Histoire naturelle d'un virus zoonotique en mode insulaire : cas de la propagation du virus grippal pandémique H1N1p 2009 à la Réunion, de l'homme au porc, il n'y a qu'un pas

Bien que n'ayant jamais été identifié chez le porc avant d'être détecté chez l'Homme, il a été craint, dès l'émergence du virus influenza A/H1N1 responsable de la pandémie de 2009 (pH1N1), que ce multi-réassortant n'ait la capacité de transgresser facilement la barrière d'espèce Homme/porc puisque tous ses gènes proviennent de virus influenza préalablement adaptés à l'espèce porcine. Peu de temps après son identification chez l'Homme fin avril 2009, des élevages étaient d'ailleurs déclarés infectés en Amérique du Nord, puis partout dans le monde. A l'issue de la phase pandémique en août 2010, des cas étaient rapportés dans une vingtaine de pays. L'Homme a été suspecté être à l'origine de l'infection dans la majorité d'entre eux. Les porcs touchés ont généralement développé un syndrome grippal commun, sans mortalité. On relèvera que certains cas ont également été détectés dans le cadre de programmes de surveillance active menée chez des porcs asymptomatiques. Des inoculations expérimentales ont par ailleurs confirmé la grande sensibilité des porcins. Les animaux inoculés ont présenté de l'hyperthermie, de l'apathie, des difficultés respiratoires et des lésions pulmonaires caractéristiques des infections à virus influenza chez le porc. Du virus a été retrouvé dans les sécrétions nasales jusqu'à 10 jours post-infection et a été transmis à des porcs sentinelles. Considérant ces données, il était légitime de craindre que le pH1N1 s'adapte à l'espèce porcine, comme d'ailleurs les virus responsables des pandémies de 1918 et 1968, la transmission des virus influenza de l'Homme vers le porc étant en outre favorisée lorsque la pression d'infection est très forte. Des investigations sérologiques ont donc été menées sur des animaux reproducteurs, la mise en évidence d'anticorps spécifiques chez ces animaux pouvant révéler l'éventuel passage du virus pH1N1 dans la population porcine. Ainsi, 120 reproducteurs (115 truies de réforme et 5 verrats) âgés de 3 à 5 ans et provenant de 57 élevages différents, ont été prélevés suite à tirage au sort dans l'unique abattoir de l'île, entre novembre 2009 et février 2010. 98/120 sérums (81,6% de l'échantillon analysé) se sont révélés contenir des anticorps anti-virus pH1N1, ceci à des titres relativement élevés puisque 54,2 % d'entre eux ont présenté un titre IHA supérieur ou égal à 160. Une deuxième étude, menée en juin-juillet 2010, a alors porté sur 390 porcs charcutiers, âgés au maximum de 7 mois, c'est dire nés au plus tôt en novembre 2009 et n'ayant donc pas pu être infectés par l'Homme, le virus ne circulant plus de manière significative dans la population humaine à compter de cette date. L'objectif de cette enquête était i) de déterminer le statut sérologique de cette génération de porcs charcutiers vis-à-vis du pH1N1 et ii) de tenter, par des analyses virologiques, de détecter le virus en cas de circulation active. Des anticorps ont été détectés dans 9/320 sérums analysés (soit 2,8%), à des titres allant de 20 à 160. Les analyses virales ont été effectuées par RT-PCR sur le gène M puis H1 et N1 ; du génome de virus influenza A pH1N1 a été détecté dans 14 / 390 prélèvements, lesquels provenaient de 5 élevages différents. Les caractérisations antigéniques (par tests IHA) et génétiques (séquençage des gènes HA et NA) de cet isolat (A/Sw/LaRéunion/0164/10) ont confirmé son appartenance au lignage pH1N1. Depuis la surveillance est maintenue mais les cas d'infection des porcs avec le virus Influenza A pH1N1 restent sporadiques. (Texte intégral

a European comparative cohort study

Funding Information: This study was supported in part by a grant from the French government through the\u2009 6A\u2009Programme Investissement d\u2019Avenir\u2009 6B\u2009(I-SITE ULNE) managed by the Agence Nationale de la Recherche (coVAPid project). The funders of the study had no role in the study design, data collection, analysis, or interpretation, writing of the report, or decision to submit for publication. Publisher Copyright: © The Author(s) 2025.Background: The management of severe SARS-CoV-2 pneumonia, alongside logistical constraints, evolved between the first and subsequent COVID-19 waves. This study aimed to compare the prevalence of early bacterial pulmonary co-infections and the incidence of ventilator-associated lower respiratory tract infections (VA-LRTI) across the first and second waves of the pandemic, and to characterize their microbiology. Methods: Latter part of a multicenter retrospective European cohort analysis conducted in 35 ICUs. Adult patients admitted for SARS-CoV-2 pneumonia and requiring invasive mechanical ventilation ≥ 48 h were consecutively included from both waves (February-May 2020 for period 1, October 2020-April 2021 for period 2). Co-infections were defined by bacterial isolation in respiratory secretions or blood cultures, or a positive pneumococcal urinary antigen test, within 48 h after intubation. VA-LRTI, including ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP), were diagnosed using clinical, radiological and quantitative microbiological criteria. The 28-day cumulative incidence of first VA-LRTI episodes was estimated using the Kalbfleisch and Prentice method, with co-infection prevalence and VA-LRTI incidence compared using multivariable logistic regression and Fine-and-Gray models, respectively. Results: The study included 1,154 patients (558 in period 1 and 596 in period 2). Co-infection prevalence significantly rose from 9.7% in period 1 to 14.9% in period 2 (adjusted odds ratio (95% confidence interval) 1.52 (1.04–2.22), p = 0.03). Gram-positive cocci dropped from 59 to 48% of co-infections between periods 1 and 2. The overall incidence of VA-LRTI was similar across periods (50.4% and 53.9%, adjusted sub distribution hazard ratio (sHR) 1.14 (0.96–1.35), p = 0.11), with a significant increase in VAP incidence in period 2 (36% to 44.8%, adjusted sHR 1.37 (1.12–1.66), p = 0.001), predominantly occurring within the initial 14 days after intubation, and a concurrent significant decrease in VAT incidence (14.3% to 9.1%, adjusted sHR 0.61 (0.42–0.88), p = 0.007). Gram-negative bacilli, led by Pseudomonas aeruginosa, Enterobacter spp., and Klebsiella spp., were responsible for 89% and 84% of VA-LRTI in periods 1 and 2, respectively. Conclusions: Between the first and second COVID-19 waves, the prevalence of early bacterial pulmonary co-infections significantly increased among intubated patients. Although the overall incidence of VA-LRTI remained stable, there was a significant shift from VAT to VAP episodes.publishersversionpublishe

Histoire de Naples et de Sicile : contenant ce qui s'est passé de plus mémorable en Italie pendant quatre cens trente deux ans, à sçavoir depuis Roger Guischard premier conquerant de Naples en l'année mil cent vingt sept jusques en l'année mil cinq cens cinquante neuf soubs Henry II

par Matthieu Turpin de LonchampFehlpaginierungen: nach S. 168 folgen 189 ff ; 227 statt S. 225 ; 234 statt S. 236 ; nach S. 356 folgen S. 355-358, dann fol. 359-362 ; dann S. 363-366; dann S. 369ff."Exlibrisprägestempel: "Immanuel Friedlaender" 002331333_0002 Exemplar der ETH-BI

Vers une oncologie plus « verte » à l’heure du réchauffement climatique ?

International audienc

False negative 18F-fluorodeoxyglucose positron emission tomography/computed tomography in primary b-cell lymphoma of the bone

We present a case of a 15-year-old male with primary bone lymphoma who was initially referred for suspicion of chronic osteomyelitis of the mandible. A bone scan and gallium scan demonstrated congruent uptake in the mandible, suggestive of chronic osteomyelitis. A biopsy subsequently showed B-cell lymphoma of the bone with low Ki-67. A fluorodeoxyglucose positron emission tomography (FDG-PET) scan performed before therapy for staging revealed no increased uptake in the mandible. This case shows an atypical presentation of a rare disorder and is presented to emphasize the importance of baseline FDG-PET

Cerebellar and Striatal Implications in Autism Spectrum Disorders: From Clinical Observations to Animal Models

Autism spectrum disorders (ASD) are complex conditions that stem from a combination of genetic, epigenetic and environmental influences during early pre- and postnatal childhood. The review focuses on the cerebellum and the striatum, two structures involved in motor, sensory, cognitive and social functions altered in ASD. We summarize clinical and fundamental studies highlighting the importance of these two structures in ASD. We further discuss the relation between cellular and molecular alterations with the observed behavior at the social, cognitive, motor and gait levels. Functional correlates regarding neuronal activity are also detailed wherever possible, and sexual dimorphism is explored pointing to the need to apprehend ASD in both sexes, as findings can be dramatically different at both quantitative and qualitative levels. The review focuses also on a set of three recent papers from our laboratory where we explored motor and gait function in various genetic and environmental ASD animal models. We report that motor and gait behaviors can constitute an early and quantitative window to the disease, as they often correlate with the severity of social impairments and loss of cerebellar Purkinje cells. The review ends with suggestions as to the main obstacles that need to be surpassed before an appropriate management of the disease can be proposed

Cerebellar and Striatal Implications in Autism Spectrum Disorders: From Clinical Observations to Animal Models

Autism spectrum disorders (ASD) are complex conditions that stem from a combination of genetic, epigenetic and environmental influences during early pre- and postnatal childhood. The review focuses on the cerebellum and the striatum, two structures involved in motor, sensory, cognitive and social functions altered in ASD. We summarize clinical and fundamental studies highlighting the importance of these two structures in ASD. We further discuss the relation between cellular and molecular alterations with the observed behavior at the social, cognitive, motor and gait levels. Functional correlates regarding neuronal activity are also detailed wherever possible, and sexual dimorphism is explored pointing to the need to apprehend ASD in both sexes, as findings can be dramatically different at both quantitative and qualitative levels. The review focuses also on a set of three recent papers from our laboratory where we explored motor and gait function in various genetic and environmental ASD animal models. We report that motor and gait behaviors can constitute an early and quantitative window to the disease, as they often correlate with the severity of social impairments and loss of cerebellar Purkinje cells. The review ends with suggestions as to the main obstacles that need to be surpassed before an appropriate management of the disease can be proposed.</jats:p

Bacterial coinfection in critically ill COVID-19 patients with severe pneumonia

International audienceSevere 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU). Bacterial coinfection has been reported to be rare. We aimed at describing the rate of bacterial coinfection in critically ill adult patients with severe COVID-19 pneumonia. All the patients with laboratory-confirmed severe COVID-19 pneumonia admitted to the ICU of Tenon University-teaching hospital, from February 22 to May 7th, 2020 were included. Respiratory tract specimens were obtained within the first 48 h of ICU admission. During the study period, 101 patients were referred to the ICU for COVID-19 with severe pneumonia. Most patients (n = 83; 82.2%) were intubated and mechanically ventilated on ICU admission. Overall, 20 (19.8%) respiratory tract specimens obtained within the first 48 h. Staphylococcus aureus was the main pathogen identified, accounting for almost half of the early-onset bacterial etiologies. We found a high prevalence of early-onset bacterial coinfection during severe COVID-19 pneumonia, with a high proportion of S. aureus. Our data support the current WHO guidelines for the management of severe COVID-19 patients, in whom antibiotic therapy directed to respiratory pathogens is recommended. Keywords Coronavirus disease 2019 • Bacterial coinfection • Staphylococcus aureus • Intensive care unit • Pneumonia Abbreviations COVID 19 Coronavirus infectious disease ICU Intensive care unit SAPSII Simplified acute physiology score SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 SOFA Sequential Organ Failure Assessmen