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Among 359 healthcare workers (HCW) employed in Panzi General Referral Hospital located in Bukavu in the Democratic Republic of Congo, 148 (41.2%) tested positive for SARS-CoV-2 antibodies. Thirty-three (22.3%) of the 148 personnel with positive serology reported symptoms evoking a prior COVID-19 illness. None of the infected HCWs reported COVID-related hospitalization, and all of them recovered. Our findings indicate high and underestimated circulation of SARS-CoV-2 within the Bukavu area., SCOPUS: ar.j, info:eu-repo/semantics/published

Malaria control and elimination remained challenging in sub-Saharan Africa where pregnant women and their fetuses are mostly affected. The current strategy proposed by the WHO and its partners for accelerating progress toward malaria elimination is to use quality data for targeting and tailoring interventions toward those needing them most. The overall objective of our study was to contribute to improving the control of malaria in pregnancy through adequate identification of high-risk groups that could be potentially targeted by programs for specific actions or strategies. Specifically, we aimed at 1) determining the prevalence of placental malaria and assessing whether its associated factors are varying with age; 2) determining the low birth weight or prematurity prevalence in newborns from mothers infected with malaria and its burden in teenagers; 3) accurately estimating fetal biometry in pregnant women with malaria in rural settings for gestational age and abnormal fetal size determination. We analyzed data from pregnant women treated for malaria in the framework of a clinical trial and explored interactions between age and maternal factors. We found that young pregnant women with low gravidity, anemia, and presenting with symptoms like fever were more at risk of placental malaria and delivered more low birth weight or preterm neonates than their older counterparts. Also, the estimation of the fetal size in these women varied with the reference biometric chart used. Our findings are in line with the approach in the fight against malaria. They point out the need for comprehensive interventions targeting young pregnant women including malaria prevention and treatment but also nutritional support. Ultrasound practice should be standardized, particularly the choice of ultrasound reference biometric chart for accurate gestational age and fetal size estimation. This might benefits greatly the fetuses of the young mothers affected by malaria in pregnancy, (SP - Sciences de la santé publique) -- UCL, 2020

As of 2018, 40 (77%) of 50 countries/territories in Latin America and the Caribbean have established policies for seasonal influenza vaccination. Despite high coverage levels among the high-risk groups targeted for vaccination, these countries have not routinely measured influenza vaccine effectiveness (VE). We aimed to estimate VE in preventing influenza-associated severe illness among young children and the elderly in Latin America to demonstrate the value of current vaccination strategies and sustain investments in influenza vaccines. We built on the existing severe acute respiratory infections (SARI) surveillance platforms, integrating data from immunization programs to conduct a multi-country case test-negative control study at 123 sentinel hospitals during 2013–2017 in Argentina, Brazil, Chile, Colombia, Costa-Rica, Honduras, El Salvador, Panama, and Paraguay. Surveillance staff identified children aged six months‒2 years and adults aged ≥60 years (both eligible for influenza vaccination provided free of charge by immunization programs) among patients hospitalized with SARI and collected a respiratory specimen from them within ten days of illness onset. Cases were SARI case-patients with influenza virus infection confirmed by reverse transcription polymerase chain reaction (RT-PCR); controls were SARI case-patients RT-PCR negative for influenza viruses. An individual was considered vaccinated if he/she had documented proof of vaccination during the most recent influenza vaccination campaign/season and at least 14 days before the onset of symptoms. We defined full vaccination as the receipt of one dose among adults, and children aged ≤2 years if previously vaccinated; two doses were required for full vaccination of vaccine naïve children aged ≤2 years. All countries used trivalent inactivated influenza vaccines. We used a two-stage random effects model to estimate pooled VE per target age group (children or older adults), adjusting for calendar time (month of i, Doctorat en Santé Publique, info:eu-repo/semantics/nonPublished

Background: After more than 15 years of community-directed treatment with ivermectin (CDTI) in the Centre 1, Littoral 2 and West CDTI projects in Cameroon, the epidemiological evaluation conducted in 2011 revealed that onchocerciasis endemicity was still high in some communities. The conceptual framework for onchocerciasis elimination recommends in such case, to conduct additional phase 1A surveys at intervals of three to four years. Therefore, to assess the progress made towards the elimination of onchocerciasis in the three CDTI projects, we conducted in 2015 a cross-sectional survey in 23 unevaluated communities where the highest baseline endemicity levels were found. To investigate the potential reasons explaining this high endemicity, a cluster coverage survey was conducted during the same period in three health districts (HD), to assess the implementation of the CDTI, the 2014 therapeutic coverage and the five-year adherence to treatment. Results: In the Bafia HD (Centre 1), the microfilaridermia weighted prevalences varied from 24.4 to 57.0 % while in the Yabassi HD (Littoral 2), they varied from 12.3 to 59.3 %. In surveyed communities of the West Region, the microfilaridermia weighted prevalences varied from 0 to 41.6%. Except for Makouopsap which had 41.6%, all the 14 surveyed communities were below 15% with 11 (73.3%) communities having <5%. The community microfilarial load significantly dropped by 98–100% in all surveyed communities. The CDTI organization and the involvement of household’s heads were usually weak, with 84.0% (95% CI: 81.2-86.4) of them who didn’t participate in activities during the 2014 mass drug administration (MDA). The 2014 weighted therapeutic coverage was 64.1% (95% CI: 56.8-70.9), with no significant difference in the three HDs. The survey coverages were lower than the reported coverages with significant differences varying from 14.1 to 22.0%. Factors associated with the five-year adherence were a good organization and implication, (SP - Sciences de la santé publique) -- UCL, 2018

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has initiated a revolution in routine microbiology. Septicemia is a severe infection and a rapid microbiological diagnosis can lead to prompt optimization of antimicrobial therapy and improved clinical outcomes. Validation of MALDI-TOF MS identification directly from positive blood culture bottles and from young subcultured colonies allowed results on the day of positivity detection. Routine-integration of these approaches with rapid resistance detection tests significantly reduced the turn-around-time to laboratory results and to the administration of the optimal antimicrobial treatment. MALDI-TOF MS has also been challenged as a typing tool for the investigation of nosocomial outbreaks. Dendrogram results showed good concordance with molecular typing techniques. Further standardization is essential., La spectrométrie de masse (MS) de type MALDI-TOF (matrix-assisted laser desorption ionization time of flight) est à l’origine d’une révolution en microbiologie clinique. Le diagnostic microbiologique rapide d’une septicémie permet la mise en place accélérée d’un traitement antibiotique ciblé et une amélioration de l’issue clinique du patient. La validation de l’identification des pathogènes par MALDI-TOF MS directement sur hémocultures positives et sur jeunes subcultures a permis l’obtention d’un résultat le jour de détection de positivité des hémocultures. L’intégration de ces approches dans une procédure de prise en charge des hémocultures positives avec des tests rapides de détection de résistance a permis de réduire significativement le temps jusqu’à l’administration d’un traitement ciblé. MALDI-TOF MS a également été évaluée comme outil de typage dans des épidémies nosocomiales. Les dendrogrammes ont montré une concordance correcte avec des techniques de typage moléculaire., (MED - Sciences médicales) -- UCL, 2016

Les bactéries du genre Shigella sont responsables de la shigellose, une maladie diarrhéique invasive du colon. L’entrée et la dissémination de Shigella à travers l’épithélium colique sont médiées par un système de sécrétion de type III (SST3) codé par un plasmide de virulence. Au sein de ce plasmide se trouve une région de 30-kb comportant les gènes impliqués dans l’entrée de la bactérie dans les cellules hôtes. Ces gènes sont regroupés en deux loci :le locus ipa-ipg qui code pour les protéines sécrétées et leurs chaperons ainsi que le locus mxi-spa codant pour les composants de l’appareil de sécrétion de type III (AST3), constitué d’un bulbe cytoplasmique, d’un corps basal transmembranaire et d’une aiguille se projetant au niveau extracellulaire. Ce système permet la sécrétion ordonnée et hiérarchique de différentes classes de protéines et la translocation de certaines d’entre elles (appelées effecteurs) dans le cytoplasme de la cellule hôte où elles interfèrent avec les voies de signalisation cellulaires. Avant le contact avec la cellule hôte, l’AST3 est inactif et verrouillé par les protéines IpaB et IpaD formant le complexe d’extrémité.Chez Shigella, le gatekeeper MxiC séquestre les effecteurs au niveau du cytoplasme bactérien avant la transmission par l’aiguille du signal d’activation de la sécrétion mais les composants intermédiaires liant l’aiguille à MxiC restaient inconnus. Au cours de ce travail, nous avons montré que MxiC forme un complexe avec la sous-unité de la tige interne, MxiI, afin de bloquer l’entrée du canal de sécrétion et que cette interaction est conservée chez Yersinia et Salmonella. Nous démontrons que, suite au contact cellulaire, la dissociation de ce complexe facilite le switch de sécrétion des translocateurs aux effecteurs. Nos résultats révèlent également que MxiC est capable de s’associer au chaperon IpgC afin de réguler la sécrétion des translocateurs. De plus, nous avons identifié les domaines de MxiC engagés dans la régulation du, Doctorat en Sciences biomédicales et pharmaceutiques, info:eu-repo/semantics/nonPublished

Ketolides differ from macrolides by removal of the 3-O-cladinose (replaced by a keto group), a 11,12- or 6,11-cyclic moiety and a heteroaryl-alkyl side chain attached to the macrocyclic ring through a suitable linker. These modifications allow for anchoring at two distinct binding sites in the 23S rRNA (increasing activity against erythromycin-susceptible strains and maintaining activity towards Streptococcus pneumoniae resistant to erythromycin A by ribosomal methylation), and make ketolides less prone to induce methylase expression and less susceptible to efflux in S. pneumoniae. Combined with an advantageous pharmacokinetic profile (good oral bioavailability and penetration in the respiratory tract tissues and fluids; prolonged half-life allowing for once-a-day administration), these antimicrobial properties make ketolides an attractive alternative for the treatment of severe respiratory tract infections such as pneumonia in areas with significant resistance to conventional macrolides. For telithromycin (the only registered ketolide so far), pharmacodynamic considerations suggest optimal efficacy for isolates with minimum inhibitory concentration values < or = 0.25 mg/l (pharmacodynamic/pharmacokinetic breakpoint), calling for continuous and careful surveys of bacterial susceptibility. Postmarketing surveillance studies have evidenced rare, but severe, side effects (hepatotoxicity, respiratory failure in patients with myasthenia gravis, visual disturbance and QTc prolongation in combination with other drugs). On these bases, telithromycin indications have been recently restricted by the US FDA to community-acquired pneumonia, and caution in patients at risk has been advocated by the European authorities. Should these side effects be class related, they may hinder the development of other ketolides such as cethromycin (in Phase III, but on hold in the US) or EDP-420 (Phase II).

Vancomycin and teicoplanin are still the only glycopeptide antibiotics available for use in humans. Emergence of resistance in enterococci and staphylococci has led to restriction of their use to severe infections caused by Gram-positive bacteria for which no other alternative is acceptable (because of resistance or allergy). In parallel, considerable efforts have been made to produce semisynthetic glycopeptides with improved pharmacokinetic and pharmacodynamic properties, and with activity towards resistant strains. Several molecules have now been obtained, helping to better delineate structure-activity relationships. Two are being currently evaluated for skin and soft tissue infections and are in phases II/III. The first, oritavancin (LY333328), is the 4'-chlorobiphenylmethyl derivative of chloroeremomycin, an analogue to vancomycin. It is characterised by: i) a spectrum covering vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA) and to some extent glycopeptide-intermediate S. aureus (GISA); ii) rapid bactericidal activity including against the intracellular forms of enterococci and staphylococci; and iii) a prolonged half-life, allowing for daily administration. The second molecule is dalbavancin (BI397), a derivative of the teicoplanin analogue A40926. Dalbavancin has a spectrum of activity similar to that of oritavancin against vancomycin-sensitive strains, but is not active against VRE. It can be administered once a week, based on its prolonged retention in the organism. Despite these remarkable properties, the use of these potent agents should be restricted to severe infections, as should the older glycopeptides, with an extension towards resistant or poorly sensitive bacteria, to limit the risk of potential selection of resistance.

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One hundred twenty-nine 111In-oxine-labeled leukocyte scintiscans have been performed in 117 patients with cancer in order to diagnose localized infectious disease. Of the 115 contributive scans, 40 were in patients with localizing signs, whereas in 75 fever of unknown origin constituted the indication for this examination. The overall specificity of the method was 95.4%, the overall sensitivity 86%, and the global accuracy 91.3%. In 10 cases with localizing signs, the 111In-oxine granulocyte scintigram allowed exclusion of the diagnosis of infection, whereas in 17 instances without localizing signs, a focal infectious process was demonstrated. Heterologous donor leukocytes were used successfully in five instances. With the exception of accumulation of label at the site of an osteolytic metastasis in one case, no uptake was observed in primary or secondary tumors. It is concluded that 111In-oxine-labeled leukocytes constitute a valuable tool in the diagnosis and localization of infection in patients with malignant disease., SCOPUS: NotDefined.j, FLWIN, info:eu-repo/semantics/published

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