Genetic plurality of blaKPC-2-harboring plasmids in high-risk clones of Klebsiella pneumoniae of environmental origin.

International high-risk clones of Klebsiella pneumoniae are important human pathogens that are spreading to the environment. In the COVID-19 pandemic scenario, the frequency of carbapenemase-producing strains increased, which can contribute to the contamination of the environment, impacting the surrounding and associated ecosystems. In this regard, KPC-producing strains were recovered from aquatic ecosystems located in commercial, industrial, or agricultural areas and were submitted to whole-genome characterization. K. pneumoniae and Klebsiella quasipneumoniae subsp. quasipneumoniae strains were assigned to high-risk clones (ST11, ST340, ST307) and the new ST6325. Virulome analysis showed genes related to putative hypervirulence. Strains were resistant to almost all antimicrobials tested, being classified as extensively drug-resistant or multidrug-resistant. In this context, a broad resistome (clinically important antimicrobials and hazardous metal) was detected. Single replicon (IncX5, IncN-pST15, IncU) and multireplicon [IncFII(K1)/IncFIB(pQil), IncFIA(HI1)/IncR] plasmids were identified carrying the blaKPC-2 gene with Tn4401 and non-Tn4401 elements. An unusual association of blaKPC-2 and qnrVC1 and the coexistence of blaKPC-2 and mer operon (mercury tolerance) was found. Comparative analysis revealed that blaKPC-2-bearing plasmids were most similar to plasmids from Enterobacterales of Brazil, China, and the United States, evidencing the long persistence of plasmids at the human-animal-environmental interface. Furthermore, the presence of uncommon plasmids, displaying the interspecies, intraspecies, and clonal transmission, was highlighted. These findings alert for the spread of high-risk clones producing blaKPC-2 in the environmental sector and call attention to rapid dispersion in a post-pandemic world.

Evolution of Global Health and Psychosocial Factors among Hospital Workers during First Year of SARS-CoV-2 Pandemic: A Longitudinal Study.

OBJECTIVES: To assess trends in overall health (mental and physical) and psychosocial factors in a population of workers (both healthcare and non-healthcare) in a French teaching hospital during the first year of the SARS-CoV-2 pandemic in France. METHODS: A validated version of the SATIN questionnaire with adapted scoring was used to collect data on health and impacts of work stressors. This questionnaire was sent to all workers at the hospital in T1 (July-August 2020) and T2 (July-August 2021) and self-administered online. RESULTS: A total of 1313 participants who completed the questionnaire at T1 and 826 at T2 were included. Overall, 568 workers completed the questionnaire at T1 and T2. We found a deterioration in overall health and especially stress and mental health in hospital workers and healthcare workers (HCWs), with a negative impact of the workload and work environment. CONCLUSIONS: The SARS-CoV-2 pandemic impacted negatively the mental health, work stressors, and psychosocial perceptions of both HCW and non-HCW in a French hospital. The study confirms that hospital workers are an important target.

The COVID-19 pandemic and maritime telemedicine: 18-month report.

BACKGROUND: The onset of the coronavirus disease 2019 (COVID-19) pandemic has greatly impacted maritime telemedicine services. The aim of this study is to describe the impact of the pandemic, both quantitatively and qualitatively, by analysing the teleconsultations by doctors from the French Tele-Medical Assistance Service (TMAS). MATERIALS AND METHODS: We carried out a descriptive observational study of retrospective data from the TMAS files. The main inclusion criterion for the files was a diagnosis of "influenza due to an unidentified virus". We extracted the following data: type of ship, gender, age, nationality, role on board, reason for the call and symptoms, number of calls, navigation zone, severity, medical decision, whether or not a COVID-19 test had been carried out, and treatments prescribed on board. RESULTS: One hundred and ninety-nine files were included of which 39 (20%) were clusters. We were able to analyse data from 384 patients. The study population comprised 376 suspected COVID-19 patients, of whom 334 (87%) were symptomatic and 42 (10.9%) asymptomatic. Eight (2.1%) patients were not thought to have COVID-19 but their call was related to the pandemic. Of the symptoms presented by the patients, fever was the most frequent (n = 196; 59%), while 129 (39%) presented a cough, 60 (18%) a headache, 41 (12%) non-specific ear, nose, throat signs, and 40 (12%) dyspnoea. Two hundred fifty-two (75%) patients stayed on board, 55 (17%) were disembarked, for 14 (4%) a ship diversion was arranged, and 13 were evacuated including 4 medical evacuations. CONCLUSIONS: The most important problem encountered related to managing asymptomatic or pauci-symptomatic patients at sea, which was the subject of the majority of calls. The TMAS doctors played an important role in managing the pandemic by emphasising the need for social distancing and quarantine procedures at sea to limit the spread of the virus, while adapting to the sometimes difficult implementation conditions and logistics for medical decision and quarantine.

Maritime workers and their global health: Need to improve scientific knowledge and prevention

Recently, the World Health Organisation (WHO) declared seafarers as essential workers and recommended they have priority access to COVID-19 vaccination [6]. [...]maritime workers have a high rate of occupational accidents. Most of them are linked to human factors and work performance [9]. [...]depression, boredom and fatigue have been described as risk factors [9-11]. Improving and building of Cohort studies, creating Exposure assessment and Prevention measures, improving Equity, Health, and Education. 1 ORPHY Laboratory, University Brest, Brest, France 2 Occupational and Environmental Diseases Center, Teaching Hospital, Brest, France 3 French Society of Maritime Medicine Brest, Brest, France 4 Centre for Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark 5 Universidad Metropolitana de Educación Ciencia y Tecnología.

Health impact of work stressors and psychosocial perceptions among French hospital workers during the COVID-19 outbreak: a cross-sectional survey.

OBJECTIVE: To compare global health, mental health impact of work stressors and psychosocial perception of healthcare workers (HCWs) and non-HCWs in a hospital after the first peak of the COVID-19 outbreak in France. METHODS: A validated version of the SATIN (Santé Au Travail Inrs université Nancy 2)questionnaire with adapted scoring was used to collect data on health and impact of work stressors. This questionnaire was sent to all workers at a hospital in July 2020 and was self-administered online. In a multinomial regression model, we included HCW status, age, gender and front-line worker status as covariates. RESULTS: Data from a total of 1405 participants were included. We found that being an HCW, male and front-line worker was a risk factor for negative perception of work demand (OR 7.35, 95% CI 4.2 to 11.47; OR 2.55, 95% CI 1.11 to 5.89; OR 1.78, 95% CI 1.04 to 3.06). Being an HCW was a predictive factor for stress (OR 1.47, 95% CI 1.04 to 2.08), poor global health (OR 1.71, 95% CI 1.14 to 2.55) and negative perception of work activity environment (OR 1.9, 95% CI 1.3 to 2.8). CONCLUSION: We have shown that all HCWs suffered from some health impact shortly after the first peak of the COVID-19 outbreak. We underline some stressors with high impact, including work demand, work abilities and organisational context, and emphasise the need for risk management.

[Impact of the Covid-19 pandemic on the health of nurses in a university hospital]. / Impact de la pandémie de Covid-19 sur la santé des infirmiers d'un CHU.

In a university hospital in Brittany, health monitoring of the staff was set up at the beginning of the Covid-19 pandemic. The first results of the studies carried out in this context showed that nurses showed a greater deterioration of their physical health than other professionals. However, thanks to psychological balancing measures, nurses did not appear to be more affected in terms of psychological health and well-being at work than the other hospital workers.

Health Impact and Psychosocial Perceptions among French Medical Residents during the SARS-CoV-2 Outbreak: A Cross-Sectional Survey.

This study compared the impact on mental health and the psychosocial perceptions of medical residents and healthcare workers (HCWs) in a hospital after the first peak of the SARS-CoV2 outbreak in France. A validated version of the SATIN questionnaire with a modified scoring system was used to collect data on health and psychosocial factors. This questionnaire was sent to all workers at the hospital in July 2020 and was self-administered online. Using a multivariate multinomial regression model, the study included demographic variables such as age, gender, years at workplace and the relevant of covariate as HCW status. One thousand, four hundred and six questionnaires were available for analysis including 393 non-HCWs, 891 HCWs and 122 medical residents. Medical resident status is a risk factor for stress (OR 4.77 [2.48-9.18] p < 0.001), worse global health (OR 4 [1.7-9.6] p < 0.001) and mental health (OR 2.58 [1.3-5.1] p = 0.02), negative perception of work demand (OR 8.25 [3.5-19.6] p <0.001), work activity environment (OR 3.18 [1.5-6.7] p = 0.02) and organizational context (OR 4.9 [2.38-10.4] p <0.001). Action on collective support, protection equipment, organizational context and framework are important.

Seafarers' mental health in the COVID-19 era: lost at sea?

Seafarers are exposed to several physical and psychosocial stressors. Recent studies highlighted specific disorders as fatigue, boredom and diseases as depression. Seafarers are also commonly exposed to post-traumatic stress disorder (piracy, accidents, threats). Coronavirus disease 2019 (COVID-19) impacts seafarers with an estimated 400,000 of whom are stranded on vessels around the world, with extended time on board, repatriation's difficulties and the financial concerns of the unexpectedly unemployed. International Maritime Organization has established the Seafarer Crisis Action Team to help them. In France, in last 10 months a dedicated call centre received 142 calls from 32 seafarers for psychological phone consultations mostly linked to this era. With the increase of duration of the COVID-19 crisis, psychological health care, repatriations and financial solutions are needed for seafarers.

Too afraid to vote? The effects of COVID-19 on voting behaviour.

This paper studies the causal effect of local exposure to COVID-19 on voting behaviour and electoral outcomes using evidence from the regional elections held in Spain on 12 July 2020. Exploiting the variation in exposure to COVID-19 and using a difference-in-differences identification strategy, we show that turnout was between 2.6 and 5.1 percentage points lower in municipalities that experienced positive cases of COVID-19. In addition, the results show a substantial increase in the probability of voting for nationalist parties. We discuss the idea of perceived fear being the potential mechanism driving our results.