References of "MELIN, Pierrette"
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See detailAcute cholecystitis with Listeria monocytogenes
DESCY, Julie ULg; De Mol, Patrick ULg; HAYETTE, Marie-Pierre ULg et al

in Acta Clinica Belgica (2012), 67(4), 295-297

Listeriosis, an opportunistic food-borne disease caused by Listeria monocytogenes, is infrequent and occurs preferentially in patients at the extremes of age, during pregnancy or in immunocompromised ... [more ▼]

Listeriosis, an opportunistic food-borne disease caused by Listeria monocytogenes, is infrequent and occurs preferentially in patients at the extremes of age, during pregnancy or in immunocompromised hosts. Most common manifestations are maternofoetal and neonatal infections, severe invasive presentations such as bacteraemia with or without central nervous system symptoms occuring preferentially in immunosuppressed patients and self-limited gastro-enteritis affecting healthy individuals. Exceptionally, focal infections such as cholecystitis are described. We report here a case of acute cholecystitis caused by Listeria monocytogenes in an 82-year-old woman. Thanks to a successful treatment: cholecystectomy and antimicrobial therapy (amoxicillin plus clavulanic acid), the patient soon recovered. This case-report provides an opportunity to review the current literature concerning the association of Listeria monocytogenes and cholecystitis. [less ▲]

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See detailEUCAST in Belgium: A difficult road !
MELIN, Pierrette ULg

Conference (2012, June 21)

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See detailGBS AND THE NEONATE: PREVENTION STRATEGIES
MELIN, Pierrette ULg

in MELIN, Pierrette (Ed.) Abstract book of 30th Annual Meeting of the European Society for Paediatric Infectious Diseases (2012, May)

Streptococcus agalactiae, or group B streptococcus (GBS), remains the leading cause of neonatal sepsis and meningitis, early onset and late onset diseases (EOD, LOD). Where consensus guidelines to detect ... [more ▼]

Streptococcus agalactiae, or group B streptococcus (GBS), remains the leading cause of neonatal sepsis and meningitis, early onset and late onset diseases (EOD, LOD). Where consensus guidelines to detect and treat intrapartum women with GBS colonization have been widely adopted, incidence of neonatal EOD has dramatically declined. In response to both successful impacts on the incidence of GBS-EOD and analyses of missed opportunities, the first American guidelines for prevention issued in the 90s have since been adapted in several stages to improve their efficacy. In some countries in Europe, nationwide guidelines, whether screening-based or risk-based, for the prevention of neonatal GBS diseases have also been issued and adopted, with the expected impact on incidence of GBS-EOD. In spite of universal screening, in spite of the great progress that has been made, GBS-EOD continues to occur and the GBS burden remains a significant public health issue. Continuous efforts to improve screening for GBS status continue to be important and may be able to take advantage of new rapid diagnostic technologies. The current screening-based strategy for prevention is highly effective but imperfect. Given the challenges, limitations and potential complications of maternal intrapartum prophylaxis, a new approach is still needed. Maternal immunization against GBS is an attractive alternative for the prevention of not only neonatal diseases but also stillbirths and maternal diseases. Vaccines against GBS may likely become the most effective and sustainable long-term preventive strategy. [less ▲]

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See detailEvaluation of three immunoassays for serodiagnosis of human Mycoplasma pneumoniae infection
HUYNEN, Pascale ULg; TOUSSAINT, Françoise ULg; HAYETTE, Marie-Pierre ULg et al

in Clinical Microbiology & Infection (2012, April), 18(S3), 231

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See detailEvaluation of three immunoassays for serodiagnosis of human Mycoplasma pneumoniae infection
HUYNEN, Pascale ULg; TOUSSAINT, Françoise ULg; HAYETTE, Marie-Pierre ULg et al

Poster (2012, April)

The aim of this study was to evaluate three commercial automated immunoassays for the serological diagnosis of M. pneumoniae infection.

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See detailProportion of extended-spectrum ß-lactamase-producing Enterobacteriaceae in community setting in Ngaoundere, Cameroon
LONCHEL, Carine Magoué; MEEX, Cécile ULg; Gangoué-Piéboji, Joseph et al

in BMC Infectious Diseases (2012), 12

BACKGROUND: There is no information regarding the resistance mechanisms of extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae in community setting in Cameroon. The current study aimed to ... [more ▼]

BACKGROUND: There is no information regarding the resistance mechanisms of extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae in community setting in Cameroon. The current study aimed to determine the proportion of ESBLs in Enterobacteriaceae isolated in the community and to analyse some risk factors associated with ESBL carriage. METHODS: Faecal samples were collected from 208 different outpatients and 150 healthy student volunteers between 3 January and 3 April 2009. Enterobacterial isolates resistant to third-generation cephalosporins were screened for ESBL production by the double-disk synergy test. Presumptive ESBL-producing isolates with positive synergy test were identified by Mass Spectrometry using the BioTyper MALDI-TOF. For such ESBL positive isolates, antibiotic susceptibility was determined by the Vitek 2 system. PCR and sequencing were performed for the detection of different types of ESBL genes in presumptive ESBL-producing isolates. Statistical methods were used for the univariate calculation of risk factors. RESULTS: During the study period, a total of 358 faecal samples were analysed; 58 of such samples (16%) showed an ESBL phenotype and were confirmed by PCR. The proportion of ESBL producers in faecal carriage was statistically different between outpatients and student volunteers (23.1% vs. 6.7%: p < 0.000). According to a univariate analysis, previous use of antibiotics (ciprofloxacin) appeared to be a risk factor for ESBL carriage (p < 0.05).Escherichia coli was the species most frequently isolated among the ESBL producers in outpatients (66.7%) and student volunteers (90%). Isolates showed additional resistance to gentamicin, ciprofloxacin and trimethoprim/sulfamethoxazole but none of them was resistant to temocillin, amikacin or meropenem. Most of the strains (97%) produced a CTX-M group 1 enzymes [CTX-M-15 (98%) or CTX-M-1 (2%)] and the remaining strains produced SHV-12 enzyme (3%). CONCLUSIONS: The use of drugs such as amoxicillin, ciprofloxacin and trimethoprim/sulfamethoxazole does not seem appropriate for empirical treatment because of emerging resistance. The implementation in Cameroon or in other African countries of methods of screening ESBL-producing organisms in routine laboratories is of great importance in order for us to offer patients appropriate treatment and for infection control efforts to succeed. [less ▲]

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See detailPrevention of group B streptococcal neonatal disease revisited. The DEVANI European project
Rodriguez-Granger, J.; Alvargonzales, J. C.; Berardi, A. et al

in European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology (2012)

The purpose of this paper was to present the current knowledge on the prevention of group B streptococcus (GBS)neonatal infections and the status of prevention policies in European countries and to ... [more ▼]

The purpose of this paper was to present the current knowledge on the prevention of group B streptococcus (GBS)neonatal infections and the status of prevention policies in European countries and to present the DEVANI pan-European program, launched in 2008. The aim of this program was to assess the GBS neonatal infection burden in Europe, to design a new vaccine to immunize neonates against GBS infections, to improve the laboratory performance for the diagnosis of GBS colonization and infection, and to improve the methods for the typing of GBS strains. The current guidelines for GBS prevention in different countries were ascertained and a picture of the burden before and after the instauration of prevention policies has been drawn. After the issue of the Centers for Disease Control and Prevention (CDC) guidelines, many European countries have adopted universal screening for the GBS colonization of pregnant women and intrapartum prophylaxis to colonized mothers. Nevertheless, some European countries continue advocating the risk factor approach to GBS prevention. Most European countries have implemented policies to prevent GBS neonatal infections and the burden of the disease has decreased during the last several years. Nevertheless, further steps are necessary in order to develop new strategies of prevention, to improve microbiological techniques to detect GBS colonization and infection, and to coordinate the prevention policies in the EU. [less ▲]

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See detailPrévention de la contamination microbienne et parasitaire des aliments par des opérateurs porteurs ou malades
Daube, Georges ULg; Debanterlé, René; Dierick, Katelijne et al

Book published by Conseil Supérieur de la Santé - D/2012/7795/4 (2012)

Les toxi-infections d’origine alimentaire (TIA) à la suite de l’ingestion de denrées alimentaires contaminées par des toxines ou des germes (bactéries, virus, parasites, …) sont très fréquentes. On ... [more ▼]

Les toxi-infections d’origine alimentaire (TIA) à la suite de l’ingestion de denrées alimentaires contaminées par des toxines ou des germes (bactéries, virus, parasites, …) sont très fréquentes. On considère que, dans les pays industrialisés, chaque personne en souffre entre une fois par an et une fois tous les trois ans. Heureusement, les germes les plus virulents (Salmonella typhi, Shigella dysenteriae, Vibrio cholerae) ont été éradiqués dans nos pays et, dans la plupart des cas, les autres agents sont uniquement responsables de problèmes symptomatiques moins graves mais très coûteux pour la société. Quelques affections connaissent une issue fatale (Listeria monocytogenes, Clostridium botulinum) ou sont couplées avec une pathologie sévère (Escherichia coli O157:H7 entérohémorragiques). Les agents transmissibles par l’alimentation sont de nature très variée: des virus, des bactéries, des protozoaires, des helminthes et des toxines. Au vu des données épidémiologiques actuellement disponibles en Belgique, les affections les plus fréquentes dans notre pays sont, dans l’ordre décroissant du nombre de cas annuels déclarés, celles causées par Campylobacter spp, Salmonella spp, Yersinia enterocolitica, Shigella spp, E. coli entérohémorragiques dont E. coli O157:H7, les norovirus, Listeria monocytogenes, Staphylococcus aureus, Bacillus cereus et Clostridium perfringens. L’absence de recherche systématique sous-évalue l’incidence des infections virales, en particulier celles causées par les norovirus. De plus, dans les cas d’infections mixtes bactérie/virus où une étiologie bactérienne a été identifiée, la recherche de virus est très rarement menée. Pour certains de ces agents, la contamination d’origine humaine est majoritaire alors que, dans beaucoup de cas, il s’agit d’agents zoonotiques dont le réservoir principal est le tube digestif des animaux et qui peuvent contaminer les aliments à l’un des stades de leur production. Enfin, l’environnement peut aussi être une source de contamination. Cette brochure s’adresse à tout médecin impliqué dans l’accompagnement médical des personnes actives dans la production, le traitement, la transformation et la manipulation de denrées alimentaires. En effet, l’AR du 03 février 2012 modifiant l’AR du 22 décembre 2005 prescrit que tout travailleur pouvant entrer en contact direct avec des denrées alimentaires non ou semi-emballées prêtes à consommer doit disposer d’un certificat médical relatif à l’hygiène des denrées alimentaires. Ce sont les médecins traitants, les médecins du travail et les médecins-conseil qui vont être amenés à envisager l’aptitude à la fonction, l’arrêt ou bien la reprise du travail avec ou sans conditions pour ces travailleurs. Ils doivent pouvoir disposer de toutes les informations médico-scientifiques utiles à leurs prises de décisions ou à leur mission de conseil. Afin de prendre la décision la plus adéquate, le médecin devra évaluer au cas par cas les risques liés à la fonction de la personne. L’objet de cette brochure est d’offrir un outil pour réaliser le diagnostic clinique différentiel des affections qui - par une contamination des denrées alimentaires - peuvent provoquer des TIA et, éventuellement, requérir des examens complémentaires. Dans cette brochure, les caractéristiques de ces agents pathogènes sont mentionnées afin que l’attestation requise puisse être établie en connaissance de cause et que le patient puisse être conseillé au mieux en matière de prévention. Les personnes actives dans le secteur agro-alimentaire peuvent jouer un rôle prépondérant dans le cadre de la transmission des TIA. Elles peuvent notamment être à l’origine de foyers épidémiques si elles sont malades et/ou porteuses de certains de ces agents et ne respectent pas les précautions d’hygiène de base. C’est la raison pour laquelle les mesures d’hygiène de base sont également rappelées dans cette brochure. Il est également intéressant de savoir qu’à coté de ce document, il existe une brochure dédiée spécifiquement aux opérateurs de la filière agro-alimentaire et à leurs employeurs et dans laquelle les mesures générales et spécifiques à mettre en œuvre en fonction du secteur et de la fonction sont précisées. Toute personne intéressé à obtenir plus d'informations pourra trouver en fin de brochure des références aux lectures conseillées ainsi que les coordonnées générales des services et des personnes concernées. [less ▲]

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See detailTypage des souches de Norovirus circulant dans les populations symptomatiques et asymptomatiques au Burkina Faso
HUYNEN, Pascale ULg; Mauroy, Axel ULg; MARTIN, Caroline et al

Poster (2012)

Appartenant à la famille des Caliciviridae, genre Norovirus, les norovirus (NoV) sont des virus non enveloppés dont le génome est composé d’un ARN monocaténaire de polarité positive ... [more ▼]

Appartenant à la famille des Caliciviridae, genre Norovirus, les norovirus (NoV) sont des virus non enveloppés dont le génome est composé d’un ARN monocaténaire de polarité positive d’approximativement 7,5 kb. Les NoV infectent l’homme chez qui ils représentent au niveaumondial un agent majeur de gastroentérites épidémiques, d’origine souvent alimentaire mais aussi sporadique, et ce, toutes classes d'âges confondues. Les souches humaines sont classées génétiquement dans différents génotypes au sein de trois des cinq génogroupes, nommés (G) I, II et IV, composant le genre Norovirus. La voie de transmission des NoV est féco-orale. Les NoV sont très résistants dans l’environnement et la dose infectieuse est faible. Dans la population humaine, une grande diversité de souches appartenant principalement aux G I et II co-circulent. Parmi ces souches, le génotype Lordsdale (GII-4) est prédominant dans les épidémies actuelles, notamment lorsqu'une transmission de personne à personne est incriminée, alors que les souches du G I semblent plus fréquemment rapportées au cours des épidémies d’origine environnementale, comme celles liées à la consommation de fruits de mer. Si de nombreuses études d'épidémiologie moléculaire concernant ces virus ont été réalisées dans les pays industrialisés, les données sont par contre manquantes ou ténues pour bien des pays non industrialisés, et en particulier africains. Au cours d'une étude épidémiologique réalisée à Bobo Dioulasso au Burkina Faso et portant sur la prévalence des NoV dans les échantillons de selles de patients présentant ou non des symptômes de gastro-entérite, les souches détectées ont été quantifiées, leur génogroupe a été déterminé et pour certaines d'entre elles le génotype a été précisé. Quatre cent cinquante trois patients ont été prélevés, dont 319 présentant des symptômes diarrhéiques et 134 sujets témoins ne présentant pas de symptomatologie digestive. La détection des NoV et la quantification des charges virales excrétées ont été effectuées sur tous les échantillons par RT-PCR en temps réel permettant de discriminer les souches appartenant aux G I ou II. Une RT-PCR conventionnelle visant les régions de la polymérase (ORF1 du virus) ou de la capside (ORF2) a ensuite été réalisée sur une partie des échantillons détectés positifs en vue du séquençage de ces régions. Les relations phylogénétiques des souches circulant dans la population du Burkina Faso aux souches de référence ont aussi été inférées. Les résultats de RT-PCR en temps réel ont permis de mettre en évidence que les prévalences apparentes de l'infection par les NoV sont similaires dans les populations symptomatique et asymptomatique : une détection moléculaire de NoV chez 67 patients présentant de la diarrhée (21,0 %) et chez 31 des sujets témoins (23,1 %) a pu être observée. Les génotypes circulant détectés sont très variés dans les deux génogroupes, avec une proportion assez surprenante de NoV appartenant au G I. Université polytechnique de Bobo-Dioulasso, Institut supérieur des Sciences de la Santé (INSSA), Bobo-Dioulasso, Burkina Faso. Cette étude a permis de préciser l'épidémiologie moléculaire des souches de NoV circulant dans un pays représentatif de l'Afrique de l'Ouest. Elle a également montré que des individus asymptomatiques pourraient jouer un rôle assez important de réservoir du virus. Elle souligne enfin que, malgré le fait que les souches GII, et en particulier celles de génotype GII.4, soient à l'heure actuelle rapportées majoritairement au niveau mondial, les souches G I doivent être excrétées en égale proportion dans l'environnement. L'origine épidémiologique de la différence entre les prévalences apparentes des infections par les souches de GI et de GII, bien que partiellement expliquée par les différences de sensibilité génétique et d'immunité de population, reste donc à élucider. Remerciements: à la fondation A. Seghers, au Centre de Coopération au Développement de l'Université de Liège, à R. Boreux (assistance technique), aux membres du laboratoire du CMA de Dô et aux agents de santé de Bobo-Dioulasso (Burkina-Faso). [less ▲]

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See detailTables 1, 2, 3 and 4 (1-199)
independent Belgian/Luxembourg Working Party on Antimicrobial Therapy,; MELIN, Pierrette ULg; Arendt, Vic et al

in The Sanford Guide to Antimicrobial Therapy 23rd edition of the Belgian/Luxembourg Version 2012-2013 (Adapted for use by the medical profession in Belgium and Luxembourg by the independent Belgian/Luxembourg Working Party on Antimicrobial Therapy (2012)

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See detailGroup B streptococci, a European perspective with results of the DEVANI project
MELIN, Pierrette ULg

in DUCOFFRE, GENEVIèVE (Ed.) Abstract book of 27th Annual Meeting "Diagnostic et surveillance des maladies infectieuses" (2011, November)

In 2011, neonatal group B streptococcal (GBS) diseases remain a global public health concern. Where consensus guidelines to detect and treat intrapartum women with GBS colonization have been widely ... [more ▼]

In 2011, neonatal group B streptococcal (GBS) diseases remain a global public health concern. Where consensus guidelines to detect and treat intrapartum women with GBS colonization have been widely adopted, incidence of neonatal early onset disease (EOD) has dramatically declined, however despite preventive strategies cases still occur. The strategy was not expected to prevent all cases and there are challenges and limitations to this preventive approach. The best strategy for European countries is still a matter of debate and intrapartum antimicrobial prophylaxis (IAP) is not widely recommended. To adopt the best preventive strategy, we first need better data assessing more accurately the true burden of GBS diseases in the different countries. Furthermore, as the current screening-based strategy for prevention is highly effective but imperfect, given the challenges, limitations and potential complications of maternal IAP, a new approach is still needed. Maternal immunization against GBS is an attractive alternative for the prevention of not only neonatal diseases but also stillbirths and maternal diseases. Vaccines against GBS may likely become the most effective and sustainable long-term preventive strategy. But the development of vaccines with global relevance has been hampered by changes in the distribution of GBS serotypes of strains causing diseases over time and in different parts of the world. A multivalent vaccine to cover against the more prevalent serotypes suitable for European populations might not be suitable for Asian or African populations. To overcome type-specificity, new developments target vaccines based on conserved surface antigenic proteins, such as Sip protein located at the cell surface of all GBS and on immunogenic proteins from GBS pili. A pilus-based GBS vaccine is appealing and could become a globally relevant reality. The DEVANI (DEsign of a Vaccine Against Neonatal Infections) programme funded through the European Commission Seventh Framework was launched on 1 January 2008 with the key objective being the assessment of European GBS epidemiology to facilitate the design of a new vaccine that will confer neonatal immunity through a durable maternal immune response. A major component was to undertake pan European surveillance of maternal colonisation, maternal GBS antibody responses and neonatal diseases in eight European countries. Through 2009 and 2010, all Belgian laboratories sending any neonatal GBS invasive isolate to the National Reference Centre for GBS were invited to bring their contribution to this project. Belgium, Bulgaria, Czech Republic, Denmark, Germany, Italy, Spain and the United Kingdom established specific GBS screening studies during 2008/10. Maternal vaginal/rectal swabs and sera were taken between 34-37 weeks gestation and processed using a standardised microbiological screening protocol. Samples from neonatal cases were processed using local procedures. For each pregnant woman and each case of GBS neonatal disease, standardized case report forms were filled. GBS isolates were characterised using standardised serological and molecular typing methods for detection of all ten GBS capsular polysaccharide types (Ia to IX). Furthermore all the collected isolates were screened by multiplex PCR and FACS analysis to evaluate respectively gene presence and surface-exposure of pili. And clonal analysis of these isolates was performed using multi-locus sequence typing (MLST). The main microbiological results of this pan European surveillance are following. Carriage rates among pregnant women in all countries ranged from 8% to 26%. The most common GBS capsular types were III (33%), Ia (25%) and V (8%). Among GBS from EOD, the major serotypes were III (43%), V (21%) and Ia (18%). In contrast among GBS isolated from neonatal late onset disease (LOD), serotype III was highly predominant (80.6%) followed mainly by Ia (12.5%). Analysis of the pattern of pili genes showed that all isolates contained at least one gene coding for pili. The most common gene patterns found were PI-2a alone, PI 1+2a and PI 1+2b, while the PI-2b gene alone was very rare. The most prominent result was that a majority of isolates from neonatal infections carried the PI-1+2b gene pattern, while the most common pattern among pregnant women was PI-1+2a. Most of analyzed strains express at least one pilus on their surface. The clonal analysis showed that 66 sequence types were found to belong to nine clonal complexes (CC). Among these nine CCs, five were prevailing and covered 92 % of GBS isolates tested. The GBS population in pregnant women was found to be more heterogeneous than the GBS isolated from neonatal infection cases. Among neonatal isolates, the most frequent CC was CC17 (43 %) known as a highly virulent clone. Among participating countries, there were no significant differences in the occurrence of clonal complexes. The analysis of the levels of specific antibodies as surrogate markers of protection is still ongoing. More detailed and additional results as the main conclusions will be presented. [less ▲]

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See detailThe future of microbiology
MELIN, Pierrette ULg

Scientific conference (2011, October 15)

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See detailNEONATAL INVASIVE GROUP B STREPTOCOCCAL (GBS) INFECTIONS IN EUROPE
MELIN, Pierrette ULg; Berner, Reinhard; Afshar, Baharak et al

Poster (2011, September)

Objectives: To describe clinical characteristics and capsular type of GBS isolates responsible of invasive infections in infants from Belgium, Bulgaria, Czech-Republic, Denmark, Germany, Italy, Spain and ... [more ▼]

Objectives: To describe clinical characteristics and capsular type of GBS isolates responsible of invasive infections in infants from Belgium, Bulgaria, Czech-Republic, Denmark, Germany, Italy, Spain and United Kingdom, representing one of the main objectives of the DEVANI (DEsign of a Vaccine Against Neonatal Infections) project. Methods: Surveillance of invasive GBS infections in infants was performed from mid-2008 through December 2010. For each case, a standardized case report form was filled. Samples from cases were processed using local procedures. GBS isolates were characterised in national central labs using standardised type-specific (Ia, Ib-IX) latex agglutination and molecular typing methods. Results: Data on 188 infants with invasive infection were analysed: 144 (60.6%) early onset diseases (EOD) and 74 (39.4%) late onset diseases (LOD). In EOD, mean/median ages at onset were 14/0 hours and the male:female ratio was 1.25. The predominant manifestation at onset was respiratory distress (42% cases); 83% cases were associated with sepsis/bacteremia, 15% with pneumonia and 6% with meningitis. Late-prenatal screening cultures were obtained from 51% of cases’ mothers and only half of these were positive for GBS. Non-elective C-section, intrapartum fever and rupture of membrane (>18h) were more frequent in EO-cases’ mothers versus healthy babies’ GBS-positive mothers. The major serotypes were III (43%), V (21%) and Ia (18%). In LOD, mean/median ages at onset were 42/34 days and the male:female ratio was 0.9. The predominant characteristic at onset was fever (62% cases); 70% cases were associated with sepsis and 30% with meningitis. Very rare manifestations were osteomyelitis and cellulitis. Serotype III was highly predominant (80.6%) followed mainly by Ia (12.5%). Death rates were 4.7/1.5% in EOD/LOD. Conclusions: Clinical presentations were associated with age at onset of infection. Serotype III predominated in neonatal infections. Prenatal screening was not universal neither sensitive. Study funded through the European Commission Seventh Framework. [less ▲]

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See detailPili genes pattern in Group B streptococci from newborn infections and pregnant women in Europe (DEVANI Project)
Imperi, Monica; Rinaudo, Daniela; Creti, Roberta et al

Poster (2011, September)

Objectives Evaluation of the presence and expression of genes coding for pili in a collection of group B streptococcci (GBS) isolated from newborn infection and pregnant women in the course of the DEVANI ... [more ▼]

Objectives Evaluation of the presence and expression of genes coding for pili in a collection of group B streptococcci (GBS) isolated from newborn infection and pregnant women in the course of the DEVANI (Design of a Vaccine Against Neonatal Infection) project. Methods GBS isolates from pregnant women (PW) and cases of newborn infection (NI) were collected in 8 European countries (Belgium, Bulgaria, Czech Republic, Denmark, Germany, Italy, Spain, United Kingdom) during 2009/10 under the auspices of DEVANI. Total no. of strains examined was 1078 and 192 from PW and NI, respectively. Isolates were screened by multiplex PCR and FACS analysis to evaluate respectively gene presence and surface-exposure of pili. Results The most common gene patterns found were PI-2a alone, PI 1+2a and PI 1+2b, while the PI-2b gene alone was very rare. The most prominent result was that a majority of isolates from NI carried the PI-1+2b gene pattern, while the most common pattern among PW was PI-1+2a. Most of analyzed strains express at least one pilus on their surface. Conclusions All isolates contained at least one gene coding for pili. When present pili 2a and 2b were highly surface exposed. [less ▲]

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See detailSeverity of ICU-acquired pneumonia according to infectious microorganisms
DAMAS, Pierre ULg; LAYIOS, Nathalie ULg; SEIDEL, Laurence ULg et al

in Intensive Care Medicine (2011), 37(7), 1128-35

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See detailGBS colonization and screening in pregnancy: how does it work in Europe?
MELIN, Pierrette ULg

Conference (2011, June)

In Europe, as in North America, GBS infections among infants are associated to high morbidity and mortality even if some differences exist between different European countries. During the past two decades ... [more ▼]

In Europe, as in North America, GBS infections among infants are associated to high morbidity and mortality even if some differences exist between different European countries. During the past two decades, major initiatives have been proposed to prevent early onset GBS disease (EOD) and they are still subject of controversy. Several European countries have issued guidelines for the prevention of neonatal GBS diseases, either universal screening-based or risk-based strategy, others have no official guidelines at all. In countries having guidelines, despite considerable efforts and economic resources spent on intrapartum antimicrobial prophylaxis for GBS EOD, cases continue to occur. Among these cases there are a lot of missed opportunities to administer IAP but there are also false negative screening. Therefore in the setting of a maternal GBS-screening program and successful implementation of the strategy, efforts to improve screening for GBS status remain important. The natural reservoir for GBS is the gastrointestinal tract and is likely the source for vaginal colonization. Among pregnant women, GBS carriage rate in the vaginal and rectal flora ranges from 10% up to 30%. Critical factors that influence the accuracy of detecting GBS maternal colonization are the choice of the body sites sampled, the timing of sampling and the use of selective culture media. The evolution of the different culture options to improve the GBS-screening strategy will be reviewed. If the optimal time for performing antenatal cultures is between 35 to 37 weeks’ gestation, as GBS carriage is highly variable, the predictive values of GBS antenatal cultures are not always as good predictors of the maternal GBS status at presentation for delivery as expected. Potential alternative to antenatal GBS-screening culture is the identification of GBS colonization at presentation for delivery. Use of a reliable, sensitive, easy to use rapid test should be cost effective leading to the prevention of more EOGBS cases while reducing the number of unnecessarily IAP. Advances of polymerase chain reaction (PCR) and fluorescence labeling technologies has provided new detection tools for bacterial identification. Therefore, commercialization of rapid detection of GBS through real-time PCR offers the potential for GBS detection among women without prenatal care or those in whom no antenatal culture was collected. However questions of costs and logistics remain unanswered. Could such rapid intrapartum test replace existing screening strategies or could it be used in conjunction with them? Colonizing rates and recommended screening procedures existing through Europe will be reviewed. [less ▲]

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See detailNeonatal Group B Streptococcal Disease: From Pathogenesis to Preventive strategies
MELIN, Pierrette ULg

in Clinical Microbiology & Infection (2011)

Streptococcus agalactiae, or group B streptococcus (GBS), remains the leading cause of neonatal sepsis and meningitis, early onset and late onset diseases (EOD, LOD). Where consensus guidelines to detect ... [more ▼]

Streptococcus agalactiae, or group B streptococcus (GBS), remains the leading cause of neonatal sepsis and meningitis, early onset and late onset diseases (EOD, LOD). Where consensus guidelines to detect and treat intrapartum women with GBS colonization have been widely adopted, incidence of neonatal EOD has dramatically declined. In response to both successful impacts on the incidence of GBS-EOD and analyses of missed opportunities, the first American guidelines for prevention issued in the 90s have since been adapted in several stages to improve their efficacy. In some countries in Europe, nationwide guidelines, whether screening-based or risk-based, for the prevention of neonatal GBS diseases have also been issued and adopted, with the expected impact on incidence of GBS-EOD. In spite of universal screening, in spite of the great progress that has been made, GBS-EOD continues to occur and the GBS burden remains a significant public health issue. Continuous efforts to improve screening for GBS status continue to be important and may be able to take advantage of new rapid diagnostic technologies. The current screening-based strategy for prevention is highly effective but imperfect. Given the challenges, limitations and potential complications of maternal intrapartum prophylaxis, a new approach is still needed. Maternal immunization against GBS is an attractive alternative for the prevention of not only neonatal diseases but also stillbirths and maternal diseases. Vaccines against GBS may likely become the most effective and sustainable long-term preventive strategy. [less ▲]

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See detailAutomatisation en bactériologie: hier, aujourd'hui et demain
MELIN, Pierrette ULg

Scientific conference (2011, April 28)

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See detailInternational External Quality Assurance for Laboratory Identification and Typing of Streptococcus agalactiae (group B streptococci)
Afshar, Baharak; Broughton, Karen; Creti, Roberta et al

in Journal of Clinical Microbiology (2011)

We report the results from the first international multicentre external quality assessment (EQA) studies for molecular and serological typing of group B streptococcus (GBS) strains as part of DEVANI ... [more ▼]

We report the results from the first international multicentre external quality assessment (EQA) studies for molecular and serological typing of group B streptococcus (GBS) strains as part of DEVANI (DEsign of a Vaccine Against Neonatal Infections), a pan-European programme. A questionnaire-based surveillance was undertaken amongst eight DEVANI and six non-DEVANI participating laboratories from 13 countries in order to assess their current microbiological procedures for GBS screening, diagnosis and typing. GBS strains from three EQA distributions were characterised using molecular and serological methods based on GBS capsular polysaccharide typing. Participants were asked to test the first distribution using their current serotyping and genotyping methods. Strep-B-Latex agglutination method was the most widely used method with a typeability value of >90%. A multiplex PCR assay for GBS capsular gene typing was also used by two of 14 centres who achieved a typeability value of 93%; this assay only detected 9 of 10 GBS capsular polysaccharide genes. From the second and third EQA studies standardised protocols were prepared for serological and molecular typing of GBS strains based on the Strep-B-Latex agglutination method and a novel multiplex PCR assay which detected all ten GBS capsular types (Ia to IX). These standardised protocols are being used by many European laboratories and as the use of these methods increase, it is imperative to continuously improve and assess laboratory performance and offer training to any laboratories that have technical difficulties. [less ▲]

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