Epidemiology of airway colonization by Scedosporium apiospermum during cystic fibrosis

With a frequency of about 10%, species of the Scedosporium apiospermum complex (which comprises at least five distinct species with different antifungal susceptibility patterns) rank the second among the filamentous fungi colonizing the airways in cystic fibrosis (CF). Additionally, it is clearly established that these fungi may disseminate in case of immunodeficiency and that a chronic colonization of the airways by these pathogens may hinder the success of lung transplantation. In this study, we develop a new genotyping method to investigate the epidemiology of the airway colonization by these fungi. 63 multiple and sequential isolates of S. apiospermum collected from 9 CF patients, and selected among those previously studied by random amplification of polymorphic DNA (RAPD), were analyzed using the automated typing system DiversiLab (bioMérieux) based on PCR amplification of repetitive sequences. The DiversiLab Aspergillus rep-PCR kit which uses specific primers designed for Aspergillus fumigatus, was compared with the pan-fungus DiversiLab Fungal kit. Amplification products were separated by capillary electrophoresis on Agilent B2100 bioanalyzer, leading to single profiles for each isolate which were then compared using the DiversiLab software. In addition, species identification of these isolates was clarified by sequencing the betatubulin gene. Results obtained with both kits were comparable. Nevertheless, differentiation was easier using the DiversiLab Fungal kit. Additionally, rep-PCR usually confirmed the colonization patterns described by RAPD. Only two patients showed distinct genotypes. For Patient 2, two isolates were analyzed which were undistinguishable by RAPD, but rep-PCR revealed that they belonged to distinct genotypes, suggesting a transient colonization. For Patient 8 which showed by RAPD two distinct genotypes, 5 genotypes were found by rep-PCR with a dominant one represented by 5 isolates and two very close genotypes (corresponding to 3 isolates), while 4 other isolates belonged to two distant genotypes. In conclusion, the automated typing system DiversiLab proved to be an easy and efficient method to investigate the molecular epidemiology of the airway colonization by S. apiospermum in CF. Our results also confirm the capacity of the different species from the S. apiospermum complex to chronically colonize the airways of CF patients

Successful treatment of Trichosporon asahii fungemia with isavuconazole in a patient with hematologic malignancies

International audienceTrichosporon spp. are yeast-like microorganisms responsible for skin, urinary, pulmonary, or bloodstream infections. Due to intrinsic resistance to echinocandins, poor susceptibility to polyenes, and preferred occurrence in immunocompromised patients, such infections are often of poor prognosis. Yet no consensual therapeutic guidelines are presently available. Several clinical cases of Trichosporon infections have been successfully treated with azole therapy, including voriconazole which appeared frequently effective against Trichosporon both in vitro and in vivo. However, the low efficacy associated with some Trichosporon genotypes, complex pharmacokinetics, and the side effects of voriconazole represent limitations for its use and has prompted a search for other therapeutic options. Here, we report a case of T. asahii fungemia in a patient with B-cell acute lymphoblastic leukemia which was successfully treated with isavuconazole consecutive to stopping voriconazole therapy due to severe side effects. This observation suggests that isavuconazole with a similar spectrum to voriconazole, fewer pharmacology interactions, and side effects may be considered as a valuable therapeutic option against Trichosporon infections

Hydration control in the fabrication of high-density magnesia products via slip casting

To tackle the hydration problem in magnesia (MgO) aqueous suspension during slip casting fabrication, we explored the casting performance of four distinct MgO slips. Through the comparison of properties and performance between aqueous and organic MgO slips, we introduced criteria for selecting the appropriate suspension medium to prepare a good MgO slip. Moisture absorption in raw MgO powders leading to Mg(OH)2 formation was observed, undetectable by X-ray diffraction (XRD) but identified through thermogravimetric analysis (TGA). Moisture release occurred at temperature < 100 °C, followed by loosely bound water release between 160 °C and 310 °C, and then Mg(OH)2 decomposition occurred at 310 °C to 430 °C, constituting 1.05, 1.66, and 1.34 wt%, respectively. Subjecting raw powders to pre-firing at 1000 °C led to the formation of larger MgO particles, characterised by a D50 value twice that of the previous size. This transformation shifted their morphology from random rods to more durable spherical shapes, thereby improving their resistance to hydration when subjected to wet ball milling with water. Pre-firing MgO at 1000 °C resulted in a favourable aqueous slip, enabling problem-free casting of small-sized products with high density and purity

Common occurrence of Cryptosporidium hominis in asymptomatic and symptomatic calves in France

International audienceSymptomatic infection by the Apicomplexan Cryptosporidium spp. is presently considered the most frequent parasitic cause of acute diarrhea in both humans (especially severe in immunocompromised individuals and infants in both developed and developing countries) and cattle (calves), while asymptomatic infections are less often documented. Cryptosporidium (C.) hominis once considered to be restricted to humans accounts for the majority of pediatric cases in several countries. C. parvum can also infect cattle as well as C. bovis, C. andersoni, and C. ryanae. Recently, cattle C. hominis cryptosporidiosis has been reported, suggesting that the presence of C. hominis in calves was previously underestimated. The aim of this work was to characterize Cryptosporidium spp. infection in both asymptomatic and symptomatic dairy and beef calves from Metropolitan France. From February to November 2015, C. parvum or C. hominis infected calves were detected in farms from 5 geographic regions of France. Surprisingly, C. hominis was present in about one fifth of Cryptosporidium spp. infected calves, and exhibited genotypes which were previously reported in human and nonhuman primate. Further investigations are aimed at documenting direct or indirect C. hominis transmissions between and among livestock and humans

Semi-automated repetitive sequence-based PCR amplification for species of the Scedosporium apiospermum complex

International audiencePurpose: The Scedosporium apiospermum species complex usually ranks second among the filamentous fungi colonizing the airways of patients with cystic fibrosis (CF), but little is known about the molecular epidemiology of the airway colonization.Methods: Polymerase chain reaction (PCR) amplification of repetitive sequences (rep-PCR) was applied to the retrospective analysis of a panel of isolates already studied by random amplification of polymorphic DNA (RAPD) and comprising 63 isolates recovered from sputa from 9 CF patients. Results were compared to those obtained previously by RAPD, and herein by beta-tubulin (TUB) gene sequencing and Multilocus Sequence Typing (MLST).Results: Within the panel of isolates studied, S. apiospermum sensu stricto and Sce-dosporium boydii, as expected, were the predominant species with 21 and 36 isolates, respectively. Four isolates from one patient were identified as Scedosporium auranti-acum, whereas two isolates belonged to the Pseudallescheria ellipsoidea subgroup of S. boydii. rep-PCR analysis of these isolates clearly differentiated the three species and P. ellipsoidea isolates, whatever the rep-PCR kit used, and also permitted strain differentiation. When using the mold primer kit, results from rep-PCR were in close agreement with those obtained by MLST. For both S. apiospermum and S. boydii, 8 genotypes were differentiated by rep-PCR and MLST compared to 10 by RAPD. All S. aurantiacum isolates shared the same RAPD genotype and exhibited the same rep-PCR profile and sequence type.Conclusions: These results illustrate the efficacy of rep-PCR for both species identification within the S. apiospermum complex and genotyping for the two major species of this comple

Determinants of burnout in Canadian health care workers during the COVID-19 pandemic

Background: Health care workers (HCWs) are among the most vulnerable groups to experience burnout during the coronavirus (COVID-19) pandemic. Understanding the risk and protective factors of burnout is crucial in guiding the development of interventions; however, the understanding of burnout determinants in the Canadian HCW population remains limited.Objective: Identify risk and protective factors associated with burnout in Canadian HCWs during the COVID-19 pandemic and evaluate organizational factors as moderators in the relationship between COVID-19 contact and burnout.Methods: Data were drawn from an online longitudinal survey of Canadian HCWs collected between 26 June 2020 and 31 December 2020. Participants completed questions pertaining to their well-being, burnout, workplace support and concerns relating to the COVID-19 pandemic. Baseline data from 1029 HCWs were included in the analysis. Independent samples t-tests and multiple linear regression were used to evaluate factors associated with burnout scores.Results: HCWs in contact with COVID-19 patients showed significantly higher likelihood of probable burnout than HCWs not directly providing care to COVID-19 patients. Fewer years of work experience was associated with a higher likelihood of probable burnout, whereas stronger workplace support, organizational leadership, supervisory leadership, and a favourable ethical climate were associated with a decreased likelihood of probable burnout. Workplace support, organizational leadership, supervisory leadership, and ethical climate did not moderate the associations between contact with COVID-19 patients and burnout.Conclusions: Our findings suggest that HCWs who worked directly with COVID-19 patients, had fewer years of work experience, and perceived poor workplace support, organizational leadership, supervisory leadership and ethical climate were at higher risk of burnout. Ensuring reasonable work hours, adequate support from management, and fostering an ethical work environment are potential organizational-level strategies to maintain HCWs’ well-being

Optimizing military mental health and stress resilience training through the lens of trainee preferences:A conjoint analysis approach

Effective mental health and stress resilience (MHSR) training is essential in military populations given their exposure to operational stressors. The scarcity of empirical evidence supporting the benefits of these programs emphasizes the need for research dedicated to program optimization. This paper aims to identify the relative importance of MHSR training attributes preferred by military members. Conjoint analysis (CA), an experimental method used to prioritize end-user preferences for product feature development, was conducted using an online survey with 567 Canadian Armed Forces (CAF) personnel. Participants made a series of choices between hypothetical MHSR training options that were systematically varied across seven training attributes. Each training attribute consisted of 3–4 variations in the nature of the attribute or its intensity. Participants also completed questions on health beliefs, mental health and previous MHSR training experiences, and demographics, to assess whether preferences varied by individual characteristics. CA demonstrated that instructor type, leadership buy-in, degree of skills practice, and content relevance/applicability were attributes of highest and relatively equal importance. This was followed by degree of accessible supplemental content. Lowest importance was placed on degree of behavioral nudging and demographic similarity between the trainee and trainer. Sociodemographic factors were not associated with MHSR training preferences. Programs that incorporate expert-led instruction, demonstrate leadership buy-in, embed practical applications within simulated stress environments, and provide a digitally-accessible platform to augment training may be well-received among military members. Understanding and accommodating personal preferences when designing MHSR training programs may increase relevance, foster acceptance and trust, and support sustained engagement.</p

Telehealth experiences in Canadian veterans: associations, strengths and barriers to care during the COVID-19 pandemic.

INTRODUCTION: Identifying barriers to care in veteran populations is critical, as veterans face increased social isolation, relationship strains and financial insecurities. For Canadian veterans experiencing barriers to accessing healthcare, telehealth may be a promising alternative with comparable effectiveness to in-person services; however, the potential benefits and limitations of telehealth require further examination to determine its long-term utility, and to inform health policy and planning. The goal of the present research was to identify predictors and barriers to telehealth usage in Canadian veterans in the context of the COVID-19 pandemic. METHODS: Data were drawn from baseline data of a longitudinal survey examining the psychological functioning of Canadian veterans during the COVID-19 pandemic. Participants were 1144 Canadian veterans aged 18-93 years (M RESULTS: Findings suggest that sociodemographic factors and previous telehealth use were significantly associated with telehealth use during the COVID-19 pandemic. Qualitative evidence highlighted both the benefits (eg, reducing barriers of access) and drawbacks (eg, not all services can be delivered) of telehealth services. CONCLUSIONS: This paper provided a deeper understanding of Canadian veterans\u27 experiences with accessing telehealth care during the COVID-19 pandemic. While for some, the use of telehealth mitigated perceived barriers (eg, safety concerns of leaving home), others felt that not all health services could be appropriately carried out through telehealth. Altogether, findings support the use of telehealth services in increasing care accessibility for Canadian veterans. Continued use of quality telehealth services may be a valuable form of care that extends the reach of healthcare professionals