Modelled Target Attainment after Temocillin Treatment in Severe Pneumonia: Systemic and Epithelial Lining Fluid Pharmacokinetics of Continuous versus Intermittent Infusions.

The objective of this article is to describe the population pharmacokinetics (PK) of temocillin administered via continuous infusion (CI) versus intermittent infusion (II) in critically ill patients with pneumonia. Secondary objectives included characterization of epithelial lining fluid (ELF)/plasma penetration ratios and determination of the probability of target attainment (PTA) for a range of MICs. Thirty-two mechanically ventilated patients who were treated for pneumonia with 6 g of temocillin daily for in vitro sensitive pathogens were assigned to either the II (2 g every 8 h over 0.5 h) or the CI (6 g over 24 h after a loading dose of 2 g) group. A population pharmacokinetic model was developed using unbound plasma, and total ELF concentrations of temocillin and related Monte Carlo simulations were performed to assess PTAs. The area under the concentration-time curve from 0 to 24 h (AUC0-24) ELF/plasma penetration ratio was 0.73, at steady state, for both modes of infusion and whatever the level of creatinine clearance. Monte Carlo simulations showed that for the minimal pharmacodynamic (PD) targets of 50% T > 1× MIC (II group) and 100% T > 1× MIC (CI group), PK/PD breakpoints were 4 mg/L in plasma and 2 mg/L in ELF and 4 mg/L in plasma and ELF, respectively. The breakpoint was 8 mg/L in ELF for both modes of infusion in patients with creatinine clearance (CLCR) < 60 mL/min/1.73 m2. While CI provides better PKPD indexes, the latter remain below available recommendations for systemic infections, except in the case of moderate renal impairment, thereby warranting future clinical studies in order to determine the efficacy of temocillin in severe pneumonia.

[The COVID-19 breaker : PCR to the rescue !] / La déferlante COVID-19 : la PCR à la rescousse ! Chronique d'une gestion de crise au Laboratoire de Microbiologie clinique du CHU de Liège.

Chronicle of a crisis management at the Clinical Microbiology Laboratory of CHU Liège The SARS-CoV-2 outbreak in December 2019 in China and its expansion across the world and Europe have requested the participation of clinical laboratories as major players in the diagnosis of COVID-19, to perform PCR tests mainly on nasopharyngeal swabs. In Belgium, the first confirmed COVID-19 patient was diagnosed in early February, the first of many, especially travelers returning from winter sports. In order to meet the ever-increasing demands for testing, the Clinical Microbiology Laboratory of the CHU of Liege had to adapt to this situation: firstly, by developing manual PCR tests and then automated solutions, permitting to increase the number of analyzes by ensuring a short turnaround time of results. Then, a system for the communication of results on a large scale has been set up, and finally solutions to deal with the lack of sampling devices have been found. This first wave of the pandemic has also highlighted an unprecedented solidarity within the institution. In this article, we recount the chronology of the management of this unprecedented health crisis within the Clinical Microbiology Laboratory of the CHU of Liege.

L'émergence du virus SARS-CoV-2 en décembre 2019 en Chine et son expansion à travers le monde et l'Europe ont sollicité la participation des laboratoires de Biologie clinique en tant qu'acteurs majeurs dans le diagnostic de la COVID-19, via la réalisation de tests PCR principalement sur des prélèvements nasopharyngés. En Belgique, le premier patient confirmé COVID-19 a été diagnostiqué début février, avant d'être suivi par de nombreux cas d'infections, initialement chez des vacanciers revenant des sports d'hiver. Afin de répondre à l'augmentation du nombre de tests, le laboratoire de Microbiologie clinique du CHU de Liège a dû s'adapter en développant des tests PCR, d'abord manuels puis automatisés. Ceux-ci ont permis d'augmenter le nombre d'analyses, tout en garantissant un temps de rendu des résultats court, en mettant en place un système de communication des résultats à grande échelle et en trouvant des solutions pour faire face à la pénurie des dispositifs de prélèvement. Cette première vague de la pandémie a aussi révélé une solidarité sans précédent au sein de l'institution. Dans cet article, nous retraçons la chronologie de la gestion de cette crise sanitaire inédite au sein du laboratoire de Microbiologie clinique du CHU de Liège.

Effects of agricultural land use on fluvial carbon dioxide, methane and nitrous oxide concentrations in a large European river, the Meuse (Belgium).

We report a data-set of CO2, CH4, and N2O concentrations in the surface waters of the Meuse river network in Belgium, obtained during four surveys covering 50 stations (summer 2013 and late winter 2013, 2014 and 2015), from yearly cycles in four rivers of variable size and catchment land cover, and from 111 groundwater samples. Surface waters of the Meuse river network were over-saturated in CO2, CH4, N2O with respect to atmospheric equilibrium, acting as sources of these greenhouse gases to the atmosphere, although the dissolved gases also showed marked seasonal and spatial variations. Seasonal variations were related to changes in freshwater discharge following the hydrological cycle, with highest concentrations of CO2, CH4, N2O during low water owing to a longer water residence time and lower currents (i.e. lower gas transfer velocities), both contributing to the accumulation of gases in the water column, combined with higher temperatures favourable to microbial processes. Inter-annual differences of discharge also led to differences in CH4 and N2O that were higher in years with prolonged low water periods. Spatial variations were mostly due to differences in land cover over the catchments, with systems dominated by agriculture (croplands and pastures) having higher CO2, CH4, N2O levels than forested systems. This seemed to be related to higher levels of dissolved and particulate organic matter, as well as dissolved inorganic nitrogen in agriculture dominated systems compared to forested ones. Groundwater had very low CH4 concentrations in the shallow and unconfined aquifers (mostly fractured limestones) of the Meuse basin, hence, should not contribute significantly to the high CH4 levels in surface riverine waters. Owing to high dissolved concentrations, groundwater could potentially transfer important quantities of CO2 and N2O to surface waters of the Meuse basin, although this hypothesis remains to be tested.

A one-year survey of Microsporum audouinii infections in Belgium: epidemiological and genotypic characterization.

During recent years the proportion of tinea capitis infections due to Microsporum audouinii has increased in both Belgium and other European countries. To better understand the emergence of this species, the Belgian National Reference Centre for dermatophytes launched an epidemiological survey on the main anthropophilic dermatophytes causing tinea capitis in Belgium and included the genomic characterization of M. audouinii isolates. In total, 116 strains of M. audouinii were confirmed and characterized by the DiversiLab(®) system (bioMérieux). Six genotypic variants were identified, among which one major group included 90 isolates and the reference strain. Another variant group (11 strains) was exclusively confined to a geographical region in south Belgium. Analysis of epidemiological characteristics of the infected population showed that the main age category was 5- to 9-year-old children with a sex ratio (male/female) of 1.97. Data concerning the geographic origin of the family revealed a majority of Belgian nationality (44.7%), suggesting that the infection originated in Belgium. Other nationalities were primarily African. At this time, no clear correlation has been established between one particular strain and a specific country of origin.

Primary production in a tropical large lake: the role of phytoplankton composition.

Phytoplankton biomass and primary production in tropical large lakes vary at different time scales, from seasons to centuries. We provide a dataset made of 7 consecutive years of phytoplankton biomass and production in Lake Kivu (Eastern Africa). From 2002 to 2008, bi-weekly samplings were performed in a pelagic site in order to quantify phytoplankton composition and biomass, using marker pigments determined by HPLC. Primary production rates were estimated by 96 in situ (14)C incubations. A principal component analysis showed that the main environmental gradient was linked to a seasonal variation of the phytoplankton assemblage, with a clear separation between diatoms during the dry season and cyanobacteria during the rainy season. A rather wide range of the maximum specific photosynthetic rate (PBm) was found, ranging between 1.15 and 7.21 g carbong(-1)chlorophyll ah(-1), and was best predicted by a regression model using phytoplankton composition as an explanatory variable. The irradiance at the onset of light saturation (Ik) ranged between 91 and 752 µE m(-2)s(-1) and was linearly correlated with the mean irradiance in the mixed layer. The inter-annual variability of phytoplankton biomass and production was high, ranging from 53 to 100 mg chlorophyll am(-2) (annual mean) and from 143 to 278 g carbon m(-2)y(-1), respectively. The degree of seasonal mixing determined annual production, demonstrating the sensitivity of tropical lakes to climate variability. A review of primary production of other African great lakes allows situating Lake Kivu productivity in the same range as that of lakes Tanganyika and Malawi, even if mean phytoplankton biomass was higher in Lake Kivu.

Acute cholecystitis with Listeria monocytogenes.

Listeriosis, an opportunistic food-borne disease caused by Listeria monocytogenes, is infrequent and occurs preferentially in patients at the extremes of age, during pregnancy or in immunocompromised hosts. Most common manifestations are maternofoetal and neonatal infections, severe invasive presentations such as bacteraemia with or without central nervous system symptoms occuring preferentially in immunosuppressed patients and self-limited gastro-enteritis affecting healthy individuals. Exceptionally, focal infections such as cholecystitis are described. We report here a case of acute cholecystitis caused by Listeria monocytogenes in an 82-year-old woman. Thanks to a successful treatment: cholecystectomy and antimicrobial therapy (amoxicillin plus clavulanic acid), the patient soon recovered. This case-report provides an opportunity to review the current literature concerning the association of Listeria monocytogenes and cholecystitis.

[MALDI-TOF mass spectrometry in clinical bacteriology or how to identify a bacteria within one minute]. / Spectrométrie de masse MALDI-TOF en bactériologie clinique ou comment identifier une bactérie en une minute.

The major application of MALDI-TOF mass spectrometry in clinical microbiology is the bacterial identification based on the analysis of all their proteins (ribosomal and membrane-associated proteins). This technology allows the identification of most of bacteria within a few minutes. The method is fast, accurate, reliable and cost-effective by comparison to conventional phenotypic techniques. Other applications of MALDI-TOF mass spectrometry are still under development, as the detection of bacterial toxins or resistance mechanisms to antimicrobial agents.

Potamon: a dynamic model for predicting phytoplankton composition and biomass in lowland rivers.

POTAMON is a unidimensional, non-stationary model, designed for simulating potamoplankton from source to mouth. The forcing variables are discharge, river morphology, water temperature, available light and nutrient inputs. Given the description of several algal categories, POTAMON allows to simulate algal "successions" at a particular site, as well as longitudinal changes of potamoplankton composition and biomass. The algal categories differ by their physiology, their loss rates, and their sensitivity to grazing by zooplankton. Two zooplankton categories were considered, Brachionus-like and Keratella-like, which differ by their clearance rate, their incipient limiting level, their selectivity towards phytoplankton, and their growth yield. The model simulates satisfactorily the onset and the magnitude of the phytoplankton spring bloom in the Belgian part of R. Meuse, the biomass decrease in early summer, and the autumn bloom. It also renders the major variations of algal assemblages along the river. The model allows to confirm that the main driving variables of potamoplankton dynamics in a eutrophic river are physical factors: discharge and related variables (e.g. retention time), light and temperature. In addition, the simulations confirm that the zooplankton-phytoplankton interaction may result in phytoplankton biomass fluctuations and compositional changes. POTAMON can be useful to explore plankton dynamics in a large river, and it may become a tool to test various management measures.

[Knowledge and opinions on sexuality among young French-speaking Belgians]. / Connaissances et opinions en matière sexuelle parmi la jeunesse belge francophone

We shall limit ourselves to the main topics, leaving the appreciation of the questionnaire to the reader. To evaluate knowledge and opinions on sexuality in young french speaking belgian people, we have questioned : 1210 students at the University of Louvain, 773 in A1 official teaching, 819 in superior free non university teaching and 778 young people being recruted by the belgian army. The following conclusions are global. The mean vocabulary score (rated on 18) in these four samples is 13.22, 14.06, 13.57 and 6.40. This score is in students more than double than the score in young recruted people (and this phenomenon remains even if one includes only boys in higher education). The mean score (13.81) for whole students in higher education type A1 is significantly superior to the one from the University of Louvain. The score observed in official technical teaching A1 is also greater in comparison to free A1. It is also true for free A1 in comparison to the University of Louvain. The words relating to contraception are particularly misknown in the four samples. Regarding the mean score (on 38) on sexual knowledge not related to vocabulary, it is 22.61 at the University of Louvain, 22.53 in free A1 education, 23.72 in official A1 education and 18.535 in young recruted army people. The difference in mean score between official higher education and the University of Louvain is significant ; it is also significant between University of Louvain students and whole students from A1 education (mean : 23.11). There is no significant difference between the score for the University of Louvain and the one for higher free non university education. The mean score in the army, inferior to 50 %, is rather lower than the scores for the other samples, even if limited to boys. Again, questions on contraception are generally misknown. The total score (in %) is 63.98 at the University of Louvain, 64.46 in A1 free education, 67,46 in A1 official education and 44.53 in young army recruted individus. The score is about 20 % lower at the center for recruting and selecting in comparison to the other samples, even if one takes boys only. The difference between the score in A1 official education and A1 free is significant. It is also between total score (65.92) in whole students from A1 technical education and the one at the University of Louvain. It is not significant for the scores in A1 free education versus the University of Louvain. All scores in A1 official education are superior to the one for confessionnal education, even university ; the interpretation of this phenomenon is probably comparable to the influence of the variable "religion". Regarding opinions, we will only indicate that for factors expressing love (tenderness sexuality and mutual esteem) and the possible means of sexual contacts (physical pleasure, a way of expressing love and procreation) : 1...

[Methodology and results of a preliminary inquiry on the degree of information of the Belgian population on contraception]. / Méthodologie et résultats d'une pré-enquête sur le niveau de connaissances du public belge en matière de contraception

PIP: The preliminary stages of a vast survey planned in Belgium on the level of knowledge of the population with respect to contraceptives are described. The preparation and testing of the questionnaire and the selection of the population to be included in the sampling are described in detail. The findings of the preliminary survey are analyzed from 3 viewpoints: source of information of the person interviewed, subjective evaluation by those persons of their own level of information, and knowledge and evaluation of contraceptive methods.^ieng