Fatal leptospirosis in free-ranging Eurasian beavers (Castor fiber L.), Switzerland.

Leptospirosis was first diagnosed in free-ranging Eurasian beavers (Castor fiber L.) in Switzerland in 2010. Pathologic, serologic, molecular and epidemiologic analyses were carried out on 13 animals submitted for necropsy from 2010 through 2014. Typical lesions included alveolar haemorrhages in the lungs, tubular degeneration and interstitial nephritis in the kidneys. Microscopic agglutination test results were positive for serogroups Icterohaemorrhagiae, Australis, Autumnalis and Sejroe. Molecular analysis identified four distinct profiles belonging to serovar Icterohaemorrhagiae or Copenhageni. The severity and features of the lesions were consistent with a fatal disease associated with leptospires similarly to what has been reported in other animals and humans. The spatiotemporal occurrence of leptospirosis in beavers suggested an upstream spread of the bacteria and coincided with an increased incidence of leptospirosis in dogs and a case cluster in humans. However, an epidemiologic link among beaver cases and among species was not supported neither by the serologic nor molecular data.

Serogroups and genotypes of Leptospira spp. strains from bovine aborted foetuses.

Leptospirosis is a global disease of animals, with potential major economic impact on livestock industry and important zoonotic capacities. The disease represents a major challenge in the developing countries as humans and animals frequently live in close association. The serovar Hardjo of Leptospira whose primary host is cattle has been studied extensively, but few data exist on other current circulating or emerging serotypes. To better understand the disease in cattle and how to prevent and/or control it, it is necessary to identify the genotype and the serotype of circulating Leptospira. This study presents results of several investigations performed on a historical Belgian collection of congenital jaundice in bovine aborted foetuses coming from the leptospirosis emerging episode of 2014 (Delooz et al., Transboundary and Emerging Diseases, 62, 2015, 124). The results revealed that L. Grippotyphosa and L. Australis were the most prevalent serogroups with, respectively, 17/42 and 13/42 positive microscopic agglutination test (MAT) during this emerging event associated with the same clinical pattern. The study also confirms that congenital jaundice is associated with L. kirscheneri and L. interrogans and provides the genotyping of DNA obtained from these two species.

The Impact of Pregnancy on the Evaluation of Chest Pain and Shortness of Breath in the Emergency Department.

BACKGROUND: Pregnant patients are at an increased risk for severe morbidity and mortality when compared to the general population. Imaging studies have become an integral part of the work-up for patients who present to the emergency department. However, lack of clear guideline has led to confusion regarding the appropriate indications and protocols for examining pregnant patients. OBJECTIVE: To investigate the comparative rates of imaging studies between pregnant and non-pregnant female patients who presented for emergent evaluation of chest pain and shortness of breath. STUDY DESIGN: All reproductive age females presenting to the emergency department at an academic teaching institution with a chief complaint of "chest pain" or "shortness of breath" from 2010 to 2015 were identifi ed. Cohorts were divided based on pregnancy status and chief complaint. Utilization rates of imaging studies were compared between cohorts. RESULTS: Over the study period 4,834 women were included. One hundred and seventy-four were pregnant. Pregnant patients with "chest pain" or "shortness of breath" were signifi cantly more likely to undergo a venous duplex, but less likely to undergo a chest X-ray as compared to non-pregnant patients. There was no difference in the rates of chest computed tomography (CT) imaging or magnetic resonance imaging (MRI) based on pregnancy status in our data set. CONCLUSION: Imaging studies are an integral adjunct for evaluation in patients reporting "chest pain" and "shortness of breath." Pregnancy places patients at an increased risk of severe sequelae requiring prompt diagnosis to prevent harm to the mother and fetus. American College of Obstetrics and Gynecology (ACOG) Committee Opinion 656 clearly states that, with few exceptions, radiography should not be withheld from pregnant patients. This study suggests that pregnant patients are signifi cantly less likely to undergo radiography, which could place them at increased risk for delayed diagnosis and treatment.

How do Spondias mombin L (Anacardiaceae) leaves extract increase uterine smooth muscle contractions to facilitate child birth in parturient women?

BACKGROUND: Spondias mombin L. (Anacardiaceae) leaves were used in Togolese folk to treat dystocia, expel placenta and manage post-partum hemorrhage during child birth. OBJECTIVES: This study aimed to establish how the extract of S. mombin leaves increase uterine smooth muscle contractions relevant to its traditional use to facilitate child birth. METHODS: Tests were performed on uterus muscle strips from Sprague-Dawley rats. Central portion of uterine horns were dissected, cleaned of surrounding fat and loose connective tissue, and cut longitudinally into strips which were placed in the organ bath for isometric tension record in presence of different substances. RESULTS: S. mombin leaves extract increased uterine spontaneous contractions. This effect was reduced by indomethacin (2 × 10-6 M), yohimbine (2 × 10-6 M) and 2-aminoethoxydiphenyl borate (2-APB) (5 × 10-5 M), but not by atropine (3.45 × 10-8 M) and cholesterol (2.5 mg/ml). CONCLUSION: The pharmacological justification for the traditional use of S. mombin leaves to treat dystocia and expel placenta was that its hydro-ethanolic extract induced prostaglandins release, α2-adrenoceptors stimulation, calcium release from internal stores and lifted inhibitory effect of cholesterol on uterine contractions in order to increase uterine smooth muscle contractions.

HIV/AIDS clients, privacy and confidentiality; the case of two health centres in the Ashanti Region of Ghana.

BACKGROUND: While most studies on HIV/AIDS often identify stigmatization and patients' unwillingness to access health care as critical problems in the control of the pandemic, very few studies have focused on the possible consequences of accessing health care by sero-positives. This paper examines the socio-psychological trauma patients experience in their desire to access health care in two health facilities in the Ashanti Region of Ghana. METHODS: Through participant observation, informal conversation and in-depth interviews, data were collected from health workers and clients of the voluntary counselling (VCT) and antiretroviral therapy units in the two hospitals. The data gathered were analysed and categorized into themes and supported with illustrative quotes obtained from health workers and clients. RESULTS: The study found that the mere presence of a person at the HIV counselling centre or clinic is enough for the person to be labelled as or suspected to be HIV patient. It demonstrates that stigmatization may occur not only in the community but also overtly or covertly, in the health facility itself. Consequently, for many HIV/AIDS patients, access to antiretroviral therapy and treatment of related nosocomial infections are problematic. Besides, the study found that many clients and potential users of services were uncomfortable with the quality of care given by some health workers, especially as they overtly and covertly breached confidentiality about their clients' health status. This has compelled many patients and potential users of the services to adopt a modus vivendi that provides them access to some care services while protecting their identity. CONCLUSION: The paper argues that by examining issues relating to privacy and confidentiality in the provision of care for and use of services by seropositives, more light will be shed on the whys of the limited uptake of HIV-related health care services in Ghana.

Epidemiological investigation of a human leptospirosis case reported in a suburban area near Marseille.

Leptospirosis has been re-emerging in both developed and developing countries, including in Europe, where the phenomenon has notably been associated with urban transmission. In this work, we describe an epidemiological investigation that demonstrated a case of human infection due to peri-urban transmission of Leptospira interrogans serovar icterohaemorrhagiae in southeastern France.

Genotypic heterogeneity based on 18S-rRNA gene sequences among Acanthamoeba isolates from clinical samples in Italy.

Acanthamoeba keratitis (AK) is an ocular disease caused by members of a genus of free-living amoebae and it is associated predominantly with contact lens (CL) use. This study reports 55 cases of AK diagnosed in Italy. Genotype identification was carried out by PCR assay followed by sequence analysis of the 18S rRNA gene using the genus specific primers JDP1 and JDP2. Genotype assignment was based on phenetic analysis of the ASA.S1 subset of the small-subunit rRNA gene sequences. The material has been collected at the Polyclinic Tor Vergata of Rome for a total of 19 isolates and at the Polyclinic Hospital of Bari (36 isolates). Thirty-three out of the 55 genetically characterized isolates were assigned to the genotype T4. Ten isolates were identified as belonging to the genotype T15 thus confirming the first association between the genotype T15 and human amoebic keratitis previously described from the same area. We underline the occurrence of the genotype T3 and T11 identified for the first time in the country.

Presentation of glaucoma in the greater Accra metropolitan area of Ghana.

BACKGROUND: This study addresses the prevalence and clinical presentation of patients with primary open angle glaucoma (POAG) in the greater Accra metropolitan area. METHODS: This is a retrospective case series of 455 patients (813 eyes) at the Emmanuel Eye Clinic. Patients were diagnosed from May 2008 to Nov 2011. The definition of POAG conformed to the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. Information collected included basic demographic data, distribution of glaucoma subtypes, measured intraocular pressure (IOP), best corrected visual acuity (BCVA) and optic disc measurements. RESULTS: Nearly 24% presented blind in at least one eye. The average age was 56.7 +/-16.7 years and the average IOP was 33.9 mmHg +/- 12.7 mmHg for right eyes and 33.5 mmHg +/-12.0 mmHg for left eyes. The mean vertical cup to disc ratio (vCDR) was 0.83 for right eyes versus 0.82 for left eyes. A total of 32 patients (53 eyes) were diagnosed with normal tension glaucoma (NTG). Statistically significant differences between the NTG and high tension groups included age (45.3 +/- 16.7 vs. 56.7 +/-16.7, p<0.001), mean IOP (19.1 mmHg +/- 4.5 mmHg vs. 33.7 +/- 12.4 mmHg, p<0.001) and mean vCDR (0.76 +/- 0.17 vs. 0.83 +/-0.10, p<0.01). Comparing age-matched NTG patients with high tension glaucoma patients showed no significant difference in vCDR. CONCLUSIONS: The clinical presentation of POAG at the Emmanuel Eye Center is characterized by elevated IOP and grossly advanced optic neuropathy. Significant differences between high tension glaucoma and NTG were identified.

Presentation of Glaucoma in the Greater Accra Metropolitan Area of Ghana

Background: This study addresses the prevalence and clinical presentation of patients with primary open angle glaucoma (POAG) in the greater Accra metropolitan area. Methods: This is a retrospective case series of 455 patients (813 eyes) at the Emmanuel Eye Clinic. Patients were diagnosed from May 2008 to Nov 2011. The definition of POAG conformed to the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. Information collected included basic demographic data; distribution of glaucoma subtypes; measured intraocular pressure (IOP); best corrected visual acuity (BCVA) and optic disc measurements. Results: Nearly 24 presented blind in at least one eye. The average age was 56.7 +/-16.7 years and the average IOP was 33.9 mmHg +/- 12.7 mmHg for right eyes and 33.5 mmHg +/-12.0 mmHg for left eyes. The mean vertical cup to disc ratio (vCDR) was 0.83 for right eyes versus 0.82 for left eyes. A total of 32 patients (53 eyes) were diagnosed with normal tension glaucoma (NTG). Statistically significant differences between the NTG and high tension groups included age (45.3 +/- 16.7 vs. 56.7 +/-16.7; p0.001); mean IOP (19.1 mmHg +/- 4.5 mmHg vs. 33.7 +/- 12.4 mmHg; p0.001) and mean vCDR (0.76 +/- 0.17 vs. 0.83 +/- 0.10; p0.01). Comparing age-matched NTG patients with high tension glaucoma patients showed no significant difference in vCDR. Conclusions: The clinical presentation of POAG at the Emmanuel Eye Center is characterized by elevated IOP and grossly advanced optic neuropathy. Significant differences between high tension glaucoma and NTG were identified

Which antibiotics and breakpoints should be used for Aeromonas susceptibility testing? Considerations from a comparison of agar dilution and disk diffusion methods using Enterobacteriaceae breakpoints.

Aeromonas species are environmental organisms that are responsible for numerous infections in humans and animals. Their antimicrobial susceptibility is usually evaluated using Enterobacteriaceae breakpoints. Although disk diffusion and minimum inhibitory concentration (MIC)-based methods are important for infectious disease management and epidemiological surveys of resistance, comparisons between these two methods have not been extensively studied for Aeromonas isolates. We propose the first extensive comparison of agar dilution and disk diffusion susceptibility testing methods, performed for 20 antimicrobial agents, including unevaluated or incompletely evaluated antibiotics (ticarcillin with or without clavulanic acid, ertapenem, tigecycline), on 146 Aeromonas isolates affiliated with six Aeromonas species via molecular means. We evaluated the level of agreement between Enterobacteriaceae breakpoints-based methods. Reliable agreement (>95%) was observed for piperacillin, cefotaxime, cefepime, nalidixic acid, ofloxacin, ciprofloxacin, gentamicin, amikacin, tetracycline and cotrimoxazole, whereas marked inconsistencies between the methods were noted for carbapenems, amoxicillin-clavulanic acid, ticarcillin, ticarcillin-clavulanic acid, tobramycin and tigecycline. The results indicate that beta-lactam and aminoglycoside susceptibility testing should be limited to piperacillin, cephems, gentamicin and amikacin. Co-amoxiclav should be avoided given the lack of agreement between the two methods. Adjusting the zone diameter breakpoints for tigecycline and cefoxitin could also improve the agreement to >95% and reduce the error rates to acceptable levels.

[Serological study of leptospirosis in equids, camelids and bovids from Djibouti]. / Mise en evidence sérologique de leptospires chez des equidés, camélidés et bovidés a Djibouti.

Sera obtained from 31 domestic and feral animals in Djibouti were assayed for leptospiral antibodies using the microscopic agglutination test. Antibodies were detected in 26 samples (84%), corresponding to 116 positive reactions. The most common antigen serogroups were Icterohaemorrhagiae and Australis. The highest titre was recorded for serovar Munchen (1:1280) in sera from Somalian wild asses and goats. This study shows a broad dispersion and high prevalence of the different Leptospira serogroups tested. High biodiversity has been previously reported in tropical countries and is thought to be linked to the wide range of reservoir mammals. Additional study will be needed to identify the reservoirs of the different serogroups in this part of Africa.

Leptospira exposure in the human environment in France: A survey in feral rodents and in fresh water.

This paper confirms the important role of rodents to be maintenance hosts of leptospires. Their role is related to renal carriage and shedding of leptospires into urine, thus contaminating fresh water. Serological and carriage of feral rodents trapped in France were determined by MAT and hap1PCR specific for pathogenic leptospires. In same areas, fresh water samples were analyzed by hap1PCR. The overall seroprevalence was 44% in 649 rodents and was similar regardless of the species. Seroprevalence for leptospirosis is about 20-53% according to species. hap1PCR (516 kidneys) showed that renal carriage was higher in brown rats (34.7%) and muskrats (15.8%) than in coypus (3.3%). hap1PCR demonstrates a significative difference (P-value > 10(-12)) for the renal carriage between the different species: muskrats and rats are more efficient maintenance hosts than coypu but all infect water. Moreover 5/38 water samples associated with human cases were hap1PCR positive and 1/113 in controlled waters.

Serological and molecular ecology of Listeria monocytogenes isolates collected from 13 French pork meat salting-curing plants and their products.

The purpose of this study was dual: 1. to evaluate the serotype distribution of 1028 Listeria monocytogenes isolates collected in 13 French salting factories and their products and 2. to identify sources of L. monocytogenes contamination in these factories and trace the routes of spread by PFGE (Pulsed-Field Gel Electrophoresis) typing. Serotypes 1/2a, 1/2b, 1/2c, 4b and 4e occurred. Pulsotype diversity was high among strains collected in plants and products. Furthermore, strains showing similar pulsotypes occurred on the same surfaces after an interval of at least two weeks and in unrelated factories. Forty five strains were genetically closely related to a 4b serotype L. monocytogenes strain isolated from a human clinical case of listeriosis. Our results highlighted the fact that L. monocytogenes is introduced into meat processing plants through raw meat. To overcome such contamination, suppliers of raw material should adhere to specific microbiological control measures. In addition, more attention should be focused on the appropriateness and compliance with procedures of cleaning and disinfection.

Serological and molecular comparison of Mannheimia haemolytica and Pasteurella trehalosi strains isolated from wild and domestic ruminants in the French Alps.

Over a period of 17 years, 84 bacterial isolates identified as Mannheimia haemolytica or M. glucosida, and 52 isolates identified as Pasteurella trehalosi were detected in the lungs of domestic and wild ruminants in the French Alps. The isolates were serotyped according to their surface capsular antigens, and those sharing common antigens were further characterized by pulsed field gel electrophoresis. The results showed that the bacterial isolates included in the study clustered according to the host species from which they were isolated. These findings indicate that the transmission of serotypes of M. haemolytica, M. glucosida or P. trehalosi from an animal host in which they are common to another species sharing the same geographical space may be a rare epidemiological event.

Discrimination of Staphylococcus aureus strains from different species of Staphylococcus using Fourier transform infrared (FTIR) spectroscopy.

Staphylococcus aureus is a widespread opportunistic pathogen that can cause food-borne illness and is sometimes associated with raw milk and raw milk cheese products. The traditional taxonomic procedures for classification of staphylococcal species are time consuming and often several tests are required. FTIR spectroscopy offers a rapid method for the discrimination and identification of S. aureus strains isolated from raw milk and raw milk cheeses. FTIR spectroscopy was used to discriminate S. aureus from other species of Staphylococcus. This was achieved by using a model composed of 39 species and subspecies of Staphylococcus. The model was validated using a set of spectra of strains isolated from raw milk and different varieties of French raw milk cheese. S. aureus was successfully discriminated from the other species of Staphylococcus and all the strains of S. aureus isolated from raw milk and different varieties of French raw milk cheese were also successfully identified as such. These results demonstrated that FTIR spectroscopy is a rapid (results obtained within 24 h starting from a pure strain or a single colony) and robust method for the identification of S. aureus isolates of dairy origin and food-borne origin in general.

Rat bite fever caused by Streptobacillus moniliformis in a child: human infection and rat carriage diagnosed by PCR.

A child owning pet rats developed an eruptive fever with blisters, polyarthritis, and spectacular desquamation of the hands. Streptobacillus moniliformis was identified after culture of the child's blister fluid and was detected in rat samples by molecular methods. Such detection in the pet of a human victim of rat bite fever has not been reported previously.

Pulsed-field gel electrophoresis profiles of aeromonads isolated from healthy and diseased Helix aspersa from French snail farms.

The XbaI digestion patterns of chromosomal DNA of 42 aeromonads isolated from French breeding snails during a new epizootic disease, which rapidly progressed to death during the summer of 1994, were analyzed by pulsed-field gel electrophoresis. Biochemical identification to species level was also performed. Interestingly, we found that 76% of the aeromonads isolated from diseased snails clustered into a unique pulsotype (P1) whatever their geographic origin, and were assessed to belong to Aeromonas hydrophila. Other strains belonged to Aeromonas caviae or remained unspecified. Our results provide retrospective supplementary epidemiological evidence for implication of A. hydrophila strains in the snail summer disease.

Efficacy of selamectin administered topically in the treatment of feline otoacariosis.

The efficacy of a novel avermectin, selamectin (Stronghold, Pfizer), was evaluated against naturally acquired aural infestations of Otodectes cynotis. Selamectin was administered topically in a single spot to the skin of each animal's back at the base of the neck in front of the scapulae at a minimum dosage of 6mgkg(-1). Thirty cats of a cattery of 120 animals with an endemic infestation were treated on days 0 and 30. Including untreated control cats was therefore not possible because of animal welfare consideration. Clinical examination and visualization of mites by otoscopic examination of the external ear canal and microscopic examination of aural debris/exudate were performed twice weekly from days 0 to 30. On day 0 (and day 28 if the ears canals were erythematous), a swab was taken from each canal and sent to bacteriology and mycology units for detection and identification of bacteria (Staphylococcus mainly) and yeast (Malassezia pachydermatis only). Selamectin was safe, parasites were killed before day 3 and eliminated before day 17. Selamectin was 100% effective against natural aural infestations, even if erythema (26-33% of cats) and scratch reflex (23-40% of cats) persisted for 2 weeks after the cats tested negative for mites.

Diagnosis of canine parvovirus by rapid immunomigration on a membrane.

Rapid immunomigration on a membrane was applied to the diagnosis of canine parvovirus (CPV) in 128 samples of faeces containing four strains of parvovirus (two CPV-2a strains, including one vaccine strain, and two CPV-2b strains). The results were compared with the results of haemagglutination and ELISA sandwich techniques. The new test was quick and easy to use, and made it possible to identify both the CPV-2a and CPV-2b strains. Its detection thresholds per gram of faeces corresponded to specific haemagglutination titres of between 320 and 640 and a virus titre of between 10(4) and 10(5) CCID50 (dose required to infect 50 per cent of cell cultures).

Bacterial flora in foals with upper respiratory tract infections in Poland.

Bacteria isolated from nasal cavity of 80 foals with upper respiratory tract infection, as well as from 20 healthy foals, were examined. Within the group of sick animals, from 18 (22.5%) bacteria with recognized pathogenicity were isolated. Coagulase-negative staphylococci and Acinetobacter sp. were the dominant species identified (100 and 45%, respectively). No bacteria species with recognized pathogenicity were isolated from the group of healthy animals. Three cases of death within the group of sick foals were investigated. Rhodococcus equi in two cases and Klebsiella pneumoniae pneumoniae together with Escherichia coli were isolated post-mortem from lung abscesses.