Contrasted impact of two macrofaunal species (Hediste diversicolor and Scrobicularia plana) on microphytobenthos spatial distribution and photosynthetic activity at microscale.

Microphytobenthos is most often the primary source of carbon for coastal soft-sediment communities, especially in intertidal and shallow subtidal environments. The influence of benthic macrofaunal organisms on microphytobenthic biomass, spatial distribution and photosynthetic capacities is not only resulting from their feeding intensity but also indirectly from their bioturbation activity, which regulates nutrient fluxes and sediment mixing. This study compares the impact of two species (Hediste diversicolor and Scrobicularia plana) that dominate macrofaunal communities in estuarine intertidal mudflats on microphytobenthic biomass and photosynthetic activity. Imaging-PAM fluorescence was used to non-invasively map the development of microphytobenthic biomass and to assess its spatial extent. Our results showed that, due to intense deposit feeding, Scrobicularia plana quickly limited microphytobenthos growth and photosynthetic activity, even at low density (<250 ind m-2). In contrast, the negative impact of Hediste diversicolor on microphytobenthos development due to direct consumption was very low. Thereby, the stimulation of nutrient fluxes at the sediment-water interface resulting from bioirrigation seems to enhance microphytobenthos growth and photosynthesis.

Sediment stability: can we disentangle the effect of bioturbating species on sediment erodibility from their impact on sediment roughness?

Benthic organisms, in particular bioturbators, can influence erosion processes either by affecting sediment roughness through their mere presence and/or activities, or by modulating sediment characteristics (e.g., silt content, granulometry), thus altering its erodibility. To date, it was not possible to distinguish the influence of bioturbating species on sediment roughness from their impact on sediment erodibility. Consequently, uncertainties remain regarding the role played by benthic species on sediment dynamics. In this study, we used a canal flume which allows to record the bed shear stress at the surface of a non-cohesive sediment (4% of mud) during erosion experiments, thus allowing to disentangle the influence of bioturbators, here the common cockle Cerastoderma edule, on the two erosion mechanisms. In order to assess the influence of bioturbators on sediment stability in different environmental situations, we additionally tested for the effects of three factors, i.e. bivalve density, availability of suspended food (i.e. phytoplankton presence) and microphytobenthos (MPB) occurrence, which may modulate the behavior of cockles. We observed that cockles promote the erosion of the sediment surficial layer by increasing its roughness as a consequence of their sediment reworking activity and/or presence at the sediment surface (emerging shell). In contrast, we calculated similar critical bed shear stress for erosion with and without bivalves suggesting that cockles have a minor influence on the erodibility of non-cohesive substrates with a low silt content. The destabilizing effect of cockles increased with the bivalve density whereas it was attenuated by the presence of phytoplankton. We hypothesize that the magnitude of cockles' bioturbation activity was lower when a high proportion of suspended food is available. High concentrations of suspended food may also have enhanced the filtration and biodeposition rates of cockles, thus rapidly leading to the 'muddification' of the sediment bed and consequently counteracting with the own destabilizing effect of the bivalves. Finally, the sole presence of MPB did not significantly affect the resuspension dynamics of non-cohesive sediments with a low proportion of mud.

CTX-M-33, a CTX-M-15 derivative conferring reduced susceptibility to carbapenems.

CTX-M-type extended-spectrum ß-lactamases (ESBL) are widespread among Enterobacterales worldwide. The most common variant is CTX-M-15 hydrolyzing ceftazidime at high rate, but sparing carbapenems. We identified here CTX-M-33, a point mutant derivative of CTX-M-15 (Asp to Ser substitution at Ambler position 109), exhibiting a low carbapenemase activity. ß-Lactamase CTX-M-33 was identified in a Klebsiella pneumoniae isolate belonging to ST405, lacking the outer membrane protein OmpK36, that was resistant to broad-spectrum cephalosporins and ß-lactam/ß-lactamase inhibitor combinations, and displayed a decreased susceptibility to carbapenems. Comparative hydrolytic activity assays showed that CTX-M-33 hydrolyzed ceftazidime at a lower level than CTX-M-15, but significantly hydrolyzed meropenem. In addition, CTX-M-33 showed higher Mutant Prevention Concentration values and wider mutant selection window in presence of meropenem, in accordance with its observed hydrolytic properties. We identified here the very first CTX-M enzyme possessing a weak carbapenemase activity, that may correspond to an emerging phenomenon when considering its possibility to evolve from the widespread ESBL CTX-M-15.

Intentional drug poisoning care in a physician-manned emergency medical service.

OBJECTIVES: Severely poisoned patients can benefit from intensive and specific treatments. Emergency medical services (EMS) may therefore play a crucial role by matching prehospital care and hospital referral to the severity of poisoned patients. Our aim was to investigate EMS accuracy in this condition. METHODS: A 3-year retrospective study was conducted in a university hospital. Emergency telephone calls about adult patients with intentional drug poisoning (IDP) were included. In daily practice, an emergency physician answers such telephone calls and dispatches either first responders or a mobile intensive care unit (MICU). According to on-scene evaluation, patients are referred to the emergency department (ED) or to an intensive care unit (ICU). We therefore calculated global EMS accuracy according to patients' actual medical needs. We further evaluated the performance of dispatch and hospital referral decision. We also performed a regression analysis to identify factors of inappropriate dispatch. RESULTS: A total of 2,227 patients were studied. Median age was 41 years old (range 30-49) and 63% were women. Dispatch was appropriate for 1,937 (87%) patients. Sensitivity and specificity of dispatch decision were 0.43 and 0.93, respectively. Decision of patients' referral to an appropriate hospital facility had a sensitivity of 0.67 and a specificity of 0.98. Toxicological data, age, and Glasgow coma scale were significantly associated with inappropriate EMS decisions. CONCLUSIONS: A physician-operated EMS is an accurate system to provide prehospital care to IDP patients. However, dispatch physicians should pay attention, especially to toxicological anamnesis, to anticipate proper patient care.