References of "MELIN, Pierrette"
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See detailTowards a European consensus for prevention of GBS neonatal disease: old and new tools
MELIN, Pierrette ULg

in Abstract book of the 30th Scientific seminar on Infectious Diseases (2014, November 27)

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See detailDISTRIBUTION OF CAPSULAR POLYSACCHARIDES OF STREPTOCOCCUS AGALACTIAE STRAINS FROM URUGUAY. MULTIPLEX PCR VERSUS CONVENTIONAL CAPSULAR SEROTYPING
Rodriguez Cuns, Grisel ULg; BOREUX, Raphaël ULg; ADAMS, Pauline et al

in XIX Lancefield International Symposium on Streptococci and Streptococcal Diseases, Program and Abstract book (2014, November 11)

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See detailGBS and antibiotic resistance: threat to therapy
MELIN, Pierrette ULg

in XIX Lancefield International Symposium on Streptococci and Streptococcal Diseases, Program and Abstract book (2014, November)

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See detailA practical approach to the microbiological diagnosis of infectious keratitis
MELIN, Pierrette ULg

Conference (2014, October 11)

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See detailManagement of the neonate at risk for early-onset Group B streptococcal disease (GBS EOD): new paediatric guidelines in Belgium
MAHIEU, Ludo; LANGHENDRIES, Jean Paul; COSSEY, Veerle et al

in Acta Clinica Belgica (2014), 69(5), 313-319

Despite group B streptococcal (GBS) screening in late pregnancy and intrapartum antimicrobial prophylaxis, early onset sepsis in neonates remains a common source of neonatal morbidity and mortality ... [more ▼]

Despite group B streptococcal (GBS) screening in late pregnancy and intrapartum antimicrobial prophylaxis, early onset sepsis in neonates remains a common source of neonatal morbidity and mortality especially in preterm neonates. The identification of neonates with early onset sepsis is usually based on perinatal risk factors. Clinical signs are aspecific and laboratory tests not sensitive. Therefore, many clinicians will overtreat at risk infants. Inappropriate treatment with antibiotics increases the risk for late onset sepsis, necrotizing enterocolitis, mortality and prolongs hospitalisation and costs. In 2003, the Belgian Health Council (BHC), published guidelines for the prevention of perinatal GBS infections. This report presents the Belgian paediatric management guidelines, which have been endorsed by the Belgian and Flemish societies of neonatology and paediatrics. The most imported changes in the 2014 guidelines are the following: · recommendations for a lumbar puncture, · clarification of normal spinal fluid parameters and blood neutrophil indices corrected for gestation age, · specific timing for diagnostic testing after birth, · no indication for diagnostic testing in asymptomatic newborns unless additional risk factors, · a revised algorithm for management of neonates according to maternal and neonatal risk factors, · premature infants described as those below 35 weeks instead of 37 weeks The guidelines were made on the basis of the best evidence and on expert opinion when inadequate evidence exists. [less ▲]

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See detailInfections sexuellement transmissibles et rapports à risque ...
Melin, Pierrette ULg

Scientific conference (2014, September 20)

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See detailIntrapartum GBS screening and antibiotic prophylaxis: a European consensus conference
DI RENZO, Gian Carlo; MELIN, Pierrette ULg; BERARDI, Alberto et al

in The Journal of Maternal-Fetal & Neonatal Medecine (2014)

Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been ... [more ▼]

Group B streptococcus (GBS) remains worldwide a leading cause of severe neonatal disease. Since the end of the 1990s, various strategies for prevention of the early onset neonatal disease have been implemented and have evolved. When a universal antenatal GBS screening-based strategy is used to identify women who are given an intrapartum antimicrobial prophylaxis, a substantial reduction of incidence up to 80% has been reported in the USA as in other countries including European countries. However recommendations are still a matter of debate due to challenges and controversies on how best to identify candidates for prophylaxis and to drawbacks of intrapartum administration of antibiotics. In Europe, some countries recommend either antenatal GBS screening or risk-based strategies, or any combination, and others do not have national or any other kind of guidelines for prevention of GBS perinatal disease. Furthermore, accurate population-based data of incidence of GBS neonatal disease are not available in some countries and hamper good effectiveness evaluation of prevention strategies. To facilitate a consensus towards European guidelines for the management of pregnant women in labor and during pregnancy for the prevention of GBS perinatal disease, a conference was organized in 2013 with a group of experts in neonatology, gynecology- obstetrics and clinical microbiology coming from European representative countries. The group reviewed available data, identified areas where results were suboptimal, where revised procedures and new technologies could improve current practices for prevention of perinatal GBS disease. The key decision issued after the conference is to recommend intrapartum antimicrobial prophylaxis based on a universal intrapartum GBS screening strategy using a rapid real time testing. [less ▲]

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See detailStreptococcus agalactiae clones infecting humans were selected and fixed through the extensive use of tetracycline
Da Cunha, Violette; Davies, MR; Douarre, Pierre-Emmanuel et al

in Nature Communications (2014)

Streptococcus agalactiae (Group B Streptococcus, GBS) is a commensal of the digestive and genitourinary tracts of humans that emerged as the leading cause of bacterial neonatal infections in Europe and ... [more ▼]

Streptococcus agalactiae (Group B Streptococcus, GBS) is a commensal of the digestive and genitourinary tracts of humans that emerged as the leading cause of bacterial neonatal infections in Europe and North America during the 1960s. Due to the lack of epidemiological and genomic data, the reasons for this emergence are unknown. Here we show by com- parative genome analysis and phylogenetic reconstruction of 229 isolates that the rise of human GBS infections corresponds to the selection and worldwide dissemination of only a few clones. The parallel expansion of the clones is preceded by the insertion of integrative and conjugative elements conferring tetracycline resistance (TcR). Thus, we propose that the use of tetracycline from 1948 onwards led in humans to the complete replacement of a diverse GBS population by only few TcR clones particularly well adapted to their host, causing the observed emergence of GBS diseases in neonates. [less ▲]

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See detailPrevention of perinatal group B streptococcal infection: situation and new laboratory strategies
MELIN, Pierrette ULg

Scientific conference (2014, June 19)

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See detailWhat’s new in group B streptococcus screening and guidelines ?
MELIN, Pierrette ULg

Conference (2014, June 14)

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See detailThe laboratory - old and new tools to detect GBS
MELIN, Pierrette ULg

Conference (2014, June 05)

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See detailA clinical lab experience with an automated HIV Antigen/Antibody (Ag/Ab) combined assay
HUYNEN, Pascale ULg; TOUSSAINT, Françoise ULg; GERARD, Christiane ULg et al

Poster (2014, May 11)

OBJECTIVES: To describe the diagnostic performance of a new fourth-generation HIV Ag/Ab chemiluminescent immunoassay, available on the new LIAISON® XL analyser, in a clinical setting. METHODS: Through ... [more ▼]

OBJECTIVES: To describe the diagnostic performance of a new fourth-generation HIV Ag/Ab chemiluminescent immunoassay, available on the new LIAISON® XL analyser, in a clinical setting. METHODS: Through February 2012-October 2013, 12,438 samples of serum, received at our laboratory for screening for HIV infection were routinely tested with LIAISON® XL Murex HIV Ab/Ag assay (HIV-XL), which employs HIV-1, HIV-1 group O, and HIV-2 antigens and anti-p24 monoclonal antibodies in two coupled reagent cartridges, providing information of the overall Ab/Ag reactivity and detail of the specific reactivity for anti-HIV/HIV p24 antigen. Each serum with positive result or with negative result displaying a value close to the cut-off were sent to the regional AIDS-Reference Laboratory (RefLab) to perform confirmatory assays (PCR, Immunoblot). A previous verification of the HIV-XL demonstrated 100% sensitivity with a challenge panel of hundred positive sera provided by the RefLab. Performed external quality control was from United-Kingdom National External Quality Assessment Service (NEQAS). RESULTS: Out of the clinical samples, 12,312 non-reactive samples (including 6 negative results displaying a value close to the cut-off further confirmed true HIV negative), 64 Ab HIV reactive samples (all confirmed HIV-1 positive by immunoblot), including 4 samples reactive also for Ag HIV (confirmed positive by Ag assay/PCR), 42 Ab HIV reactive samples tested negative by immunoblot, and 20 Ag HIV reactive samples tested negative by the kit used for the Ag p24 detection in our HIV Reference Lab, have been found. All the 43 NEQAS specimens tested, 16 reactive and 27 non-reactive, were correctly classified. These results, considered all together, provide a calculated positive predictive value of 57.5% with an estimated specificity of 99.5% (with 95% confidence interval of 99.36-99.62%), and a calculated negative predictive value of 100% with an estimated sensitivity of 100.0% (with 95% confidence interval of 95.49-100%). CONCLUSIONS: In our experience HIV-XL showed excellent performance associated to all the advantages of a fully automated/random access instrument. [less ▲]

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See detailEVALUATION OF THE RAPID DETECTION OF ST-17 AND ST-1 GROUP B STREPTOCOCCI USING A MICROFLEX MALDI-TOF MS (BRUKER)
MEEX, Cécile ULg; SACHELI, Rosalie ULg; DESCY, Julie ULg et al

Poster (2014, May)

Objectives Clearly associated to neonatal meningitis, Group B streptococci (GBS) classified as sequence type-17 (ST-17) are defined as the “highly virulent” clone amongst GBS. The aim of this study was to ... [more ▼]

Objectives Clearly associated to neonatal meningitis, Group B streptococci (GBS) classified as sequence type-17 (ST-17) are defined as the “highly virulent” clone amongst GBS. The aim of this study was to evaluate an easy and rapid method, recently described to detect ST-17 and ST-1 GBS, based on distinguishing peak-shifts present on the protein spectrum of these 2 sequence types, using a Microflex (Bruker) matrix-assisted laser desorption/ionization time of flight mass spectrometer (MALDI-TOF MS). Methods This study was performed on 67 multi locus sequence typed (MLST) GBS originated from the Belgian and Czech National Reference Centers, including 18 ST-17 and 16 ST-1. After culture on blood agar, an ethanol/formic acid extraction was performed on each strain. Each extract was spotted once on a target plate, overlaid with 1 µl alpha-cyano-4-hydroxycinnamic acid matrix and further analysed by a Microflex MALDI-TOF MS. One spectrum per isolate was recorded, 240 laser shots being recorded for each spectrum. The spectra were further analysed using a Bruker prototype software, and 2 logarithmic values, one for ST-17 and one for ST-1, calculated from the intensities of the present and absent peaks, were obtained for each strain. If >0, this value indicated the presence of the specific sequence type. In a second step, the test was repeated on each strain with discordant result when compared with MLST. Results Compared with MLST method, the first analysis of the strains gave poor results, leading to very low sensitivities (77.8% for ST-17 and 50% for ST-1) but rather good specificities (85.7% for ST-17 and 98.0% for ST-1). After repeating the analysis on the strains with discordant result, sensitivity, 100% and 93.8%, and specificity, 87.8% and 98.0%, for ST-17 and ST-1 respectively were highly improved. Conclusion Since ST-17 and ST-1 GBS both show distinguishing peak-shifts on their protein spectrum, as described by Lartigue et al., the distinction of these 2 sequence types is now possible by MALDI-TOF MS. To our knowledge, this study is the first describing this application on a Microflex MS using a software to classify the strains. The observed results are promising but, given to the variability of the logarithmic value given by the software, the need to perform several measures on a same strain seems to be essential. After optimization of the analysis procedure, this rapid, easy and cheap method could be used to precociously detect ST-17 among GBS isolated from prenatal screenings, allowing a better follow up of the colonized mothers and a closer monitoring of their newborns. We would like to thank the Bruker Company which allowed us to evaluate the prototype software they have developed. [less ▲]

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See detailBordetella pertussis seroprevalence in Belgian adults aged 20–39 years, 2012
Huygen, K; Rodeghiero, C; Govaerts, Daniele et al

in Epidemiology & Infection (2014), 142(4), 724-728

The last report on pertussis seroprevalence in Belgium concerned samples collected during 1993–1994. In the context of the Eupert-Labnet WP6 seroprevalence study (comparing sera from 16 European member ... [more ▼]

The last report on pertussis seroprevalence in Belgium concerned samples collected during 1993–1994. In the context of the Eupert-Labnet WP6 seroprevalence study (comparing sera from 16 European member states), 1500 anonymized leftover diagnostic samples were collected randomly during the second semester of 2012 by the clinical chemistry laboratories of six participating Belgian centres, distributed equally between Flanders, Wallonia and Brussels Capital Region. As suggested by the WP6 organizers, a total of 750 samples (125/centre) were selected from subjects in the 20–29 years age group and 750 samples (125/centre) from subjects in the 30–39 years age group. Anti-PT IgG levels were measured using Virion-Serion ELISA and analysed using predefined cut-off levels. Sixty-one (4%) sera were indicative of an infection in the past 2 years (between 50 and 100 IU/ml) and another 61 (4%) sera had anti-PT IgG antibodies reflecting acute infection (>100 IU/ml). These results highlight the presence of a Bordetella pertussis reservoir in the adult ‘healthy’ Belgian population [less ▲]

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See detailFourth Belgian multicentre survey of antibiotic susceptibility of anaerobic bacteria
Wybo, Ingrid; Van den Bossche; Soetens, Oriane et al

in Journal of Antimicrobial Chemotherapy (2014), 69

Objectives: To collect recent data on the susceptibility of anaerobes to antimicrobial agents with known activity against anaerobes, and to compare them with results from previous Belgian multicentre ... [more ▼]

Objectives: To collect recent data on the susceptibility of anaerobes to antimicrobial agents with known activity against anaerobes, and to compare them with results from previous Belgian multicentre studies. Methods: Four hundred and three strict anaerobic clinical isolates were prospectively collected from February 2011 to April 2012 in eight Belgian university hospitals. MICs were determined by one central laboratory for 11 antimicro- bial agents using Etest methodology. Results: According to EUCAST breakpoints, .90% of isolates were susceptible to amoxicillin/clavulanate (94%), piperacillin/tazobactam (91%), meropenem (96%), metronidazole (92%) and chloramphenicol (98%), but only 70% and 40% to clindamycin and penicillin, respectively. At CLSI recommended breakpoints, only 71% were sus- ceptible to moxifloxacin and 79% to cefoxitin. MIC50/MIC90 values for linezolid and for tigecycline were 1/4 and 0.5/ 4 mg/L, respectively. When compared with survey data from 2004, no major differences in susceptibility profiles were noticed. However, the susceptibility of Prevotella spp. and other Gram-negative bacilli to clindamycin decreased from 91% in 1993 – 94 and 82% in 2004 to 69% in this survey. Furthermore, the susceptibility of clostridia to moxifloxacin decreased from 88% in 2004 to 66% in 2011 – 12 and that of fusobacteria from 90% to 71%. Conclusions: Compared with previous surveys, little evolution was seen in susceptibility, except a decline in activity of clindamycin against Prevotella spp. and other Gram-negative bacteria, and of moxifloxacin against clostridia. Since resistance was detected to all antibiotics, susceptibility testing of anaerobic isolates is indicated in severe infections to confirm appropriateness of antimicrobial therapy. [less ▲]

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See detailPrevalence of Campylobacter among goats and retail goat meat in Congo
Kabwang a Mpalang, Rosette; BOREUX, Raphaël ULg; Melin, Pierrette ULg et al

in Journal of Infection in Developing Countries [=JIDC] (2014), 8

Background: The prevalence of Campylobacter jejuni and Campylobacter coli was determined in goat and goat meat sold at retail outlets in Lubumbashi, Democratic Republic of Congo (DR Congo). Methodology: A ... [more ▼]

Background: The prevalence of Campylobacter jejuni and Campylobacter coli was determined in goat and goat meat sold at retail outlets in Lubumbashi, Democratic Republic of Congo (DR Congo). Methodology: A total of 644 samples, including 177 goat meat, 86 goat stomachs, 139 ready to eat (RTE) goat skewers, and 242 goat faecal samples were examined for the presence of Campylobacter jejuni and Campylobacter coli using polymerase chain reaction. Results: Overall, Campylobacter spp. were found in 34.6% of the examined samples. C. jejuni was isolated in 10.1% and C. coli in 26.7% of samples. Only 2.2% of all samples were positive for both species. There was a significant association between the prevalence of C. coli and the type of sample (p < 0.05). The overall prevalence of Campylobacter in different sample groups was 41.2%, 37.2%, 23.7%, and 35.1% for goat meat, goat stomachs, RTE goat skewers, and goat faecal samples, respectively. There was no significant difference (p > 0.05) between the prevalence observed in the rainy season (16.7%) and the dry season (20.0%). Moreover, the overall prevalence of Campylobacter in slaughter sites, open-air markets, warehouses, and semi-open-air markets was 28.2%, 34.2%, 35.4%, and 42.9%, respectively. Statistically, there was no influence of the sample collection site on the frequency of isolation of Campylobacter (p > 0.05). Conclusion: This study shows that, considering the relatively high prevalence of this [less ▲]

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See detailAssessment of pfcrt 72-76 haplotypes eight years after chloroquine withdrawal in Kinshasa, Democratic Republic of Congo
Mvumbi, Dieudonné; BOREUX, Raphaël ULg; SACHELI, Rosalie ULg et al

in Malaria Journal (2013), 12

BACKGROUND: In 2001, the World Health Organization (WHO) has recommended the use of artemisinin-based combination therapy (ACT) as the first-line treatment of uncomplicated malaria cases, as monotherapies ... [more ▼]

BACKGROUND: In 2001, the World Health Organization (WHO) has recommended the use of artemisinin-based combination therapy (ACT) as the first-line treatment of uncomplicated malaria cases, as monotherapies had become ineffective in many parts of the world. As a result, the Democratic Republic of Congo (DRC) withdrew chloroquine (CQ) from its malaria treatment policy in 2002 and an artesunate (AS)-amodiaquine (AQ) combination became the ACT of choice in DRC in 2005. AQ-resistance (AQR) has been reported in several parts of the world and mutations in codons 72-76 of the Plasmodium falciparum chloroquine-resistance transporter (pfcrt) gene have been strongly correlated with resistance, especially mutations encoding the SVMNT haplotype. This haplotype was first identified in Southeast Asia and South America but was recently reported in two African countries neighbouring DRC. These facts raised two questions: the first about the evolution of CQ resistance (CQR) in DRC and the second about the presence of the SVMNT haplotype, which would compromise the use of AQ as a partner drug for ACT. METHODS: A total of 213 thick blood films were randomly collected in 2010 from a paediatric clinic in Kinshasa, DRC. Microscopy controls and real-time polymerase chain reaction (RT-PCR) were performed for Plasmodium species identification. Haplotypes of the pfcrt gene were determined by sequencing. RESULTS: The K76T mutation was detected in 145 out of 198 P. falciparum-positive samples (73.2%).In these 145 resistant strains, only the CVIET haplotype was detected. CONCLUSIONS: This study is the first to assess the molecular markers of resistance to CQ and AQ after the introduction of ACT in DRC. The results suggest first that CQR is decreasing, as wild-type pfcrt haplotypes were found in only 26.8% of the samples and secondly that the SVMNT haplotype is not yet present in Kinshasa, suggesting that AQ remains valid as a partner drug for ACT in this region. [less ▲]

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