Development of Nanobodies as Theranostic Agents against CMY-2-Like Class C ß-Lactamases.

Three soluble single-domain fragments derived from the unique variable region of camelid heavy-chain antibodies (VHHs) against the CMY-2 ß-lactamase behaved as inhibitors. The structure of the complex VHH cAbCMY-2(254)/CMY-2 showed that the epitope is close to the active site and that the CDR3 of the VHH protrudes into the catalytic site. The ß-lactamase inhibition pattern followed a mixed profile with a predominant noncompetitive component. The three isolated VHHs recognized overlapping epitopes since they behaved as competitive binders. Our study identified a binding site that can be targeted by a new class of ß-lactamase inhibitors designed on the sequence of the paratope. Furthermore, the use of mono- or bivalent VHH and rabbit polyclonal anti-CMY-2 antibodies enables the development of the first generation of enzyme-linked immunosorbent assay (ELISA) for the detection of CMY-2 produced by CMY-2-expressing bacteria, irrespective of resistotype.

A three-year evolution and comparison of the blaCTX-M genes in pathogenic and non-pathogenic Escherichia coli isolated from young diarrheic and septicaemic calves in Belgium.

Escherichia coli producing Extended-Spectrum-ß-Lactamases (ESBL) are a major public health hazard worldwide. The most frequent ESBL belong to the CTX-M family. This study follows their prevalence in pathogenic and non-pathogenic ESBL-producing E. coli isolated from young diarrheic and septicaemic calves over three calving seasons. The triplex PCR targeted three main groups: CTX-M-1, CTX-M-2 and CTX-M-9. Of the 394 isolates studied, 388 (98.5%) were positive, with a majority of CTX-M-1 (243, 61.7%), following by CTX-M-9 (74, 18.8%) and CTX-M-2 (64, 16.2%). The progressive decrease of ESBL-resistance of pathogenic E. coli is not linked to any shift in genetic background, blaCTX-M genes still present in 99% of the isolates, or to the proportion of the three CTX-M groups. Moreover, no significant difference was observed in the CTX-M content between pathogenic and non-pathogenic E. coli.

Seven-Year Evolution of ß-Lactam Resistance Phenotypes in Escherichia coli Isolated from Young Diarrheic and Septicaemic Calves in Belgium.

Antimicrobial resistance is a major worldwide hazard. Therefore, the World Health Organization has proposed a classification of antimicrobials with respect to their importance for human medicine and advised some restriction of their use in veterinary medicine. In Belgium, this regulation has been implemented by a Royal Decree (RD) in 2016, which prohibits carbapenem use and enforces strict restrictions on the use of third- and fourth-generation cephalosporins (3 GC and 4 GC) for food-producing animals. Acquired resistance to ß-lactam antibiotics is most frequently mediated by the production of ß-lactamases in Gram-negative bacteria. This study follows the resistance to ß-lactam antibiotics in Escherichia coli isolated from young diarrheic or septicaemic calves in Belgium over seven calving seasons in order to measure the impact of the RD. Phenotypic resistance to eight ß-lactams was assessed by disk diffusion assay and isolates were assigned to four resistance profiles: narrow-spectrum ß-lactamases (NSBL); extended-spectrum ß-lactamases (ESBL); cephalosporinases (AmpC); and cephalosporinase-like, NSBL with cefoxitin resistance (AmpC-like). No carbapenemase-mediated resistance was detected. Different resistance rates were observed for each profile over the calving seasons. Following the RD, the number of susceptibility tests has increased, the resistance rate to 3 GC/4 GC has markedly decreased, while the observed resistance profiles have changed, with an increase in NSBL profiles in particular.

20 years of functional treatment for clubfoot: advantages and limitations compared with the Ponseti method.

Currently, the Ponseti method has become the most popular technique for the management of congenital clubfoot. Besides this treatment, the functional method or the 'French method' (FFM) represents another treatment option. Throughout our study, we will describe this method, based on the 'Saint Vincent de Paul' protocol with some modifications that we bring progressively. Carried out over the last 20 years at our institution. In total 145 children (210 clubfeet) were treated using FFM. Our technique is based on the 'Saint Vincent de Paul' protocol from Paris. This method consists of daily manipulations of the feet by specialised physiotherapists associated with thermoformable orthotics devices. An evaluation of the patient at 5 year of age is performed. Gait analysis was introduced in 2011 as a complementary assessment tool. Less than 15% of the feet underwent a surgical procedure at walking age. Compliance to treatment was significantly higher than with the Ponseti method. At the last follow-up, 80% of the children had good to excellent results without major residual deformity. Totally 7% of the children required a later intervention either for recurrence or for major residual deformity. FFM is an alternative approach in the management of clubfoot that has proven to be successful due to the precision and modularity of its splinting system. Good compliance and low recurrence rate are other elements to consider. However, it requires a well-trained physical therapist. The main disadvantages of this method are the high cost compared to the Ponseti method and the difficulty of applying this method in developing countries.

Identification of ß-Lactamase-Encoding (bla) Genes in Phenotypically ß-Lactam-Resistant Escherichia coli Isolated from Young Calves in Belgium.

The bla genes identification present in 94 phenotypically resistant Escherichia coli isolated from feces or intestinal contents of young calves with diarrhea or enteritis in Belgium was performed by microarrays (MA) and whole genome sequencing (WGS). According to their resistance phenotypes to 8 ß-lactams at the disk diffusion assay these 94 E. coli produced a narrow-spectrum-ß-lactamase (NSBL), an extended-spectrum-ß-lactamase (ESBL) or a cephalosporinase (AmpC). All ESBL-encoding genes identified by MA and WGS belonged to the blaCTX-M family, with a majority to the blaCTX-M-1 subfamily. Two different genes encoding an AmpC, blaCMY-2, and blaDHA-1 were detected in isolates with an AmpC phenotype. The blaTEM-1 and the blaOXA-1 were detected alone in isolates with a NSBL phenotype or in combination with ESBL-/AmpC-encoding bla genes. Furthermore, the WGS identified mutations in the ampC gene promoter at nucleotides -42 (C>T) and/or -18 (G>A) that could not be identified by MA, in several isolates with an AmpC-like resistance phenotype. No carbapenemase-encoding gene was detected. To our knowledge this is the first survey on the identification of bla genes in E. coli isolated from young diarrheic or septicemic calves in Belgium.