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1. No evidence of pathogenicity of Dientamoeba fragilis following detection in stools: A case-control study

Author

Tchamwa Bamini Germain, Charpentier Eléna, Guemas Emilie, Chauvin Pamela, Fillaux Judith, Valentin Alexis, Cassaing Sophie, Ménard Sandie, Berry Antoine, and Iriart Xavier

Subjects
dientamoeba fragilis, pathogenicity, stools, blastocystis sp., Infectious and parasitic diseases, RC109-216
Abstract

Dientamoeba fragilis is a ubiquitous intestinal parasite with detection in the stools that has become increasingly frequent following the advent of PCR as a routine screening tool. However, the pathogenicity of this parasite is still much debated. In order to assess the potentially pathogenic nature of this protozoan, a retrospective case-control study was carried out between January and December 2020 on patients from Toulouse University Hospital, with the aim of evaluating the potential clinical effects and changes in laboratory parameters linked to the presence and load of D. fragilis in stools. After matching age, sex and mode of care (consultation or hospitalisation), no significant difference was observed in the frequency of clinical signs between the 36 patients who tested positive for Dientamoeba fragilis PCR in their stools and the 72 control patients who were PCR negative for this protozoan. The presence of D. fragilis in the faeces was not associated with changes in laboratory parameters. Furthermore, a high digestive load of D. fragilis had no identifiable impact on clinical and laboratory parameters. Only the concomitant presence of Blastocystis sp. in stools was significantly more frequent in the D. fragilis group (uni- and multivariate analysis). Finally, this study showed no significant difference in clinical or laboratory signs between patients carrying Dientamoeba fragilis and the control group, regardless of the intestinal parasite load, suggesting that D. fragilis could be considered a commensal of the digestive tract.

Published
2024
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2. Rapid and Accurate Diagnosis of Dermatophyte Infections Using the DendrisCHIP® Technology

Author

Anton, Aurore, primary, Plinet, Mathilde, additional, Peyret, Thomas, additional, Cazaudarré, Thomas, additional, Pesant, Stéphanie, additional, Rouquet, Yannick, additional, Tricoteaux, Marie-Andrée, additional, Bernier, Matthieu, additional, Bayette, Jérémy, additional, Fournier, Remi, additional, Marguerettaz, Mélanie, additional, Rolland, Pierre, additional, Bayol, Thibaud, additional, Abbaoui, Nadia, additional, Berry, Antoine, additional, Iriart, Xavier, additional, Cassaing, Sophie, additional, Chauvin, Pamela, additional, Bernard, Elodie, additional, Fabre, Richard, additional, and François, Jean-Marie, additional

Published
2023
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4. Evaluation of the Performance of the Novodiag® Stool Parasites Assay for the Detection of Intestinal Protozoa and Microsporidia

Author

Chauvin, Pamela, primary, Barba, Florie, additional, Guemas, Emilie, additional, Charpentier, Eléna, additional, Cottrel, Claire, additional, Fillaux, Judith, additional, Valentin, Alexis, additional, Baklouti, Sarah, additional, Cassaing, Sophie, additional, Ménard, Sandie, additional, Berry, Antoine, additional, and Iriart, Xavier, additional

Published
2023
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5. Rapid and Accurate Diagnosis of Dermatophyte Infections Using the DendrisCHIP ® Technology.

Author

Anton, Aurore, Plinet, Mathilde, Peyret, Thomas, Cazaudarré, Thomas, Pesant, Stéphanie, Rouquet, Yannick, Tricoteaux, Marie-Andrée, Bernier, Matthieu, Bayette, Jérémy, Fournier, Remi, Marguerettaz, Mélanie, Rolland, Pierre, Bayol, Thibaud, Abbaoui, Nadia, Berry, Antoine, Iriart, Xavier, Cassaing, Sophie, Chauvin, Pamela, Bernard, Elodie, and Fabre, Richard

Subjects
MICROBIAL cultures, RINGWORM, MYCOSES, NANOTECHNOLOGY, SAMPLING (Process), DIAGNOSIS
Abstract

Dermatophytosis is a superficial fungal infection with an ever-increasing number of patients. Culture-based mycology remains the most commonly used diagnosis, but it takes around four weeks to identify the causative agent. Therefore, routine clinical laboratories need rapid, high throughput, and accurate species-specific analytical methods for diagnosis and therapeutic management. Based on these requirements, we investigated the feasibility of DendrisCHIP® technology as an innovative molecular diagnostic method for the identification of a subset of 13 pathogens potentially responsible for dermatophytosis infections in clinical samples. This technology is based on DNA microarray, which potentially enables the detection and discrimination of several germs in a single sample. A major originality of DendrisCHIP® technology is the use of a decision algorithm for probability presence or absence of pathogens based on machine learning methods. In this study, the diagnosis of dermatophyte infection was carried out on more than 284 isolates by conventional microbial culture and DendrisCHIP®DP, which correspond to the DendrisCHIP® carrying oligoprobes of the targeted pathogens implicated in dermatophytosis. While convergence ranging from 75 to 86% depending on the sampling procedure was obtained with both methods, the DendrisCHIP®DP proved to identify more isolates with pathogens that escaped the culture method. These results were confirmed at 86% by a third method, which was either a specific RT-PCR or genome sequencing. In addition, diagnostic results with DendrisCHIP®DP can be obtained within a day. This faster and more accurate identification of fungal pathogens with DendrisCHIP®DP enables the clinician to quickly and successfully implement appropriate antifungal treatment to prevent the spread and elimination of dermatophyte infection. Taken together, these results demonstrate that this technology is a very promising method for routine diagnosis of dermatophytosis. [ABSTRACT FROM AUTHOR]

Published
2023
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6. Fatal mucormycosis and aspergillosis coinfection associated with haemophagocytic lymphohistiocytosis: A case report and literature review

Author

Loubet, Dorian, primary, Sarton, Benjamine, additional, Lelièvre, Lucie, additional, Grouteau, Gaspard, additional, Iriart, Xavier, additional, Chauvin, Pamela, additional, Fillaux, Judith, additional, Valentin, Alexis, additional, Berry, Antoine, additional, Silva, Stein, additional, Bonneville, Fabrice, additional, Cassaing, Sophie, additional, and Guemas, Emilie, additional

Published
2023
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7. Evaluation of the Performance of the Novodiag ® Stool Parasites Assay for the Detection of Intestinal Protozoa and Microsporidia.

Author

Chauvin, Pamela, Barba, Florie, Guemas, Emilie, Charpentier, Eléna, Cottrel, Claire, Fillaux, Judith, Valentin, Alexis, Baklouti, Sarah, Cassaing, Sophie, Ménard, Sandie, Berry, Antoine, and Iriart, Xavier

Subjects
INTESTINAL parasites, MICROSPORIDIA, MICROSPORIDIOSIS, PROTOZOA, PATHOGENIC protozoa, PARASITES
Abstract

Objectives: We aimed to assess the performance of the Novodiag® Stool Parasites (NSP) assay in the diagnosis of the most common intestinal protozoan and microsporidia infections. Methods: A panel of 167 selected stool samples was retrospectively analysed with the NSP assay and compared to routine microscopy and qPCR methods for the detection of pathogenic protozoa and microsporidia. Results: Whereas specificity was high for all protozoa and microsporidia, NSP sensitivity was strongly dependent on the comparative method used as reference. When compared to microscopic methods, NSP sensitivity was high (96.7 to 100%) for Blastocystis hominis, Entamoeba histolytica and Cyclospora cayetanensis but was lower for Giardia intestinalis (85.2%) and ≤50% for Cystoisospora belli and Dientamoeba fragilis. In comparison to conventional qPCR, the NSP assay demonstrated lower sensitivity characteristics dependent on parasite loads, reaching 60 to 70% for G. intestinalis, D. fragilis, Cryptosporidium spp. and E. histolytica. Sensitivity was 100% for Enterocytozoon bieneusi, but none of the five samples containing Encephalitozoon spp. were detected. Conclusions: The overall performance of the NSP assay in the diagnosis of gastrointestinal protozoa and microsporidia seems to be better than or equivalent to that observed with microscopic methods but inferior to that obtainable with classical targeted qPCR. [ABSTRACT FROM AUTHOR]

Published
2023
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8. Performance of seven commercial automated assays for the detection of low levels of anti-Toxoplasma IgG in French immunocompromised patients

Author

Douet Tiphaine, Armengol Catherine, Charpentier Elena, Chauvin Pamela, Cassaing Sophie, Iriart Xavier, Berry Antoine, and Fillaux Judith

Subjects
toxoplasma gondii, igg low level, immunodiagnosis, automated tests, Infectious and parasitic diseases, RC109-216
Abstract

Background: Immunocompromised patients are at high risk for the development of severe toxoplasmosis from tissue cyst reactivation, the most frequently, or from recently acquired acute infections. Knowledge of serologic status is therefore crucial. Screening for toxoplasmosis is sometimes performed while patients are already immunocompromised and have a low or even undetectable IgG titer by routine automated enzyme immunoassays. The aim of this study was to assess the sensitivity and specificity of seven reagents for the detection of low levels of IgG. Sera from 354 patients were collected and analysed. Results: Elecsys® offered the best analytic performances, superior to those of Architect® and Platelia®, which were superior to those of Access II® and TGS TA®. Vidas II® and Liaison II® reagents exhibited poor analytical performances in this cohort. For Elecsys®, Platelia® and Architect®, new thresholds for the grey zone and positive zone have been defined to improve the sensitivity of these reagents while maintaining excellent specificity. Conclusions: Commercialized assays for toxoplasmosis screening are not suitable for IgG low-level detection in patients without adapting the supplier thresholds to avoid false negative results and risk generalized toxoplasmosis.

Published
2019
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9. Active Surveillance Program to Increase Awareness on Invasive Fungal Diseases: the French RESSIF Network (2012 to 2018)

Author

Bretagne, Stéphane, Sitbon, Karine, Desnos-Ollivier, Marie, Garcia-Hermoso, Dea, Letscher-Bru, Valérie, Cassaing, Sophie, Millon, Laurence, Morio, Florent, Gangneux, Jean-Pierre, Hasseine, Lilia, Favennec, Loïc, Cateau, Estelle, Bailly, Eric, Moniot, Maxime, Bonhomme, Julie, Desbois-Nogard, Nicole, Chouaki, Taieb, Paugam, André, Bouteille, Bernard, Pihet, Marc, Dalle, Frédéric, Eloy, Odile, Sasso, Milène, Demar, Magalie, Mariani-Kurkdjian, Patricia, Robert, Vincent, Lortholary, Olivier, Dromer, Françoise, French Mycoses Study Group, The, Damiani, Céline, Dupont, Hervé, Maizel, Julien, Totet, Anne, Bouchara, Jean-Philippe, Bellanger, Anne Pauline, Berceanu, Ana, Navellou, Jean Christophe, Scherer, Emeline, Abboud, Philippe, Aznar, Christine, Blanchet, Denis, Djossou, Félix, Cayot, Sophie, Garrouste, Cyril, Lesens, Olivier, Moluçon, Cécile, Nourrisson, Céline, Poirier, Philippe, Bailly, Éloïse, Basmaciyan, Louise, Belaid, Bouhemad, Blot, Mathieu, Caillot, Denis, Charles, Pierre-Emmanuel, Quenot, Jean Pierre, Amazan, Emmanuelle, Baubion, Emilie, Cabie, André, Chabartier, Cyrille, Deligny, Christophe, Emal, Violaine, Flechelle, Olivier, Hatchuel, Yves, Le Govic, Yohann, Merle, Harold, Miossec, Charline, Turmel, Jean-Marie, Valentino, Ruddy, Durieux, Marie-Fleur, Turlure, Pascal, Mercier, Victor, Gari-Toussaint, Martine, Risso, Karine, Simon, Loïc, Bretonnière, Cedric, Boutoille, David, Gastinne, Thomas, Lakhal, Karim, Launay, Elise, Lepoivre, Thierry, Peterlin, Pierre, Rialland, Fanny, Le Pape, Patrice, Canoui, Etienne, Dahane, Naima, Kerneis, Solène, Angebault, Cécile, Bougnoux, Marie-Elisabethh, Guennouni, Nadia, Lanternier, Fanny, Neven, Bennedicte, Oualha, Mehdi, Scemla, Anne, Sitterlé, Emilie, Suarez, Felipe, Toubiana, Julie, Bonacorci, Stéphane, Alanio, Alexandre, Bergeron, Anne, Denis, Blandine, Gits-Muselli, Maud, Hamane, Samia, Touratier, Sophie, Chaumeil, Christine, Merabet, Lilia, Claudéon, Joelle, Curlier, Elodie, Galantine, Valérie, Gallois, Jean Claude, Markowicz, Samuel, Nicolas, Muriel, Musson, Pascal, Schepers, Kinda, Minoza, Alida, Kauffmann-Lacroix, Catherine, Guégan, Hélène, Costa, Damien, Dehais, Marion, Gargala, Gilles, Bajolet, Odile, Banisadr, Firouze, Cousson, Joel, Himberlin, Chantal, Huguenin, Antoine, Toubas, Dominique, Flori, Pierre, Mahinc, Caroline, Raberin, Hélène, Denis, Julie, Herbrecht, Raoul, Mertes, Paul-Michel, Meziani, Fehrat, Sabou, Marcela, Schneider, Francis, Bertozzi, Anne-Isabelle, Chauvin, Pamela, Charpentier, Elena, Cointault, Olivier, Cottrel, Claire, Delavigne, Karen, Faguer, Stanislas, Fillaux, Judith, Guemas, Emilie, Iriart, Xavier, Lelièvre, Lucie, Ruiz, Jean, Bastides, Frédéric, Chesnay, Adélaïde, Desoubeaux, Guillaume, Therby, Audrey, Chachaty, Elisabeth, Gachot, Bertrand, Westerdijk Fungal Biodiversity Institute, Westerdijk Fungal Biodiversity Institute - Software and Databasing, Mycologie moléculaire - Molecular Mycology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals (CNRMA), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Dynamique des interactions hôte pathogène (DIHP), Université de Strasbourg (UNISTRA), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Nantes Université (Nantes Univ), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Rouen, Normandie Université (NU), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Ecologie et biologie des interactions (EBI), Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU de la Martinique [Fort de France], CHU Amiens-Picardie, Hôpital Cochin [AP-HP], CHU Limoges, SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques (ICAT), Université d'Angers (UA), Laboratoire de Parasitologie-Mycologie (CHU d'Angers), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Infections Respiratoires Fongiques (IRF), Université d'Angers (UA)-Université de Brest (UBO), Procédés Alimentaires et Microbiologiques [Dijon] (PAM), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Centre Hospitalier de Versailles André Mignot (CHV), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Hôpital Robert Debré Paris, Hôpital Robert Debré, Westerdijk Fungal Biodiversity Institute [Utrecht] (WI), Royal Netherlands Academy of Arts and Sciences (KNAW), Service des Maladies infectieuses et tropicales [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 (AGIR ), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Laboratoire de Parasitologie-Mycologie [CHU Angers], Hôpital Bretonneau, Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), This work was supported by recurrent financial support from Santé Publique France and Institut Pasteur. The funders had no role in study design, data collection, analysis, interpretation of data, or the decision to submit the work for publication., We thank Didier Che (Direction des Maladies Infectieuses, Santé Publique France) for his continuous support and interest in invasive fungal infections and Etienne Sevin (EpiConcept, Paris, France) for his contribution in the development of the RESSIF website using the VOOZANOO platform. We are thankful for the technical help of Catherine Blanc, Anne Boullié, Cécile Gautier, Virginie Geolier, and Damien Hoinard (Institut Pasteur) for the characterization of the isolates received at the NRCMA., The French Mycoses Study Group includes collaborators who contributed to these data by their involvement in the management of patients, expertise in diagnostic tools, and/or characterization of fungal isolates. They are listed in alphabetical order of a city in France and for each center, in alphabetical order of the last names: in Amiens, Céline Damiani, Hervé Dupont, Julien Maizel, and Anne Totet, in Angers, Jean-Philippe Bouchara, in Besançon, Anne Pauline Bellanger, Ana Berceanu, Jean Christophe Navellou, and Emeline Scherer, in Cayenne, Philippe Abboud, Christine Aznar, Denis Blanchet, and Félix Djossou, in Clermont-Ferrand, Sophie Cayot, Cyril Garrouste, Olivier Lesens, Cécile Moluçon, Céline Nourrisson, and Philippe Poirier, in Dijon, Éloïse Bailly, Louise Basmaciyan, Bouhemad Belaid, Mathieu Blot, Denis Caillot, Pierre-Emmanuel Charles, and Jean Pierre Quenot, in Fort de France, Emmanuelle Amazan, Emilie Baubion, André Cabie, Cyrille Chabartier, Christophe Deligny, Violaine Emal, Olivier Flechelle, Yves Hatchuel, Yohann Le Govic, Harold Merle, Charline Miossec, Jean-Marie Turmel, and Ruddy Valentino, in Limoges, Marie-Fleur Durieux and Pascal Turlure, in Nîmes, Victor Mercier, in Nice, Martine Gari-Toussaint, Karine Risso, and Loïc Simon, in Nantes, Cedric Bretonnière, David Boutoille, Thomas Gastinne, Karim Lakhal, Elise Launay, Thierry Lepoivre, Pierre Peterlin, Fanny Rialland, and Patrice Le Pape, in Paris, in Hôpital Cochin, Etienne Canoui, Naima Dahane, and Solène Kerneis, in Hôpital Necker-Enfants Malades, Cécile Angebault, Marie-Elisabethh Bougnoux, Nadia Guennouni, Fanny Lanternier, Bennedicte Neven, Mehdi Oualha, Anne Scemla, Emilie Sitterlé, Felipe Suarez, and Julie Toubiana, in Hôpital Robert-Debré, Stéphane Bonacorci, in Hôpital Saint-Louis, Alexandre Alanio, Anne Bergeron, Blandine Denis, Maud Gits-Muselli, Samia Hamane, and Sophie Touratier, in hôpital des XV-XX, Christine Chaumeil and Lilia Merabet, in Pointe-à-Pitre, Joelle Claudéon, Elodie Curlier, Valérie Galantine, Jean Claude Gallois, Samuel Markowicz, Muriel Nicolas, Pascal Musson, and Kinda Schepers, in Poitiers, Alida Minoza and Catherine Kauffmann-Lacroix, in Rennes, Hélène Guégan, in Rouen, Damien Costa, Marion Dehais, and Gilles Gargala, in Reims, Odile Bajolet, Firouze Banisadr, Joel Cousson, Chantal Himberlin, Antoine Huguenin, and Dominique Toubas, in Saint Etienne, Pierre Flori, Caroline Mahinc, and Hélène Raberin, in Strabourg, Julie Denis, Raoul Herbrecht, Paul-Michel Mertes, Fehrat Meziani, Marcela Sabou, and Francis Schneider, in Toulouse, Anne-Isabelle Bertozzi, Pamela Chauvin, Elena Charpentier, Olivier Cointault, Claire Cottrel, Karen Delavigne, Stanislas Faguer, Judith Fillaux, Emilie Guemas, Xavier Iriart, Lucie Lelièvre, and Jean Ruiz, in Tours, Frédéric Bastides, Adélaïde Chesnay, and Guillaume Desoubeaux, in Versailles, Audrey Therby, and in Villejuif, Elisabeth Chachaty and Bertrand Gachot., and CLEMENT, Nathalie

Subjects
Antifungal Agents, pneumocytosis, invasive fungal infections, Pneumonia, Pneumocystis, [SDV]Life Sciences [q-bio], candidemia, Microbiology, [SDV.MP.MYC] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, mucormycosis, [SDV] Life Sciences [q-bio], [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Virology, Humans, aspergillosis, epidemiology, Watchful Waiting, Fungemia, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Aged
Abstract

International audience; The French National Reference Center for Invasive Mycoses and Antifungals leads an active and sustained nationwide surveillance program on probable and proven invasive fungal diseases (IFDs) to determine their epidemiology in France. Between 2012 and 2018, a total of 10,886 IFDs were recorded. The incidence increased slightly over time (2.16 to 2.36/10,000 hospitalization days, P = 0.0562) in relation with an increase of fungemia incidence (1.03 to 1.19/10,000, P = 0.0023), while that of other IFDs remained stable. The proportion of ≥65-year-old patients increased from 38.4% to 45.3% (P < 0.0001). Yeast fungemia (n = 5,444) was due mainly to Candida albicans (55.6%) with stable proportions of species over time. Echinocandins became the main drug prescribed (46.7% to 61.8%), but global mortality rate remained unchanged (36.3% at 1 month). Pneumocystis jirovecii pneumonia (n = 2,106) was diagnosed mostly in HIV-negative patients (80.7%) with a significantly higher mortality than in HIV-positive patients (21.9% versus 5.4% at 1 month, P < 0.0001). Invasive aspergillosis (n = 1,661) and mucormycosis (n = 314) were diagnosed mostly in hematology (>60% of the cases) with a global mortality rate of 42.5% and 59.3%, respectively, at 3 months and significant changes in diagnosis procedure over time. More concurrent infections were also diagnosed over time (from 5.4% to 9.4% for mold IFDs, P = 0.0115). In conclusion, we observed an aging of patients with IFD with a significant increase in incidence only for yeast fungemia, a trend toward more concurrent infections, which raises diagnostic and therapeutic issues. Overall, global survival associated with IFDs has not improved despite updated guidelines and new diagnostic tools.IMPORTANCE The epidemiology of invasive fungal diseases (IFDs) is hard to delineate given the difficulties in ascertaining the diagnosis that is often based on the confrontation of clinical and microbiological criteria. The present report underlines the interest of active surveillance involving mycologists and clinicians to describe the global incidence and that of the main IFDs. Globally, although the incidence of Pneumocystis pneumonia, invasive aspergillosis, and mucormycosis remained stable over the study period (2012 to 2018), that of yeast fungemia increased slightly. We also show here that IFDs seem to affect older people more frequently. The most worrisome observation is the lack of improvement in the global survival rate associated with IFDs despite the increasing use of more sensitive diagnostic tools, the availability of new antifungal drugs very active in clinical trials, and a still low/marginal rate of acquired in vitro resistance in France. Therefore, other tracks of improvement should be investigated actively.

Published
2022
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12. New Insights into Blood Circulating Lymphocytes in Human Pneumocystis Pneumonia

Author

Charpentier, Eléna, primary, Marques, Catherine, additional, Ménard, Sandie, additional, Chauvin, Pamela, additional, Guemas, Emilie, additional, Cottrel, Claire, additional, Cassaing, Sophie, additional, Fillaux, Judith, additional, Valentin, Alexis, additional, Blanchard, Nicolas, additional, Berry, Antoine, additional, and Iriart, Xavier, additional

Published
2021
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13. Misdiagnosis of imported falciparum malaria from African areas due to an increased prevalence of pfhrp2/pfhrp3 gene deletion: the Djibouti case

Author

Iriart, Xavier, Menard, Sandie, Chauvin, Pamela, Mohamed, Hasna, Charpentier, Elena, Mohamed, Mohamed, Berry, Antoine, Aboubaker, Mohamed, PINIER, CHRISTINE, Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Parasitologie et Mycologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Général Peltier, and Laboratoire d’analyse médicale Mer Rouge

Subjects
MESH: Antigens, Protozoan / genetics, MESH: Humans, Plasmodium falciparum, MESH: Protozoan Proteins / genetics, MESH: Djibouti, histidine-rich protein 2, rapid diagnostic test, MESH: Sensitivity and Specificity, MESH: Population Surveillance, MESH: Plasmodium falciparum / classification, MESH: Gene Deletion, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, parasitic diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Diagnostic Errors, Djibouti, deletion, MESH: Malaria, Falciparum / diagnosis, MESH: Plasmodium falciparum / genetics, MESH: Prevalence, MESH: Diagnostic Tests, Routine
Abstract

International audience; Following the diagnosis of a falciparum malaria case imported from Djibouti and not detected by a pfHRP2-based rapid diagnostic test (RDT), we investigated the prevalence of the pfhrp2/pfhrp3-deleted parasites in Djibouti using 378 blood samples collected between January and May 2019, from Djiboutian patients with suspected malaria. Malaria diagnosis by quantitative PCR confirmed the presence of Plasmodium falciparum for 20.9% (79/378) samples while RDTs did not detect HRP2 antigen in 83.5% (66/79) of these samples. Quantitative PCRs targeting the pfhrp2/pfhrp3 genes confirmed the absence of both genes for 86.5% of P. falciparum strains. The very large number (86.5%) of falciparum parasites lacking the pfhrp2/pfhrp3 genes observed in this study, now justifies the use of non-HRP2 alternative RDTs in Djibouti. In this area and in most countries where HRP2-based RDTs constitute the main arsenal for falciparum malaria diagnosis, it is important to implement a systematic surveillance and to inform biologists and clinicians about the risk of malaria misdiagnosis. Further investigations are needed to better understand the mechanism of selection and diffusion of the pfhrp2/pfhrp3-deleted parasites

Published
2020
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14. Real-time PCR for diagnosis of imported schistosomiasis

Author

Guegan, Hélène, Fillaux, Judith, Charpentier, Elena, Robert-gangneux, Florence, Chauvin, Pamela, Guemas, Emilie, Boissier, Jérôme, Valentin, Alexis, Cassaing, Sophie, Gangneux, Jean-pierre, Berry, Antoine, Iriart, Xavier, Guegan, Hélène, Fillaux, Judith, Charpentier, Elena, Robert-gangneux, Florence, Chauvin, Pamela, Guemas, Emilie, Boissier, Jérôme, Valentin, Alexis, Cassaing, Sophie, Gangneux, Jean-pierre, Berry, Antoine, and Iriart, Xavier

Abstract

Background The diagnosis of schistosomiasis currently relies on microscopic detection of schistosome eggs in stool or urine samples and serological assays. The poor sensitivity of standard microscopic procedures performed in routine laboratories, makes molecular detection methods of increasing interest. The aim of the study was to evaluate two in-house real-time Schistosoma PCRs, targeting respectively S. mansoni [Sm] and S. haematobium [Sh] in excreta, biopsies and sera as potential tools to diagnose active infections and to monitor treatment efficacy. Methods Schistosoma PCRs were performed on 412 samples (124 urine, 86 stools, 8 biopsies, 194 sera) from patients with suspected schistosomiasis, before anti-parasitic treatment. Results were compared to microscopic examination and serological assays (enzyme-linked immunosorbent assay (ELISA), indirect haemagglutination (HA) and Western Blot (WB) assay). Results Compared to microscopy, PCRs significantly increased the sensitivity of diagnosis, from 4% to 10.5% and from 33.7% to 48.8%, for Sh in urine and Sm in stools, respectively. The overall sensitivity of PCR on serum samples was 72.7% and reached 94.1% in patients with positive excreta (microscopy). The specificity of serum PCR was 98.9%. After treatment, serum PCR positivity rates slowly declined from 93.8% at day 30 to 8.3% at day 360, whereas antibody detection remained positive after 1 year. Conclusion Schistosoma PCRs clearly outperform standard microscopy on stools and urine and could be part of reference methods combined with WB-based serology, which remains a gold standard for initial diagnosis. When serological assays are positive and microscopy is negative, serum PCRs provide species information to guide further clinical exploration. Biomarkers such as DNA and antibodies are of limited relevance for early treatment monitoring but serum PCR could be useful when performed at least 1 year after treatment to help confirm a cured infection. Author summary Sc

Published
2019
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15. Optimization of MALDI-ToF mass spectrometry for yeast identification: a multicenter study

Author

Normand, Anne-Cécile, primary, Gabriel, Frédéric, primary, Riat, Arnaud, primary, Cassagne, Carole, primary, Bourgeois, Nathalie, primary, Huguenin, Antoine, primary, Chauvin, Pamela, primary, De Geyter, Deborah, primary, Bexkens, Michiel, primary, Rubio, Elisa, primary, Hendrickx, Marijke, primary, Ranque, Stéphane, primary, and Piarroux, Renaud, primary

Published
2019
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16. Real-time PCR for diagnosis of imported schistosomiasis

Author

Guegan, Hélène, primary, Fillaux, Judith, additional, Charpentier, Eléna, additional, Robert-Gangneux, Florence, additional, Chauvin, Pamela, additional, Guemas, Emilie, additional, Boissier, Jérôme, additional, Valentin, Alexis, additional, Cassaing, Sophie, additional, Gangneux, Jean-Pierre, additional, Berry, Antoine, additional, and Iriart, Xavier, additional

Published
2019
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17. No evidence of pathogenicity of Dientamoeba fragilisfollowing detection in stools: A case-control study

Author

Tchamwa Bamini, Germain, Charpentier, Eléna, Guemas, Emilie, Chauvin, Pamela, Fillaux, Judith, Valentin, Alexis, Cassaing, Sophie, Ménard, Sandie, Berry, Antoine, Iriart, Xavier, Tchamwa Bamini, Germain, Charpentier, Eléna, Guemas, Emilie, Chauvin, Pamela, Fillaux, Judith, Valentin, Alexis, Cassaing, Sophie, Ménard, Sandie, Berry, Antoine, and Iriart, Xavier

Abstract

Dientamoeba fragilisis a ubiquitous intestinal parasite with detection in the stools that has become increasingly frequent following the advent of PCR as a routine screening tool. However, the pathogenicity of this parasite is still much debated. In order to assess the potentially pathogenic nature of this protozoan, a retrospective case-control study was carried out between January and December 2020 on patients from Toulouse University Hospital, with the aim of evaluating the potential clinical effects and changes in laboratory parameters linked to the presence and load of D. fragilisin stools. After matching age, sex and mode of care (consultation or hospitalisation), no significant difference was observed in the frequency of clinical signs between the 36 patients who tested positive for Dientamoeba fragilisPCR in their stools and the 72 control patients who were PCR negative for this protozoan. The presence of D. fragilisin the faeces was not associated with changes in laboratory parameters. Furthermore, a high digestive load of D. fragilishad no identifiable impact on clinical and laboratory parameters. Only the concomitant presence of Blastocystissp. in stools was significantly more frequent in the D. fragilisgroup (uni- and multivariate analysis). Finally, this study showed no significant difference in clinical or laboratory signs between patients carrying Dientamoeba fragilisand the control group, regardless of the intestinal parasite load, suggesting that D. fragiliscould be considered a commensal of the digestive tract.

Published
2024
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18. Optimization of MALDI-ToF mass spectrometry for yeast identification: a multicenter study.

Author

Normand, Anne-Cécile, Gabriel, Frédéric, Riat, Arnaud, Cassagne, Carole, Bourgeois, Nathalie, Huguenin, Antoine, Chauvin, Pamela, Geyter, Deborah De, Bexkens, Michiel, Rubio, Elisa, Hendrickx, Marijke, Ranque, Stéphane, and Piarroux, Renaud

Abstract

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-ToF MS) is routinely used in mycology laboratories to rapidly identify pathogenic yeasts. Various methods have been proposed to perform routine MS-based identification of clinically relevant species. In this study, we focused on Bruker technology and assessed the identification performance of three protocols: two pretreatment methods (rapid formic acid extraction directly performed on targets and full extraction using formic acid/acetonitrile in tubes) and a direct deposit protocol that omits the extraction step. We also examined identification performance using three target types (ground-steel, polished-steel, and biotargets) and two databases (Bruker and online MSI [biological-mass-spectrometry-identification application]) in a multicenter manner. Ten European centers participated in the study, in which a total of 1511 yeast isolates were analyzed. The 10 centers prospectively performed the three protocols on approximately 150 yeast isolates each, and the corresponding spectra were then assessed against two reference spectra databases (MSI and Bruker), with appropriate thresholds. Three centers evaluated the impact of the targets. Scores were compared between the various combinations, and identification accuracy was assessed. The protocol omitting the extraction step was inappropriate for yeast identification, while the full extraction method yielded far better results. Rapid formic acid extraction yielded variable results depending on the target, database and threshold. Selecting the optimal extraction method in combination with the appropriate target, database and threshold may enable simple and accurate identification of clinically relevant yeast samples. Concerning the widely used polished-steel targets, the full extraction method still ensured better scores and better identification rates. [ABSTRACT FROM AUTHOR]

Published
2020
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22. Multicenter Outbreak of Infections by Saprochaete clavata , an Unrecognized Opportunistic Fungal Pathogen

Author

Vaux, Sophie, Criscuolo, Alexis, Desnos-Ollivier, Marie, Diancourt, Laure, Tarnaud, Chloé, Vandenbogaert, Matthias, Brisse, Sylvain, Coignard, Bruno, Dromer, Françoise, Garcia-Hermoso, Dea, Blanc, Catherine, Hoinard, Damien, Lortholary, Olivier, Bretagne, Stéphane, Thiolet, Jean-Michel, de Valk, Henriette, Courbil, Rémi, Chabanel, Anne, Simonet, Marion, Maire, Francoise, Jbilou, Saadia, Tiberghien, Pierre, Blanchard, Hervé, Venier, Anne-Gaëlle, Bernet, Claude, Simon, Loïc, Sénéchal, Hélène, Pouchol, Elodie, Angot, Christiane, Ribaud, Patricia, Socié, G., Flèche, M., Brieu, Nathalie, Lagier, Evelyne, Chartier, Vanessa, Allegre, Thierry, Maulin, Laurence, Lanic, Hélène, Tilly, Hervé, Bouchara, Jean-Philippe, Pihet, Marc, Schmidt, Aline, Kouatchet, Achille, Vandamme, Yves-Marie, Ifrah, Norbert, Mercat, Alain, Accoceberry, Isabelle, Albert, Olivier, Leguay, Thibaut, Rogues, Anne-Marie, Bonhomme, Julie, Reman, Oumédaly, Lesteven, Claire, Poirier, Philippe, Chabrot, Cécile Molucon, Calvet, Laure, Baud, Olivier, Cambon, Monique, Farkas, Jean Chistophe, Lafon, Bruno, Dalle, Frédéric, Caillot, Denis, Lazzarotti, Aline, Aho, Serge, Combret, Sandrine, Facon, Thierry, Sendid, Boualem, Loridant, Séverine, Louis, Terriou, Cazin, Bruno, Grandbastien, Bruno, Bourgeois, Nathalie, Lotthé, Anne, Cartron, Guillaume, Ravel, Christophe, Colson, Pascal, Gaudard, Philippe, Bonmati, Caroline, Simon, Loic, Rabaud, Christian, Machouart, Marie, Poisson, Didier, Carp, Diana, Meunier, Jérôme, Gaschet, Anne, Miquel, Chantal, Sanhes, Laurence, Ferreyra, Milagros, Leibinger, Franck, Geudet, Philippe, Toubas, Dominique, Himberlin, Chantal, Bureau-Chalot, Florence, Delmer, Alain, Favennec, Loïc, Gargala, Gilles, Michot, Jean-Baptiste, Girault, Christophe, David, Marion, Leprêtre, Stéphane, Jardin, Fabrice, Honderlick, Pierre, Caille, Vincent, Cerf, Charles, Cassaing, Sophie, Recher, Christian, Picard, Muriel, Protin, Caroline, Huguet, Françoise, Huynh, Anne, Ruiz, Jean, Riu-Poulenc, Béatrice, Letocart, Philippe, Marchou, Bruno, Verdeil, Xavier, Cavalié, Laurent, Chauvin, Pamela, Iriart, Xavier, Valentin, Alexis, Bouvet, Emmanuelle, Delmas-Marsalet, Béatrice, Jeblaoui, Asma, Kassis-Chikhani, Najiby, Mühlethaler, Konrad, Zimmerli, Stefan, Zalar, Polona, Sánchez-Reus, Ferran, Gurgui, Merce, Institut de Veille Sanitaire (INVS), Génotypage des Pathogènes et Santé Publique (Plate-forme) (PF8), Institut Pasteur [Paris], Génétique Evolutive Humaine - Human Evolutionary Genetics, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Immunologie des Infections fongiques - immunology of fungal infections, Génomique évolutive des Microbes / Microbial Evolutionary Genomics, Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire (CNRMA), Institut Pasteur [Paris] (IP), and Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Genotype, Molecular Sequence Data, Geotrichum-capitatum, Fungal contamination, Sequence Homology, High-throughput, Diseases, Fungus, Sequences, Microbiology, Saprochaete clavata, Disease Outbreaks, 03 medical and health sciences, Yeasts, Virology, Cluster Analysis, DNA, Fungal, Mycological Typing Techniques, Clade, Pathogen, Genotyping, Phylogeny, Alignment, Blastoschizomyces-capitatus, 030304 developmental biology, Cross Infection, Molecular Epidemiology, 0303 health sciences, Leukemia, biology, 030306 microbiology, Outbreak, Sequence Analysis, DNA, Agents, Fungal pathogen, biology.organism_classification, QR1-502, 3. Good health, Molecular Typing, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Mycoses, Saccharomycetales, [SDV.IMM]Life Sciences [q-bio]/Immunology, Health Facilities, France, Research Article
Abstract

Rapidly fatal cases of invasive fungal infections due to a fungus later identified as Saprochaete clavata were reported in France in May 2012. The objectives of this study were to determine the clonal relatedness of the isolates and to investigate possible sources of contamination. A nationwide alert was launched to collect cases. Molecular identification methods, whole-genome sequencing (WGS), and clone-specific genotyping were used to analyze recent and historical isolates, and a case-case study was performed. Isolates from thirty cases (26 fungemias, 22 associated deaths at day 30) were collected between September 2011 and October 2012. Eighteen cases occurred within 8 weeks (outbreak) in 10 health care facilities, suggesting a common source of contamination, with potential secondary cases. Phylogenetic analysis identified one clade (clade A), which accounted for 16/18 outbreak cases. Results of microbiological investigations of environmental, drug, or food sources were negative. Analysis of exposures pointed to a medical device used for storage and infusion of blood products, but no fungal contamination was detected in the unused devices. Molecular identification of isolates from previous studies demonstrated that S. clavata can be found in dairy products and has already been involved in monocentric outbreaks in hematology wards. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen. This report also underlines further the potential of WGS for investigation of outbreaks due to uncommon fungal pathogens., IMPORTANCE Several cases of rapidly fatal infections due to the fungus Saprochaete clavata were reported in France within a short period of time in three health care facilities, suggesting a common source of contamination. A nationwide alert collected 30 cases over 1 year, including an outbreak of 18 cases over 8 weeks. Whole-genome sequencing (WGS) was used to analyze recent and historical isolates and to design a clade-specific genotyping method that uncovered a clone associated with the outbreak, thus allowing a case-case study to analyze the risk factors associated with infection by the clone. The possibility that S. clavata may transmit through contaminated medical devices or can be associated with dairy products as seen in previous European outbreaks is highly relevant for the management of future outbreaks due to this newly recognized pathogen.

Published
2014
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23. Prevalence ofPlasmodium falciparumparasites resistant to sulfadoxine/pyrimethamine in pregnant women in Yaoundé, Cameroon: emergence of highly resistantpfdhfr/pfdhpsalleles

Author

Chauvin, Pamela, primary, Menard, Sandie, additional, Iriart, Xavier, additional, Nsango, Sandrine E., additional, Tchioffo, Majoline T., additional, Abate, Luc, additional, Awono-Ambéné, Parfait H., additional, Morlais, Isabelle, additional, and Berry, Antoine, additional

Published
2015
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24. Mucormycose pulmonaire chez un enfant diabétique

Author

Fougère, Claire, Bremont, François, Serres, Isabelle, Iriart, Xavier, Fillaux, Judith, Gayda, Fabien, Martin-Blondel, Guillaume, Berry, Antoine, Berjaud, Jean, Da Costa, Maeva, Chauvin, Pamela, Martin-Blondel, Audrey, Blanchon, Sylvain, Lanternier, Fanny, Lortholary, Olivier, Dahan, Marcel, and Cassaing, Sophie

Published
2017
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25. Concomitant cases of disseminatedGeotrichum clavatuminfections in patients with acute myeloid leukemia

Author

Picard, Muriel, primary, Cassaing, Sophie, additional, Letocart, Philippe, additional, Verdeil, Xavier, additional, Protin, Caroline, additional, Chauvin, Pamela, additional, Iriart, Xavier, additional, Cavalié, Laurent, additional, Valentin, Alexis, additional, Marchou, Bruno, additional, Ruiz, Jean, additional, Riu-Poulenc, Béatrice, additional, Huguet, Françoise, additional, and Récher, Christian, additional

Published
2013
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26. An extraction method of positive blood cultures for direct identification ofCandidaspecies by Vitek MS matrix-assisted laser desorption ionization time of flight mass spectrometry

Author

Lavergne, Rose-Anne, primary, Chauvin, Pamela, additional, Valentin, Alexis, additional, Fillaux, Judith, additional, Roques-Malecaze, Christine, additional, Arnaud, Sylvie, additional, Menard, Sandie, additional, Magnaval, Jean-François, additional, Berry, Antoine, additional, Cassaing, Sophie, additional, and Iriart, Xavier, additional

Published
2013
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27. An extraction method of positive blood cultures for direct identification of Candida species by Vitek MS matrix-assisted laser desorption ionization time of flight mass spectrometry.

Author

Lavergne, Rose-Anne, Chauvin, Pamela, Valentin, Alexis, Fillaux, Judith, Roques-Malecaze, Christine, Arnaud, Sylvie, Menard, Sandie, Magnaval, Jean-François, Berry, Antoine, Cassaing, Sophie, and Iriart, Xavier

Abstract

Candida spp. are an important cause of nosocomial bloodstream infections. Currently, complete identification of yeasts with conventional methods takes several days. We report here the first evaluation of an extraction method associated with the Vitek MS matrix-assisted laser desorption ionization time of flight mass spectrometry for direct identification of Candida species from positive blood cultures. We evaluated this protocol with blood cultures that were inoculated with reference and routine isolates (eight reference strains, 30 patients isolates and six mixed cultures containing two strains of different Candida species), or from patients with candidemia (28 isolates). This method performed extremely well (97% correct identification) with blood cultures of single Candida spp. and significantly reduced the time of diagnosis. Nevertheless, subculture remains indispensable to test fungal resistance and to detect mixed infections. [ABSTRACT FROM AUTHOR]

Published
2013
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28. Concomitant cases of disseminated Geotrichum clavatum infections in patients with acute myeloid leukemia.

Author

Picard, Muriel, Cassaing, Sophie, Letocart, Philippe, Verdeil, Xavier, Protin, Caroline, Chauvin, Pamela, Iriart, Xavier, Cavalié, Laurent, Valentin, Alexis, Marchou, Bruno, Ruiz, Jean, Riu-Poulenc, Béatrice, Huguet, Françoise, and Récher, Christian

Subjects
ACUTE leukemia, MYELOID leukemia, GEOTRICHUM, INFECTION, PATIENTS
Abstract

The article presents case studies of a 46 year old female patient, a 70 year old male patient and a 63 year old female patient who were all admitted to a hospital for treatment of acute myeloid leukemia. A discussion of disseminated Geotrichum infections which were diagnosed in the patients, and which played a role in the death of each of the patients, is presented.

Published
2014
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29. Performance of seven commercial automated assays for the detection of low levels of anti-ToxoplasmaIgG in French immunocompromised patients

Author

Douet, Tiphaine, Armengol, Catherine, Charpentier, Elena, Chauvin, Pamela, Cassaing, Sophie, Iriart, Xavier, Berry, Antoine, Fillaux, Judith, Douet, Tiphaine, Armengol, Catherine, Charpentier, Elena, Chauvin, Pamela, Cassaing, Sophie, Iriart, Xavier, Berry, Antoine, and Fillaux, Judith

Abstract

Background: Immunocompromised patients are at high risk for the development of severe toxoplasmosis from tissue cyst reactivation, the most frequently, or from recently acquired acute infections. Knowledge of serologic status is therefore crucial. Screening for toxoplasmosis is sometimes performed while patients are already immunocompromised and have a low or even undetectable IgG titer by routine automated enzyme immunoassays. The aim of this study was to assess the sensitivity and specificity of seven reagents for the detection of low levels of IgG. Sera from 354 patients were collected and analysed. Results: Elecsys®offered the best analytic performances, superior to those of Architect®and Platelia®, which were superior to those of Access II®and TGS TA®. Vidas II®and Liaison II®reagents exhibited poor analytical performances in this cohort. For Elecsys®, Platelia®and Architect®, new thresholds for the grey zone and positive zone have been defined to improve the sensitivity of these reagents while maintaining excellent specificity. Conclusions: Commercialized assays for toxoplasmosis screening are not suitable for IgG low-level detection in patients without adapting the supplier thresholds to avoid false negative results and risk generalized toxoplasmosis.

Published
2019
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30. Fatal mucormycosis and aspergillosis coinfection associated with haemophagocytic lymphohistiocytosis: A case report and literature review.

Author

Loubet D, Sarton B, Lelièvre L, Grouteau G, Iriart X, Chauvin P, Fillaux J, Valentin A, Berry A, Silva S, Bonneville F, Cassaing S, and Guemas E

Subjects
Humans, Antifungal Agents therapeutic use, Fungi, Mucormycosis complications, Mucormycosis diagnosis, Mucormycosis drug therapy, Coinfection complications, Coinfection diagnosis, Coinfection drug therapy, Lymphohistiocytosis, Hemophagocytic complications, Lymphohistiocytosis, Hemophagocytic diagnosis, Lymphohistiocytosis, Hemophagocytic drug therapy, Aspergillosis complications, Aspergillosis diagnosis, Aspergillosis drug therapy
Abstract

Invasive mould infections are life-threatening and mainly occur in immunocompromised patients. Whereas aspergillosis is described during haemophagocytic lymphohistiocytosis (HLH), only a few cases of concomitant mucormycosis with HLH have been reported. Here, we present an uncommon coinfection of mucormycosis and aspergillosis associated with HLH probably due to a varicella zoster virus (VZV) viraemia which was unresponsive to triple antifungal therapy (liposomal amphotericin B combined with isavuconazole and caspofungin). A review of the cases of mucormycosis with HLH showed that this uncommon association was always lethal and underscored the relevance of screening for mould infections in patients with HLH., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest., (Copyright © 2022 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Published
2023
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31. Misdiagnosis of imported falciparum malaria from African areas due to an increased prevalence of pfhrp2/pfhrp3 gene deletion: the Djibouti case.

Author

Iriart X, Menard S, Chauvin P, Mohamed HS, Charpentier E, Mohamed MA, Berry A, and Aboubaker MH

Subjects
Diagnostic Errors, Diagnostic Tests, Routine, Djibouti, Humans, Plasmodium falciparum classification, Population Surveillance, Prevalence, Sensitivity and Specificity, Antigens, Protozoan genetics, Gene Deletion, Malaria, Falciparum diagnosis, Plasmodium falciparum genetics, Protozoan Proteins genetics
Abstract

Following the diagnosis of a falciparum malaria case imported from Djibouti and not detected by a pfHRP2-based rapid diagnostic test (RDT), we investigated the prevalence of the pfhrp2/pfhrp3 -deleted parasites in Djibouti using 378 blood samples collected between January and May 2019, from Djiboutian patients with suspected malaria. Malaria diagnosis by quantitative PCR confirmed the presence of Plasmodium falciparum for 20.9% (79/378) samples while RDTs did not detect HRP2 antigen in 83.5% (66/79) of these samples. Quantitative PCRs targeting the pfhrp2/pfhrp3 genes confirmed the absence of both genes for 86.5% of P. falciparum strains. The very large number (86.5%) of f alciparum parasites lacking the pfhrp2/pfhrp3 genes observed in this study, now justifies the use of non-HRP2 alternative RDTs in Djibouti. In this area and in most countries where HRP2-based RDTs constitute the main arsenal for falciparum malaria diagnosis, it is important to implement a systematic surveillance and to inform biologists and clinicians about the risk of malaria misdiagnosis. Further investigations are needed to better understand the mechanism of selection and diffusion of the pfhrp2/pfhrp3 -deleted parasites.

Published
2020
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