In a study conducted in 11 health care settings for elderly patients, we demonstrated a significant negative correlation between the proportion of glove use outside any risk of exposure to body ...fluids and compliance with hand hygiene ( P < .02). This result underscores a major limitation of strategies for controlling the spread of multidrug-resistant bacteria that recommend systematic glove use for each contact with carriers or their environment.
Buruli ulcer, the third mycobacterial disease after tuberculosis and leprosy, is caused by the environmental mycobacterium M. ulcerans. Various modes of transmission have been suspected for this ...disease, with no general consensus acceptance for any of them up to now. Since laboratory models demonstrated the ability of water bugs to transmit M. ulcerans, a particular attention is focused on the transmission of the bacilli by water bugs as hosts and vectors. However, it is only through detailed knowledge of the biodiversity and ecology of water bugs that the importance of this mode of transmission can be fully assessed. It is the objective of the work here to decipher the role of water bugs in M. ulcerans ecology and transmission, based on large-scale field studies.
The distribution of M. ulcerans-hosting water bugs was monitored on previously unprecedented time and space scales: a total of 7,407 water bugs, belonging to large number of different families, were collected over one year, in Buruli ulcer endemic and non endemic areas in central Cameroon. This study demonstrated the presence of M. ulcerans in insect saliva. In addition, the field results provided a full picture of the ecology of transmission in terms of biodiversity and detailed specification of seasonal and regional dynamics, with large temporal heterogeneity in the insect tissue colonization rate and detection of M. ulcerans only in water bug tissues collected in Buruli ulcer endemic areas.
The large-scale detection of bacilli in saliva of biting water bugs gives enhanced weight to their role in M. ulcerans transmission. On practical grounds, beyond the ecological interest, the results concerning seasonal and regional dynamics can provide an efficient tool in the hands of sanitary authorities to monitor environmental risks associated with Buruli ulcer.
Healthcare-associated infections (HAI) remain a burden in healthcare facilities, environmental surfaces being a potential reservoir for healthcare-associated pathogens. In this context, exploration ...of materials with potential antimicrobial activities represents a way forward for the future. Here, we explored the survival of four bacterial species commonly involved in HAI (Acinetobacter baumannii, Enterococcus faecalis, Klebsiella pneumoniae, Staphylococcus aureus), on oak versus three other materials (aluminum, polycarbonate, stainless steel). Twenty microliters of each bacterial suspension (approximatively 107 bacteria) were deposited on each material. Bacterial counts were measured by grinding and culturing on day 0, 1, 2, 6, 7 and 15. Analyses were performed in triplicate for each material and each time evaluated. It appeared that the bacteria viable count decreased rapidly on transversal and tangential oak compared with the other materials for all bacterial species. Furthermore, no difference was noticed between transversal and tangential oak. These results underline the potential for use of oak materials in healthcare facilities, a consideration that should be supported by further investigations.
Buruli ulcer is a neglected tropical disease caused by M. ulcerans, an environmental mycobacterium. This cutaneous infectious disease affects populations with poor access to sanitation, safe water ...and healthcare living in rural areas of West and Central Africa. Stagnant open bodies of surface water and slow-running streams are the only risk factor identified in Africa, and there is no human-to-human transmission. Appropriate and effective prevention strategies are required for populations living in endemic areas. Based on a multidisciplinary approach in an area in which Buruli ulcer is endemic in South Benin, we investigated the link between all human-environment interactions relating to unprotected water and behaviors associated with Buruli ulcer risk likely to affect incidence rates. We characterised the sources of water as well as water bodies and streams used by communities, by conducting a prospective case-control study directly coupled with geographic field observations, spatial analysis, and the detection of M. ulcerans in the environment. A full list of the free surface waters used for domestic activities was generated for a set of 34 villages, and several types of human behaviour associated with a higher risk of transmission were identified: (i) prolonged walking in water to reach cultivated fields, (ii) collecting water, (iii) and swimming. Combining the results of the different analyses identified the risk factor most strongly associated with Buruli ulcer was the frequency of contact with unprotected and natural water, particularly in regularly flooded or irrigated lowlands. We confirm that the use of clean water from drilled wells confers protection against Buruli ulcer. These specific and refined results provide a broader scope for the design of an appropriate preventive strategy including certain practices or infrastructures observed during our field investigations. This strategy could be improved by the addition of knowledge about irrigation practices and agricultural work in low-lying areas.
We compared the sensitivity of screening with nasal culture alone with that of a multiple-site screening method for the identification of carriers of methicillin-resistant Staphylococcus aureus at ...hospital admission. If nasal cultures alone had been used during the 1-year study, 27.0% of carriers of methicillin-resistant S. aureus would have been missed, which corresponds to 560 theoretical isolation days. If rectal screening had not been used, 431 theoretical isolation days would have been missed, and, if axillary screening had not been used, 99 theoretical isolation days would have been missed.
Despite susceptibility testing, recurrent infections are common and are associated with resistance. Using whole-genome sequencing, Stracy et al. demonstrated that recurrence is often driven by a ...different strain than the original infection. By machine-learning analysis, they developed an algorithm for patient-specific recommendations to minimize antimicrobial resistance (AMR) at the individual-patient level.
Abstract
In pharmaceutical studies, a course of bacteriology based on case studies provided by the teacher was transformed in a course based on a combination of student/teacher co-creation of cases ...and peer reviewing. Our objectives were to describe the perception of students about the new format and to assess the impact of changing on the learning outcomes. For teaching evaluation, we used a questionnaire and focus groups. The assessment of learning outcome was performed by comparing the students’ scores in final tests with the previous and the revised course formats. The students embraced the creation of cases in small groups with the teacher. In addition, they reported a perception of weakened hierarchy between the teacher and themselves, an increase of their self-confidence and a better ability to transfer their learning to their professional activities in community pharmacies. Lastly, their opinion about the transferability of this format in other disciplines were divided.
Co-constructing learning activities with students, increases self-confidence and wellness in class, and enhances students' ability to transfer knowledge and skills into the work place.
Abstract
For undergraduate pharmacy students, the first step of antimicrobial stewardship learning objectives is to integrate antimicrobial knowledge from the foundational sciences. We hypothesised ...that using a multidisciplinary approach including two sessions of tutorials could be relevant in term of students’ interest, satisfaction and learning retention time. The evaluation of students’ feelings was based on a questionnaire including different dimensions and three focus groups with four students. Quantitative data were analysed with the EPI-INFO 7.2 software and a thematic analysis was implemented for qualitative data by using NVivo 12 software. The evaluation of students’ learning concerned both short-time learning retention (STLR) and medium-time learning retention (MTLR), six months after the last session. Overall, 63 students responded to the questionnaire. Most of them appreciated the tutorials according to the different dimensions envisaged. Focus groups confirmed the interest of students for the multidisciplinary approach, interactions with teachers and opportunities of learning transfers. Concurrently, a lack of self-efficacy, low confidence towards the other students, external regulation of motivation and poor autonomy were recorded for some participants. Finally, there was no significant decrease between the scores of the STLR assessment and those of the MTLR assessment (58.5 ± 12.1/100 and 54.4 ± 8.9/100, respectively).
A multidisciplinary teaching approach to enhance interest and knowledge of pharmacy students about antibiotics and the future transfer of this knowledge to their professional practice.
We assessed the impact of improving glove using on the hand hygiene (HH) compliance in a multicenter study including 9 chronic care settings. If gloves had been used correctly during the evaluation, ...the overall compliance with HH measured after contacts with patients or environment would have only increased from 66.3% to 68.7%. This weak impact suggests that improving glove usage is not in itself an alternative strategy to improve HH compliance.
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