Microbial diversity remains largely unexplored across environments and scales, notably because at local scales many microbial taxa exist under a dormant state. Microbial biogeography is shaped by edaphic and ecological drivers, and shifts in microbial community composition are frequently associated with host community structure and health. Nontuberculous mycobacteria represent a striking example of environmental microorganisms with opportunistic pathogenic potential. Unfortunately, data on their diversity, distribution, and ecological interactions in aquatic environments remain limited. However, understanding competition for niche space and the role of abiotic and biotic factors shaping their biogeography is crucial for predicting disease emergence and transmission. Here we aimed at i) identifying microhabitat abiotic and biotic drivers influencing their distribution, ii) assessing the predictability of their diversity and distribution across continents, and iii) examining potential exclusion or associations between pathogenic and nonpathogenic mycobacterial species. By deploying an eDNA-based metabarcoding approach from freshwater samples collected in urban and rural sites in French Guiana and Côte d’Ivoire, we have boosted our understanding of environmental mycobacteria ecology by highlighting the influence of habitat type, abiotic factors, and microbial interactions on mycobacterial distribution. In addition, the detection of pathogenic species further highlighted the importance of environmental reservoirs in mycobacterial disease transmission. ### Competing Interest Statement The authors have declared no competing interest. LabEx CEBA, Guyane Française, FR Agence Nationale de la Recherche, ANR-17-CE35-0006-01 PRIME
Children with sickle cell disease (SCD) frequently experience chronic inflammation, increased metabolic demands, and recurrent acute complications. Asthma is a recognised comorbidity associated with increased morbidity in SCD. However, the contribution of nutritional status, particularly body mass index (BMI), to clinical severity among children with SCD and confirmed asthma remains poorly documented, especially in tropical settings. The objective of this study was to describe the nutritional status of children with SCD and spirometry-confirmed asthma and to assess the association between BMI-for-age z-scores and clinical severity. We conducted a multicentre observational study including children aged 5–17 years with SCD and spirometry-confirmed asthma. Nutritional status was assessed using WHO 2007 BMI-for-age z-scores calculated from measured weight and height. Undernutrition was defined as a BMI-for-age z-score < − 2. Clinical severity was defined as the occurrence of at least two hospitalisations for vaso-occlusive crises and/or acute chest syndrome in the preceding 12 months. Associations between nutritional indicators and clinical severity were evaluated using bivariate and multivariable logistic regression models adjusted for relevant clinical covariates. A total of 138 children were included (median age 8.0 years). Overall, 17.4
Background/Objectives: Strongyloides stercoralis may persist through autoinfection and is clinically important before corticosteroid exposure, but its relationship with airway obstruction in children with sickle cell disease (SCD) is uncertain. We examined whether routine-detected S. stercoralis infection was associated with spirometry-defined airway obstruction in children with SCD in French Guiana. Methods: This multicentre cross-sectional secondary analysis used an availability-based sample from a routine respiratory screening database. Eligible children aged 5–17 years had SCD, spirometry, and stool parasitology documented during routine care. The primary outcome was FEV1/FVC < 80%. Logistic regression adjusted for age, sex, genotype, hydroxyurea treatment, previous acute chest syndrome, and atopy. Results: Stool parasitology was available for 160 children; 26 (16.2%) had S. stercoralis detected. Among 138 children with complete spirometry and covariate data, 45 (32.6%) had obstruction. S. stercoralis was not associated with obstruction in univariable analysis (OR 0.75, 95% CI 0.30–1.91) or after adjustment (adjusted OR 1.02, 95% CI 0.37–2.86; p = 0.964). Male sex was independently associated with obstruction (adjusted OR 2.32, 95% CI 1.11–4.83). Conclusions: Routine-detected S. stercoralis infection was not an independent correlate of airway obstruction. The wide confidence interval, limited exposure ascertainment, and small infected subgroup mean that clinically important protective or harmful associations cannot be excluded.
French Guiana has developed a health organization to respond to its geographical situation. Remote health centers provide primary and emergency care in isolated areas. The limited technical facilities at the remote health centers result in a significant number of patient transfers to the Cayenne emergency department (ED). The objective of this study was to describe the epidemiology and management of patients transferred to Cayenne ED. A retrospective observational study was conducted from January 1 to December 31, 2019, and it included all patients transferred from remote health centers to Cayenne ED. All sociodemographic, prehospital, hospital, and referral data were collected; 842 patients were transferred by remote health centers to the Cayenne ED. The male/female ratio was 1.27, with an age of 36 (±23) years old. The two main modes of transportation used were helicopter (36%) and plane (22%). The most frequent reasons for transfer were trauma (28%), digestive (9%), respiratory (9%), and infectious (8%) conditions. Patients were hospitalized in 71% of cases. Among patients who were not hospitalized, 7% did not require further examination or specialist advice in the ED. Our work underlines the important use of airborne resources, particularly medical ones; they were initially intended for the management of vital emergencies, but they are also used for nonurgent situations. The geography and road access in French Guiana make alternative means of transport difficult. Our work identifies a number of areas for optimizing care to decrease the number of transfers: improving biomedical equipment, improving imaging equipment, and use of telemedicine.
Cutaneous abscesses are the most common skin infections in Amazonia; however, data on the infectious agents in this tropical region are scarce. The humid and hot climate of the Amazon region, coupled with exposure to environmental contaminants from aquatic, telluric, plant, insect, and animal sources, could modify the infectious agents responsible for skin abscesses, which are largely dominated by Staphylococcus aureus (S. aureus) in temperate regions. A retrospective monocentric study was conducted from January 1, 2023 to January 15, 2024. Any patient over 18 years of age admitted to the Surgery Department of Cayenne Hospital, French Guiana, for drained abscesses who had a positive microbiological specimen was included. Contiguous osteoarticular infection, necrotizing fasciitis, amputation, and unfavorable evolution requiring revision surgery were considered complications. Of 123 eligible patients, 118 patients were analyzed. Gram-positive cocci were found in 75% of samples (primarily S. aureus), whereas Gram-negative bacilli were present in 36% of samples. Snakebites accounted for a significant proportion of abscesses (14%; n = 17). In the univariate analysis, infections caused by group 3 Enterobacteriaceae, which naturally produce low-level cephalosporinase (n = 23), Aeromonas hydrophila. (n = 20), and waterborne Enterobacteriaceae (n = 26) were significantly associated with lower limb location, secondary abscess, snakebite, polymicrobial infection, and water exposure. Group 3 Enterobacteriaceae-positive cultures were significantly associated with the occurrence of complications, whereas waterborne Enterobacteriaceae were linked to informal settlement housing. In conclusion, these data indicate that in the Amazon region, empiric antibiotic therapy for infections of the lower limbs or secondary to snakebite should target group 3 Enterobacteriaceae and Aeromonas sp. Sulfamethoxazole-trimethoprim may be an effective treatment option for these patients.
