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Background: The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) isolated in horse infections is not well documented, especially in France. The aim of the study was to evaluate the prevalence of MRSA isolates in horse infections from 2007 to 2013 in France and to characterize phenotypically and genotypically this collection., Results: Out of 1393 S. aureus horse isolates, 85 (6.1%) were confirmed to be MRSA. Interestingly, the prevalence of MRSA significantly increased from 2007-2009 to 2010-2013 (0.7 vs. 9.5%, P <0.0001). Resistance to methicillin was due to the presence of the mecA gene in 84 strains (98.8%) while one strain (1.2%) possessed the mecC gene. The vast majority of the strains (83/85, 97.6%) was resistant to at least three different classes of antibiotics. Multi-locus sequence typing (MLST) showed that MRSA strains belonged mainly since not all belong to two sequence types (STs): ST398 (53/85, 62.4%) and ST8 (28/85, 32.9%). It is worth to note that all ST398 MRSA isolates were detected in the period 2010-2013. Other molecular typing methods were also used, such SCC mec analysis, spa typing and rep-PCR (Diversilab, bioMérieux). All these four techniques were in good agreement, with spa typing and rep-PCR being more discriminative than MLST and SCC mec typing., Conclusions: This study is the first epidemiological study in France with extensive characterization of MRSA isolates associated with horse infections in stud farms. It shows that there is a significant increase of MRSA prevalence between 2007 and 2013, which mainly results from the spread of ST398 clones. It also highlights the importance of horses as a potential reservoir of important antimicrobial resistance genes.

Activators of plant defence responses against pathogens are a potential alternative to fungicides, and the well-known resistance inducer salicylic acid (SA) protects wheat (Triticum aestivum L.) against powdery mildew. The aim of our work was to investigate through biochemical and molecular approaches whether lipid metabolism alteration could be considered as a characteristic feature of induced resistance in wheat upon SA infiltration. Expression levels of lox, PI-PLC2 and ltp genes encoding for a lipoxygenase (LOX), a phospholipase C2 and a lipid-transfer protein, respectively, were investigated. Increase of phosphatidic acid (PA) content 48h after SA infiltration in wheat leaves, upregulation of PI-PLC2 gene expression and increased diacylglycerol content were recorded, indicating the involvement of the PLC pathway in the PA synthesis. The wheat octadecanoid pathway was shown to be highly responsive to SA infiltration through simultaneous increases in lox gene expression and LOX activity, as well as a reduction in the content of linolenic acid. Changes in several FA contents and increases of the ltp gene expression were also recorded during the latest hours after SA infiltration. The status of lipid metabolism, as well as the connections between its components as markers of SA-induced resistance in wheat, are discussed.

Effects of the encapsulation in cyclodextrins (CDs) on the solubility, photostability and antifungal activities of some phenylpropanoids (PPs) were investigated. Solubility experiments were carried out to evaluate the effect of CDs on PPs aqueous solubility. Loading capacities and encapsulation efficiencies of freeze-dried inclusion complexes were determined. Moreover, photostability assays for both inclusion complexes in solution and solid state were performed. Finally, two of the most widespread phytopathogenic fungi, Fusarium oxysporum and Botrytis cinerea, were chosen to examine the antifungal activity of free and encapsulated PPs. Results showed that encapsulation in CDs significantly increased the solubility and photostability of studied PPs (by 2 to 17-fold and 2 to 44-fold, respectively). Free PPs revealed remarkable antifungal properties with isoeugenol showing the lowest half-maximal inhibitory concentration (IC50) values of mycelium growth and spore germination inhibition. Encapsulated PPs, despite their reduced antifungal activity, could be helpful to solve drawbacks such as solubility and stability., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Powdery mildew would be one of the most damaging wheat diseases without the extensive use of conventional fungicides. Some of the alternative control strategies currently emerging are based on the use of resistance inducers. The disacharride trehalose (TR) is classically described as an inducer of defenses in plants to abiotic stress. In this work, the elicitor or priming effect of TR was investigated in wheat both before and during a compatible wheat-powdery mildew interaction through molecular, biochemical, and cytological approaches. In noninoculated conditions, TR elicited the expression of genes encoding chitinase (chi, chi1, and chi4 precursor), pathogenesis-related protein 1, as well as oxalate oxidase (oxo). Moreover, lipid metabolism was shown to be altered by TR spraying via the upregulation of lipoxygenase (lox) and lipid-transfer protein (ltp)-encoding gene expression. On the other hand, the protection conferred by TR to wheat against powdery mildew is associated with the induction of two specific defense markers. Indeed, in infectious conditions following TR spraying, upregulations of chi4 precursor and lox gene expression as well as an induction of the LOX activity were observed. These results are also discussed with regard to the impact of TR on the fungal infectious process, which was shown to be stopped at the appressorial germ tube stage. Our findings strongly suggest that TR is a true inducer of wheat defense and resistance, at least toward powdery mildew.

Heptanoyl salicylic acid (HSA) is a salicylic acid (SA) derivative obtained by esterification of 2-OH benzoic acid with heptanoic acid. In wheat, the protection levels obtained against Blumeria graminis f. sp. tritici (Bgt) increased from 50% with SA to 95% with HSA. Using molecular, biochemical and cytological approaches, we investigated here how wheat lipid metabolism is differentially activated by SA and HSA in both infectious and non-infectious conditions, and how Bgt infectious process is altered by both inducers. First, in the absence of Bgt, continuous lipoxygenase (LOX)-encoding gene expression and corresponding activity were specifically induced by HSA. Moreover, compared to SA, HSA treatment resulted in earlier up-regulations of the phospholipase C2-encoding gene expression and it specifically affected the expression of a lipid transfer protein-encoding gene. In infectious context, both HSA and SA sprayings impaired penetration events and therefore haustorium formation, leading to less frequent fungal colonies. While this alteration only slowed down the evolution of Bgt infectious process in SA-sprayed leaves, it completely impaired the establishment of successful infectious events in HSA-sprayed leaves. In addition, HSA induced continuous increases of a LOX-encoding gene expression and of the corresponding LOX activity when compared to SA-sprayed leaves. Lipid metabolism is therefore overall highly responsive to HSA spraying and could represent effective defence mechanism triggered during the induction of resistance in wheat toward Bgt. The concepts of priming and energy costs of the defences induced by SA and HSA are also discussed., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

Three families of lipopeptides (LPs), surfactin, iturin (including mycosutilin) and fengycin, produced by the rhizabacterium Bacillus subtilis have received considerable attention for their antimicrobial, cytotoxic, antitumor, immunosuppressant and surfactant properties. Among them, iturins and fengycins generally display a strong in vitro antifungal activity. In addition, surfactins are powerful bio surfactants, and although they don't show any direct fungitoxicity, they exhibit some synergistic effect with the antifungal activity of iturins. The aim of our work is to characterize mycosubtilin, surfactin and fengycin, for their ability to protect wheat against two pathogens, Blumeria graminis f.sp. tritici (Bgt), an obligate parasitic fungus responsible for powdery mildew and Mycosphaerella graminicola (Mg), an hemibiotrophic fungus causing Septoria leaf blotch, two of the most important diseases of this crop. In a first step, we measured the protection efficacy of a preventive treatment with LPs against powdery mildew on wheat leaves. At least 41% and 44% protection levels were obtained when surfactin and mycosubtilin, respectively, were sprayed on wheat leaves at doses corresponding to 4g.ha(-1) in the field. We also tested in vitro the impact of LPs on germination of spores. No direct antifungal effect of LPs was observed on Bgt conidia germination, irrespective of the tested concentrations. However, fengycin strongly decreased the germination of Mg conidia and also considerably delayed its growth. Mycasubtilin completely inhibited conidial germination and therefore also its growth while surfactin did not remarkably affect either germination or growth of this fungus. In a second step, RT-qPCR was used to investigate elicitor and priming effects of surfactin and mycosubtilin on the expression levels of defence-related genes. In non-infectious conditions, both surfactin and mycosubtilin induced the expression of two peroxidase encoding genes (POX2, POX381), however, the expression of LOX (lipoxygenase), AOS (allene oxide synthase) genes involved in the octadecanoid pathway, as well as of the pathogenesis-related genes PR1 was only induced by mycosubtilin. In infectious conditions, only surfactin induced the expression of these genes in response to pBgt, mycosubtilin did not exhibit any priming effect. Depending on the targeted pathogen and on the type of LP, these molecules could exhibit direct antifungal effect and/or defence induction, through either elicitation or potentialisation.

Our work aimed at a global investigation of the lipid metabolism during the induction of resistance in wheat (Triticum aestivum) against powdery mildew (Blumeria graminis f.sp. tritici). More specifically, the effect of salicylic acid, known as playing a key role in the activation of defence reactions against pathogens in plants, has been investigated. After salicylic acid infiltration, accumulation of phosphatidic acid was observed that could be due to the phospholipase C pathway since an up-regulation of a phospholipase C-encoding gene expression as well as an accumulation of diacylglycerol were observed. The phosphatidic acid accumulation could also result from the phospholipase D pathway since a reduction of phosphatidylethanolamine content occurred. The response to salicylic acid at the octadecanoid pathway level was also investigated: both a lipoxygenase-encoding gene expression and lipoxygenase enzymatic activity were induced by salicylic acid simultaneously with a decrease of the linolenic acid content. Finally, a lipid transfer protein-encoding gene expression was also up-regulated upon salicylic acid infiltration. These observations indicate that lipid metabolism could be considered as a marker of elicitation in wheat.

In conventional agricultural practices, fungicides are extensively used to control the development of many fungal plant pathogens. However, the reduction of pesticide applications in the field, which is recommended by authorities and approved by public opinion, may lead to a re-emergence of diseases. Alternative strategies have therefore to be developed in order to control fungal infection; one of them is based on plants natural resistance reinforcement caused by elicitors. Our project aims at characterizing mycosubtilin, surfactin and fengycin, three bacterial cyclic non-ribosomal lipopeptides produced by the rhizobacterium Bacillus subtilis, for their ability to induce resistance in wheat against powdery mildew (Blumeria graminis f.sp. tritici). RT-qPCR approach was used to investigate effect of lipopeptides on expression pattern of defence-related genes, such as PR protein-encoding genes or genes involved in plant defence pathways (reactive oxygen species (ROS) metabolism, lipid peroxidation, phenylpropanoid and octadecanoid pathways) in response to fungus and revealed that expression of LOX and PR1 was strongly induced by surfactin at 24h and 18h after inoculation, respectively. Mycosubtilin seemed to be more efficace to induce expression of OXO and Ltp. Surfactin could also induce expression of chitinase encoding genes but neither surfactin nor mycosubtilin could induce the expression of GSTphi and PAL genes in response to the fungus.

Enterococcus faecium UCN71, isolated from a blood culture, was resistant to low levels of vancomycin (MIC, 16 μg/ml) but susceptible to teicoplanin (MIC, 0.5 μg/ml). No amplification was observed with primers specific for the previously described glycopeptide resistance ligase genes, but a PCR product corresponding to a gene called vanN was obtained using degenerate primers and was sequenced. The deduced VanN protein was related (65% identity) to the d-alanine:d-serine VanL ligase. The organization of the vanN gene cluster, determined using degenerate primers and by thermal asymmetric interlaced (TAIL)-PCR, was similar to that of the vanC operons. A single promoter upstream from the resistance operon was identified by rapid amplification of cDNA ends (RACE)-PCR. The presence of peptidoglycan precursors ending in d-serine and d,d-peptidase activities in the absence of vancomycin indicated constitutive expression of the resistance operon. VanN-type resistance was transferable by conjugation to E. faecium. This is the first report of transferable d-Ala-d-Ser-type resistance in E. faecium.

Objectives: Unprecedented outbreaks of vancomycin-resistant enterococci (VRE) have occurred in French hospitals since 2004. The aim of this study was to provide a picture of the spread and control of VRE in France and to characterize the isolates., Methods: Notification of VRE cases to Institut de Veille Sanitaire has been mandatory since 2001. Isolates of VRE were sent to the National Reference Centre for species and vancomycin-resistance gene identification. Isolates were tested for antimicrobial susceptibility and typed by PFGE and multilocus sequence typing., Results: Five hundred and four VRE notifications from 195 hospitals were recorded, corresponding to 2475 cases of infection (n=243) or colonization (n=2232) and 74 episodes of clustered cases. Outbreaks were controlled by implementation of infection control measures, although the number of new hospitals reporting isolation of VRE was increasing. The majority of 902 VRE isolated from 2006 to 2008 were Enterococcus faecium (94.8%) with the vanA or vanB gene. No isolate was resistant to linezolid, tigecycline or fusidic acid. PFGE analysis showed 161 different patterns. Generally a few predominant clones and several minor clones spread in a single hospital. In a subset of 46 representatives of PFGE clones, 13 different sequence types were characterized, all belonging to clonal complex CC17, while the esp and hyl genes were inconsistently detected., Conclusions: The national mandatory notification of unusual nosocomial events allowed rapid identification of VRE outbreaks and early implementation of control measures that have proved effective. However, VRE continue to emerge in a growing number of hospitals.

We have assessed the performance of semi-automated rep-PCR (Diversilab®) and multilocus sequence typing (MLST) in comparison to pulsed-field gel electrophoresis (PFGE) for typing a collection of 29 epidemiologically characterized vancomycin-resistant Enterococcus faecium (VRE). Sixteen strains that harbored the Tn1546 element were typed by PCR mapping. The discriminative power of the typing methods was calculated by the Simpson's index of diversity, and the concordance between methods was evaluated by the Kendall's coefficient of concordance. Semi-automated rep-PCR appeared as discriminative as PFGE and was further compared with PFGE for typing 67 VRE isolated during a hospital outbreak. Rep-PCR appeared to be more discriminative than PFGE for this second set of strains. Reproducibility of DiversiLab® was also tested against 35 selected isolates. Only three showed less than 97% similarity, indicating high reproducibility at this level of discrimination. In conclusion, semi-automated rep-PCR is a useful tool for rapid screening of VRE isolates during an outbreak, although cost of the system may be limiting for routine implementation. PFGE, which remains the reference method, should be used for confirmation and evaluation of the genetic relatedness of epidemic isolates., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Objectives: To estimate the associations between occupational exposure to pesticides and extrahepatic biliary tract carcinoma in men, a population-based case-control study was carried out., Methods: Cases (n = 104), aged 35-70, diagnosed in 1995-1997, were sampled by active reporting systems from hospitals. Controls (n = 1,401) were a random sample of the general male population. Information on occupation and confounding factors was obtained by questionnaires. Exposures were quantified with respect to time, application methods, and use of personal protective equipment. Intensity was evaluated by using a published algorithm which weighted the exposure assigned according to the use of personal protective equipment and mode of application. Logistic regression analyses were conducted adjusted for gallstones, age, and country., Results: Being ever exposed to pesticides resulted in an odds ratio (OR) of 1.0 [95%-confidence interval (CI) 0.6-1.6]. A modestly elevated risk was found for backpack mounted sprayers OR = 1.4 [95% CI 0.7-2.6] and vine farmers OR = 2.5 [95% CI 0.9-7.2]. Using time periods and exposure frequency as intensity measure, no elevated risks were found. The only exception was year of maximum exposure which yielded an OR of 1.6 [95% CI 0.7-3.5]. However, no clear trend was observed in this analysis., Conclusions: This study does not rule out that pesticide exposure represents an occupational risk factor for extrahepatic biliary tract carcinoma, but no indication of a strong association was observed. Some modes of exposure were weakly, albeit not significantly associated with carcinoma risk. The observed estimates of effects may be influenced by a lack of precise exposure assessment. Different chemical compositions of pesticides were utilized during a long time span of pesticide exposure, and it should be considered that the exposure is assessed with substantial uncertainty that could non-differential and bias results toward the null.

The detection of vancomycin-resistant enterococci using a novel commercial multiplex real-time polymerase chain reaction assay (Xpert vanA/vanB, Cepheid, Sunnyvale, CA) was evaluated on 804 rectal swab specimens. Compared to enriched culture, sensitivity and negative predictive value of this method were 100%. Many false-positive results were recovered (sensitivity, 85.4%; positive predictive value, 8.7%), especially for the vanB gene.

The aim of this study was to investigate the infection process of M. graminicola and the defence mechanisms related to active oxygen species (AOS) in five French wheat cultivars. These cultivars exhibited various resistant levels to M. graminicola infection: Maxyl, Caphorn and Gen11 are susceptible cultivars, whereas Capnor and Gen23 show high levels of quantitative resistances. In addition, Capnor, Gen23 and Gen11 are tolerant cultivars, i.e., their yield performance was less affected by infection compared to non-tolerant cultivars. Cultivars were inoculated with the IPO323 reference M. graminicola strain. First wheat leaves were collected 3, 5, 7, 9, 11, 13, 15, 17, 19, and 21 days after inoculation. The cytological and antioxidant response of the cultivars were both studied over the whole time course. Although infection occurred mainly through stomata, direct penetration attempts were also scored. Moreover, papilla formation turned out to be very rare. Assays for changes in peroxydase (PO), glutathione-S-transferase (GST) and lipoxygenase (LOX) activities allowed us to compare their levels in the five French wheat cultivars regarding to their resistance and/or tolerance towards M. graminicola infection. PO and GST were correlated to necrosis probably as a consequence of detoxification and LOX was related to some of the germination process steps. We also showed that significant differences for several biochemical parameters exist between the studied cultivars in non inoculated conditions but these differences were less important in the presence of the fungus.

Objectives: This study investigated the association between cancer of the extrahepatic biliary tract and exposure to endocrine-disrupting compounds., Methods: Altogether 183 men with histologically confirmed carcinoma of the extrahepatic biliary tract and 1938 matched controls were interviewed between 1995 and 1997 in the frame of an international multicenter case-control study in six European countries (Denmark, France, Germany, Italy, Spain, and Sweden). Self-reported job descriptions were converted to semiquantitative variables (intensity, probability, and duration of exposure) for 14 endocrine-disrupting compounds. The cases were compared with 1421 population controls and 517 colon adenocarcinoma patients. Odds ratios (OR) and 95% confidence intervals (95% CI) were obtained with unconditional logistic regression and adjusted for age, country, and gallstones., Results: Occupational exposure to endocrine-disrupting compounds resulted in an OR of 1.4 (95% CI 1.0-2.1) with no dose-effect relationship for cumulative exposure (low: OR 1.3, 95% CI 0.6-3.0; medium: OR 1.5, 95% CI 0.8-2.7; high: OR 1.4, 95% CI 0.9-2.4) (only index participants). The elevated risk was restricted to extrahepatic bile ducts and ampulla Vateri (OR 1.7, 95% CI 1.0-2.6). The adjusted OR for cancer of the extrahepatic biliary tract after exposure to polychlorinated biphenyls was 2.8 (95% CI 1.3-5.9, only index participants)., Conclusions: The data show some associations between exposure to endocrine-disrupting compounds in the workplace and the risk for cancer of the extrahepatic biliary tract among men, particularly for the extrahepatic bile duct and ampulla of Vater. Polychlorinated biphenyls could possibly be a strong risk factor.

We present the main results of the first population-based cancers survival study gathering all French registry data. Survival data on 205,562 cancer cases diagnosed between 01/01/1989 and 31/12/1997 were analysed. Relative survival was estimated using an excess rate model. The evolution of the excess mortality rate over the follow-up period was graphed. The analysis emphasised the effect of age at diagnosis and its variation with time after diagnosis. For breast and prostate cancers, the age-standardised five-year relative survivals were 84% and 77%, respectively. The corresponding results in men and women were 56% versus 58% for colorectal cancer and 12% versus 16% for lung cancer. For some cancer sites, the excess mortality rate decreased to low values by five years after diagnosis. For most cancer sites, age at diagnosis was a negative prognostic factor but this effect was often limited to the first year after diagnosis.

Using a multilevel Cox model, the association between socioeconomic and geographical aggregate variables and survival was investigated in 81 268 patients with digestive tract cancer diagnosed in the years 1980-1997 and registered in 12 registries in the French Network of Cancer Registries. This association differed according to cancer site: it was clear for colon (relative risk (RR)=1.10 (1.04-1.16), 1.10 (1.04-1.16) and 1.14 (1.05-1.23), respectively, for distances to nearest reference cancer care centre between 10 and 30, 30 and 50 and more than 90 km, in comparison with distance of less than 10 km; P-trend=0.003) and rectal cancer (RR=1.09 (1.03-1.15), RR=1.08 (1.02-1.14) and RR=1.12 (1.05-1.19), respectively, for distances between 10 and 30 km, 30 and 50 km and 50 and 70 km, P-trend=0.024) (n=28 010 and n=18 080, respectively) but was not significant for gall bladder and biliary tract cancer (n=2893) or small intestine cancer (n=1038). Even though the influence of socioeconomic status on prognosis is modest compared to clinical prognostic factors such as histology or stage at diagnosis, socioeconomic deprivation and distance to nearest cancer centre need to be considered as potential survival predictors in digestive tract cancer.

83 participants thought about a white bear before or after trying to suppress the idea. There was no rebound effect (more expression of white-bear thoughts after than before suppression) for either introverts or extraverts.

We report a case of desmoid tumor in the submandibular region in an 18-month-old girl. Head and neck desmoid tumors are uncommon in children and diagnosis is a difficult task because the tumors are often classified as different types of fibromatosis. This histologically benign affection is characterized by local expansion or destruction and tends to recur. Pathology gives the positive diagnosis, showing fibroblastic monoclonal proliferation between the cellular center and the collagen periphery. Electron microscopy evidences an abundant collagen network enclosing a polymorphous cellular proliferation. Immunohistochemistry defines vimentin and actin positive desmoid tumors. Surgery is usually the therapeutic choice. Chemotherapy and radiotherapy may be used in conjunction with surgery in situations of recurrence or unsatisfactory surgical margin. There is a risk of recurrence which can be detected with regular follow-up examinations.

We present a case of right sided blindness caused by a cavernous carotid artery aneurysm in a 17-year-old patient presenting with an Alagille syndrome. The diagnosis was made by magnetic resonance imaging and confirmed by angiography. This aneurysm was treated successfully with endovascular placement of detachable balloons. Cerebral vascular malformations are rarely reported in association with this syndrome. We discuss the clinical presentation, diagnosis, treatment and detection of this type of abnormality.

Craniofacial fibrous dysplasia manifests clinically with dysmorphic syndrome, ophtalmologic or otologic signs. We report a case of temporal polyostotic fibrous dysplasia with vertigo and sensorineural hearing loss. Sensorineural hearing loss, with no cholesteatoma associated, as described in our case is rarely described. We review the literature concerning main clinical, diagnostic and therapeutic aspects of this disease.

We report a case of Kikuchi's disease in a young man. It is a rare entity, described for the first time in 1972. It manifests clinically with cervical adenopathy and fever, often associated with other non-specific clinical signs. Laboratory tests are often normal. The diagnosis is established on the basis of histologic of lymph node excisional biopsy. Kikuchi's disease is likely to be misinterpreted as malignant lymphoma or systemic lupus erythematosus. It generally needs no treatment because it runs a spontaneously benign course with complete resolution of the symptoms within 6 months. Secondary systemic lupus erythematosus may develop. For this reason, regular follow-up of patients is recommended. The etiopathogenesis of this disease is still unknown, perhaps due to an immunologic phenomenon. It could be a hyperimmune reaction induced by various antigenic agents (infectious, neoplasic), or an autoimmune process.