54 results on '"Gabriel, Frederic"'
Search Results
52. Utility of Mucorales PCR to diagnose Rhizomucor infections in neutropenic patients.
- Author
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Pfister E, Brousse X, Blanchard E, Issa N, Gabriel F, Jubert C, Kaminski H, Forcade E, Dumas PY, Delhaes L, Lefranc M, and Imbert S
- Abstract
Mucormycoses are life-threatening infections related to fungi from the Mucorales order. Based on fungal culture, the most frequently involved genera are Rhizopus spp., Mucor spp. or Lichtheimia spp. However, since the introduction of Mucorales PCR, many diagnoses are made without positive fungal culture, biasing mucormycosis epidemiology. We conducted a single-center retrospective observational study on invasive mucormycosis cases diagnosed between April 2020 and December 2022. Cases were classified according to EORTC/MSGERC definitions, adding a "PCR-only" category for patients with a positive Mucorales PCR as the only mycological evidence. Genus/species identification was obtained by sequencing the Mucorales 18S rDNA directly on Mucorales PCR-positive samples. We identified 35 cases of mucormycosis, including 6 proven, 7 probable and 22 "PCR-only". Genus/species identification was achievable in 34 cases, and surprisingly revealed the genus Rhizomucor as the main aetiological agent (n=14, 41.2%). Interestingly, all the Rhizomucor infections, except one, were classified as "PCR-only", while fungal culture was positive in 11/20 (55%) for other Mucorales genera (p < 0.001). Moreover, in comparison with other genera, the genus Rhizomucor was significantly more associated with neutropenia (11/14 [78.6%] vs 2/20 [10%], p < 0.0001) and pulmonary localizations (11/14 [78.6%] vs 6/20 [30%], p = 0.01). Our study reveals the changing epidemiology of mucormycosis in our center with the use of Mucorales PCR and underlines the importance of the genus Rhizomucor especially in neutropenic patients. This highlights the benefits using Mucorales PCR in clinical practice for mucormycosis diagnosis in high-risk patients, and the need to include it in diagnostic criteria., (© The Author(s) 2025. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.) more...
- Published
- 2025
- Full Text
- View/download PDF
53. Invasive Aspergillosis Due to Aspergillus Section Usti: A Multicenter Retrospective Study.
- Author
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Glampedakis E, Cassaing S, Fekkar A, Dannaoui E, Bougnoux ME, Bretagne S, Neofytos D, Schreiber PW, Hennequin C, Morio F, Shadrivova O, Bongomin F, Fernández-Ruiz M, Bellanger AP, Arikan-Akdagli S, Erard V, Aigner M, Paolucci M, Khanna N, Charpentier E, Bonnal C, Brun S, Gabriel F, Riat A, Zbinden R, Le Pape P, Klimko N, Lewis RE, Richardson M, İnkaya AC, Coste AT, Bochud PY, and Lamoth F more...
- Subjects
- Antifungal Agents therapeutic use, Aspergillus, Humans, Retrospective Studies, Aspergillosis drug therapy, Aspergillosis epidemiology, Invasive Fungal Infections diagnosis, Invasive Fungal Infections drug therapy, Invasive Fungal Infections epidemiology
- Abstract
Background: Aspergillus spp. of section Usti (A. ustus) represent a rare cause of invasive aspergillosis (IA). This multicenter study describes the epidemiology and outcome of A. ustus infections., Methods: Patients with A. ustus isolated from any clinical specimen were retrospectively identified in 22 hospitals from 8 countries. When available, isolates were sent for species identification (BenA/CaM sequencing) and antifungal susceptibility testing. Additional cases were identified by review of the literature. Cases were classified as proven/probable IA or no infection, according to standard international criteria., Results: Clinical report forms were obtained for 90 patients, of whom 27 had proven/probable IA. An additional 45 cases were identified from literature review for a total of 72 cases of proven/probable IA. Hematopoietic cell and solid-organ transplant recipients accounted for 47% and 33% cases, respectively. Only 8% patients were neutropenic at time of diagnosis. Ongoing antimold prophylaxis was present in 47% of cases. Pulmonary IA represented 67% of cases. Primary or secondary extrapulmonary sites of infection were observed in 46% of cases, with skin being affected in 28% of cases. Multiple antifungal drugs were used (consecutively or in combination) in 67% of cases. The 24-week mortality rate was 58%. A. calidoustus was the most frequent causal agent. Minimal inhibitory concentrations encompassing 90% isolates (MIC90) were 1, 8, >16, and 4 µg/mL for amphotericin B, voriconazole, posaconazole, and isavuconazole, respectively., Conclusions: Aspergillus ustus IA mainly occurred in nonneutropenic transplant patients and was frequently associated with extrapulmonary sites of infection. Mortality rate was high and optimal antifungal therapy remains to be defined., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.) more...
- Published
- 2021
- Full Text
- View/download PDF
54. Guidelines for prophylaxis of Pneumocystis pneumonia cannot rely solely on CD4-cell count in autoimmune and inflammatory diseases.
- Author
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Baulier G, Issa N, Gabriel F, Accoceberry I, Camou F, and Duffau P
- Subjects
- Adult, Aged, Aged, 80 and over, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis complications, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis drug therapy, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis immunology, Arthritis, Rheumatoid complications, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid immunology, Autoimmune Diseases complications, Autoimmune Diseases immunology, CD4 Lymphocyte Count, Cryoglobulinemia complications, Cryoglobulinemia drug therapy, Cryoglobulinemia immunology, Dermatomyositis complications, Dermatomyositis drug therapy, Dermatomyositis immunology, Disease Management, Female, Giant Cell Arteritis complications, Giant Cell Arteritis drug therapy, Giant Cell Arteritis immunology, HIV Infections complications, Hepatitis, Autoimmune complications, Hepatitis, Autoimmune drug therapy, Hepatitis, Autoimmune immunology, Humans, Immunocompromised Host, Lymphopenia etiology, Lymphopenia immunology, Male, Middle Aged, Neoplasms complications, Neoplasms immunology, Neoplasms therapy, Organ Transplantation, Pneumonia, Pneumocystis etiology, Pneumonia, Pneumocystis immunology, Practice Guidelines as Topic, Retrospective Studies, Autoimmune Diseases drug therapy, CD4-Positive T-Lymphocytes immunology, HIV Infections therapy, Immunosuppressive Agents adverse effects, Lymphopenia drug therapy, Pneumonia, Pneumocystis prevention & control
- Abstract
Objectives: Guidelines for preventing Pneumocystis pneumonia (PCP) in HIV patients are based on CD4 below 200/mm3. Such cut-off value is suggested to guide prophylaxis in non-HIV conditions (NHIV) especially in autoimmune and inflammatory diseases (AD). We aimed to determine if CD4 could be used to guide PCP prophylaxis in AD., Methods: CD4 and lymphocyte-count were retrospectively studied in patients diagnosed with PCP between January 2013 and February 2016., Results: 129 patients were included. The median CD4-count was 302/mm3 in AD, which was significantly higher than in HIV patients (19/mm3; p<0.0001). Fifty percent (n=10) of AD patients had CD4 counts greater than 300/mm3., Conclusions: Prophylaxis for PCP cannot rely solely on CD4-count in NHIV patients especially in AD. more...
- Published
- 2018
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