The information system of REIN / Le système d'information de REIN

On the occasion of the 20th anniversary of the REIN (French Renal Epidemiology and Information Network), a summary work on the contributions of the national French ESKD register was carried out. On the issue of its information system, the following key messages were retained. The REIN information system accompanies the register throughout the life cycle of the data. Two collection tools, one for dialysis, the other for transplantation are accessible via a secure WEB site. Several data quality control tools have been added. Finally, several reporting tools, including a geographic information system completes REIN's information system.

À l'occasion des 20 ans du REIN (Réseau Épidémiologie et Information en Néphrologie), un travail de synthèse sur les apports du registre a été mené. Sur la question de son système d'information, les messages clés suivants ont été retenus. Le système d'information de REIN accompagne le registre sur tout le cycle de vie de la donnée. Deux outils de recueil, l'un pour la dialyse, l'autre pour la greffe sont accessible via un site WEB sécurisé. Plusieurs outils de contrôle de la qualité des données y ont été ajoutés. Et enfin, plusieurs outils de retours d'information, dont un système d'information géographique, complètent le système d'information de REIN.

Assessment of the Transmission Dynamics of Clostridioides difficile in a Farm Environment Reveals the Presence of a New Toxigenic Strain Connected to Swine Production.

The recent increase in community-acquired Clostridioides difficile infections discloses the shift in this bacterium epidemiology. This study aimed at establishing a transmission network involving One Health components, as well as assessing the zoonotic potential and genomic features of dominant clones. Samples were collected from different compartments of animal, human and environmental origin, from an animal production unit. C. difficile isolates were characterized for toxigenic profile by multiplex-PCR, while genetic diversity was evaluated by PCR-ribotyping and whole genome-based analysis. The overall C. difficile prevalence was 37.2% (70/188), and included samples from environmental (58.3%, 35/60) and animal (31.5%, 35/111) compartments; human samples (n = 17) taken from healthy workers were negative. A predominant clone from RT033 was found in almost 90% of the positive samples, including samples from all compartments connected to the pig production unit, with core-genome single nucleotide variant (SNV)-based Analysis supporting a clonal transmission between them (mean distance of 0.1 ± 0.1 core-SNVs). The isolates from this clone (herein designated PT RT033) were positive for all C. difficile toxin genes (tcdA, tcdB, cdtA/cdtB). The phyloGenetic positioning of this clone was clearly distinct from the classical RT033 cluster, suggesting a different evolutionary route. This new clone shares genomic features with several RTs from the clade 5 Sequence Type (ST) 11, including a complete pathogenicity locus (PaLoc) that is more similar to the one found in toxigenic strains and contrasting to the less virulent classical RT033 (tcdA-, tcdB-, cdtA + /cdtB +). The presence of a tcdA gene truncated into two ORFs, not previously described, requires further evaluation concerning toxin functionality. We hypothesize that the unique combination of genetic elements found in the PT RT033 clone may contribute to host tropism and environmental dissemination and maintenance. This study constitutes the first report of a toxigenic RT033 clone and adds to the overall knowledge on Clade 5 sequence type 11, considered the C. difficile evolutionary lineage with the highest zoonotic potential. The presence of this clone in all compartments associated with the pig production unit suggests a transmission chain involving these animals and contributes to unveil the role played by animal and environmental reservoirs in this pathogen epidemiology.

[Project rehabilitating]. / Projeto reabilitar.

BACKGROUND: As the population gets older, the rehabilitation nurse's importance gets higher. The rehabilitation nurse improves the patient's quality of life, well being, and contributes to upgrade health care worldwide. It has a fundamental role in multidisciplinary healthcare teams. In our institution's orthopedics ward, there was no rehabilitation care during the weekend and holidays, due to the absence of rehabilitation nurses during that period. AIM: Ensure rehabilitation nursing care on weekends and holidays, continuing care and helping to decrease the length of stay in inpatient surgical services. METHODS: We did a retrospective analysis of the length of stay in the orthopedics ward at our hospital, after the implementation of rehabilitation care during weekends and holidays. RESULTS: In the last three years, since rehabilitation care is maintained during the weekend and holidays, the length of stay at the ward decreased. CONCLUSIONS: The results sustain the importance of rehabilitation nurses in multidisciplinary teams, and emphasize its role in reducing the length of stay at the ward with health care gains.