ABSTRACT
OBJECTIVES: Burns to the perineum are frequently exposed to faeces. Diverting colostomy is often described to prevent faecal soiling. Because this technique is invasive with frequent complications, use of non-surgical devices including specifically designed faecal management systems has been reported in perineal burns. METHODS: In order to standardise the faecal management strategy in patients with perineal burns, a group of French experts was assembled. This group first evaluated the ongoing practice in France by analysing a questionnaire sent to every French burn centre. Based on the results of this study and on literature data, the experts proposed recommendations on the management of perineal burns in adults. RESULTS: Specifically designed faecal management systems are the first-line method to divert faeces in perineal burns. The working group proposed recommendations and an algorithm to assist in decisions in the management of perineal burns in four categories of patients, depending on total burn skin area, depth and extent of the perineal burn. CONCLUSION: In France, non-surgical devices are the leading means of faecal diversion in perineal burns. The proposed algorithm may assist in decisions in the management of perineal burns. The expert group emphasises that large clinical studies are needed to better evaluate these devices.
Subject(s)
Burns/therapy , Catheters , Colostomy , Perineum/injuries , Wound Infection/prevention & control , Feces , France , Graft Survival , Humans , Skin Transplantation , Wound HealingABSTRACT
BACKGROUND: Severely burned patients may develop life-threatening nosocomial infections due to Pseudomonas aeruginosa, which can exhibit a high-level of resistance to antimicrobial drugs and has a propensity to cause nosocomial outbreaks. Antiseptic and topical antimicrobial compounds constitute major resources for burns care but in vitro testing of their activity is not performed in practice. RESULTS: In our burn unit, a P. aeruginosa clone multiresistant to antibiotics colonized or infected 26 patients over a 2-year period. This resident clone was characterized by PCR based on ERIC sequences. We investigated the susceptibility of the resident clone to silver sulphadiazine and to the main topical antimicrobial agents currently used in the burn unit. We proposed an optimized diffusion assay used for comparative analysis of P. aeruginosa strains. The resident clone displayed lower susceptibility to silver sulphadiazine and cerium silver sulphadiazine than strains unrelated to the resident clone in the unit or unrelated to the burn unit. CONCLUSIONS: The diffusion assay developed herein detects differences in behaviour against antimicrobials between tested strains and a reference population. The method could be proposed for use in semi-routine practice of medical microbiology.
Subject(s)
Anti-Bacterial Agents/pharmacology , Anti-Infective Agents, Local/pharmacology , Burns/complications , Disk Diffusion Antimicrobial Tests/methods , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/drug effects , Cross Infection/drug therapy , Cross Infection/etiology , Cross Infection/microbiology , Humans , Pseudomonas Infections/drug therapy , Pseudomonas Infections/etiology , Pseudomonas aeruginosa/classification , Pseudomonas aeruginosa/genetics , Pseudomonas aeruginosa/isolation & purificationABSTRACT
An antigen delivery system based on subviral particles formed by the self-assembly of the capsid protein of infectious bursal disease virus and carrying foreign peptides at the top of the projection domain was investigated. We report here the effective insertion of the foot-and-mouth disease virus (FMDV) immunodominant epitope in one of the four external loops of the subviral particles. Out of the two loops tested, one of them tolerated an insert of 12 amino acids without disrupting the subviral particle assembly. The subviral particles reacted with neutralizing FMDV type O1 monoclonal and polyclonal antibodies and elicited a neutralizing antibody response in immunized mice. Furthermore, we found that they have the potential for the detection of FMDV antibodies in a competitive ELISA for diagnostic.
Subject(s)
Antibodies, Viral/biosynthesis , Antigens, Viral/immunology , Capsid Proteins/immunology , Foot-and-Mouth Disease Virus/immunology , Infectious bursal disease virus/chemistry , Animals , Antibodies, Viral/genetics , Antibody Specificity , Baculoviridae , Capsid/immunology , Cattle , Cells, Cultured , Epitopes/immunology , Foot-and-Mouth Disease/diagnosis , Foot-and-Mouth Disease/immunology , Foot-and-Mouth Disease Virus/chemistry , Infectious bursal disease virus/immunology , Mice , Mice, Inbred BALB C , SpodopteraABSTRACT
The complete nucleotide sequence of foot-and-mouth disease virus (FMDV) O/FRA/1/2001 (bovine isolate) was determined from five cDNA clones covering most of the genome and compared with the British porcine isolate (O/UKG/35/2001) it originated from. Seven substitutions, out of which three resulted in amino acid changes (in the leader protease, 3A protein and 3D RNA-dependent RNA polymerase sequences) were identified and confirmed by direct sequencing of RT-PCR products obtained from in vitro infected cells and skin vesicles of an infected cow. RACE amplification allowed determination of the exact 3' end of the genome. These changes and possibly the unusual 3A substitution between the British and its French derivate may account for the consecutive species shifts.
Subject(s)
Foot-and-Mouth Disease Virus/genetics , Genome, Viral , Amino Acid Sequence , Amino Acid Substitution , Animals , Antigens, Viral/genetics , Base Sequence , Cattle , Cattle Diseases/virology , DNA, Complementary/chemistry , DNA, Complementary/isolation & purification , DNA, Viral/chemistry , DNA, Viral/isolation & purification , Endopeptidases/genetics , Foot-and-Mouth Disease/virology , Foot-and-Mouth Disease Virus/isolation & purification , France , Molecular Sequence Data , Mutation, Missense , Point Mutation , United Kingdom , Viral Nonstructural Proteins/geneticsABSTRACT
Foot-and-mouth disease virus (FMDV) is an important veterinary pathogen which can cause widespread epidemics. Due to the high antigenic variability of FMDV, it is important to undertake mutation analysis under immunological pressure. To study the bovine antibody response at a molecular level, phage display technology was used to produce bovine anti-FMDV Fabs. CH1-VH chains with FMDV specific binding could be isolated after selection from a library made from vaccinated cattle. Though their involvement in the bovine immune response remains to be ascertained, it is planned to express the five different selected VH domains in bacterial or insect systems as sequence homologies with integrin beta6 chain could shed light on the basis of FMDV type receptor specificities.
Subject(s)
Antibodies, Viral/immunology , Cattle Diseases/virology , Foot-and-Mouth Disease Virus/immunology , Foot-and-Mouth Disease/immunology , Immunoglobulin Fragments/isolation & purification , Immunoglobulin Variable Region/isolation & purification , Amino Acid Sequence , Animals , Antibodies, Viral/genetics , Base Sequence , Blotting, Western/veterinary , Cattle , Cattle Diseases/immunology , Cloning, Molecular , DNA, Viral/chemistry , DNA, Viral/genetics , Enzyme-Linked Immunosorbent Assay/veterinary , Epitopes/immunology , Foot-and-Mouth Disease Virus/genetics , Gene Library , Immunoglobulin Fragments/genetics , Immunoglobulin Fragments/immunology , Immunoglobulin Variable Region/genetics , Immunoglobulin Variable Region/immunology , Molecular Sequence Data , Peptide Library , Polymerase Chain Reaction/veterinaryABSTRACT
Foot-and-mouth disease (FMD) diagnostic methods are reviewed. As the presence of clinical signs alone is inconclusive, laboratory diagnosis should always be carried out. The presence of FMD virus can be demonstrated by cell culture isolation, complement fixation test, ELISA or the more recent polymerase chain reaction (PCR) method. Serological diagnosis is also a valuable tool. The virus neutralization test has been replaced by ELISA and the antibody response to some viral non-structural proteins allows to discriminate between vaccinated and infected animals on a herd basis. More rapid and accurate tests as well as an earlier detection system in preclinical state are still needed.