Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease: an observational cohort study of 22 053 patients.

OBJECTIVES: The role of Pseudomonas aeruginosa in the long-term prognosis of chronic obstructive pulmonary disease (COPD) is unknown. The purpose of this study was to determine whether P. aeruginosa is associated with increased risk of exacerbations or death in patients with COPD. METHODS: This is a multiregional epidemiological study based on complete data on COPD outpatients between 1 January 2010 and 31 October 2017 and corresponding microbiology and national register data. Time-dependent Cox proportional hazards models and propensity matching was used to estimate hospitalization-demanding exacerbations and death after 2 years, separately and in combination. RESULTS: A total of 22 053 COPD outpatients were followed for a median of 1082 days (interquartile-range: 427-1862). P. aeruginosa was present in 905 (4.1%) patients. During 730 days of follow-up, P. aeruginosa strongly and independently predicted an increased risk of hospitalization for exacerbation or all-cause death (HR 2.8, 95%CI 2.2-3.6; p <0.0001) and all-cause death (HR 2.7, 95%CI 2.3-3.4; p <0.0001) in analyses adjusted for known and suspected confounders. The signal remained unchanged in unadjusted analyses as well as propensity-matched subgroup analyses. Among patients 'ever colonized' with P. aeruginosa, the incidence of hospital-demanding exacerbations doubled after the time of the first colonization. CONCLUSIONS: COPD patients in whom P. aeruginosa can be cultured from the airways had a markedly increased risk of exacerbations and death. It is still not clear whether this risk can be reduced by offering patients targeted antipseudomonal antibiotics. A randomized trial is currently recruiting patients to clarify this (ClinicalTrials.gov: NCT03262142).

[Parasitological study of 78 cases of human cystic echinococcosis collected between 2005 to 2012 in Mustapha hospital center of Algiers]. / Étude parasitologique de 78 cas d'échinococcose kystique humaine colligés entre 2005 et 2012 au CHU Mustapha d'Alger.

AIM: The aim of this work is to know the fertility rate of the metacestodes resulting from patients suffering from hydatidosis, the one of protoscoleces's viability and by comparing the results obtained with those found elsewhere. It reports, also, the epidemiological, clinical and diagnostically aspects of the studied patients. MATERIALS AND METHODS: This study has carried on 78 hydatics samples resulting from 78 patients collected between 2005 and 2012 at the laboratory of parasitology of the Mustapha hospital center of Algiers. A questionnaire on the epidemiological context (contact with an animal-host of the cycle, place of residence, presence of family cases reached of hydatidosis and knowledge on the hydatic disease) concerned 69 patients. For each sample, a direct microscopic examination is made with or without vital staining. The presence of protoscoleces made qualified the fertile cyst. Those visualized moving or resistant to eosin at 0.2% are considered viables. Indirect diagnosis is based on the techniques: passive hemagglutination, electrophoresis, Elisa IgG Echinococcus granulosus and immunoblotting IgG "Echinococcus". Molecular analysis is based on PCR and sequencing the partials fragments of two mitochondrial genes with the primers COX1 and ND1. RESULTS: The results obtained show that the surgical frequency of hydatidosis is significant at the young adult and at the child. The epidemiological context associated at the disease is the conjointly presence of a dog and herbivores. The fertility rate of human hydatid cysts is 88.4% and the ones of viability of the protoscoleces is 74.5%. In this series, the serology shows global positivity at 70%. The molecular characterization of five samples identify the species: E. granulosus ss. CONCLUSION: Finally, the viability and fertility rates found here are raised. Sometimes viables protoscoleses are found after use of scolicidal solution. In front of these results, the parasitical treatment is more than necessary in order to minimize the risk of occurred of secondary echinococcosis or the relapses postoperatives.

[Hydatid fertility and protoscolex viability in humans: study of 78 hydatid samples collected between 2005 and 2012 and analyzed at the parasitology laboratory of the Mustapha University Hospital Center of Algiers]. / Fertilité des hydatides et viabilité des protoscolex chez l'homme Étude de soixante-dix-huit échantillons hydatiques collectés entre 2005 et 2012 au laboratoire de parasitologie du CHU Mustapha d'Alger.

An analysis at the Mustapha University Hospital Center of Algiers examined 78 hydatid samples collected between 2005 and 2012 to determine the fertility rate of metacestodes and the viability of protoscolices. The fertility rate of the hydatid cysts in humans was 88.4% and the protoscolex viability rate 74.5%. The fertility and viability rates found here are high, despite the use of scolicides.

[Epidemiological profile of 290 cases of human cystic echinococcosis diagnosed in the Mustapha University Hospital (Algiers) from 2006 to 2011]. / Profil épidémiologique de 290 cas d'échinococcose kystique humaine diagnostiqués au CHU Mustapha d'Alger (2006 à 2011).

THE AIM OF THE STUDY: This study reports a series of 290 cases of hydatidosis confirmed by the surgery and/or the imagery with a positive immuno-diagnosis collected between 1st January 2006 and 31 March 2011 at parasitology-mycology laboratory of hospital university center of Mustapha of Algiers. Our aim is to specify, through the listed cases, the epidemiological aspects of this affection and compared with those obtained in two previous Algerian epidemiological investigations carried out, between 1963-1964 and 1966-1975. PATIENTS AND METHODS: It is a retrospective (2006-2008) and prospective (2008-2011) study. The parasitological diagnosis was carried out by the direct macroscopic and/or microscopic identification of the parasite and indirect diagnosis based on four techniques: passive hemagglutination, Elisa IgG "Echinococcus granulosus", Western Blot IgG "Echinococcus" and electrophoresis. RESULTS: The study shows that this affection is still prerogative of the young adult. It bring out also in this study that the child of school age (ten years), in particular the boy, pays a heavy tribute. At the child, the preferential pulmonary seat of the hydatic disease is not devoid of risk. At adult, this parasitic disease mainly affect the active woman. CONCLUSION: Generally, the epidemiological and clinical characteristics join the endemic countries data and confirmed the row of our country among them. The transmission seems as strong as in the past, in spite of a much better social educational level.

[Study of 71 cases of visceral leishmaniasis diagnosed at the Mustapha University Hospital (Algiers) from 1998 to 2009]. / Étude de 71 cas de leishmaniose viscérale diagnostiqués au CHU Mustapha d'Alger entre 1998 et 2009.

OBJECTIVE: The authors retrospectively studied the epidemiological, clinical, diagnostic and therapeutic aspects of 71 cases of visceral leishmaniasis from 1998 to 2009. POPULATION AND METHODS: The diagnosis was made by finding Leishmania amastigotes in bone marrows smears and/or by serology. RESULTS: Most cases occur in winter (35.2%) and in spring (36.6%). The source areas are endemic ones located in the north of Algeria (74.6%) and more rarely arid or semi-arid climate areas (8.4%). 88.7% of patients are children. The sex ratio is 1.53. The clinical characteristics are: fever (77.4%), paleness (43.6%); splenomegaly (83%), hepatomegaly (57.7%). The biological anomalies are: anemia (56.3%), thrombocytopenia (33.8%), and leucopenia (28.1%). N-methylglucamine (Glucantime(®)) was most often prescribed (70.4%). Four deaths (5.6%) were recorded. CONCLUSION: Visceral leishmaniasis remains a pediatric affection but does not spare adults.

[Human infection due to Bertiella sp (cestode: Anoplocephalidae) in a man originating from Yemen in Algeria]. / Infection humaine due à Bertiella sp (cestode: Ano- plocephalidae) observée en Algérie chez un étudiant originaire du Yémen.

Bertiella is a frequent parasite in animals, particularly in nonhuman primates. The infestation occurs in man by accidental ingestion of the intermediate host, an acarus containing the cysticercoid larva of Bertiella studeri or Bertiella mucronata. The diagnosis is based on the morphology of the gravid proglottis and eggs with pyriform embryo which is characteristic of the Anoplocephalinae. Human infection is asymptomatic or can induce minor non specific digestive disturbances and the niclosamide is effective in one single dose. The authors report the first case of human bertiellosis in Algeria in a student originating from Yemen.

[First Algerian case of human otomyiasis from Chrysomya bezziana]. / Premier cas algérien d'otomyiase humaine à Chrysomya bezziana.

In Algeria, Human myiasis, essentially ophtalmomyiasis, are known for a long time. Most of cases are due to Oestrus ovis. In this papers the authors report, in a shepherd, the first case of otomyiasis due to Chrysomya bezziana larvae, a species still unknown in North Africa. This observation which indicates the presence of the species in a Northern part of Algeria is also the first report of the insect outside of its endemic traditional area.