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We performed a systematic sampling and analysis of airborne SARS-CoV-2 RNA in different hospital areas to assess viral spread. Systematic air filtration was performed in rooms with COVID-19 infected patients, in corridors adjacent to these rooms, to rooms of intensive care units, and to rooms with infected and uninfected patients, and in open spaces. RNA was extracted from the filters and real-time reverse transcription polymerase chain reaction was performed using the LightMix Modular SARS-CoV-2 E-gene. The highest occurrence of RNA was found in the rooms with COVID-19 patients (mean 2600 c/m 3 ) and the adjacent corridor (mean 4000 c/m 3 ) which was statistically significant more exposed (p < 0.01). This difference was related to the ventilation systems. As is commonly found in many hospitals, each of the rooms had an individual air inlet and outlet, while in the corridors these devices were located at the distance of every four rooms. There was a significant transfer of viruses from the COVID-19 patients' rooms to the corridors. The airborne SARS-CoV-2 RNA in the corridors of ICUs with COVID-19 patients or care rooms of uninfected patients were ten times lower, averages 190 c/m 3 and 180 c/m 3 , respectively, without presenting significant differences. In all COVID-19 ICU rooms, patients were intubated and connected to respirators that filtered all exhaled air and prevented virus release, resulting in significantly lower viral concentrations in adjacent corridors. The results show that the greatest risk of nosocomial infection may also occur in hospital areas not directly exposed to the exhaled breath of infected patients. Hospitals should evaluate the ventilation systems of all units to minimize possible contagion and, most importantly, direct monitoring of SARS-CoV-2 in the air should be carried out to prevent unexpected viral exposures., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The aim of this study was to evaluate a 54-kDa recombinant protein encoded by the CPn0980 gene for use in a Chlamydia pneumoniae-specific ELISA. The ability of this affinity-purified protein to detect C. pneumoniae-specific antibodies was evaluated with a panel of 105 serum samples from 62 patients with community-acquired pneumonia. The results of this assay were compared with those obtained with a direct PCR-based detection assay and an outer-membrane complex-based immunoassay. The 54-kDa protein induced specific antibodies following infection of humans, and the recombinant 54-kDa ELISA detected anti-C. pneumoniae IgG and/or IgM antibodies with a sensitivity of 66.7% and a specificity of 79.2% compared with the direct PCR-based detection assay.

Chlamydiae are obligate intracellular bacteria. Chlamydia trachomatis is the most common sexually transmitted disease (STD). The C. trachomatis damaging disease sequelae such as sterility is based on intense and chronic inflammation elicited and maintained by reinfection or persistent infection. The high prevalence of C. trachomatis infection reflects the long and successful adaptation of these organisms to persist in their human host population. The large group of asymptomatically infected persons is not only at risk of serious long-term sequelae but also sustains transmission within communities. C. trachomatis acute infections have been diagnosed by cell culture, direct immunofluorescence, enzyme immunoassay, direct DNA hybridization, and more recently by nucleic acid amplification tests (NAATs). In chronic or persistent chlamydial infections, the level of Chlamydia is very low and bacteria are often not viable. Such infections would be characterized by continuing positive NAATs but only intermittent isolation of viable Chlamydia and positive assays for chlamydial protein antigen. The development of NAATs has been a major advance in the field of chlamydial diagnosis. The use of NAATs associated with serology test is the best diagnosis. The introduction of assays based on amplification of genetic material has subsequently increased the sensitivity of detecting chlamydial infections and offers the opportunity to use non-invasive sampling techniques to screen for infections in asymptomatic subjects. In this article, it was proposed the best diagnosis approaches for detection of acute and chronic infections.

Atherosclerotic lesions often harbor Chlamydophila pneumoniae (C. pneumoniae). The objective of the present study was to examine whether serological tests are able to predict individual endovascular infection. Endarterectomy specimens from 70 patients with severe carotid artery stenosis were stained immunohistochemically for C. pneumoniae. Antibody titers to C. pneumoniae were measured in serum with a recombinant ELISA recognizing chlamydial lipopolysaccharide (cLPS) and with microimmunofluorescence (MIF). C. pneumoniae antigens were detected in 64 (91%) carotid artery specimens. Serum IgG antibodies to C. pneumoniae were detected in 43% of patients by cLPS-ELISA and in 77% by MIF test. Detection of C. pneumoniae positive cells within atherectomy specimens was strongly correlated to seroprevalence (P = 0.002) and to titers (P = 0.003) of cLPS-IgG antibodies, but not to results of the MIF-test. We conclude that cLPS-IgG antibodies hold promise as a surrogate marker to identify individuals with high endovascular antigen load.

Objective: We report the results of a systematic direct detection screening protocol for Chlamydia trachomatis in urine samples from young women., Material and Method: The study included 1026 patients aged 13 to 30 years. Urine samples were tested with a molecular biology assay: AMP-CT., Results: Thirty-five patients (3.4%) were positive: 80% of the positive patients were aged less than 25 years, 48.6% less than 20 years. All these patients were treated and post treatment controls were negative., Conclusion: This study suggests that national screening programs for Chlamydia trachomatis could be beneficial for women aged between 15 and 25 years and that the "Calmat" law could be modified in consequence.

The respiratory pathogen Chlamydia pneumoniae has been implicated in the pathogenesis of coronary heart disease. Evidence for this includes the direct demonstration of the organism in atherosclerotic plaques and the results of seroepidemiological studies. Of the several serological tests available, the microimmunofluorescence (MIF) test is the most widely used and has become a 'gold standard' because of its specificity and selectivity. In spite of differences in serological criteria of infection and interpretation, the findings of various research groups who have used the MIF test have suggested a link between atherosclerotic cardiovascular disease and Chlamydia pneumoniae infection. Further research is now required in accordance with standard criteria and using pre-defined techniques to confirm the role of the organism in coronary heart disease.

We present here a new method of IgM antibody-capture enzyme-linked immunosorbent assay (IgM-Capture-ELISA) for the diagnosis of recently acquired infections with Chlamydia trachomatis. For this analysis, plates were coated with goat IgG anti-human Fc mu. The capture of serum IgM antibodies was revealed indirectly by the sequential addition of biotinylated chlamydial proteins and peroxidase-conjugated streptavidin. In chlamydial extracts, cysteine-rich proteins are preferential antigenic targets for the humoral response. 3-(N-maleimidopropionyl)-biocytin (MPB), which binds biotinylated moieties to sulfhydryl groups, was used for the labeling procedure. The preservation of the antigenic specificity of labeled proteins was controlled by a blotting of these proteins, which were, respectively, probed either with specific IgM antibodies or with streptavidin. This analysis revealed that, after labeling, recognized epitopes are more particularly present on the major outer membrane protein (MOMP) of Chlamydia trachomatis. The validation of IgM-Capture-ELISA was assessed by using 170 selected sera from patients suspected of being infected by Chlamydia. Results were respectively compared to conventional indirect immunofluorescence assays (MIF-IgM assays) and to Western blotting. Sixteen sera were found to possess IgM antibodies against Chlamydia trachomatis with IgM-Capture-ELISA. Among these 16 sera, 14 and 15 were, respectively, positive with MIF-IgM assays and in Western blotting. Data obtained with IgM-Capture-ELISA reveal the absence of false-positive results in sera containing rheumatoid factor, which has been shown to interfere in the two other methods. IgM-Capture-ELISA value was then confirmed using sera from patients consulting for genital or pulmonary diseases, from patients with confirmed chlamydial infections, and from patients with other pathologies. IgM-Capture-ELISA appears as an alternative simple semi-quantitative assay for the detection of early chlamydial infection.

Objectives: An experimental model of Chlamydia trachomatis salpingitis was developed in mice to study the effect of combination antibiotic and antiinflammatory therapy on restoring fertility after tubal infection., Methods: The mice were infected by injection via the ovarian bursa with a suspension containing a human strain of Chlamydia trachomatis sevar F. After treatment with antibiotics alone or in combination with antiinflammatory agents, fertility was studied at 4 months., Results: With doxycycline and ofloxacine, there was not a significant difference in fertility between animals treated with antibiotics alone and those treated with antibiotics and antiinflammatory agents. However, a piroxicam and azythromycin combination improved fertility with a longer delay than with azythromycin alone. The most important factor appeared to be the antibiotic treatment., Conclusion: Associating an antiinflammatory agent was not shown to have a beneficial effect in reducing infertility after Chlamydia trachomatis salpingitis.

The determination of the viral genotype in chronically HCV infected patients is used as an epidemiologic tool, a predictive marker of the evolution of the disease and especially of the response to the interferon alfa therapy. Its determination needs an amplification of the selected genomic region and remains expensive. Thus an indirect determination of the genotype has been proposed using the characterization of type-specific antibodies. In 101 chronically HCV infected patients, a serologic method specific for HCV type 1, 2 and 3 has been evaluated in relation to the genotyping one. The test was interpretable in 64 sera and in agreement with the genotyping method in 92% of the samples. The reactivity of the test was lower in hemodialysis and IVDUs patients (p < 0.02). The mixed results obtained by the serologic typing method were not in agreement with the results of the genotyping coinfections. We could not differentiate the possible past infections from the cross-reactivities of the test. The serotyping methods was simple and rapid, allowing generally a deduction of the viral genotype. It could be an attractive approach if the reactivity was improved and the subtyping was possible.

Most microorganisms are destroyed by the host tissues through processes which usually involve phagocytosis and lysosomal disruption. However, some organisms are capable of growing inside macrophages and avoiding destruction. This paper describes the normal phagocytic process and how it is avoided by certain viruses, bacteria and protozoa, and the complex cycle of intracellular replication by species of Chlamydia.

Objective: To evaluate a new antibiotic strategy with a combination of ofloxacin + co-amoxiclav in the treatment of pelvic infectious diseases., Design: An open-non-comparative multicentre (10) study., Subjects: 123 patients (118 salpingitis and 5 endometritis) were included clinical, laparoscopic and bacteriological assessments were performed before treatment and a laparoscopic control was done in 35% of cases. Among positive bacteriological samples before treatment 48.7% C. trachomatis were isolated; 56.1% of salpingitis were considered as severe (COGIT score > 6)., Treatment: Patients received at entry oral ofloxacin 200 mg bid in combination with parenteral co-amoxiclav 2 to 4 g following by oral route. Total duration of treatment was 21 days., Results: With respectively 97.2% and 91.6% satisfactory clinical and bacteriological results, this combination should take a major place in the treatment of pelvic infectious diseases.

A group of 24 Chlamydia psittaci strains isolated from ruminants, belonging to serotype 1 and previously classified as invasive in a mouse model of virulence, was compared to a group of 10 non-invasive strains belonging to serotype 2 by using determination of glucose-6-phosphate and L-malate dehydrogenase zymotypes resulting of the infection of cells by these strains. The serotype 1 or invasive isolates represent a homogeneous group by sharing a unique zymotype which was not observed in the non-invasive strains. On the contrary, the serotype 2 or non-invasive isolates constitute a heterogeneous group in generating 2 different zymotypes. Zymotyping clearly distinguishes the ruminant strains from an avian C. psittaci and two C. trachomatis isolates studied for comparison. Our results suggest the usefulness of the studied molecular approach for chlamydiae typing. Furthermore, it can be used as marker of virulence within the C. psittaci strains isolated from ruminants.

One hundred and eight clinical strains and 24 reference strains of C. trachomatis were typed using differential restriction mapping of omp1, the gene which encodes the major outer membrane protein. The gene was obtained by polymerase chain reaction (PCR). This molecular typing method correlated well with serological typing. Eighty-four per cent of clinical strains were typed using the enzyme AluI alone. Heterogeneity was looked for among the most common serovars (E, F, and D; 62%, 17%, and 9%, respectively). Analysis of the PCR-amplified fourth variable domain of omp1 using denaturing gradient gel electrophoresis followed by direct sequencing of the variants disclosed substantial heterogeneity within the D serovar. Conversely, serovars E and F were homogeneous, with however a single variant strain of serovar E.

Twenty-one Branhamella catarrhalis strains selected for their diversity by esterase electrophoretic polymorphism, and belonging to 20 distinct zymotypes, were studied by restriction fragment length polymorphism (RFLP) of total DNA after ethidium bromide staining and of ribosomal DNA regions (ribotyping). The former analysis allowed the distinction of 20 patterns and the latter the delineation of 19 ribotypes. The three methods were correlated and showed a clonal diversity of the species. Esterase electrophoresis and Hinfl RFLP patterns after ethidium bromide staining appeared to be simple tools for use in B. catarrhalis epidemiology.

Minimal inhibitory concentrations of cefuroxime were determined by an agar dilution procedure and compared with erythromycin and four other beta-lactam antibiotics (amoxycillin, amoxycillin + clavulanate, cefadroxil, cefaclor) on 76 strains of Moraxella (Branhamella) catarrhalis. Sixty four of them produced a beta-lactamase. Results show that the beta-lactamase of Moraxella (Branhamella) catarrhalis abrogates the activity of amoxycillin (MIC 90% = 4 mg/l) meanwhile the combination of amoxycillin-clavulanate is inhibitory at low concentration (MIC 90% = 0.25 mg/l). There are no difference in MICs between strains producing or not producing beta-lactamase with erythromycin (MIC 90% = 0.25 mg/l). All the strains evaluated in this investigation, producing or not producing beta-lactamase have MIC 90% less than or equal to 2 mg/l for cefuroxime lower than those obtained for the two other cephalosporins.

This study was undertaken to evaluate the diagnostic value of detection and titration of specific IgA antibodies against Chlamydia trachomatis in active infections of the upper genital tract. Three different techniques using L2 serovar antigens were compared: immunofluorescence on cells infected with Chlamydia trachomatis, microimmunofluorescence as described by Wang and Grauston, and an indirect immunoperoxidase method on infected cells. Good correlations were found between the three techniques. Results demonstrated that the cutoff level should be 1/16.

The serovar distribution of 53 Chlamydia trachomatis strains obtained from 53 clinical isolates in Amiens (France) was studied by a micro-immunofluorescence test with a panel of 15 monoclonal antibodies. The isolates were of ocular (babies) or urogenital origin (adults). This typing showed that E was the most common serovar (62.3%) followed by F (9.4%), Ba, D, J (5.6%), H (3.8%) and G, K (1.9%). Two mixed infections were detected (one EG and one FG). Consequently, the serovar distribution of C. trachomatis in Amiens (France), was characterized by a predominance of serovar E higher than in other European countries.

The in vitro antibacterial activity of miocamycin was compared with four other macrolides (erythromycin, roxithromycin, josamycin, spiramycin) and pristinamycin against 90 clinical isolates of Branhamella catarrhalis by determination of minimum inhibitory concentrations. Sixty three strains were producing penicillinase. Fourteen carbons macrolides and pristinamycin are more effective than sixteen carbons macrolides. In this group, miocamycin have the best activity. There were no significant differences of susceptibility between penicillinase producing and non producing strains.

Unlabelled: Thirty patients were treated with continuous ambulatory peritoneal dialysis during 313 patients months. 26 episodes of peritonitis defined by a cloudy dialysate with more than 100 cells/mm1 and more than 50 p. cent of polynuclear were observed. The organisms initially responsible were Gram-positive in 11 cases (6 Staphylococcus aureus, 1 Staphylococcus albus, 4 Streptococcus viridans), a gram negative in 3 cases (1 Klebsiella, 1 serratio, one unidentified), a Candida in 2 cases. In 10 cases, the culture was negative, Initial treatment was peritoneal lavage (40 l/day) with in situ antibiotics: in the absence of Candida, the association sulfamethoxazole (SMZ) (80 mg/l) and trimethoprim (TMP) (16 mg/l) was used; when Candida was present amphotericin B (5 mg/l) was used. The association SMZ + TMP led to cure of PT in 17 cases, in 7 +/- 4 days. In 5 cases, this initial treatment was changed at the 48th hour because of initial resistance in one case or secondary resistance of Candida surinfection (2 cases). Candida surinfection occurred later in 2 other cases. For these 6 primary or secondary Candida peritonitis, the catheter was changed within 48 hours. Nevertheless, death occurred in 3 cases and cure was obtained after 51 +/- 11 days in the 3 other cases., Conclusions: 1) The initial treatment by SMZ + TMP appears quite effective in most cases (73%). 2) The severity and the high incidence of Candida surinfection suggest that its systematic prophylaxis may be appropriate.

A group of 39 strains isolated from pigeons, parakeets, parrots, sheep, goats, cats, guinea-pigs, mice and humans were immunotyped by a one-way or two-way cross-reaction micro-immunofluorescence test. Eight immunotypes were found. Among them, two new immunotypes were characterized: a cat conjunctivitis strain and a mouse inapparent respiratory infection strain. The immunotypes of feline pneumonitis and guinea-pig conjunctivitis, recently described by Perez-Martinez and Storz, were confirmed. Three human strains were similar to avian isolates, while a fourth was identical to that of feline pneumonitis; this suggests a possible contamination of humans by cats.

Since 1978, 54 episodes of PT occurred in patients treated by PD, first 26 PT (group A) were treated by CLM (40 l/day) and in situ antibiotics (AB): in the absence of Candida, the association of sulfamethoxazol (SMZ: 80 mg/l) and trimethoprime (TMP: 16 mg/l) was used. Only when a Candida was present amphotericine B (AMB: 5 mg/l) was used. CLM was continued until PT was cured. The last 29 PT (group B) were treated by 4 bags/day of CAPD with in situ AB: SMZ: 200 mg/l and TMP 40 mg/l and a systematic oral prophylaxis of Candida was performed by AMB 1,5 g/day. In group A, 5 patients died and 2 others in group B. Complications were more frequent in group A (14) than in group B (6): p less than 0.02. In group A, the AB was changed in 7 cases because of initial resistance (1) or bacterial superinfection (2) or Candida superinfection (4). In group B, AB was changed in 9 cases because of initial resistance (7) or Candida superinfection (2). In conclusion the treatment of PT by 4 bags per day with in situ AB cure PT as rapidly as CLM in spite of lower doses of SMZ - TMP. However, this method is easier to perform and give less complication than CLM. It must be the treatment of choice of PT from peritoneal dialysis.

In vitro study of spiramycine action on C. psittaci and C. trachomatis demonstrates that this antibiotic is active in a concentration similar to that found in the serum of patients who have received an injection of 4 g. However, it should be noted that even with a higher dose, few inclusions are still present. On the other hand, the action of spiramycine on mice infected with C. psittaci is highly efficient. The difference between the in vitro results and the excellent in vivo results could be explained by an important accumulation of antibiotic in the tissue.

In vitro study on C. psittaci and C. trachomatis demonstrates that pristinamycin is active in a very small dose. With 5 g/l, inclusions are rare. To study pristinamycin activity in vivo, we used mice infected IP with C. psittaci. Mortality in the control group was 70%. Three groups of mice received 25 mg/kg, 50 mg/kg and 100 mg/kg pristinamycin respectively. The antibiotic was active in the 100 mg/kg dosage which is the therapeutic dosage. Due to its action on Gonococcus, it would be of interest to study pristinamycin in patients with sexually transmitted disease.

The in vitro antibacterial activities of three fluoroquinolones (pefloxacin, ofloxacin, ciprofloxacin) against 90 clinical isolates of Branhamella catarrhalis were assessed by determination of minimum inhibitory concentrations (MICs). 73.5% of the strains were producing penicillinase. The MICS90 were as follow: ciprofloxacin = 0.2 mg/l. The MIC50 and the MIC90 were similar. There was no correlation of MICs with beta-lactam resistance. Lung parenchyma and bronchial mucus diffusion of these three fluoroquinolones allowed their utilisation in Branhamella catarrhalis bronchopulmonary infections.

A kinetic study of chlamydia antibody was performed in the C57BL/6 mouse to demonstrate whether some cell wall polypeptides could be useful in the detection of early infection. Polyacrylamide gel electrophoresis was employed, followed by electrophoretic transfer to nitrocellulose sheets of the polypeptides, separated according to their molecular weights. One polypeptide triplet appeared to be very interesting, that of 66, 65 and 64 Kd. The first two, and particularly the 65-Kd polypeptide, were determinant carriers which provoked an antibody response in the C57BL/6 mouse during an early phase of infection by the two species of chlamydia; the 65-Kd polypeptide reacted only with C. psittaci. The extension of this study to human disease was undertaken and preliminary results are encouraging; polypeptide markers of early infection in the C57BL/6 mouse, and especially that of 65 Kd, were revealed by the tested human sera and provoked the same type of response. A more extensive study in human species, in correlation with clinical observations, is currently being undertaken in our laboratory.

The authors report two cases of endocarditis secondary to Streptobacillus moniliformis. A 41 year-old man, bitten by a rat, is hospitalized 5 weeks later for an endocarditis demonstrated by echocardiography, with massive aortic escape and hemodynamic failure requiring emergency valve replacement: after a favorable course, the patient dies suddenly 4 months later. A 63 year-old woman is admitted for a septicemic syndrome with sterno-clavicular arthritis which occurred 10 days after a rat bite; followed by a transient ischemic cerebral vascular accident; echocardiogram shows a clubshaped bulge of the distal end of the large mitral valve; the course is uneventful under antibiotherapy. In both cases, blood cultures isolate a Streptobacillus moniliformis. Infections secondary to Streptobacillus moniliformis are rare; this Gram negative bacillus, saprophyte of the rat's rhinopharynx, is transmitted to man, most of the time, by bite, and this causes a septicemia, the evolution of which is usually favorable. Complications, especially endocarditis, are exceptionally rare: only 12 cases are found in the world's literature. The evolution is always fatal in the absence of treatment which must include the association penicillin-aminoside. Prophylaxis of this disease is provided by penicillin antibiotherapy which should be systematic after a rodent's bite.