[Endoscopic surgery and covid 19 disease: case report]. / Chirurgie par voie endoscopique et infection de la maladie a covid 19 a propos d'un cas clinique.

The objective of this work is to raise the issue of contamination of covid 19 disease during endoscopic endonasal surgery for pituitary tumor. This is a 32-year-old patient with a body mass index at 49,38 seen in an outpatient clinic for headache, erectile dysfunction and gynecomania, a CT scan revealed a pituitary macroadenoma. The preoperative workup was unremarkable including the rapid polymerase chain reaction (PCR) test was negative. The endonasal approach was decided for surgery. The tumor was removed by aspiration. The postoperative course was straightforward until the fifth day when the patient presented a dry cough with a fever at 38 ° 5 associated to respiratory discomfort. The thoracic CT-scan showed "ground glass" opacities located at peripheral and bilateral, and essentially posterior suggesting covid 19 disease. A second test was performed. Before the result, the anticoagulant treatment associated with third generation cephalosporin was done. The test results came back after 72 hours and was positive. Azithromycin, hydroxychloroquine, and oral vitamin C have been used for 11 days. The outcome was favorable and the patient was discharged from the hospital on the twelfth day after the negative PCR test.

L'objectif de ce travail est de poser la problématique d'une contamination de la maladie à covid 19 lors L'objectif de ce travail est de poser la problématique d'une contamination de la maladie à covid 19 lors d'une chirurgie endoscopique endonasale pour tumeur hypophysaire. Il s'agissait d'un patient de 32 ans avec un indice de masse corporelle à 49,38 vu en consultation pour céphalées, dysfonctionnement érectile et gynécomanie, la tomodensitométrie avait mis en évidence un macroadénome hypophysaire. Le bilan préopératoire était sans particularité incluant le test rapide « réaction en chaine par Polymérase ¼ (PCR) qui était négatif. La voie endonasale a été décidée pour la chirurgie. La tumeur a été évidée par aspiration. Les suites opératoires ont été simples jusqu'au cinquième jour ou le patient a présenté une toux sèche avec une fièvre à 38°5 associée à une gêne respiratoire. Le scanner thoracique a visualisé des opacités « en verre dépoli ¼ de topographie périphérique et bilatérales et essentiellement postérieure évoquant la maladie à covid 19. Un deuxième test a été effectué.En attendant le résultat le traitement anticoagulant associé à la céphalosporine de troisième génération a été instauré. Les résultats du test sont revenus positifs après 72 heures. L'azithromycine, l'hydroxychloroquine, et la vitamine C par voie orale ont été associées pendent 11 jours. L'évolution a été favorable et le patient est sorti de l'hôpital au douzième jour après la négativité du test PCR de contrôle.

Growth performance, breast yield, gastrointestinal ecology and plasma biochemical profile in broiler chickens fed multiple doses of a blend of red, brown and green seaweeds.

1. A total of 864 d old (male) Ross × Ross 708 broiler chicks were allocated to 48 floor pens (12 pens/treatment and 18 birds/pen) to investigate dose-response of a blend of seaweeds (SB) on growth performance, breast yield, jejunal histomorphology, microbial metabolites and community and plasma biochemical profile. 2. A maize-soybean meal diet was formulated with 0, 5, 10 or 20 g/kg of SB. Diets were formulated for a three-phase feeding programme (starter: d 0-10, grower: d 11-24, and finisher: d 25-42) and met or exceeded Aviagen nutrient specifications. Diets were allocated to pens (n = 12) balanced for body weight (BW). Birds had free access to feed and water, BW and feed intake (FI) were monitored by phase. One bird per pen was randomly selected on d 42, bled for plasma, and samples for intestinal tissue and caecal digesta were taken. Microbial DNA was extracted and submitted for microbial community profile using the Illumina Miseq® platform. 3. In the starter phase, SB linearly (P ≤ 0.01) improved BW, body weight gain (BWG), and FCR. However, the improvement was quadratic, such that there was no further improvement beyond 5 g/kg SB inclusion. Growth performance response to SB in the grower phase was similar to the starter phase, with the exception of FCR (P > 0.05). Overall, from d 0-42, a linear and quadratic (P < 0.01) response was observed for final BW (d 42), whereby birds fed 5, 10 and 20 g/kg SB were heavier than control by 166, 183 and 180 g, respectively. A quadratic (P = 0.03) effect was observed for breast yield in response to SB. There was a quadratic reduction (P < 0.05) in gamma-glutamyl transferase (GGT) and a linear increase in glutamate dehydrogenase (GDH) in response to SB. Supplemental SB linearly reduced (P ≤ 0.04) the relative abundance of phylum Bacteroidetes and Proteobacteria, and increased the abundance of phylum Firmicutes (linearly; P = 0.02) and Actinobacteria (quadratically; P = 0.03). 4. The data indicated that the optimal inclusion for SB was between 5 and 10 g/kg for improved growth performance and breast yield. However, increased abundance of Firmicutes and actinobacteria in the caecal digesta suggested that the higher doses enhanced prebiotic effects of seaweed components.

[Healthcare associated infections in the neurosurgical department of Gabriel Touré teaching Hospital in Bamako]. / Les infections associees aux soins dans le service de neurochirurgie du CHU Gabriel Toure a Bamako.

INTRODUCTION: Healthcare-associated infections or nosocomial infections are a public health problem due to their frequency, severity and economic impact. They cause an increase of the morbidity, the mortality, the hospital stay and the expenses of taking care of the patients. According to the WHO, 7.1 million people are affected each year, of which about 100,000 die. AIM OF STUDY: The aim of this study was to determine the frequency of healthcare-associated infections in the Neurosurgery Department of Gabriel Touré University teaching Hospital and to identify the risk factors associated with these infections. MATERIAL AND METHODS: This was an epidemiological, descriptive, analytic, cross-sectional and prospective study lasting 6 months from May 29 to November 30, 2016. The study focused on patients who stayed more than 48 hours in the Neurosurgical department Gabriel Touré teaching hospital. The collected data focused on the clinical and biological characteristics of the patients during their hospitalization. The maximum size of the sample was 200 patients. A sample was taken for each type of infection. The criteria used for the diagnosis of Healthcare-associated infections were those of the CDC (Center for Disease Control) and the realization of a thick drop in our context. The chi-square test was used for the comparison of qualitative variables and Kruskal Wallis and Anova for quantitative variables. The materiality threshold has been set to a value of p less than 0.05. RESULTS: At the end of our study, we had 34 infected patients out of 200, a rate of 17%. The significant risk factors found in our study were: high age (p = 0.04), ASA class (p = 0.002), pre-surgical shaving (p = 0.02), long duration surgical intervention (p = 0.002) and long hospital stay (p = 0.004). The types of infections associated with the care found were: urinary in 18 (53%) cases, respiratory in 9 (26%) cases, operative site in 6 (18%) cases and 1 (3%) cases of bacteremia. The bacterial spectrum of these infections was dominated by Negative Gram Bacilli, among which Escherichia coli in 11 (32.3%) cases. The clinical course of patients treated for these infections was marked by healing in 31 (91.2%) cases, complications in 2 (5.9%) cases, and death in 1 (2.9%) case. CONCLUSION: The prevalence of Healthcare-associated infections in our department remains high compared to that found in developed countries. This study allowed us to identify the main risk factors associated with these infections. A stricter adherence to the rules of hygiene and prevention of Healthcare-associated infections is needed to reduce this rate.

INTRODUCTION: Les infections associées aux soins (IAS) ou infections nosocomiales constituent un problème de santé publique par leur fréquence, leur gravité et leur retentissement économique. Elles causent une augmentation de la morbidité, la mortalité, le séjour hospitalier et les frais de prise en charge des malades.Selon l'OMS, 7,1 millions de personnes seraient affectées par les IAS chaque année parmi lesquelles environ 100000 meurent de suites de ces ISA. BUT: Le but de cette étude était de déterminer la fréquence des infections associées aux soins dans le service de Neurochirurgie du CHU Gabriel Touré et d'identifier les facteurs de risque associés à ces infections. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude prospective d'une durée de 6 mois allant du 29 Mai au 30 Novembre 2016. L'étude a porté sur les patients ayant séjourné plus de 48 heures dans le service de Neurochirurgie du CHU Gabriel Touré.Les données collectées ont porté sur les caractéristiques cliniques et biologiques des patients au cours de leur hospitalisation.La taille maximum de l'échantillon a été de 200 malades. Un prélèvement a été fait pour chaque type d'infection.Les critères utilisés pour le diagnostic de l'IAS étaient ceux du CDC (Center for Disease Control) d'Atlanta ainsi que la réalisation d'une goutte épaisse dans notre contexte.Le test de khi2 a été utilisé pour la comparaison des variables qualitatives et Kruskal Wallis et Anova pour les variables quantitatives. Le seuil de signification a été fixé à une valeur de p inférieure à 0,05. RÉSULTATS: Au terme de notre étude nous avons eu 34 patients infectés sur 200, soit un taux de 17%. Les différents facteurs de risque significatifs retrouvés dans notre étude ont été : l'âge élevé (p=0,04), la classe ASA (p=0,002), le rasage pré-chirurgical (p=0,02), la longue durée de l'intervention chirurgicale (p=0,002) ainsi que la longue durée d'hospitalisation (p=0,004). Les types d'infections associées aux soins retrouvés ont été : urinaires dans 18 (53 %) cas, respiratoires dans 9 (26%) cas, site opératoire dans 6 (18%) cas et 1 (3%) cas de bactériémie. Le spectre bactérien de ces infections était dominé par les Bacilles Gram Négatifs parmi lesquels l'Escherichia coli dans 11 (32,3%) cas.L'évolution clinique des patients traités pour ces infections a été marquée par la guérison dans 31 (91,2%) cas, les complications dans 2 (5,9%) cas et le décès dans 1(2,9%) cas. CONCLUSION: La prévalence des infections associées aux soins dans notre service reste élevée par rapport à celle retrouvée dans les pays développés. Cette étude nous a permis d'identifier les principaux facteurs de risque associés à ces infections. Une observance plus stricte des règles d'hygiène et de prévention des IAS s'impose pour faire baisser ce taux.

[Acute Complications Of Snakebite Envenomation In Department Resuscitation Of CHU-Mother Child "Luxembourg" Of Bamako]. / Complications Aigues De L'Envenimation Par Morsures De Serpent Au Service De Reanimation Du Chu Mere Enfant "Le Luxembourg" De Bamako.

Envenomation by snakebite remains a public health problem in Africa. The purpose of our work was to study the acute complications of snakebite envenomation and the risk factors for its complications. METHOD: This was a retrospective and prospective study over a period of 07 years, which was performed in the department of anesthesia resuscitation and emergencies of CHU-Mother Child "Luxembourg" of Bamako. RESULTS: During this period, 76 cases of Ophidian envenomation were recorded. The average age of the patients was 34 ± 12 years old. . The family of vipers (Echis and Bitis) was the most incriminated 84,61% of the cases. Hemorrhagic complications were observed in 78.94% of patients, other complications (cardiovascular, neurological, dermatological, ophthalmological ...) were observed in 21.05% of patients. The main risk factor for complication observed was the delay in management (> 6 hours delay) in 100% of patients. The absence of serotherapy and or the initial resort to traditional treatment have been complicating risk factors. Almost all victims of Elapidae bites, 89.9% (5/6 cases) died. Serotherapy was performed urgently in 97.4% of cases. The morbidity in our study was 10.52% with a 7.8% mortality. CONCLUSION: in our context, the management of envenomations by snake bite remains dependent on a multitude of complications. The prognosis is conditioned by the early administration of symptomatic treatment and a specific antidote.

L'envenimation par morsure de serpent reste un problème de santé publique en Afrique. Notre travail avait pour objectif d'étudier les complications aigues de l'envenimation par morsure de serpent, ainsi que les facteurs de risque de ses complications. MÉTHODE: Il s'agissait d'une étude rétrospective et prospective sur une période de 07 ans, qui a été réalisée dans le département d'anesthésie réanimation et des urgences du CHU-Mère enfant le « Luxembourg ¼ de Bamako. RÉSULTATS: Durant cette période, 76 cas d'envenimations ophidiennes ont été enregistrés. L'âge moyen des patients était de 34±12 ans. . La famille des vipéridés (Echis et Bitis) était la plus incriminée 84,61% des cas. Les complications hémorragiques ont été observées chez 78,94% des patients, d'autres complications (cardiovasculaire, neurologique, dermatologique, ophtalmologique...) ont été observées chez 21,05% des patients. Le principal facteur de risque de survenu de complication observé, était le retard de prise en charge (délai> 6heures) Chez 100% des patients. L'absence de la sérothérapie et ou le recours initial à un traitement traditionnel ont été des facteurs de risques de complication. La presque totalité des victimes par morsures d'Elapidés soit 89,9% (5/6 cas) sont décédées. La sérothérapie a été effectuée en urgence chez 97,4% des cas. La morbidité dans notre étude a été de 10,52% avec une mortalité à 7,8%. CONCLUSION: dans notre contexte, la prise en charge des envenimations par morsure de serpent reste tributaire d'une multitude de complications. Le pronostic est conditionné par l'administration précoce d'un traitement symptomatique et d'un antidote spécifique.

Complications aigues de l'envenimation par morsures de serpent au service de Réanimation du chu mère enfant ''le Luxembourg'' de Bamako

L'envenimation par morsure de serpent reste un problème de santé publique en Afrique. Notre travail avait pour objectif d'étudier les complications aigues de l'envenimation par morsure de serpent, ainsi que les facteurs de risque de ses complications. Méthode : Il s'agissait d'une étude rétrospective et prospective sur une période de 07 ans, qui a été réalisée dans le département d'anesthésie réanimation et des urgences du CHU-Mère enfant le « Luxembourg » de Bamako. Résultats : Durant cette période, 76 cas d'envenimations ophidiennes ont été enregistrés. L'âge moyen des patients était de 34±12 ans.La famille des vipéridés (Echis et Bitis) était la plus incriminée 84,61% des cas. Les complications hémorragiques ont été observées chez 78,94% des patients, d'autres complications (cardiovasculaire, neurologique, dermatologique, ophtalmologique…) ont été observées chez 21,05% des patients. Le principal facteur de risque de survenu de complication observé, était le retard de prise en charge (délai> 6heures) Chez 100% des patients. L'absence de la sérothérapie et ou le recours initial à un traitement traditionnel ont été des facteurs de risques de complication. La presque totalité des victimes par morsures d'Elapidés soit 89,9% (5/6 cas) sont décédées. La sérothérapie a été effectuée en urgence chez 97,4% des cas. La morbidité dans notre étude a été de 10,52% avec une mortalité à 7,8%. Conclusion : dans notre contexte, la prise en charge des envenimations par morsure de serpent reste tributaire d'une multitude de complications. Le pronostic est conditionné par l'administration précoce d'un traitement symptomatique et d'un antidote spécifique

Anesthésie pour séparation d'un Craniopagus parasiticus

Le jumeau parasite est un type de siamois chez lequel un des jumeaux est représenté par une formation rudimentaire parasitant le jumeau principal. L'incidence des siamois est estimée de 1:50.000 à 1:100.000 naissances vivantes. Les siamois sont décrits en fonction des organes conjoints ou éventuellement partagés. La classification de Spencer est la plus classique. La séparation chirurgicale -si envisagée et réalisable- relève d'une prise en charge multidisciplinaire.La séparation d'un jumeau parasite est une intervention à risque per et post-opératoire élevé, nécessitant une exploration clinique, radiologique et physiologique notamment en ce qui concerne les organes conjoints ou fusionnés. Le risque anesthésique porte particulièrement sur l'intubation difficile, l'hémorragie, la transfusion massive, les troubles métaboliques. Pour partager notre expérience et discuter les principes de prise en charge, nous rapportons un cas d'anesthésie pour la séparation d'un cas de Craniopagus parasiticus réussi avec des suites post-opératoires sans complications

Prevalence of methicillin-resistant Staphylococcus aureus in Canadian commercial pork processing plants.

AIMS: This study investigated the prevalence of Methicillin-resistant Staphylococcus aureus (MRSA), their spa-types, and antimicrobial resistance profiles at various steps during commercial pork production from three plants designated as A, B and C. METHODS AND RESULTS: Over a period of 1 year 2640 samples from three commercial pork plants were obtained on a rotating basis. Sample sources were: nasal swabs after bleeding (NSAB), nasal swab after scalding (NSASs, plant C) or skinning (NSASk, plants A, B), carcass swabs after pasteurization (CSAP, plant C) or washing (CSAW, plants A, B) and retail pork (RP). Overall MRSA prevalence at each sampling point in the pork plants after adjusting for clustering was: 61·93, 28·38 7·58 and 1·21% for NSAB, NSASc/Sk, CSAP/CSAW and RP respectively. The majority of MRSA isolates from the three pork plants belonged to livestock-associated MRSA spa-types t034 and t011 (3·8%; ST398). The mainly human spa-type t002 (15%) was also recovered. All MRSA isolates were resistant to ß-lactam and tetracycline antibiotics. Overall resistance to tigecycline was found in about 10% of MRSA isolates while <3% isolates were resistant to daptomycin, gentamicin, quinupristin/dalfopristin and trimethoprim/sulfamethoxazole. CONCLUSION: A higher prevalence of MRSA in the nasal cavity of incoming pigs was observed at all three plants, but a notable reduction in MRSA along the pork processing steps occurred. SIGNIFICANCE AND IMPACT OF THE STUDY: The highest prevalence of MRSA was found in the nasal cavity of incoming pigs in three commercial pig slaughter and pork processing plants. A reduction in MRSA prevalence occurred along the processing chain, and pork products from these plants showed significantly lower MRSA than the initial steps of slaughter and processing, suggesting a reduction in MRSA during the slaughter process with minimal cross-contamination.

[Epidemiological, clinical and therapeutical study of depressed skull fractures in the neurosurgical department of the gabriel toure hospital: about 72 cases]. / Etude epidemiologique, clinique et therapeutique des fractures embarrures du crane a propos de 72 cas dans le service de neurochirurgie du CHU Gabriel Toure.

INTRODUCTION: Depressed skull fractures are common and frequent among neurosurgical diseases of whose danger stem from the associated intracranial lesions. The aims of this study were to describe the epidemiological characteristics of depressed skull fractures, to determine their etiology, to describe the clinical signs, to highlight the complications and sequelae and to evaluate care management. PATIENTS AND METHODS: It was a retrospective and descriptive study from January to December 2013 including 72 patients admitted to the neurosurgical department of the Gabriel Toure hospital. RESULTS: The frequency was 14.7% and the male to female ratio was 13.4. The peak frequency of these injuries occurred in the 16-to 25-year-old age group accounting for 38.9% of cases. Road traffic accidents were the most common causes of depressed skull fractures (59.7%). Neurosurgical treatment was performed in 25 (34.72%) patients and the most common surgical technique performed was the craniectomy in (64%). Infection of the wound was found in 15.3% and the mortality rate was 1.39%. CONCLUSIONS: Depressed skull fractures are a frequent neurosurgical disease in the Gabriel Touré hospital. Young people are most affected and road traffic accidents involving motorbikes are the main cause the fractures. The infection of the wound is a poor prognostic factor. Therefore, an early management is required to expect a good outcome.

INTRODUCTION: Les Fractures embarrures constituent des affections fréquentes en neurochirurgie dont la gravité est liée aux lésions intracrâniennes associées. Les objectifs de ce travail sont les suivants : décrire les caractéristiques épidémiologiques des fractures embarrures du crâne, déterminer les étiologies, décrire les signes cliniques, dégager les complications et les séquelles et évaluer la prise en charge. PATIENTS ET MÉTHODES: il s'agissait d'une étude rétrospective descriptive portant sur 72 malades de janvier à décembre 2013 dans le service de neurochirurgie du CHU Gabriel Touré. La fréquence était de 14,7% avec une forte prédominance masculine (93% des cas). Les jeunes de 16-25 ans étaient les plus touchés soit 38,9%. Les AVP constituaient la principale étiologie avec 59,7% des cas. Le traitement neurochirurgical a été effectué chez 25 patients soit 34,72% et la craniectomie à os perdu était la technique la plus utilisés (64% des cas opérés). L'infection de la plaie a été la complication post opératoire dominante avec 15,3%. le taux de mortalité était de 1,39%.

[Clinical and therapeutical aspects of lumbar stenosis in the gabriel touré hospital: about 24 cases]. / Aspect clinique et therapeutique du canal lombaire a propos de 24 cas enregistres au CHU Gabriel Toure de Bamako.

INTRODUCTION: Lumbar stenosis is a disease caused by a conflict between the neural structures (spinal cord and nerve roots) and spinal structures (bones and ligaments). The objectives of this study were to highlight the frequency, the diagnosis and therapeutics options, and to evaluate the treatment outcomes. PATIENTS AND METHODS: It was a retrospective study from January 2012 to December 2012 including 24 patients admitted to the neurosurgical department of the Gabriel Touré Hospital. RESULTS: The frequency of lumbar stenosis was 6.19% of all neurosurgical diseases. The sex-ratio was 0.71. The age ranged from 28 to 81 years with an average of 52 years. The neurogenic claudication was found in 87.5%. The straight leg raising test was positive in 41.7% of cases. The most vertebras involved were L4 and L5. Lumbar disc herniation was associated in 70.83%. Degenerative lumbar stenosis was the most common form, found in 66.67% of cases. Surgical treatment was performed in 29.17% of cases. The outcome was good in 85.6% of cases. CONCLUSIONS: Lumbar stenosis is a prevalent disease that occurs typically occurs around 50 years of age. The diagnosis was confirmed by myelography and a post myelographic CT scan. Good outcomes are achieved with both surgical or medical treatments.

INTRODUCTION: Le canal lombaire étroit (C.L.E.) est une pathologie liée à un conflit entre le contenant (ostéo-discoligamentaire) et le contenu (moelle épinière et ses composantes). Les objectifs de ce travail étaient de déterminer la fréquence du CLE, de déterminer les méthodes de diagnostic et de traitement, d'évaluer les résultats du traitement. PATIENTS ET MÉTHODE: Il s'agissait d'une étude rétrospective portant sur 24 cas de canal lombaire étroit colligés entre le 1er Janvier 2012 et le 31 Décembre 2012% dans le service de Neurochirurgie du C.H.U Gabriel Touré. RÉSULTATS: le CLE constitue 6,19% de nos patients opérés. Le sexe féminin prédominait avec 58%. L'âge moyen était 52 ans avec les extrêmes de 28 ans et de 81 ans. La claudication était retrouvée à l'interrogatoire chez 87,5% des cas. le signe de Sonnette était retrouvé chez 41,7% des patients. Les vertèbres L4 et L5 étaient les plus touchés. La hernie discale était associée dans 70 .83%. Le CLE acquis représentait 66,67% des cas, la forme constitutionnelle,25% et celle congénitale, 8,33%. Le traitement a été médical dans 70,83% des cas et chirurgical 29,17%. Les résultats étaient bons dans 85,6%. CONCLUSION: le CLE est une affection fréquente se manifestant vers l'âge de 50 ans. La confirmation du diagnostic était faite par la saccoradiculographie couplée au myéloscanner. Le traitement médical ou chirurgical donne des bons résultats.

Etude epidemiologique; clinique et therapeutique des fractures embarrures du crane a propos de 72 cas dans le service de neurochirurgie du CHU Gabriel Toure

Introduction : Les fractures embarrures constituent des affections frequentes en neurochirurgie dont la gravite est liee aux lesions intracraniennes associees. Les objectifs de ce travail sont les suivants : decrire les caracteristiques epidemiologiques des fractures embarrures du crane; determiner les etiologies; decrire les signes cliniques; degager les complications et les sequelles et evaluer la prise en charge. Patients et Methodes : il s'agissait d'une etude retrospective descriptive portant sur 72 malades de janvier a decembre 2013 dans le service de neurochirurgie du CHU Gabriel Toure. La frequence etait de 14;7% avec une forte predominance masculine (93% des cas). Les jeunes de 16-25 ans etaient les plus touches soit 38;9%. Les AVP constituaient la principale etiologie avec 59;7% des cas. Le traitement neurochirurgical a ete effectue chez 25 patients soit 34;72% et la craniectomie a os perdu etait la technique la plus utilises (64% des cas operes). L'infection de la plaie a ete la complication post operatoire dominante avec 15;3%. le taux de mortalite etait de 1;39%

Pathogenic and multidrug-resistant Escherichia fergusonii from broiler chicken.

An Escherichia spp. isolate, ECD-227, was previously identified from the broiler chicken as a phylogenetically divergent and multidrug-resistant Escherichia coli possessing numerous virulence genes. In this study, whole genome sequencing and comparative genome analysis was used to further characterize this isolate. The presence of known and putative antibiotic resistance and virulence open reading frames were determined by comparison to pathogenic (E. coli O157:H7 TW14359, APEC O1:K1:H7, and UPEC UTI89) and nonpathogenic species (E. coli K-12 MG1655 and Escherichia fergusonii ATCC 35469). The assembled genome size of 4.87 Mb was sequenced to 18-fold depth of coverage and predicted to contain 4,376 open reading frames. Phylogenetic analysis of 537 open reading frames present across 110 enteric bacterial species identifies ECD-227 to be E. fergusonii. The genome of ECD-227 contains 5 plasmids showing similarity to known E. coli and Salmonella enterica plasmids. The presence of virulence and antibiotic resistance genes were identified and localized to the chromosome and plasmids. The mutation in gyrA (S83L) involved in fluoroquinolone resistance was identified. The Salmonella-like plasmids harbor antibiotic resistance genes on a class I integron (aadA, qacEΔ-sul1, aac3-VI, and sulI) as well as numerous virulence genes (iucABCD, sitABCD, cib, traT). In addition to the genome analysis, the virulence of ECD-227 was evaluated in a 1-d-old chick model. In the virulence assay, ECD-227 was found to induce 18 to 30% mortality in 1-d-old chicks after 24 h and 48 h of infection, respectively. This study documents an avian multidrug-resistant and virulent E. fergusonii. The existence of several resistance genes to multiple classes of antibiotics indicates that infection caused by ECD-227 would be difficult to treat using antimicrobials currently available for poultry.

Development of a DNA microarray for enterococcal species, virulence, and antibiotic resistance gene determinations among isolates from poultry.

A DNA microarray (Enteroarray) was designed with probes targeting four species-specific taxonomic identifiers to discriminate among 18 different enterococcal species, while other probes were designed to identify 18 virulence factors and 174 antibiotic resistance genes. In total, 262 genes were utilized for rapid species identification of enterococcal isolates, while characterizing their virulence potential through the simultaneous identification of endogenous antibiotic resistance and virulence genes. Enterococcal isolates from broiler chicken farms were initially identified by using the API 20 Strep system, and the results were compared to those obtained with the taxonomic genes atpA, recA, pheS, and ddl represented on our microarray. Among the 171 isolates studied, five different enterococcal species were identified by using the API 20 Strep system: Enterococcus faecium, E. faecalis, E. durans, E. gallinarum, and E. avium. The Enteroarray detected the same species as API 20 Strep, as well as two more: E. casseliflavus and E. hirae. Species comparisons resulted in 15% (27 isolates) disagreement between the two methods among the five API 20 Strep identifiable species and 24% (42 isolates) disagreement when considering the seven Enteroarray identified species. The species specificity of key antibiotic and virulence genes identified by the Enteroarray were consistent with the literature adding further robustness to the redundant taxonomic probe data. Sequencing of the cpn60 gene further confirmed the complete accuracy of the microarray results. The new Enteroarray should prove to be a useful tool to accurately genotype strains of enterococci and assess their virulence potential.

Growth performance, meat quality, and gut microflora of broiler chickens fed with cranberry extract.

Cranberry fruit components have been reported to have antimicrobial activities against a variety of pathogenic bacteria and to be beneficial for human health. Studies on their effects are very limited in animals and especially in chickens. This study investigated the effect of feed supplementation with a commercial cranberry fruit extract (CFE) on the performance, breast meat quality, and intestinal integrity of broiler chickens. Twelve hundred male 1-d-old broiler chicks were allocated randomly to CFE treatments at 0, 40, 80, or 160 mg/kg of feed from d 0 to 35. Cloacal and cecal samples were collected weekly to evaluate the influence of treatments on the intestinal population of generic Escherichia coli, Clostridium perfringens, Enterococcus spp., and Lactobacillus spp. At d 35, BW were 1.62, 1.60, 1.61, and 1.64 kg for the control birds and birds fed 40, 80, and 160 mg of CFE/kg of feed, respectively. Feed intake ranged from 2.7 to 2.8 kg and feed efficiency from 1.8 to 1.9 g of feed/g of BW. However, the treatment effects on bird performance were not statistically significant (P > 0.05). The mortality rate tended to be lower (P = 0.09) in birds fed 40 mg of CFE/kg of feed. Feed supplementation with CFE did not significantly alter any broiler meat properties evaluated when compared with the control diet (P > 0.05). At d 28, the populations of Enterococcus spp. in cecal and cloacal samples were significantly lower (P < 0.05) in birds receiving CFE at 160 mg/kg of feed than the other groups. No significant differences were noted between the control and the treatment groups for general health and intestinal integrity (P > 0.05). These findings suggest that more studies are needed to investigate potential beneficial effects of CFE or its derivatives in broiler production.

Veterinary pharmaceuticals and antibiotic resistance of Escherichia coli isolates in poultry litter from commercial farms and controlled feeding trials.

Veterinary pharmaceuticals are commonly used in poultry farming to prevent and treat microbial infections as well as to increase feed efficiency, but their use has created public and environmental health concerns. Poultry litter contains antimicrobial residues and resistant bacteria; when applied as fertilizer, the level and effects of these pharmaceuticals and antimicrobial-resistant bacteria in the environment are of concern. The purpose of this study was to investigate poultry litter for veterinary pharmaceuticals and resistance patterns of Escherichia coli. Litter samples were collected from controlled feeding trials and from commercial farms. Feed additives bacitracin, chlortetracycline, monensin, narasin, nicarbazin, penicillin, salinomycin, and virginiamycin, which were present in the feed on commercial farms and added to the feed in the controlled trials, were extracted in methanol and analyzed by liquid chromatography-mass spectrometry techniques. Sixty-nine E. coli were isolated and identified by API 20E. The susceptibility of the isolates to antibiotics was determined using Avian plates and the Sensititer automated system. This study confirmed the presence of antimicrobial residues in broiler litter from controlled environments as well as commercial farms, ranging from 0.07 to 66 mg/L depending on the compound. Concentrations of individual residues were higher in litter from controlled feeding trials than those from commercial farms. All E. coli isolates from commercial farms were multiresistant to at least 7 antibiotics. Resistance to beta-lactam antibiotics (amoxicillin, ceftiofur), tetracyclines, and sulfonamides was the most prevalent. This study concluded that broiler litter is a source of antimicrobial residues and represents a reservoir of multiple antibiotic-resistant E. coli.

Genotype comparison of sorbitol-negative Escherichia coli isolates from healthy broiler chickens from different commercial farms.

Hybridization on arrays was used to assess the presence of virulence-associated genes and to determine the relatedness of 32 non-O157 sorbitol-negative Escherichia coli isolates from healthy broiler chickens. These isolates were from commercial farms that used feed supplemented with different antimicrobial agents (virginiamycin, bacitracin, salinomycin, narasin, nicarbazin, or diclazuril). For each isolate, fluorescent probes were made from genomic DNA and were hybridized on DNA arrays composed of genes associated with general functions, virulence, iron uptake systems, and DNA repair genes (e.g., mut genes). Hybridization on arrays results showed that isolates from the same farm tended to be clustered but actually represented 18 genetically distinct groups of isolates. Results revealed that some isolates showed similarity to human uropathogenic E. coli or avian pathogenic E. coli. Four avian pathogenic E. coli-like isolates were detected. Another isolate possessed the intimin gene (eaeA) and typical genes of the type 3 secretion system associated with enteropathogenic E. coli and enterohemorrhagic E. coli strains. Genes from a second system (secondary type 3 secretion system) homologous to that found in Salmonella Typhimurium were detected in many isolates. Several of the studied isolates also possessed the aerobactin, salmochelin, and yersiniabactin genes involved in iron acquisition in pathogenic bacteria. Our results clearly suggest that commensal E. coli isolates from chickens are reservoirs of virulence-associated genes and may represent colibacillosis and zoonotic risks.

Utilization of lactoferrin to fight antibiotic-resistant mammary gland pathogens.

The widespread use of antibiotics has lead to the increased presence of pathogens that are less susceptible to their antibacterial effect. Lactoferrin (Lf) is naturally produced by the mammary gland. Lactoferrin is the main whey protein in human milk and is also present in cow's milk but at a much lower concentration than in human milk. This protein appears to have many biological functions, including antibacterial and antiinflammatory activities. The best-known effect of Lf is to bind iron that is essential for bacterial growth. However, the cationic nature of this protein also appears to be important for the antimicrobial activity of this protein. Lactoferrin has a weak antibacterial effect when used alone, but interestingly, Lf appears much more effective when used at low concentration in combination with several antibiotics. The most striking observation is that Lf increases the inhibitory activity of penicillin up to 4-fold in most penicillin-susceptible Staphylococcus aureus strains, whereas this increase was 4- to 16-fold in penicillin-resistant strains. Indeed, Lf reduces beta-lactamase activity in S. aureus strains producing this enzyme. Transcription of beta-lactamase gene is dramatically repressed in the presence of Lf. We evaluated the efficacy of intramammary treatments containing penicillin G or bovine Lf (bLf), or both, to cure chronic mastitis caused by a clinical isolate of S. aureus highly resistant to beta-lactam antibiotics. In a first trial, mastitis was induced in lactating cows by injecting a low dose of S. aureus through the teat canal of all quarters. Bacterial cure rate was null for control quarters, 11.1% for bLf, 9.1% for penicillin, and 45.5% for the combination of bLf and penicillin. A second trial was undertaken to investigate the effect of an extended therapy on chronic mastitis acquired in a previous lactation. Quarters were treated with 100,000 IU of penicillin G with or without 250 mg of bLf for 7 d. Bacterial cure rate was greater for the bLf + penicillin combination (33.3%) compared with penicillin alone (12.5%). In conclusion, bLf added to penicillin is an effective combination for the treatment of stable S. aureus infections resistant to beta-lactam antibiotics.

Efficacy of a lactoferrin-penicillin combination to treat {beta}-lactam-resistant Staphylococcus aureus mastitis.

The efficacy of intramammary (IM) treatments containing penicillin G (PG) alone or a combination of PG and bovine lactoferrin (bLF) was evaluated using a model of experimentally induced chronic bovine mastitis caused by a clinical isolate of Staphylococcus aureus highly resistant to beta-lactam antibiotics. First, we confirmed that this strain could cause mastitis and infection could not be cured with PG alone. In a second trial, chronic mastitis was induced in 19 late-lactating cows by injecting a low dose of Staph. aureus through the teat canal of all quarters. After 15 d, cows with stable infections in their 4 quarters had their mammary quarters randomly assigned, within cow, to 1 of 4 IM treatments as follows: 1) citrate buffer, 2) 100,000 IU of PG, (3) 1 g of bLF, or 4) 1 g of bLF + 100,000 IU of PG. Treatments were repeated twice a day for 5 d. A third trial was undertaken to investigate the effect of an extended therapy on chronic mastitis acquired in a previous lactation. One month before dry-off, 20 gravid cows regrouped by dates of calving were infected in their 4 quarters. Once infections were established, cows were dried off abruptly. After calving, aseptic milk samples were collected separately from all quarters for 4 wk to monitor infection. Mammary quarters from enrolled cows were then randomly assigned, within cow, to 1 of 2 treatments as follows: 1) 100,000 IU of PG or 2) 250 mg of bLF + 100,000 IU of PG. Treatments were administered IM twice a day for 7 d. For all trials, milk samples were taken to monitor bacterial concentration and somatic cell count. Bacteriological cure rate was determined using milk samples taken 3 and 4 wk after initiation of treatments. For the second trial, cure rate was null for control quarters, 11.1% for bLF, 9.1% for PG, and 45.5% for the bLF + PG combination. For cows infected in their previous lactation, cure rate was higher for the bLF + PG combination (33.3%) compared with PG alone (12.5%). In conclusion, bLF added to PG is an effective combination (i.e., 3- to 5-times higher cure rate) for the treatment of stable Staph. aureu infections highly resistant to beta-lactam antibiotics.

Response of Staphylococcus aureus isolates from bovine mastitis to exogenous iron sources.

Staphylococcus aureus can survive in conditions of extremely low iron concentration. The ability of S. aureus to use two exogenous hydroxamate types of siderophores (desferrioxamine and ferrichrome) and four iron-containing proteins found in cattle (hemin, hemoglobin, ferritin, and lactoferrin) were tested on 16 reference and clinical isolates. For all strains tested, ferrichrome and desferrioxamine showed strong growth-promoting activities in a disk diffusion assay and in liquid medium. The heme proteins hemin and hemoglobin were also found to support growth in culture media lacking other iron sources, while lactoferrin failed to do so. On media containing the iron chelator dipyridyl, ferritin induced a growth inhibition effect that was further enhanced in the presence of lactoferrin in seven of the 13 tested strains. Staphylococcus aureus was able to bind hemin and the level of binding activity was not increased after growth in iron-rich or -poor media. Dot-blot competition tests showed that biotin-labeled lactoferrin binds to S. aureus, and this binding can be inhibited by unlabeled lactoferrin. Expression of lactoferrin-binding activity was independent of the level of iron in the medium and the iron saturation status of lactoferrin. For each strain tested, ligand blots showed lactoferrin-binding proteins of molecular weights ranging from 32 to 92 kDa. Possible functions of these lactoferrin-binding proteins could not be related to iron acquisition mechanism in S. aureus.

Effect of lactoferrin in combination with penicillin on the morphology and the physiology of Staphylococcus aureus isolated from bovine mastitis.

The objective of the present study was to evaluate the therapeutic potential of bovine lactoferrin or lactoferricin in combination with penicillin G against Staphylococcus aureus. Minimal inhibitory concentrations of lactoferrin, lactoferricin, penicillin, and combinations of lactoferrin or lactoferricin with penicillin were determined for 15 S. aureus strains including several strains resistant to beta-lactam antibiotics. The fractional inhibitory concentration index indicated a synergistic effect between lactoferrin and penicillin. Combination of lactoferrin with penicillin increased the inhibitory activity of penicillin by two- to fourfold and reduced the growth rate in S. aureus strains tested, whereas the increase in the inhibitory activity of lactoferrin by penicillin was 16- to 64-fold. The addition of iron to the medium containing a combination of penicillin and lactoferrin had no effect on growth inhibition. Electron microscopy revealed that concentration below the minimal inhibitory concentrations of penicillin induced important ultrastructure alterations, which were further enhanced by the presence of lactoferrin. When S. aureus cells were grown in the presence of a combination of penicillin and lactoferrin, changes in the protein profile of the bacteria, including the disappearance of several protein bands due to the presence of lactoferrin, were observed. These data suggest that bovine lactoferrin or lactoferricin in combination with beta-lactam antibiotics can increase the antibacterial activity of these antibiotics against S. aureus resistant to antibiotics.

Postantibiotic and physiological effects of tilmicosin, tylosin, and apramycin at subminimal and suprainhibitory concentrations on some swine and bovine respiratory tract pathogens.

The antimicrobial activity of tilmicosin, tylosin, and apramycin on some important gram-negative swine and bovine pathogens namely, Pasteurella multocida, Pasteurella haemolytica, Bordetella bronchiseptica, and Actinobacillus pleuropneumoniae were studied in vitro. The effect of minimal inhibitory concentrations (MICs) and sub-MICs (1/4, 1/2 MIC) on bacterial growth was evaluated. The presence of tilmicosin, tylosin and apramycin in the medium decreased the rate of growth of the bacterial strains tested using drug concentrations as low as 1/4 MIC. The postantibiotic effect (PAE) which is the suppression of optimal bacterial growth that persists after a short exposure (2 h) of microorganisms to an antibiotic was studied by exposure of bacteria to drugs at 1/4, 1/2, 1, 4 and 8 times MIC. The duration of PAEs increased with rising concentration for all drugs tested but at concentrations below the MIC, tilmicosin showed more significant PAEs than tylosin or apramycin against P. multocida and A. pleuropneumoniae. Tilmicosin and tylosin caused PAEs of up to 8 h when used at 8 times the MIC, while apramycin caused PAEs of up to 5 h when used at this concentration. Sub-MICs of either tilmicosin, tylosin, or apramycin had no effect on P. multocida dermonecrotic toxin production. However sub-MICs of tylosin, or apramycin significantly reduced the haemolytic activity of A. pleuropneumoniae and affected the capsular material production of this isolate and of one isolate of P. multocida (type A). The in vitro effect of tilmicosin, tylosin, and apramycin (even when used at sub-MIC levels) on growth, production of capsular material, and haemolytic activity might impair the virulence of some of the microorganisms studied. In addition to the effects of these drugs on some putative virulence factors, we suggest that the strong PAEs caused by tilmicosin, tylosin, and apramycin may also contribute to the in vivo efficacy of these drugs.