Noncontiguous finished genome sequences and description of Bacteroides mediterraneensis sp. nov., Bacteroides ihuae sp. nov., Bacteroides togonis sp. nov., Bacteroides ndongoniae sp. nov., Bacteroides ilei sp. nov. and Bacteroides congonensis sp. nov. identified by culturomics

Culturomics is a concept developing different culture conditions in order to enlarge our knowledge of the human microbiota through the discovery of previously uncultured bacteria. This enabled us to isolate six new species of the Bacteroides genus: Bacteroides mediterraneensis strain Marseille-P2644, Bacteroides ihuae strain Marseille-P2824, Bacteroides togonis strain Marseille-P3166, Bacteroides ndongoniae strain Marseille-P3108, Bacteroides ilei strain Marseille-P3208 and Bacteroides congonensis strain Marseille-P3132. Those bacteria are Gram-negative anaerobic bacilli. We describe here their phenotypic features, together with phylogenetic analysis, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry spectrum, fatty acid composition, and genome sequencing and annotation.

Noncontiguous finished genome sequence and description of Mediterranea massiliensis gen. nov., sp. nov., a new member of the Bacteroidaceae family isolated from human colon

Strain Marseille-P2645^T was isolated in a colon sample from a Frenchwoman who underwent a colonoscopy. Bacterial cells were Gram negative, non–spore forming, mobile and strictly anaerobic. The genome of strain Marseille-P2645^T is 3 950 441 bp long and contains 3374 protein-coding genes. The DNA G+C content is of 51.66 mol%. Strain Marseille-P2645^T exhibited a 92.9% sequence similarity with Bacteroides helcogenes strain P36-108^T (GenBank accession no. CP002352), the phylogenetically closest species with standing in nomenclature. Strain Marseille-P2645^T (= CSUR P2645 = DSM 103034) is therefore a candidate as a type species of a new genus belonging to the Bacteroidaceae family, for which the name of Mediterranea massiliensis gen. nov., sp. nov., is proposed.

G-POEM with antro-pyloromyotomy for the treatment of refractory gastroparesis: mid-term follow-up and factors predicting outcome

BACKGROUND

Gastric peroral endoscopic pyloromyotomy (G-POEM) was introduced for treating refractory gastroparesis.

AIM

To present a series of patients focussed on clinical mid-term efficacy and predictive outcomes factors.

METHODS

This was a single centre study of 29 patients operated on between January 2014 and April 2016, with disturbed gastric emptying scintigraphy (GES) and/or elevated Gastroparesis Cardinal Symptoms Index (GCSI). The procedures were performed as previously described. The primary endpoint was the efficacy at 3 and 6 months, based on GCSI and symptoms. The secondary endpoints were GES evolution, procedure reproducibility and safety, and identification of predictive factors for success.

RESULTS

There were 10 men, 19 women (mean age 52.8±18). The technical success rate was 100% (average 47 minutes). There were two complications managed conservatively: one bleeding and one abscess. The median follow-up was 10±6.4 months. The clinical success rate was 79% at 3 months, 69% at 6 months, with a significant decrease in the mean GCSI compared to pre-operatively (3.3±0.9 vs 1±1.2 and 1.1±0.9 respectively). The GES (n=23) normalised in 70% of cases, with a significant improvement of the mean half emptying time and retention at 2 hours, and a discordance in 21% of the cases. In univariate analysis, diabetes and female gender were significantly associated with risk of failure, but not confirmed in multivariate analysis.

CONCLUSIONS

The mid-term efficacy of G-POEM reaches 70% at 6 months. The procedure remains reproducible and safe. Diabetes and female gender were predictive of failure.

'Metaprevotella massiliensis' gen. nov., sp. nov., isolated from human ileum

We report here the main characteristics of 'Metaprevotella massiliensis' strain Marseille-P-3114T (CSURP3114) that was isolated from a human ileum sample.

‘Caecibacter massiliensis’ gen. nov., sp. nov., isolated from human right colon

We report here the main characteristics of ‘Caecibacter massiliensis’ strain Marseille-P-2974^T (CSUR P2974), which was isolated from a human right colon sample.

‘Duodenibacillus massiliensis’ gen. nov., sp. nov., a new species identified in human duodenum

We present here the main characteristics of ‘Duodenibacillus massiliensis’ strain Marseille-P2968, which was isolated from a human duodenum liquid sample of a 60-year-old man.

‘Tidjanibacter massiliensis’ gen. nov., sp. nov., a new bacterial species isolated from human colon

We report the summary of main characteristics of Tidjanibacter massiliensis strain Marseille-P3084^T, a new bacterial species isolated from the liquid sample of the colon of a patient with a history of irritable bowel syndrome.

Rectal intussusception: can high resolution three-dimensional ano-rectal manometry compete with conventional defecography?

BACKGROUND

Three-dimensional high-resolution anorectal manometry (3DHRAM), used for exploring anorectal disorders, was recently developed, providing interesting topographic data for the diagnosis of pelvic floor disorders such as excessive perineal descent. The aim of our study was to define a diagnostic strategy based on selected 3DHRAM parameters to identify rectal intussusceptions (RI), considering conventional defecography (CD) as the gold standard.

METHODS

All patients referred to our center in the previous 6 months for 3DHRAM to explore fecal incontinence or constipation, and who previously achieved CD, were eligible. 3DHRAM results were obtained for all classical parameters and the presence of a narrow band of high pressure in the anal canal during attempted defecation, which was recently found to be associated with RI in some studies. The sensitivity, specificity, and positive and negative predictive values were calculated for various 3DHRAM criterion in order to propose a diagnostic strategy for RI.

KEY RESULTS

Twenty-six patients (66%) presented with RI on CD. On 3DHRAM, according to our diagnostic strategy, the most relevant manometric criterion for the diagnosis of RI was the association of an anterior additional high-pressure area and an excessive perineal descent, with a positive predictive value of 100% [81.5-100], a specificity of 100% [75.3-100] and a sensibility of 69.2% [48.2-85.7].

CONCLUSIONS & INFERENCES

In this study, 3DHRAM was used to diagnose RI, and we confirmed its use in the diagnosis of pelvic floor disorders. Further studies will be necessary to define classifications for these new anatomic data from 3DHRAM.

'Millionella massiliensis' gen. nov., sp. nov., a new bacterial species isolated from human right colon

We report here the main characteristics of 'Millionella massiliensis' strain Marseille-P3215^T (= CSUR P3215), which was isolated from a human right colon liquid sample.

Massilioclostridium coli gen. nov., sp. nov., a new member of the Clostridiaceae family isolated from the left colon of a 27-year-old woman

Massilioclostridium coli strain Marseille-P2976^T (= CSUR P2976 = DSM 103344) is a new bacterial genus isolated from the left colon of a patient who underwent colonoscopy for colorectal cancer screening. Massilioclostridium coli is a Gram-negative bacillus, strict anaerobic, nonsporogenous and nonmotile organism. We describe here the strain Marseille-P2976^T and provide its complete annotated genome sequence according to taxonogenomics concepts. Its genome is 2 985 330 bp long and contains 2562 predicted genes and 75 RNA genes.

'Pseudoflavonifractor phocaeensis' gen. nov., sp. nov., isolated from human left colon

We describe here characteristics of ‘Pseudoflavonifractor phocaeensis’ strain Marseille-P3064^T, which was isolated from a human left colon wash sample.

Noncontiguous finished genome sequence and description of Fusobacterium massiliense sp. nov. isolated from human duodenum

The strain Marseille-P2749^T (= CSUR P2749 = DSM 103085) was isolated as part of culturomics study from a liquid duodenum sample from a French man. Bacterial cells were Gram-negative bacilli, fusiform shaped and non–spore forming, and they grew in microaerophilic and anaerobic atmosphere. Its genome is 1 809 169 bp long and contains 1646 protein-coding genes. The DNA G+C content was 27.33 mol%. This strain exhibited a 95.9% sequence similarity with Fusobacterium periodonticum, the phylogenetically closest species with standing in nomenclature. Strain Marseille-P2749^T is suggested to be a novel species belonging to the genus Fusobacterium, for which the name Fusobacterium massiliense sp. nov. is proposed.

Noncontiguous finished genome sequence and description of Streptococcus timonensis sp. nov. isolated from the human stomach

Strain Marseille-P2915^T, a Gram-positive, facultative anaerobic and nonmotile coccus, was isolated from the gastric lavage of a patient with severe anaemia. The 16S rRNA and rpoB gene comparison exhibited a sequence identity of 98.7 and 92.6% with Streptococcus infantis strain JCM 10157^T, respectively, collocating it within the ‘Streptococcus mitis’ group. On the basis of phenotypic and genomic analysis, we propose the validation of the type strain Streptococcus timonensis sp. nov. Marseille-P2915T (= DSM 103349 = CSUR P2915).

'Acidaminococcus timonensis' sp. nov. and 'Acidaminococcus massiliensis' sp. nov. isolated from human gut

We report here the main characteristics of 'Acidaminococcus timonensis' strain Marseille-P2764^T, isolated from human right colon, and 'Acidaminococcus massiliensis' strain Marseille-P2828^T, isolated from human duodenum.

“Ihuprevotella massiliensis” gen. nov., sp. nov., isolated from human gut

We report here the main characteristics of “Ihuprevotella massiliensis” strain Marseille-P2826^T (CSURP 2826) that was isolated from a human right colon lavage sample.

Three-dimensional high-resolution anorectal manometry: does it allow automated analysis of sphincter defects?

AIM

Anorectal manometry is the most common test used to explore anorectal disorders. The recent three-dimensional high-resolution anorectal manometry (3D-HRAM) technique appears to be able to provide new topographic information. Our objective was to develop an automated analysis of 3D-HRAM images to diagnose anal sphincter defects and compare the results with those of endoanal ultrasonography (EUS), which is considered to be the gold standard.

METHOD

All patients being tested in our department for faecal incontinence or dyschezia by 3D-HRAM and EUS were eligible for the study. 3D-HRAM was used to record resting and squeeze pressure, reflecting internal and external anal sphincter function, respectively. A software platform was designed to automatically analyse the 3D-HRAM images and calculate a diagnostic score for any anal sphincter defect compared with EUS.

RESULTS

A total of 206 (91% female) patients of mean age of 54 years were included in the study. A sphincter defect was diagnosed by EUS in 130 (63%). The diagnostic scores from the 3D-HRAM automated analysis for an internal anal sphincter defect showed a sensitivity of 65% and a specificity of 65%. For an external anal sphincter defect, the sensitivity was 43% and the specificity 87%.

CONCLUSION

Our study developed a method based on 3D-HRAM to automatically diagnose sphincter defects, allowing a systematic and comprehensive analysis of the test recordings. Compared with EUS, the 3D-HRAM image analysis procedure revealed poor sensitivity and specificity.

Three-dimensional high-resolution anorectal manometry and diagnosis of excessive perineal descent: a comparative pilot study with defaecography

AIM

Three-dimensional high-resolution anorectal manometry (3DHRAM) is a new technique that can simultaneously provide physiological and topographical data on the terminal part of the digestive tract. Our object was to assess whether 3DHRAM is able to reliably diagnose excessive perineal descent already diagnosed with conventional defaecography, which is considered to be the gold standard.

METHOD

All patients referred to our centre for anorectal manometry and conventional defaecography were evaluated with a maximum of 6 months between the two examinations. Anorectal manometry was performed using the 3D High-Resolution Given Imaging® probe. Excessive perineal descent was defined as the downward movement of the anal high-pressure zone during straining. At the end of the straining effort, the high-pressure zone regained its initial position, thereby indicating that the probe had not moved.

RESULTS

Nineteen female patients of median age 53 (21-70) years were included in the study. All cases with excessive perineal descent diagnosed using defaecography were visualized with 3DHRAM. The degree of perineal descent determined by 3D and conventional defaecography was compared (Spearman correlation 0.726, P = 0.01). In contrast, the averages measured were significantly different; the average was 11.68 ± 3.3 mm for 3DHRAM but 34.21 ± 13.3 mm for conventional defaecography (P = 0.002).

CONCLUSION

The results of the study demonstrate that 3DHRAM can diagnose excessive perineal descent with the same degree of reliability as defaecography. Quantitative measures were not correlated, however, possibly because of methodological differences. The study confirms the value of the morphological data provided by 3DHRAM.

[Ecstasy and its "counterparts"]

RISK AWARENESS: Use of psychostimulants is spreading in France, particularly at "techno" dances. The generic term "ecstasy" covers a wide variety of molecules with variable formulations. The situation is a true public health problem, generally concerning very young subjects who must be informed of the risks involved. Knowledge of the chemical makeup of the products currently used is needed to provide valid information and reduce risks.

CHEMICAL ANALYSIS

Two types of chemical analysis are used for rapid controls. A coloration test is used by the Rave mission implemented by "Médecins du Monde". More elaborate analysis methods are used to identify the active substances and quantify the compounds in the different "tablets".

FINDINGS

Rapid controls give a means of quickly identifying samples containing methylenedioxyamphetamines and distinguishing them from other samples which may contain any number of substances with unknown toxicity. A precise analysis of 73 samples has shown highly variable compositions with 22% actually containing methylenedioxyamphetamines.

PREVENTION

Precise analytical knowledge of the drugs circulating in "techno" dances has revealed the extreme danger of a large number of the substances used. A continuous control of ongoing consumption is required to correctly warn the users and reduce risk.