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Biguenet A, Bertrand X, Bourgeon M, Gnide DC, Gbaguidi-Haore H, Slekovec C. Population structure of community-acquired extended-spectrum beta-lactamase producing Escherichia coli and methicillin resistant Staphylococcus aureus in a French region showed no difference between urban and rural areas. PLoS One 2023; 18:e0294433. [PMID: 37972023 PMCID: PMC10653544 DOI: 10.1371/journal.pone.0294433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
Antimicrobial resistance is a global health issue and extended-spectrum β-lactamase producing Escherichia coli (ESBL-Ec) and methicillin-resistant Staphylococcus aureus (MRSA) are of particular concern. Whole genome sequencing analysis of isolates from the community is essential to understand the circulation of those multidrug-resistant bacteria. Our main objective was to determine the population structure of clinical ESBL-Ec and MRSA isolated in the community setting of a French region. For this purpose, isolates were collected from 23 sites belonging to 6 private medical biology laboratories in the Bourgogne-Franche-Comté region. One hundred ninety ESBL-Ec and 67 MRSA were sequenced using the Illumina technology. Genomic analyses were performed to determine the bacterial typing, presence of antibiotic resistance genes, metal resistance genes as well as virulence genes. Analysis showed that ST131 was the major ESBL-Ec clone circulating in the region, representing 42.1% of the ESBL-Ec isolates. The blaCTX-M genes represented 98% of blaESBL with the majority being blaCTX-M-15 (53.9%). MRSA population consisted of mainly of CC8 (50.7%) and CC5 (38.8%) clonal complexes. Interestingly, we found a prevalence of 40% of the zinc resistance gene czrC in our MRSA population. We observed no differences in our ESBL-Ec or MRSA populations between urban and rural areas in our French region, suggesting no impact of population density or rural environment.
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Affiliation(s)
- Adrien Biguenet
- Université de Franche-Comté, UMR-CNRS 6249 Chrono-Environnement, Besançon, France
- CHU de Besançon, Hygiène Hospitalière, Besançon, France
| | - Xavier Bertrand
- Université de Franche-Comté, UMR-CNRS 6249 Chrono-Environnement, Besançon, France
- CHU de Besançon, Hygiène Hospitalière, Besançon, France
| | - Marilou Bourgeon
- CHU de Besançon, Centre de Ressources Biologiques - Filière Microbiologique, Besançon, France
| | - Dossi Carine Gnide
- CHU de Besançon, Bioinformatique et Big Data Au Service de La Santé, Besançon, France
| | - Houssein Gbaguidi-Haore
- Université de Franche-Comté, UMR-CNRS 6249 Chrono-Environnement, Besançon, France
- CHU de Besançon, Hygiène Hospitalière, Besançon, France
| | - Céline Slekovec
- Université de Franche-Comté, UMR-CNRS 6249 Chrono-Environnement, Besançon, France
- CHU de Besançon, Hygiène Hospitalière, Besançon, France
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Compagne C, Gabriel D, Ferrero L, Magnin E, Tannou T. Tools for the Assessment of Risk-Taking Behavior in Older Adults with Mild Dementia: A Cross-Sectional Clinical Study. Brain Sci 2023; 13:967. [PMID: 37371445 DOI: 10.3390/brainsci13060967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Diseases such as Alzheimer's cause an alteration of cognitive functions, which can lead to increased daily risk-taking in older adults living at home. The assessment of decision-making abilities is primarily based on clinicians' global analysis. Usual neuropsychological tests such as the MoCA (Montreal Cognitive Assessment) cover most of the cognitive domains and include mental flexibility tasks. Specific behavioral tasks for risk-taking, such as the Balloon Analogue Risk Task (BART) or the Iowa Gambling Task (IGT), have been developed to assess risk-taking behavior, particularly in the field of addictology. Our cross-sectional study aims to determine whether the MoCA global cognitive assessment could be used as a substitute for behavioral tasks in the assessment of risky behavior. In the current study, 24 patients (age: 82.1 ± 5.9) diagnosed with mild dementia completed the cognitive assessment (MoCA and executive function assessment) and two behavioral risk-taking tasks (BART, simplified version of the IGT). Results revealed no relationship between scores obtained in the MoCA and behavioral decision-making tasks. However, the two tasks assessing risk-taking behavior resulted in concordant risk profiles. In addition, patients with a high risk-taking behavior profile on the BART had better Trail Making Test (TMT) scores and thus retained mental flexibility. These findings suggest that MoCA scores are not representative of risk-taking behavioral inclinations. Thus, additional clinical tests should be used to assess risk-taking behavior in geriatric settings. Executive function measures, such as the TMT, and behavioral laboratory measures, such as the BART, are recommended for this purpose.
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Affiliation(s)
- Charline Compagne
- UR LINC, Université de Franche-Comté, 25 000 Besançon, France
- CIC-1431 INSERM, Centre Hospitalier Universitaire, 25 000 Besançon, France
| | - Damien Gabriel
- UR LINC, Université de Franche-Comté, 25 000 Besançon, France
- CIC-1431 INSERM, Centre Hospitalier Universitaire, 25 000 Besançon, France
- Plateforme de Neuroimagerie Fonctionnelle Neuraxess, 25 000 Besançon, France
| | - Lénaïc Ferrero
- CIC-1431 INSERM, Centre Hospitalier Universitaire, 25 000 Besançon, France
| | - Eloi Magnin
- UR LINC, Université de Franche-Comté, 25 000 Besançon, France
- CHU Département de Neurologie, Centre Hospitalier Universitaire, 25 000 Besançon, France
| | - Thomas Tannou
- UR LINC, Université de Franche-Comté, 25 000 Besançon, France
- Plateforme de Neuroimagerie Fonctionnelle Neuraxess, 25 000 Besançon, France
- CIUSS Centre-Sud de l'Ile-de-Montréal, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
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Tannou T, Godard-Marceau A, Joubert S, Daneault S, Kergoat MJ, Magnin E, Comte A, Gabriel D, Vidal C, Pazart L, Aubry R. Added value of functional neuroimaging to assess decision-making capacity of older adults with neurocognitive disorders: protocol for a prospective, monocentric, single-arm study (IMAGISION). BMJ Open 2021; 11:e053549. [PMID: 34588264 PMCID: PMC8483026 DOI: 10.1136/bmjopen-2021-053549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Assessment of decision-making capacity (DMC) is essential in daily life as well as for defining a person-centred care plan. Nevertheless, in ageing, especially if signs of dementia appear, it becomes difficult to assess decision-making ability and raises ethical questions. Currently, the assessment of DMC is based on the clinician's evaluation, completed by neuropsychological tests. Functional MRI (fMRI) could bring added value to the diagnosis of DMC in difficult situations. METHODS AND ANALYSIS IMAGISION is a prospective, monocentric, single-arm study evaluating fMRI compared with clinical assessment of DMC. The study will begin during Fall 2021 and should be completed by Spring 2023. Participants will be recruited from a memory clinic where they will come for an assessment of their cognitive abilities due to decision-making needs to support ageing in place. They will be older people over 70 years of age, living at home, presenting with a diagnosis of mild dementia, and no exclusion criteria of MRI. They will be clinically assessed by a geriatrician on their DMC, based on the neuropsychological tests usually performed. Participants will then perform a behavioural task in fMRI (Balloon Analogue Risk Task) to analyse the activation areas. Additional semistructured interviews will be conducted to explore real life implications. The main analysis will study concordance/discordance between the clinical classification and the activation of fMRI regions of interest. Reclassification as 'capable', based on fMRI, of patients for whom clinical diagnosis is 'questionable' will be considered as a diagnostic gain. ETHICS AND DISSEMINATION IMAGISION has been authorised by a research ethics board (Comité de Protection des Personnes, Bordeaux, II) in France, in accordance with French legislation on interventional biomedical research, under the reference IDRCB number 2019-A00863-54, since 30 September 2020. Participants will sign an informed consent form. The results of the study will be presented in international peer-reviewed scientific journals, international scientific conferences and public lectures. TRIAL REGISTRATION NUMBER NCT03931148.
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Affiliation(s)
- Thomas Tannou
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche Comté, Besancon, France
- Inserm, CIC 1431, Centre d'Investigation Clinique, Besançon, F-25000 France, University Hospital of Besançon, Besançon, France
- Geriatrics, University Hospital of Besançon, Besancon, France
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Aurelie Godard-Marceau
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche Comté, Besancon, France
- Inserm, CIC 1431, Centre d'Investigation Clinique, Besançon, F-25000 France, University Hospital of Besançon, Besançon, France
| | - Sven Joubert
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
- Departement de psychologie, Université de Montréal, Montreal, Québec, Canada
| | - Serge Daneault
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Marie-Jeanne Kergoat
- Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Eloi Magnin
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche Comté, Besancon, France
| | - Alexandre Comte
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche Comté, Besancon, France
- Inserm, CIC 1431, Centre d'Investigation Clinique, Besançon, F-25000 France, University Hospital of Besançon, Besançon, France
| | - Damien Gabriel
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche Comté, Besancon, France
- Inserm, CIC 1431, Centre d'Investigation Clinique, Besançon, F-25000 France, University Hospital of Besançon, Besançon, France
| | - Chrystelle Vidal
- Inserm, CIC 1431, Centre d'Investigation Clinique, Besançon, F-25000 France, University Hospital of Besançon, Besançon, France
| | - Lionel Pazart
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche Comté, Besancon, France
- Inserm, CIC 1431, Centre d'Investigation Clinique, Besançon, F-25000 France, University Hospital of Besançon, Besançon, France
| | - Regis Aubry
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche Comté, Besancon, France
- Inserm, CIC 1431, Centre d'Investigation Clinique, Besançon, F-25000 France, University Hospital of Besançon, Besançon, France
- Geriatrics, University Hospital of Besançon, Besancon, France
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