Whole Genome Sequencing and Molecular Epidemiology of Clinical Isolates of Staphylococcus aureus from Algeria.

Staphylococcus aureus is an important pathogen responsible for various healthcare- and community-acquired infections. In this study, whole genome sequencing (WGS) was used to genotype S. aureus clinical isolates from two hospitals in Algeria and to characterize their genetic determinants of antimicrobial resistance. Seventeen S. aureus isolates were included in this study. WGS, single-nucleotide polymorphism (SNP)-based phylogenetic analysis, in silico multilocus sequence typing (MLST), spa and staphylococcal cassette chromosome mec (SCCmec) typing and in silico antimicrobial resistance profiling were performed. Phenotypic antibiotic susceptibility testing was performed using the Vitek 2 system and the disk diffusion method. The isolates were separated into sequence types (STs), with ST80 being predominant; five clonal complexes (CCs); four spa types (t044, t127, t368, t386); and two SCCmec types (IVc and IVa). Whole genome analysis revealed the presence of the resistance genes mecA, blaZ, ermC, fusB, fusC, tetK, aph(3')-IIIa and aad(6) and mutations conferring resistance in the genes parC and fusA. The rate of multidrug resistance (MDR) was 64%. This work provides a high-resolution characterization of methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) isolates and emphasizes the importance of continuous surveillance to monitor the spread of S. aureus in healthcare settings in the country.

Bayesian spatio-temporal analysis of the incidence of lung cancer in the North West of Algeria, 2014-2020.

Lung cancer is the most common type of cancer worldwide. This study assessed the spatio-temporal variations of the incidence rate of lung cancer between 2014 and 2020 in Chlef, a province in the North West of Algeria. Case data recoded by municipality, sex and age were collected from the oncology department in a local hospital. A hierarchical Bayesian spatial model, adjusted by urbanization level, with zero inflated Poisson distribution was used to study the variation of lung cancer incidence. A total of 250 lung cancer cases were registered during the study period, with a crude incidence rate of 4.12 per 100,000 inhabitants. The results of the model showed that residents in urban municipalities had a significantly higher risk of lung cancer than those in rural municipalities: incidence ratio rate (IRR) = 2.83 (95% CI: 1.91 - 4.31) and 1.80 (95% CI: 1.02 - 3.16) for men and women, respectively. In addition, the estimated incidence rate by the model for both sexes in the Chlef province indicated that only three urban municipalities had a higher incidence rate of lung cancer than the average of the province. The results of our study suggest that the risk factors for lung cancer in the North West of Algeria were mainly related to the level of urbanization. Our findings provide important information to guide the health authorities in designing measures for the surveillance and control of lung cancer.

Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals.

INTRODUCTION: Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals. METHODOLOGY: Between 2016 and 2019, faecal specimens were collected from in-patients and were cultured for C. difficile. Isolates were characterised by toxin genes detection, Polymerase Chain Reaction (PCR)-ribotyping, Multilocus Sequence Typing (MLST), antimicrobial susceptibility testing against a panel of antibiotics, and screened for antimicrobial resistance genes. RESULTS: Out of 300 patient stools tested, 18 (6%) were positive for C. difficile by culture, and were found to belong to 11 different ribotypes (RT) and 12 sequence types (ST): RT 085/ST39, FR 248/ST259, FR 111/ST48, RT 017/ST37, RT 014/ST2, RT 014/ST14, FR 247/new ST, RT 005/ST6, RT 029/ST16, RT 039/ST26, RT 056/ST34 and RT 446/ST58. MLST analysis assigned the isolates to two clades, 1 and 4. Clade 4 was more homogeneous, as it mainly included non-toxigenic isolates. Three toxin gene profiles were detected, two toxigenic, A+B+CDT- (33.3%) and A-B+CDT- (11%); and one non-toxigenic, A-B-CDT- (55.5%). All C. difficile isolates were susceptible to metronidazole, vancomycin and moxifloxacin. CONCLUSIONS: Overall prevalence of C. difficile in our healthcare settings was 6%. Antibiotic resistance rates ranged from 72.2% (clindamycin) to 16.6% (tetracycline). This study highlighted a relatively high genetic diversity in term of ribotypes, sequence types, toxin and antibiotic resistance patterns, in the C. difficile isolates. Further larger studies are needed to assess the true extent of C. difficile infections in Algeria.

Modeling tuberculosis dynamics, detection and control in cattle herds.

Epidemiological models are key tools for designing and evaluating detection and control strategies against animal infectious diseases. In France, after decades of decrease of bovine tuberculosis (bTB) incidence, the disease keeps circulating. Increasing prevalence levels are observed in several areas, where the detection and control strategy could be adapted. The objective of this work was to design and calibrate a model of the within-herd transmission of bTB. The proposed model is a stochastic model operating in discrete-time. Three health states were distinguished: susceptible, latent and infected. Dairy and beef herd dynamics and bTB detection and control programs were explicitly represented. Approximate Bayesian computation was used to estimate three model parameters from field data: the transmission parameter when animals are inside (ßinside) and outside (ßoutside) buildings, and the duration of the latent phase. An independent dataset was used for model validation. The estimated median was 0.43 [0.16-0.84] month-1 for ßinside and 0.08 [0.01-0.32] month-1 for ßoutside. The median duration of the latent period was estimated 3.5 [2]-[8] months. The sensitivity analysis showed only minor influences of fixed parameter values on these posterior estimates. Validation based on an independent dataset showed that in more than 80% of herds, the observed proportion of animals with detected lesions was between the 2.5% and 97.5% percentiles of the simulated distribution. In the absence of control program and once bTB has become enzootic within a herd, the median effective reproductive ratio was estimated to be 2.2 in beef herds and 1.7 in dairy herds. These low estimates are consistent with field observations of a low prevalence level in French bTB-infected herds.