Relationship between biosecurity and production/antimicrobial treatment characteristics in pig herds.

The biosecurity status of 95 breeder-finisher pig herds was quantified using a risk-based weighted scoring system. Data relating to herd-, farmer- and production-characteristics and to the prophylactic use of antimicrobials were also collected. The average external biosecurity score (measures to prevent pathogens from entering a herd) was 65 (range, 45-89) and the average internal score (measures to reduce the within-herd spread of pathogens) was 52 (range, 18-87). External scores were positively associated with herd size, while internal scores were negatively associated with both 'age of buildings' and 'years of experience of the farmer', indicating that biosecurity is generally better implemented in larger herds, in more modern facilities and by younger farmers. External and internal biosecurity scores were positively associated with daily weight gain and negatively associated with feed conversion ratio of fattening pigs. Internal scores were negatively associated with disease treatment incidence, suggesting that improved biosecurity might help in reducing the amount of antimicrobials used prophylactically. This study demonstrates and quantifies a clear link between biosecurity and both production- and antimicrobial treatment-related criteria in pig herds.

Assessment of human exposure to 3rd generation cephalosporin resistant E. coli (CREC) through consumption of broiler meat in Belgium.

Acquired resistance of Escherichia coli to 3rd generation cephalosporin antimicrobials is a relevant issue in intensive broiler farming. In Belgium, about 35% of the E. coli strains isolated from live broilers are resistant to 3rd generation cephalosporins while over 60% of the broilers are found to be carrier of these 3rd generation cephalosporin resistant E. coli (CREC) after selective isolation. A model aimed at estimating the exposure of the consumer to CREC by consumption of broiler meat was elaborated. This model consists of different modules that simulate the farm to fork chain starting from primary production, over slaughter, processing and distribution to storage, preparation and consumption of broiler meat. Input data were obtained from the Belgian Food Safety agencies' annual monitoring plan and results from dedicated research programs or surveys. The outcome of the model using the available baseline data estimates that the probability of exposure to 1000 colony forming units (cfu) of CREC or more during consumption of a meal containing chicken meat is ca. 1.5%, the majority of exposure being caused by cross contamination in the kitchen. The proportion of CREC (within the total number of E. coli) at primary production and the overall contamination of broiler carcasses or broiler parts with E. coli are dominant factors in the consumer exposure to CREC. The risk of this exposure for human health cannot be estimated at this stage given a lack of understanding of the factors influencing the transfer of cephalosporin antimicrobial resistance genes from these E. coli to the human intestinal bacteria and data on the further consequences of the presence of CREC on human health.

Antimicrobial resistance of Escherichia coli and Enterococcus faecalis in housed laying-hen flocks in Europe.

The aim of this study was to determine the potential association between housing type and multiple drug resistance (MDR) in Escherichia coli and Enterococcus faecalis isolates recovered from 283 laying-hen flocks. In each flock, a cloacal swab from four hens was collected and produced 1102 E. coli and 792 E. faecalis isolates. Broth microdilution was used to test susceptibility to antimicrobials. Country and housing type interacted differently with the MDR levels of both species. In the E. coli model, housing in a raised-floor system was associated with an increased risk of MDR compared to the conventional battery system [odds ratio (OR) 2·12, 95% confidence interval (CI) 1·13-3·97)]. In the E. faecalis model the MDR levels were lower in free-range systems than in conventional battery cages (OR 0·51, 95% CI 0·27-0·94). In Belgium, ceftiofur-resistant E. coli isolates were more numerous than in the other countries.

In situ ESBL conjugation from avian to human Escherichia coli during cefotaxime administration.

AIMS: The behaviour of an Escherichia coli isolate of broiler origin harbouring a bla(TEM-52) -carrying plasmid (lactose-negative mutant of B1-54, IncII group) was studied in an in situ continuous flow culture system, simulating the human caecum and the ascending colon during cefotaxime administration. METHODS AND RESULTS: Fresh faeces from a healthy volunteer, negative for cephalosporin-resistant E. coli, were selected to prepare inocula. The microbiota was monitored by plating on diverse selective media, and a shift in the populations of bacteria was examined by 16S rDNA PCR denaturing gradient gel electrophoresis. Escherichia coli transconjugants were verified by plasmid and pulsed-field gel electrophoresis profiles (PFGE). The avian extended-spectrum ß-lactamase-positive E. coli was able to proliferate without selective pressure of cefotaxime, and E. coli transconjugants of human origin were detected 24 h after inoculation of the donor strain. Upon administration of cefotaxime to the fresh medium, an increase in the population size of E. coli B1-54 and the transconjugants was observed. PFGE and plasmid analysis revealed a limited number of human E. coli clones receptive for the bla(TEM-52) -carrying plasmid. CONCLUSIONS: These observations provide evidence of the maintenance of an E. coli strain of poultry origin and the horizontal gene transfer in the human commensal bowel microbiota even without antimicrobial treatment. SIGNIFICANCE AND IMPACT OF THE STUDY: The fact that an E. coli strain of poultry origin might establish itself and transfer its bla gene to commensal human E. coli raises public health concerns.

Risk factors for ceftiofur resistance in Escherichia coli from Belgian broilers.

A cross-sectional study on 32 different Belgian broiler farms was performed in 2007 and 2008 to identify risk factors for ceftiofur resistance in Escherichia coli. On each farm, one E. coli colony was isolated from 30 random birds. Following susceptibility testing of 14 antimicrobials, an on-farm questionnaire was used to obtain information on risk factors. Using a multilevel logistic regression model two factors were identified at the animal level: resistance to amoxicillin and to trimethoprim-sulfonamide. On the farm level, besides antimicrobial use, seven management factors were found to be associated with the occurrence of ceftiofur resistance in E. coli from broilers: poor hygienic condition of the medicinal treatment reservoir, no acidification of drinking water, more than three feed changes during the production cycle, hatchery of origin, breed, litter material used, and treatment with amoxicillin. This study confirms that not only on-farm antimicrobial therapy, but also management- and hatchery-related factors influence the occurrence of antimicrobial resistance.

[The BEHAC nail--a new intramedullary implant for managing 2-stage fractures of the humerus]. / Der BEHAC-Nagel--ein neues intramedulläres Implantat zur Versorgung von 2-Etagen-Frakturen des Humerus.

The BEHAC-nail is a new implant for the treatment of complex humeral fractures, particularly for segmental fractures. It is an elastic intramedullary implant that is inserted retrograde into the distal humerus. The special feature of this nail is its proximal "loop design" which reduces the implant penetration at the proximal fixation site in the subchondral area of the humeral head in comparison to implants with tips such as Rush pins or Hackethal's nails. Thus, the risk of nail migration and perforation of the humeral head is less with the BEHAC-nail than with other nails. Another advantage of the "loop design" is that the humeral head fragment can be fixed adequately. Even short proximal fragments can be stabilized with this design. In contrast a short humeral head fragment cannot be held with implants like the UHN, HVN or Seidel's nail. The BEHAC-nail is a useful implant for segmental fractures of the humerus.

[Leg fractures: choice of treatment according to type of fracture]. / Fractures de jambe: choix d'une méthode en fonction du type de fracture.

The authors report the experience of the Strasbourg Center of Orthopaedics and Traumatology (France). They analyse first a series of 104 tibial shaft fractures treated by dynamic casting according to Sarmiento's technique. Their conclusion show off therapeutic indications and contra-indications. Another series of 297 tibial fractures treated by intramedullary locked nailing is presented with an analysis of all the complications and the means of avoiding them. The authors specify also the use of intramedullary nailing in the management of open fractures of the leg. Finally, they point out the indications for the external fixator in Strasbourg.

[Chiari's osteotomy in the treatment of coxarthrosis in adults. Apropos of 39 cases]. / L'ostéotomie de Chiari dans le traitement de la coxarthrose de l'adulte. A propos de 39 cas.

The authors have reviewed 39 Chiari pelvic osteotomies for hip arthrosis in adults. The surgical technique was found to be difficult and several modifications have been made during the last ten years. The complication rate was high initially but improved later thanks to technical improvements. However, the overall results were very satisfactory as regards both function and radiological appearances. Improved coverage of the femoral head was usually obtained when the operation was performed correctly and pain was diminished in two-thirds of the patients. The results were less satisfactory as regards gait, hip movement and the radiological joint space. In 13 cases a femoral osteotomy was made in association with Chiari pelvic osteotomy without any special complications.