[Combating antimicrobial resistance: audits of practices to target actions]. / Lutte contre l'antibiorésistance : audits des pratiques pour cibler les actions.

Antibiotic resistance is a public health emergency requiring a concerted approach and motivating the implementation of antibiotic stewardship programmes. As part of an institutional project at the Centre hospitalier universitaire vaudois, we collected data on the appropriateness of antimicrobial prescriptions in various medical and surgical departments in order to identify areas for improvement. The results show that there is room for improvement and that there are differences between departments, particularly regarding surgical prophylaxis administered beyond the operating time, adaptation of the spectrum and duration. Prescribing appropriateness data is an essential complement to consumption data for adapting effective intervention strategies.

L'antibiorésistance constitue une urgence de santé publique justifiant une approche concertée et motivant la mise en place de programmes de gestion des antibiotiques (Antibiotic Stewardship). Dans le cadre d'un projet institutionnel conduit au Centre hospitalier universitaire vaudois, nous avons collecté dans différents services médico-chirurgicaux des données d'adéquation des prescriptions afin d'identifier les domaines d'amélioration. Les résultats obtenus montrent qu'il existe une marge d'amélioration et des différences interservices, en particulier concernant les prophylaxies chirurgicales administrées au-delà du temps opératoire, l'adaptation du spectre et la durée. Les données d'adéquation des prescriptions sont un complément essentiel aux données de consommation pour adapter des stratégies d'intervention efficaces.

Synthesis, Experimental and Theoretical Study of Azidochromones.

A series of 2-(haloalkyl)-3-azidomethyl and 6-azido chromones has been synthetized, characterized and studied by theoretical (DFT calculations) and spectroscopic methods (UV-Vis, NMR). The crystal structure of 3-azidomethyl-2-difluoromethyl chromone, determined by X-ray diffraction methods, shows a planar framework due to extended π-bond delocalization. Its molecular packing is stabilized by F···H, N···H and O···H hydrogen bonds, π···π stacking and C-O···π intermolecular interactions. Moreover, AIM, NCI and Hirshfeld analysis evidenced that azido moiety has a significant role in the stabilization of crystal packing through weak intermolecular interactions, where analysis of electronic density suggested closed-shell (CS) interatomic interactions.

[Pulmonary tularemia : a diagnosis not to be missed]. / Tularémie pulmonaire : un diagnostic à ne pas manquer.

Tularemia (caused by the facultative intracellular Gram-negative bacillus Francisella tularensis) is an endemic zoonotic disease in Europe, which exhibits different clinical patterns. Following the glandular form, pneumonia is the second most frequent manifestation in Switzerland. Pulmonary tularemia often has a subacute course and fails to respond to beta-lactam antibiotics. It can also mimic tuberculosis, because of the presence of systemic symptoms, such as fever, sweats and weight loss. History of animal exposure is not always reported. Clinicians should be aware of pulmonary tularemia. They should be able to diagnose it with appropriate tools (PCR, serology) and initiate appropriate therapy (fluoroquinolones, tetracyclines or aminoglycosides).

La tularémie (causée par le bacille Gram négatif intracellulaire facultatif Francisella tularensis) est une zoonose endémique en Europe qui peut se présenter sous divers syndromes cliniques. Après la forme glandulaire, la pneumonie est la deuxième manifestation la plus courante en Suisse. La tularémie pulmonaire se caractérise par une évolution souvent subaiguë qui ne répond pas aux antibiotiques de type bêtalactamines. Elle peut aussi être confondue avec une tuberculose en raison des symptômes systémiques associés (fièvre, sudations, perte pondérale). L'exposition animale n'est pas toujours documentée. Il est important pour le clinicien de savoir reconnaître cette forme de pneumonie atypique, la diagnostiquer à l'aide des bons outils (PCR ou sérologie) et la traiter de manière appropriée (fluoroquinolones, tétracyclines ou aminoglycosides).

Antibodies against HPV16E6 oncoprotein in the Swiss HIV cohort study: Kinetics and anal cancer risk prediction.

Our aim was to describe HPV16E6 antibody kinetics prior to anal cancer in people living with HIV/AIDS (PLWHA) and evaluate the possible contribution of HPV16E6 serology to anal cancer risk prediction. For 91 persons diagnosed with anal cancer in the Swiss HIV Cohort Study (1989-2017), serial serum/plasma samples were tested for HPV16E6 antibodies using multiplex serology, supplemented with samples from 1,356 participants without anal cancer. Anal cancer incidence was estimated for PLWHA from 40 years-old in the cART era, stratified by HPV16E6 serostatus. HPV16E6 seroprevalence was 23.3% in samples <2 years prior to anal cancer diagnosis and decreased with increasing time prior to cancer: 16.7% at 2-4 years, 4.4% at 5-9, and 7.0% at ≥10 years. Of 25 individuals with anal cancer who were HPV16E6-seropositive at any time during follow-up, the majority (n = 18) remained seropositive in all samples after seroconversion, whereas for seven cases, seropositivity was transitory. Among individuals with anal cancer, HPV16E6 seroprevalence was marginally higher in women vs. men who have sex with men (adjusted OR = 4.3, 95% CI: 1.1, 17.2) and in older participants (adjusted OR = 6.2, 95% CI: 1.1, 34.8 for cases diagnosed at ≥55 vs. <45 years). Anal cancer incidence was 402/100,000 person-years in HPV16E6-positive vs. 82/100,000 in HPV16E6-negative PLWHA (incidence rate ratio = 4.9, 95% CI: 1.3, 13.1). In conclusion, HPV16E6 serology, despite its low sensitivity, allows characterization of a group of individuals with very high anal cancer incidence and may have a place in secondary prevention in groups at high risk for anal cancer such as PLWHA.

Actividad antimicrobiana de adhesivo ortodóntico con nanopartículas de plata sobre Streptococcus mutans / Antimicrobial activity of orthodontic adhesive with silver nanoparticles on Mutans streptococci / Atividade antimicrobiana de adesivo ortodôntico com nanopartículas de prata sobre streptococcus mutans

La aparatología fija usada en ortodoncia dificulta una adecuada higiene bucal, en estas condiciones el de-sarrollo de lesiones cariosas puede ser una complicación, uno de los principales agentes etiológicos involu-crados es Streptococcus mutans. La nanotecnología con plata tiene una aplicación preventiva importante en biomateriales dentales. Objetivo: Se determinó la actividad antimicrobiana sobre Streptococcus mutans de nanopartículas de plata (AgNPs) incluidas en adhesivos ortodónticos a diferentes concentraciones. Materia-les y métodos: En 20 cajas Petri con Streptococcus mutans inoculada en agar Müller-Hinton suplementado con 5% de sangre, se colocaron 6 discos de papel, 4 embe-bidos con AgNPs incluidas en un adhesivo orto-dóntico a concentraciones de 25, 75, 125 y 175 ppm, y 2 discos controles con clorhexidina al 0.12% y agua destilada. Se determinó la capacidad antimicrobiana en función de promedios de halos de inhibición a las 48 horas de incubación, en comparación con la escala de Duraffourd y la clorhexidina 0.12%. Resultados: A 25 ppm no existió capacidad antibacteriana, a 75 ppm el 50% alcanzó sensibilidad límite, pero el 100% de las muestras a 125 y 175 ppm consiguieron sensibilidad límite, sin embargo, la clorhexidina al 0,12% presentó mayor sensibilidad entre media 60% y sumamente sensible 40%. Conclusión: Las nanopartículas de plata con tamaño inferior a 100 nm, incluidas a 125 y 175 ppm en adhesivos de ortodoncia poseen actividad anti-microbiana sobre Streptococcus mutans, sin embargo, en el tiempo de estudio no alcanzan la sensibilidad de la clorhexidina al 0.12%.

The fixed appliances used in orthodontics make proper oral hygiene difficult, in these conditions the develop-ment of carious lesions can be a complication, one of the main etiologic agents involved is Mutans streptococci. It was determined that silver nanotechnology has an important preventive application in dental biomaterials. Objective: Antimicrobial activity on Mutans streptococci of silver nanoparticles (AgNPs) included in orthodon-tic adhesives at different concentrations. Materials and methods: In 20 Petri dishes with Mutans streptococci inoculated in Müller-Hinton agar supplemented with 5% blood, 6 paper discs were placed, 4 soaked up with AgNPs included in an orthodontic adhesive at concentrations of 25, 75, 125 and 175 ppm, and 2 control discs with 0.12% chlorhexidine and distilled water. Antimicrobial capacity was determined based on averages of inhibition halos at 48 hours of incubation, compared to the Duraffourd scale and 0.12% chlorhexidine. Results:At 25 ppm there was no antibacterial capacity, at 75 ppm 50% reached limit sensitivity, but 100% of the sam-ples at 125 and 175 ppm achieved limit sensitivity, however, chlorhexidine 0.12% showed higher sensitivity be-tween average 60% and highly sensitive 40%. Conclusión: Silver nanoparticles smaller than 100 nm, included at 125 and 175 ppm in orthodontic adhessives, have antimicrobial activity on Strptococcus mutans, however, when studying, they don't reach the sensitivity of chlorhexidine at 0.12%.

Os aparelhos fixos utilizados em ortodontia dificultam uma higiene bucal adequada, nessas condições o desenvolvimento de lesões cariosas pode ser uma complicação, um dos principais agentes etiológicos envol-vidos é o Streptococcus mutans. A nanotecnologia com partículas de prata tem uma importante aplicação pre-ventiva em biomateriais dentários. Objetivo: Determinou-se a atividade antimicrobiana das nanopartículas de prata (AgNPs) incluídas em adesivos ortodônticos em diferentes concentrações sobre Streptococcus mutans. Materiais e métodos: Em 20 placas de Petri com Streptococcus mutans inoculadas em ágar Müller-Hinton suplementado com 5% do sangue, foram colocados 6 discos de papel, 4 ensopados com AgNPs incluídos em um adesivo ortodôntico nas concentrações de 25, 75, 125 e 175 ppm e 2 discos de controle com 0,12% de clorexidina e água destilada. O efeito antimicrobiano foi determinado com base nas médias de halos de inibição às 48 horas de incubação, em comparação com a escala de Duraffourd e com clorexidina a 0,12%. Resultados: A 25 ppm não havia capacidade antibacteriana, a 75 ppm 50% atingiram a sensibilidade limite, mas 100% das amostras a 125 e 175 ppm atingiram a sensibilidade limite, no entanto, 0,12% de clorexidina apresentou maior sensibilidade entre 60% em média e 40% altamente sensíveis. Conclusão: Nanopartículas de prata menores que 100 nm, incluídas em 125 e 175 ppm em adesivos ortodônticos, têm atividade antimi-crobiana em Streptococcus mutans, no entanto, no tempo

A small, new gerbil-mouse Eligmodontia (Rodentia: Cricetidae) from dunes at the coasts and deserts of north-central Chile: molecular, chromosomic, and morphological analyses.

A small, new species of gerbil rodents of the genus Eligmodontia from the southwestern dunes of the Atacama Desert in northern Chile is described; the genus had not been reported for this western lowland region. Our description is based on cytogenetic and molecular data, as well as cranial and external morphology. In order to support this hypothesis, we studied 27 specimens captured in Playa Los Choros (Coquimbo) and Copiapó (Atacama), comparing them with samples of all the extant species of the genus. Nineteen individuals consistently showed 2N=50, FN=48, with telocentric chromosomes and G-bands identical to those of the geographically northeastern E. hirtipes; these two groups were geographically separated by E. puerulus (2N = 34, FN = 48). The phylogenetic analysis of 56 Eligmodontia cytochrome-b gene sequences yielded a maximum-likelihood phylogenetic tree where the new species formed a divergent and well-supported clade within the genus, which was also confirmed by unweighted parsimony, minimum evolution, and Bayesian analyses. The new species has K2P genetic distances of 12.8% from the geographically distant E. hirtipes, and 10.3% from E. puerulus. Axes 1 and 2 of Principal Component Analysis based on 12 body and skull measurements clearly separated the new species, the latter having a smaller head+body length (70.6 +/- 3.4 mm, n = 17) and lower weight (11.9 +/- 1.9 g, n = 20). We provide strong evidence to recognize a distinct new western lineage within Eligmodontia genus, Eligmodontia dunaris sp. nov., for which we give a complete taxonomic description and a hypothetical biogeographic scenario. The new species should be considered endangered, due to its level of endemism, its low population numbers (which can be occasionally increased after a blooming desert) and its fragile dry habitat patchily distributed near the Atacama Desert.