Multiple host colonization and differential expansion of multidrug-resistant ST25-Acinetobacter baumannii clades.

The Acinetobacter baumannii clonal lineage ST25 has been identified in humans and animals and found associated with outbreaks globally. To highlight possible similarities among ST25 A. baumannii of animal and human origins and to gather clues on the dissemination and evolution of the ST25 lineage, we conducted a phylogenetic analysis on n = 106 human and n = 35 animal A. baumannii ST25 genomes, including 44 sequenced for this study. Resistance genes and their genetic background were analyzed, as well. ST25 genomes are clustered into four clades: two are widespread in South America, while the other two are largely distributed in Europe, Asia and America. One particular clade was found to include the most recent strains and the highest number of acquired antibiotic resistance genes. OXA-23-type carbapenemase was the most common. Other resistance genes such as blaNDM-1, blaPER-7, and armA were found embedded in complex chromosomal regions present in human isolates. Genomic similarity among multidrug resistant ST25 isolates of either animal or human origin was revealed, suggesting cross-contaminations between the two sectors. Tracking the clonal complex ST25 between humans and animals should provide new insights into the mode of dissemination of these bacteria, and should help defining strategies for preserving global health.

Chronic Pruritus in the Absence of Skin Disease: A Retrospective Study of 197 French Inpatients.

Chronic pruritus (CP) can occur in the absence of skin diseases, and may be secondary to various causes. The aim of this study was to retrospectively analyse the causes of CP without skin disease in a cohort of patients from the dermatology department, including all patients hospitalized for management of their CP between 2008 and 2018. A total of 197 patients with CP without skin disease were included, mean age 66.7 years, 50.8% men. The main causes identified were psychogenic pruritus (41.1% of patients), neuropathic (36.5%), endocrine (12.2%), haematological (9.6%) and iatrogenic (7.1%) causes. The cause was unknown in 20.8% of patients. Total percent is more than 100 because some patients had several etiologies. Only one aetiology of CP was identified in most patients (69.5%), and 2 aetiologies (in 18.3%) or more (in 12.2%). Concerning symptomatic treatments, emollients were prescribed for 40.6% of patients and topical steroids for 20.3%. Among systemic treatments, gabapentinoids (33%), antidepressants (27.4%) and antihistamines (25.3%) were prescribed. The efficacy of these treatments was rarely complete.