[Microbiological testing of flexible endoscopes: contribution of the approach of accreditation in the implementation of regulation]. / Analyse microbiologique des solutions de contrôle d'endoscope : apport de la démarche d'accréditation dans la mise en application de la réglementation.

The microbiological surveillance of flexible endoscopes reprocessing involves counts of the mesophilic total aerobic revivable flora and the detection of indicator microorganisms of dysfunction. We presented the assay at the COFRAC certification, to ensure a maximal level of confidence in the quality of our results. The existing quality system management was used by the type B widened flexible scope for data from previous accreditations for the identification of Staphylococcus aureus, Enterococci and Enterobacteriaceae. The quality insurance of the results and the technical authorization were guaranteed by the participation at a program of interlaboratory comparisons and the elaboration of internal quality controls. Risks analyses and conventions were wrote with endoscopy sectors. The visit led the opening of a single and not critical deviation sheet on the control of consumables and the accreditation for the analysis was pronounced.

Dengue seroprevalence: data from the clinical development of a tetravalent dengue vaccine in 14 countries (2005-2014).

Dengue seroprevalence data in the literature is limited and the available information is difficult to compare between studies because of the varying survey designs and methods used. We assessed dengue seropositivity across 14 countries using data from 15 trials conducted during the development of a tetravalent dengue vaccine between October 2005 and February 2014. Participants' dengue seropositivity (n=8592) was determined from baseline (before vaccination) serum samples at two centralized laboratories with the plaque reduction neutralization test (PRNT50). Seropositivity rates generally increased with age in endemic settings. Although seropositivity rates varied across geographical areas, between countries, and within countries by region, no major differences were observed for given age groups between the two endemic regions, Latin America and Asia-Pacific. Seropositivity rates were generally stable over time. The proportion of participants who had only experienced primary infection tended to be higher in younger children than adolescents/adults. These results will help inform and guide dengue control strategies in the participating countries.

Efficacy of Bendiocarb Used for Indoor Residual Spraying for Malaria Control in Madagascar: Results With Local Anopheles Species (Diptera: Culicidae) From Experimental Hut Trials.

To control malaria in Madagascar, two primary vector control interventions are being scaled up: insecticide-treated nets and indoor residual spraying of bendiocarb, which was implemented in the Malagasy Central Highlands in 2009. The current efficacy of bendiocarb against Anopheles species was evaluated in a small-scale field trial. An experimental hut trial comparing the effectiveness of bendiocarb sprayed on five substrates (cement, wood, tin, mud, and vegetative materials) was carried out against Anopheles species in two study sites located in the eastern foothills of Madagascar. No significant difference was detected in either exophily or blood-feeding rates between treated and untreated huts. The mortality rate was significantly greater in treated huts compared to untreated huts. Efficacy up to 80% was found for 5 mo posttreatment. Although effective, bendiocarb has been used for 7 yr, and therefore an alternative insecticide may be needed to avoid the emergence of resistance.

Problems associated with the microbiological control of the breast milk from hospital milk bank units.

The microbiological tests on breast milk performed when samples of pasteurized breast milk are added to hospital milk banks are covered by French regulations dating from December 3rd 2007. They involve counts of the aerobic total flora and of Staphylococcus aureus in a sample of milk before pasteurization, and culture after pasteurization to check that the treated milk is sterile. The regulations specify the nature of the agar plates to be used, together with the conditions for plating and incubation, but they lack detail in other areas. We developed a quality assurance system, modified our process to meet the statutory requirements, prepared for COFRAC certification of the laboratory for this parameter, and proposed solutions to overcome the inadequacies of the regulations. The modifications of the process associated with the quality approach led to a successful initial certification visit. However, the preparation for this certification highlighted other inadequacies of the regulations that might affect the final results obtained for total flora and S. aureus counts. We think that the text should be modified to overcome these problems and to ensure high-quality counting such that those running hospital milk banks can have confidence in the laboratory results they receive.

First evaluation of bendiocarb in experimental huts using different substrates in Madagascar.

BACKGROUND: Indoor residual spraying with insecticide is recommended for malaria control in high-transmission settings. Determination of residual activity of insecticides is essential for the selection of appropriate indoor spraying policy. The present study was undertaken to evaluate the residual effect of bendiocarb, a carbamate insecticide used in Madagascar, on different indoor surfaces in order to elaborate future vector control interventions. METHODS: The residual activity of bendiocarb was evaluated in both experimental huts and houses. Tests in experimental huts on different substrates represented a small scale-field trials. The houses IRS performed in parallel of experimental huts IRS, was done to compare semi-field results and field results. Bioassays according to the World Health Organization (WHO) standard protocol were carried out on different substrates impregnated with bendiocarb using susceptible strains of Anopheles arabiensis and Aedes albopictus. RESULTS: Bendiocarb induced significantly high mortality in treated huts against exposed mosquito (p < 0.005) compared to untreated huts. The mortality is up to the WHO threshold of 80 % during 5 months post-treatment. Using a multivariate analysis, Ae. albopictus mortality decreased significantly from the 3rd month post-treatment. However, An. arabiensis mortality decreased significantly from the 4th month after treatment. Comparing mosquito mortality results from the mud experimental huts and the mud houses showed no significant difference regarding the persistence of bendiocarb on wall. CONCLUSIONS: Current data suggest variable persistence of bendiocarb according to the type of wall surfaces, highlighting the importance of testing insecticide for IRS in local context before using them in large scale. Data from this study validate also the importance of using experimental huts as representative tool to evaluate the effectiveness of an insecticide.