Occurrence of Extended Spectrum Cephalosporin-, Carbapenem- and Colistin-Resistant Gram-Negative Bacteria in Fresh Vegetables, an Increasing Human Health Concern in Algeria.

The aim of this study was to screen for extended spectrum cephalosporin-, carbapenem- and colistin-resistant Gram-negative bacteria in fresh vegetables in Batna, Algeria. A total of 400 samples of fresh vegetables were collected from different retail stores. Samples were immediately subjected to selective isolation, then the representative colonies were identified using matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF-MS). Phenotypic and genotypic analyses were carried out in terms of species identification and relative antibiotic resistance. Transferability of the carbapenemase and mcr-bearing plasmids was verified by conjugation. The clonal relationships of carbapenemase and mcr-positive Escherichia coli isolates were studied by multi-locus sequence typing (MLST). Sixty-seven isolates were characterised and were mostly isolated from green leafy vegetables, where the dominant species identified included Citrobacter freundii, Klebsiella pneumoniae, Enterobacter cloacae, Stenotrophomona maltophilia, E. coli and Citrobacter braakii. PCR and sequencing results showed that E. coli was the bacterial species presenting the highest antibiotic resistance level in parallel to blaTEM (n = 16) and blaCTX-M-15 (n = 11), which were the most detected genes. Moreover, five isolates carried carbapenemase genes, including the blaOXA-48 and/or blaVIM-4 genes. The mcr-1 gene was detected in two E. coli isolates. MLST analysis revealed three different E. coli sequence types: ST101 (n = 1), ST216 (n = 1) and ST2298 (n = 1). Conjugation assays confirmed the transferability of the blaOXA-48 and mcr-1 genes. In this study we report, for the first time, the detection of the blaOXA-48 gene in E. coli and C. braakii isolates and the blaVIM-4 gene in vegetables. To the best of our knowledge, this is the first report on the detection of mcr-1 genes from vegetables in Algeria.

[A case of acute renal failure revealing brucellian endocarditis and neurological complications in Batna (Algeria)]. / Un cas d'insuffisance rénale aiguë révélant une endocardite brucellienne et des complications neurologiques à Batna (Algérie).

Introduction: Brucellosis is a major zoonosis affecting livestock and transmitted to humans; it is widespread worldwide with 500,000 new cases per year according to the World Health Organization. It has become rare in countries that have established an eradication policy of the disease in animals and pasteurization of milk, but remains endemo-epidemic in Algeria, where it constitutes a public health problem (incidence of 24.41 per 100,000 inhabitants in 2017). The disease is more crippling than fatal. Severe forms are exceptional, and deaths are rare, most often following endocarditis or complicated neurological damage. The biological diagnosis is made by culturing the samples (mainly blood cultures), serology or molecular biology methods. We report the case of a patient with complicated and fatal subacute multiorgan brucellosis. Observation: A 51-year-old man is hospitalized in cardiology for endocarditis, complicated by neurovascular and skin manifestations, discovered in the stage of severe renal failure, one of the dreaded autoimmune complications of infectious endocarditis. The diagnoses were confirmed by various radiographic (echocardiography, brain computed tomography, magnetic resonance imaging) and biological examinations. The brucellian etiology was proved by bacteriological test of blood cultures (Brucella melitensis) and Wright's serodiagnosis, in the absence of the Polymerase Chain Reaction (PCR) test. Conclusion: Brucellosis can have atypical, multiple, varied and misleading presentations, responsible for a difficult clinical diagnosis. The possibly fatal evolution of this pathology should remind practitioners to evoke it, in particular in front of a multivisceral infectious presentation, in a country where brucellosis is endemic. Clinicians must also act quickly and not hesitate to ask for at least a serological test.

Detection of NDM-5 and MCR-1 antibiotic resistance encoding genes in Enterobacterales in long-distance migratory bird species Ciconia ciconia, Algeria.

ß-lactams and colistin resistance in Enterobacterales is a global public health issue. In this study we aimed to investigate the occurrence and genetic determinants of Extended-Spectrum ß-lactamases, carbapenemases and mcr-encoding-genes in Enterobacterales isolates recovered from the migratory bird species Ciconia ciconia in an Algerian city. A total of 62 faecal samples from white storks were collected. Samples were then subjected to selective isolation of ß-lactams and colistin-resistant-Enterobacterales. The representative colonies were identified using Matrix-Assisted Laser Desorption-Ionisation Time-of-Flight Mass Spectrometry. Susceptibility testing was performed using the disk-diffusion method. ESBL, carbapenemases, and colistin resistance determinants were searched for by PCR and sequencing. The clonality relationships of the obtained isolates were investigated by multilocus sequence typing assays. Mating experiments were carried out to evaluate the transferability of the carbapenemase and mcr-genes. Forty-two isolates were identified as follows: Escherichia coli (n = 33), Klebsiella pneumoniae (n = 4), Proteus mirabilis (n = 4) and Citrobacter freundii (n = 1). Molecular analysis showed that twelve isolates carried the blaESBL genes alone, fifteen E. coli isolates were positive for the blaOXA-48 gene, six isolates were NDM-5-carriers (two P. mirabilis, two K. pneumoniae and two E. coli) and eight E. coli strains were positive for the mcr-1 gene. MLST results showed a high clonal diversity, where NDM-5-producing strains were assigned to two sequence types (ST167 for E. coli and ST198 for K. pneumoniae), whereas the mcr-1 positive E. coli isolates belonged to ST58, ST224, ST453, ST1286, ST2973, ST5542, ST9815 and the international high-risk resistant lineage ST101. To the best of our knowledge, this is the first report of blaNDM-5 gene in white storks and also the first describing the mcr-1 gene in white storks in Algeria. This study underlines the important role of migratory white storks as carriers of high-level drug-resistant bacteria, allowing their possible implication as indicators and sentinels for antimicrobial resistance surveillance.

Epidemiological situation analysis of cutaneous leishmaniasis in Batna (northeast): An important focus in Algeria.

Cutaneous leishmaniasis (CL) is a parasitic infection which poses a real public health problem in various countries, including Algeria. We aimed in this study to investigate the current epidemiological situation of CL in the wilaya of Batna (northeastern Algeria) during 2010-2020 and to discuss some control measures used to combat the disease in the most endemic foci. Data on CL cases and control measures were obtained from the "Direction de la Santé et de la Population (DSP) of Batna" and the "Etablissement Public de la Santé de Proximité (EPSP) of Barika". Data were analyzed and mapped using Microsoft Office Excel 2007, SPSS.21, and ArcGIS 10.3. A total of 9259 cases were notified, with a peak incidence of 1924 cases in 2010. The annual evolution of the disease showed decreasing and increasing trends during the study period. Cases were detected year-round, with a peak notification in November (1957 cases) and January (1663 cases). CL affects both genders and all age groups with predominance for males (58.6%) and infants less than 9 years old (54.4%). Most cases have occurred in western areas of the wilaya especially in the commune of Barika with 2979 cases (32.17%), followed by Abdelkader Azil (13.37%), Bitam (12.32%), Djezzar (8.67%), Ouled Ammar (7.07%), and Amdoukal (4.36%) communes. Spatiotemporal analysis showed that the highest frequencies of CL were exclusively reported in the western regions. There was no evidence of a possible relationship between Deltamethrin house spraying and leishmaniasis incidence. This study revealed that CL is highly endemic in the western areas of Batna, especially in Barika, with children less than 9 years old as the most age group at risk. The development of control measures and the selection of appropriate strategies are necessary to prevent, control, and eradicate the disease.

Buyers, Maybe Moving Second Is Not That Bad After All: Low-Power, Anxiety, and Making Inferior First Offers.

The behavioral decision-making and negotiations literature usually advocates a first-mover advantage, explained the anchoring and adjustment heuristic. Thus, buyers, who according to the social norm, tend to move second, strive to make the first offer to take advantage of this effect. On the other hand, negotiation practitioners and experts often advise the opposite, i.e., moving second. These opposite recommendations regarding first offers are termed the Practitioner-Researcher paradox. In the current article, we investigate the circumstances under which buyers would make less favorable first offers than they would receive were they to move second, focusing on low power and anxiety during negotiations. Across two studies, we manipulated negotiators' best alternative to the negotiated agreement (BATNA) and measured their anxiety. Our results show that, when facing neutral-power sellers, weak buyers who feel anxious would make inferior first offers (Studies 1 and 2). When facing low-power sellers, weak buyers would make inferior first offers across all anxiety levels (Study 2). Our findings shed light on two critical factors leading to the Practitioner-Researcher paradox: power and anxiety, and offer concrete guidelines to buyers who find themselves at low power and highly anxious during negotiations.

Using a multi-disciplinary approach to characterize groundwater systems in arid and semi-arid environments: The case of Biskra and Batna regions (NE Algeria).

This study presents a multi-disciplinary approach for the hydrogeological assessment and characterization of water resources in typical arid and semi-arid areas with high anthropogenic pressure, and where environmental conditions and political context prevent extensive field surveys. The use of a three-dimensional (3D) hydrogeological conceptual model, integrating hydrochemical and multi-isotope data, is proposed for the Batna and Biskra area (NE Algeria). Geological data were assembled in 3D geological software, from which a 3D hydrogeological conceptual model was constructed, which included the delineation of groundwater flow directions. The isotopic characterization, including deuterium and oxygen isotopic composition of water (δ2H and δ18O), and tritium (3H), provided information regarding recharge sources, flow pathways and residence times of groundwaters. Hydrochemical parameters, measured on the same samples, supported the interpretation of isotope data. All data were processed in a geographic information system (GIS) environment. The effectiveness of this approach was tested on a complex system of aquifers with high hydrogeological heterogeneity. Results show the important role the tectonic setting of an area can play in the hydrogeology and hydrochemistry of its principal groundwater systems. The fault network in the study region connects different aquifers, resulting in the mixing of groundwaters. The region most influenced by geological structures is the southern part of the study area, close to Biskra city. In fact, besides a limited contribution of recharge from rain and surface water derived from flood events, the recharge of the Cenozoic aquifers seems to proceed from the ascension of deeper Cretaceous groundwaters through the fault network, as indicated by temperature, bulk chemistry and in particular δ2H, δ18O and 3H results. In contrast, results suggest that the recharge of the low mineralized Maastrichtian waters is primarily influenced by local precipitation and runoff in the mountainous northern part of the study area. Tritium content, low salinity, and bulk chemistry all suggest such waters to be a mix of pre-bomb (deeper flow-lines within the aquifer) and recent water, with no contribution from the deepest Continental Intercalaire groundwaters. The proposed approach reduces ambiguity about the studied aquifer systems, greatly improves the conceptual understanding of their behaviour, and could provide insights into the vulnerability of the aquifers to different anthropogenic pollution phenomena. The methodology used appears to be a valid tool that could be applied to other geographical areas, to inform the design and implementation of efficient management strategies aimed at improving the quality and availability of water resources. Moreover, three-dimensional modelling methods are becoming increasingly applied to different aspects of groundwater management, to obtain a detailed picture of subsurface conditions.

Smokeless Tobacco Use, Cigarette Smoking, and Upper Aerodigestive Tract Cancers: A Case-Control Study in the Batna Region, Algeria, 2008-2011.

BACKGROUND: A significant proportion of the Algerian population uses tobacco products and is at risk of developing tobacco-associated cancers. AIMS: This case-control study reports on the association between tobacco use and the occurrence of upper aerodigestive tract (UADT) cancers in Batna, Algeria. METHODS: Incident primary UADT cancer cases in residents of Batna in 2008-2011 were identified using the regional tumor registry. One hospital and 1 population control were matched to each case by sex, year of birth, and residence. Information on tobacco use was collected, and odds ratios (ORs) were obtained using conditional logistic regression also after sex stratification. RESULTS: The study included 192 cases (80%) of the 241 primary UADT cancer cases identified and 384 controls. Males represented 76.6% of cancer cases. Cancers of the nasopharynx (48%) and the larynx (26%) were the most common types. Ever use of smokeless tobacco (ST) (OR = 1.0; 95% confidence interval [CI]: 0.6-1.5) or current ST use (OR = 1.1; 95% CI: 0.6-1.7) was not associated with overall risk of UADT cancers. Associations with cancers of the nasopharynx (OR = 1.5; 95% CI: 0.5-4.6) and oral cavity/oropharynx (OR = 3.0; 95% CI: 0.8-11.8) were found when comparing use of ST only to no consumption of any tobacco. Cigarette smoking was associated with an increase in the overall risk of UADT cancers, with a 3-fold increase in the risk of laryngeal cancer when comparing smoking only to no consumption of any tobacco (OR = 3.3; 95% CI: 1.0-11.5). Associations for smokers who also consumed ST differed by cancer site. CONCLUSION: In this study from Algeria dominated by male cases and by cancer in the nasopharynx, cigarette smoking but not ST was associated with UADT cancer. Analyses by anatomical site and using as reference never use of any type of tobacco suggested few associations with ST but of lower precision.