supported the use of satellite imagery and meteorological data to predict malaria vector densities. Such fine-scale modeling approach might be a useful tool for health authorities to plan control strategies and social communication in a cost-effective, targeted, and timely manner.
ISSN: 1932-6203

hal-01383486
https://hal.archives-ouvertes.fr/hal-01383486
https://hal.archives-ouvertes.fr/hal-01383486/document
https://hal.archives-ouvertes.fr/hal-01383486/file/Adde_et_al_PlosONE_2016.pdf
DOI : 10.1371/journal.pone.0164685

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
In 2008 a fatal case of primary amoebic meningoencephalitis, due to the amoeboflagellate Naegleria fowleri, occurred in Guadeloupe, French West Indies, after a child swam in a bath fed with geothermal water. In order to improve the knowledge on free-living amoebae in this tropical part of France, we investigated on a monthly basis, the presence of Naegleria spp. in the recreational baths, and stream waters which feed them. A total of 73 water samples, 48 sediments and 54 swabs samples were collected from 6 sampling points between June 2011 and July 2012. The water samples were filtered and the filters transferred to non-nutrient agar plates seeded with a heat-killed suspension of Escherichia coli while sediment and swab samples were placed directly on these plates. The plates were incubated at 44°C for the selective isolation of thermophilic Naegleria. To identify the Naegleria isolates the internal transcribed spacers, including the 5.8S rDNA, were amplified by polymerase chain reaction and the sequence of the PCR products was determined. Thermophilic amoebae were present at nearly all collection sites. The pathogenic N. fowleri was the most frequently encountered thermophilic species followed by N. lovaniensis. The concentration of N. fowleri was rather low in most water samples, ranging from 0 to 22 per liter. Sequencing revealed that all N. fowleri isolates belonged to a common Euro-American genotype, the same as detected in the human case in Guadeloupe. These investigations need to be continued in order to counsel the health authorities about prevention measures, because these recreational thermal baths are used daily by local people and tourists.
ISSN: 1932-6203

pasteur-00782031
https://hal-riip.archives-ouvertes.fr/pasteur-00782031
https://hal-riip.archives-ouvertes.fr/pasteur-00782031/document
https://hal-riip.archives-ouvertes.fr/pasteur-00782031/file/article_naegleria_plos_one.pdf
DOI : 10.1371/journal.pone.0054414

Éditeur(s) : HAL CCSD Springer Verlag (Germany)
Résumé : International audience
Naegleria fowleri is found in most geothermal baths of Guadeloupe and has been responsible for the death of a 9-year-old boy who swam in one of these baths in 2008. We wanted to determine the origin for the presence of this amoeba in the water.Water samples were taken at the origin of the geothermal sources and at the arrival in the baths. After filtration, cultures were made and the number of Naegleria present was determined using the most probable number method. Soil samples collected in the proximity of the baths were also tested for the presence of thermophilic amoebae. The species identification was obtained by PCR. During three consecutivemonths, no Naegleria could be found at the origin of any geothermal source tested. In contrast, N. fowleri was isolated at least once in all baths at the arrival of the water, except one. Thermophilic amoebae could be found in each soil sample, especially near the baths located at a lower altitude, but N. fowleri was only isolated near two baths, which were also the baths most often contaminated with this species. So it appears that the contamination of the water with N. fowleri occurs after emerging from the geothermal source when the water runs over the soil. Therefore, it should be possible to reduce the concentration of N. fowleri in thegeothermal baths of Guadeloupe to for example less than 1 N. fowleri/10 L by installing a pipeline between the geothermal sources and the baths and by preventing flooding water from entering the baths after rainfall. By taking these measures, we were able to eliminate N. fowleri from a poollocated inside a reeducation clinic.
ISSN: 0932-0113

pasteur-01136739
https://hal-riip.archives-ouvertes.fr/pasteur-01136739
DOI : 10.1007/s00436-014-4197-x.
PUBMED : 25352239