71 results on '"I. Accoceberry"'
Search Results
2. Casponfungine, où en est-on des adaptations posologiques ? Retour d'expérience d'un centre hospitalier universitaire
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L. Renaud, P. Marque, N. Issa, I. Accoceberry, A. Dewitte, O. Gebrouin, C. Cazanave, S. Pedeboscq, V. Servant, and M. Lahouati
- Published
- 2023
3. Pneumocystosis and quantitative PCR
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G. Baulier, O. Guisset, Frédéric Gabriel, Fabrice Camou, Naoum P. Issa, I. Accoceberry, and G. Mourissoux
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,030106 microbiology ,Direct examination ,Human immunodeficiency virus (HIV) ,Context (language use) ,Real-Time Polymerase Chain Reaction ,medicine.disease_cause ,Pneumocystis pneumonia ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Pneumocystosis ,Humans ,Pneumocystis jirovecii ,030212 general & internal medicine ,Aged ,Retrospective Studies ,biology ,business.industry ,Pneumonia, Pneumocystis ,Retrospective cohort study ,Middle Aged ,biology.organism_classification ,medicine.disease ,Infectious Diseases ,Real-time polymerase chain reaction ,Female ,business - Abstract
Objective Pneumocystis pneumonia (PCP) is now predominantly observed in immunosuppressed non-HIV-infected patients. The sensitivity of the PCR is here higher than direct examination (DE) of respiratory secretions because the infection is caused by a lower inoculum of Pneumocystis jirovecii (P. jirovecii). The objective of our retrospective study was to assess the contribution of quantitative PCR (qPCR) in the diagnosis of PCP. Patients and methods All patients hospitalized for PCP suspicion with a positive qPCR were included. Irrespective of the qPCR value, patients were initially classified into two groups (infection and colonization [PCP ruled out]) based on clinical, radiological, and microbiological data. Both groups were then compared based on the qPCR value. Results Between 2013 and 2016, 150 patients were included; 75% of them were not infected with HIV. The diagnosis of PCP was retained for 129 patients and rejected for 21 patients. The DE was negative in 60% of PCP cases. The median value of qPCR was 76,650 copies/mL among infected patients and 3220 copies/mL among colonized patients. The threshold corresponding to a specificity of 100% was 56,000 copies/mL. The optimal value to distinguish an infection from a colonization was 10,100 copies/mL. Conclusion Our study confirms the diagnostic value of the qPCR in immunosuppressed patients, especially when the DE is negative. When the qPCR is ˂ 56,000 copies/mL, the result should be interpreted based on the clinical context and paraclinical examinations.
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- 2018
4. Infections de matériel prothétique ostéoarticulaire à Aspergillus fumigatus
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Frédéric Gabriel, Michel Dupon, Garrett A. Wirth, H Dutronc, I. Accoceberry, and S. de Faucal
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0301 basic medicine ,03 medical and health sciences ,Infectious Diseases ,biology ,business.industry ,030106 microbiology ,Medicine ,business ,Joint infections ,biology.organism_classification ,Microbiology ,Aspergillus fumigatus - Published
- 2018
5. Spondylodiscite à Scedosporium apiospermum chez un patient immunocompétent : à propos d’un cas et revue de la littérature
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M. Masson, Charles Cazanave, F. Gabriel, Hervé Dutronc, M. Puges, and I. Accoceberry
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Rheumatology - Abstract
Introduction Scedosporium spp. sont des champignons filamenteux presents dans le sol, les eaux usees et stagnantes. Scedosporium apiospermum est responsable d’un large spectre d’infections allant d’une atteinte cutanee superficielle a une infection disseminee. Observation Nous rapportons ici le cas d’un homme immunocompetent de 27 ans ayant developpe une spondylodiscite a S. apiospermum associee a des lesions pulmonaires, ophtalmiques et cerebrales apres une noyade. Le tableau a debute par un syndrome de detresse respiratoire aigue. De la fievre est apparue apres quelques semaines. Une hemoculture est revenue positive pour Ochrobactrum intermedium, germe Gram-negatif, proche de Brucella spp. Les prelevements pulmonaires ont permis d’isoler Burkholderia cepacia. Il a alors beneficie de plusieurs lignes d’antibiotiques. Peu de temps apres, le patient a signale des cervicalgies. L’IRM a revele une spondylodiscite en C3–C4 avec epidurite anterieure et le scanner, la presence de micronodules pulmonaires diffus avec une lesion excavee du lobe superieur droit, et un epanchement pleural homolateral. Les hemocultures etaient negatives, de meme que la recherche d’une tuberculose, les serologies VIH, le VHC, VHB, Brucella sp., Bartonella sp., Coxiella burnetii et Aspergillus sp. Il n’y avait aucun argument echographique pour une endocardite. Une biopsie disco-vertebrale a ete effectuee dont la culture fongique a permis d’isoler S. apiospermum. Le meme champignon filamenteux a egalement ete retrouve dans les prelevements bronchopulmonaires. Un traitement antifongique par voriconazole a ete debute, dont le taux serique est reste infra-therapeutique, malgre la majoration de la posologie. L’analyse genetique a revele un profil heterozygote CYP2C191*/1*7, conferant un phenotype de metaboliseur ultrarapide. Par consequent, le traitement a ete remplace par du posaconazole. Aucune intervention chirurgicale n’a ete necessaire. Le patient a recu un total de 6 mois de therapie antifongique. L’evolution clinique a ete favorable a la fin du traitement et 6 mois apres, avec une resolution complete des symptomes. Discussion Jusqu’a present, 12 cas de spondylodiscites ont ete decrits dans la litterature. L’etage lombaire etait la localisation la plus frequente. Plusieurs methodes permettent de faire le diagnostic, mais la culture reste necessaire pour les tests de susceptibilite, car Scedosporium spp. ont une susceptibilite limitee aux antifongiques actuels. Le prise en charge necessite un traitement antifongique prolonge, souvent associee a une intervention chirurgicale. Une chirurgie a ete necessaire dans neuf cas decrits. La duree mediane du traitement etait de 13 mois. Le voriconazole est l’antifongique le plus efficace contre S. apiospermum, et est actuellement recommande comme therapie de premiere ligne. Une immunodepression est un facteur de risque important d’infections disseminee, mais des cas chez des patients immunocompetents ont ete signales, classiquement dans un contexte de noyade. L’atteinte des poumons et du systeme nerveux central est frequente dans ce contexte, alors que seulement 5 cas de spondylodiscites ont ete decrits. Conclusion La rarete de cette infection peut entrainer un retard de diagnostic qui doit etre envisage lorsque les cultures bacteriennes sont negatives, en particulier apres une noyade. Des localisations secondaires doivent etre recherchees, notamment cerebrales.
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- 2020
6. Species Identification and
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S, Imbert, A C, Normand, S, Ranque, J M, Costa, J, Guitard, I, Accoceberry, C, Bonnal, A, Fekkar, N, Bourgeois, S, Houzé, C, Hennequin, R, Piarroux, E, Dannaoui, and F, Botterel
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Azoles ,Echinocandins ,Antifungal Agents ,Aspergillus ,Susceptibility ,Amphotericin B ,Humans ,Microbial Sensitivity Tests ,Itraconazole ,bacterial infections and mycoses - Abstract
Aspergillus section Terrei is a species complex currently comprised of 14 cryptic species whose prevalence in clinical samples as well as antifungal susceptibility are poorly known. The aims of this study were to investigate A. Terrei clinical isolates at the species level and to perform antifungal susceptibility analyses by reference and commercial methods. Eighty-two clinical A. Terrei isolates were collected from 8 French university hospitals. Molecular identification was performed by sequencing parts of beta-tubulin and calmodulin genes. MICs or minimum effective concentrations (MECs) were determined for 8 antifungal drugs using both EUCAST broth microdilution (BMD) methods and concentration gradient strips (CGS). Among the 79 A. Terrei isolates, A. terreus stricto sensu (n = 61), A. citrinoterreus (n = 13), A. hortai (n = 3), and A. alabamensis (n = 2) were identified. All strains had MICs of ≥1 mg/liter for amphotericin B, except for two isolates (both A. hortai) that had MICs of 0.25 mg/liter. Four A. terreus isolates were resistant to at least one azole drug, including one with pan-azole resistance, yet no mutation in the CYP51A gene was found. All strains had low MECs for the three echinocandins. The essential agreements (EAs) between BMD and CGS were >90%, except for those of amphotericin B (79.7%) and itraconazole (73.4%). Isolates belonging to the A. section Terrei identified in clinical samples show wider species diversity beyond the known A. terreus sensu stricto. Azole resistance inside the section Terrei is uncommon and is not related to CYP51A mutations here. Finally, CGS is an interesting alternative for routine antifungal susceptibility testing.
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- 2017
7. [Aspergillus fumigatus prosthetic bone and joint infections]
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S, de Faucal, G, Wirth, H, Dutronc, F, Gabriel, I, Accoceberry, and M, Dupon
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Male ,Arthritis, Infectious ,Antifungal Agents ,Prosthesis-Related Infections ,Tibia ,Coinfection ,Arthroplasty, Replacement, Hip ,Aspergillus fumigatus ,Staphylococcal Infections ,Abscess ,Anti-Bacterial Agents ,Osteotomy ,Debridement ,Diabetes Mellitus, Type 2 ,Neoplasms ,Surgical Wound Dehiscence ,Aspergillosis ,Humans ,Surgical Wound Infection ,Female ,Disease Susceptibility ,Hip Prosthesis ,Aged - Published
- 2017
8. Reverse line blot hybridisation screening of Pseudallescheria/Scedosporium species in patients with cystic fibrosis
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R. Li, A. H. G. Gerrits van den Ende, Jean-Philippe Bouchara, Laurence Delhaes, I. Accoceberry, Isabelle Durand-Joly, Qiaoyun Lu, F. Hernandez, and G.S. de Hoog
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0303 health sciences ,biology ,Scedosporium prolificans ,030306 microbiology ,Pseudallescheria ,Dermatology ,General Medicine ,biology.organism_classification ,medicine.disease ,Cystic fibrosis ,Microbiology ,Scedosporium ,Pseudallescheria boydii ,Blot ,03 medical and health sciences ,Infectious Diseases ,medicine ,Sputum ,In patient ,medicine.symptom ,030304 developmental biology - Abstract
The PCR-RLB (reverse line blot hybridisation) was applied as a molecular technique for the detection of members of Pseudallescheria and Scedosporium from sputum of patients with cystic fibrosis (CF). Fifty-nine sputum samples were collected from 52 CF patients, which were analysed by culture and PCR-RLB. Conventional and semi-selective culture yielded five positive samples, but the PCR-RLB hybridisation assay permitted the detection of members of Pseudallescheria/Scedosporium in 32 out of 52 patients (61.5%). In total, PCR-RLB yielded 47 positives. Pseudallescheria apiosperma was detected in 20 samples, while Pseudallescheria boydii and Pseudallescheria aurantiacum were detected in 17 and eight samples, respectively. Six samples gave a positive reaction with two distinct species-specific probes and one sample with three probes. In conclusion, the PCR-RLB assay described in this study allows the detection of Scedosporium spp. in CF sputum samples and the identification of Pseudallescheria apiosperma, P. boydii, S. aurantiacum, Scedosporium prolificans and Pseudallescheria minutispora.
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- 2011
9. Apport de la PCR pour le diagnostic de pneumocystose en médecine et en réanimation
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I. Accoceberry, Frédéric Gabriel, Fabrice Camou, G. Baulier, and N. Issa
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Infectious Diseases - Abstract
Introduction La pneumocystose (PCP) est une infection pulmonaire aigue dont l’incidence augmente. L’infection concerne desormais principalement des patients non infectes par le virus de l’immunodeficience humaine (VIH) exposes a divers immunosuppresseurs. Dans ce contexte, le diagnostic de PCP est difficile car la presentation clinique est atypique et l’examen direct (ED) des secretions respiratoires, gold standard diagnostique, est souvent negatif. Dans cette situation, la detection d’ADN de Pneumocystis jirovecii dans les secretions respiratoires par polymerase chain reaction quantitative en temps reel (qPCR) est un examen prometteur mais peu evalue. Materiels et methodes Afin d’evaluer l’apport diagnostique de la qPCR, tous les patients hospitalises en service de medecine ou de reanimation dans un CHU et ayant une qPCR positive dans les secretions respiratoires ont ete inclus dans une etude retrospective menee entre 2013 et 2016. A partir des donnees cliniques, du resultat de l’ED des secretions respiratoires, de l’imagerie et du traitement administre, les patients ont ete classes en trois groupes : PCP certaine, possible ou colonisation, independamment de la valeur de qPCR. Resultats Cent cinquante patients, dont 38 infectes par le VIH, ont ete inclus : 75 en medecine et 75 en reanimation. Quatre-vingt-dix patients (60 %) ont beneficie d’un lavage broncho-alveolaire. Le diagnostic de PCP etait juge certain ou possible pour respectivement 52 et 77 patients et rejete (colonisation) pour 21 patients. L’ED etait negatif pour 78 % des patients non VIH et 29 % des patients VIH. Parmi les 129 patients avec PCP, dont 97 % ont ete traites par cotrimoxazole, la mortalite hospitaliere etait de 35,9 % en reanimation et de 21,5 % en medecine. La valeur mediane de qPCR etait de 76 650 copies/mL parmi les patients avec PCP et de 3220 copies/mL parmi les patients colonises ( p Conclusion Si la qPCR s’avere, a elle seule, imparfaite pour le diagnostic differentiel entre colonisation et infection, elle a pour merite d’orienter le clinicien vers le diagnostic de PCP notamment pour les patients non VIH dont l’ED des secretions respiratoires est negatif dans pres de 80 % des cas, autant en medecine qu’en reanimation.
- Published
- 2017
10. Dirofilariose orbitaire à Dirofilaria repens en France. Un cas humain contracté sur le littoral atlantique
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B. Couprie, Félix Djossou, Denis Malvy, François-Xavier Weill, V. Montané, J.J. Le Moine, I. Accoceberry, and M. Le Bras
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Gynecology ,medicine.medical_specialty ,Infectious Diseases ,Dirofilariasis ,medicine ,Biology ,biology.organism_classification ,medicine.disease ,Larva migrans ,Dirofilaria repens ,Dirofilaria - Abstract
Resume Nous rapportons une nouvelle observation francaise de dirofilariose orbitaire a Dirofilaria repens . Ce parasite, repandu chez le chien, est transmis par l'intermediaire d'insectes vecteurs, surtout les moustiques. En France, le principal foyer de cette filariose se trouve sur le bassin mediterraneen. Les observations humaines sont rares avec environ 60 cas autochtones connus. Les manifestations cliniques sont benignes a type de nodules sous-cutanes ou orbitaires. L'exerese permet de porter le diagnostic et assure le traitement. L'interet de cette observation reside dans le fait que la parasitose a ete contractee sur le littoral atlantique de Charente-Maritime, foyer de dirofilariose jusqu'alors insoupconne.
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- 1999
11. Reverse line blot hybridisation screening of Pseudallescheria/Scedosporium species in patients with cystic fibrosis
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Q, Lu, A H G Gerrits, van den Ende, G S, de Hoog, R, Li, I, Accoceberry, I, Durand-Joly, J-P, Bouchara, F, Hernandez, L, Delhaes, Univ Angers, Okina, Peking University [Beijing], CBS-KNAW Fungal Biodiversity Centre, Institute of the Royal Netherlands Academy of Arts and Sciences, University of Amsterdam [Amsterdam] (UvA), Hôpital Saint-André, Centre Hospitalier Dunkerque, Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), Université d'Angers (UA), Laboratoire de Parasitologie-Mycologie [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de Parasitologie-Mycologie [CHRU LIlle], Institut de Microbiologie [CHRU Lille], Pôle de Biologie Pathologie Génétique [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Pôle de Biologie Pathologie Génétique [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), This work was funded by Special Scientific Research Project and Public Welfare Project of Health Profession of China, 11th Five‐year key special subject for Sci & Tech Research of China and China Scholarship Council., Evolutionary Biology (IBED, FNWI), Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, and Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)
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MESH: Pseudallescheria / genetics ,MESH: Humans ,[SDV]Life Sciences [q-bio] ,MESH: Mycoses / complications ,Nucleic Acid Hybridization ,Reproducibility of Results ,MESH: Mycoses / diagnosis ,Sensitivity and Specificity ,Cystic fibrosis ,MESH: Sensitivity and Specificity ,Pseudallescheria ,[SDV] Life Sciences [q-bio] ,MESH: Reproducibility of Results ,MESH: Scedosporium / genetics ,Mycoses ,MESH: Nucleic Acid Hybridization ,Humans ,Scedosporium ,MESH: Pseudallescheria / isolation & purification ,MESH: Cystic Fibrosis / complications ,MESH: Scedosporium / isolation & purification ,reverse line blot hybridisation - Abstract
International audience; The PCR-RLB (reverse line blot hybridisation) was applied as a molecular technique for the detection of members of Pseudallescheria and Scedosporium from sputum of patients with cystic fibrosis (CF). Fifty-nine sputum samples were collected from 52 CF patients, which were analysed by culture and PCR-RLB. Conventional and semi-selective culture yielded five positive samples, but the PCR-RLB hybridisation assay permitted the detection of members of Pseudallescheria/Scedosporium in 32 out of 52 patients (61.5%). In total, PCR-RLB yielded 47 positives. Pseudallescheria apiosperma was detected in 20 samples, while Pseudallescheria boydii and Pseudallescheria aurantiacum were detected in 17 and eight samples, respectively. Six samples gave a positive reaction with two distinct species-specific probes and one sample with three probes. In conclusion, the PCR-RLB assay described in this study allows the detection of Scedosporium spp. in CF sputum samples and the identification of Pseudallescheria apiosperma, P. boydii, S. aurantiacum, Scedosporium prolificans and Pseudallescheria minutispora.
- Published
- 2011
12. Leishmaniose cutanée à Leishmania (Leishmania) amazonensis contractée en Guyane française
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F. Pratlong, J.P. Dedet, I. Accoceberry, B. Couprie, C. Beylot, François-Xavier Weill, M. S. Doutre, and F. Delage
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Leishmania amazonensis ,biology ,business.industry ,Meglumine antimonate ,Kinetoplastida ,Leishmaniasis ,Drug resistance ,biology.organism_classification ,Leishmania ,medicine.disease ,Virology ,Infectious Diseases ,Cutaneous leishmaniasis ,medicine ,business ,Pentamidine ,medicine.drug - Abstract
Resume Nous rapportons la quatrieme observation humaine confirmee de leishmaniose cutanee a Leishmania (Leishmania) amazonensis contractee en Guyane francaise. Elle s'est presentee sous la forme d'une lesion fessiere recidivante ayant necessite l'utilisation de trois cures d'isethionate de pentamidine et d'une cure intramusculaire d'antimoniate de N methylglucamine. La description clinique est completee par une revue de la litterature sur les aspects epidemiologiques, cliniques et therapeutiques des atteintes humaines a Leishmania (Leishmania) amazonensis.
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- 2000
13. Evaluation and mangement of fungal risk in cystic fibrosis: first results of a national French study
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V. Conseil, Annlyse Fanton, C. Person, Sylvie Leroy, Christophe Marguet, Laurence Delhaes, O. Vagnier, Frédéric Dalle, I. Accoceberry, C. Pinel, Gilles Gargala, Stéphanie Bui, P. Domblides, Stéphane Dominique, I. Durand-Joly, Jean-Philippe Bouchara, Catherine Llerena, G.-A.L. Loeuille, Yolande Lemeille, Marc Pihet, Amale Boldron, Nathalie Wizla, L. Favenne, Bérengère Coltey, J.-L. Giniès, Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), and Université d'Angers (UA)
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Family medicine ,[SDV]Life Sciences [q-bio] ,Pediatrics, Perinatology and Child Health ,medicine ,Pediatrics, Perinatology, and Child Health ,medicine.disease ,business ,Cystic fibrosis ,3. Good health - Abstract
175 Evaluation and management of fungal risk in Cystic Fibrosis: first results of a national French study S. Leroy1, V. Conseil1, B. Coltey2, Y. Lemeille2, S. Dominique3, G. Gargala3, P. Domblides4, I. Accoceberry4, G. Loeuille5, I. Durand-Joly5, A. Fanton6, O. Vagnier6, F. Dalle6, A. Boldron5, C. Llerena2, C. Pinel2, J.L. Ginies7, M. Pihet7, C. Person7, J. Bouchara7, N. Wizla1, C. Marguet3, L. Favenne3, S. Bui4, L. Delhaes1. 1CHRU, Lille, France; 2CHU, Grenoble, France; 3CHU, Rouen, France; 4CHU, Bordeaux, France; 5CHG, Dunkerque, France; 6CHU, Dijon, France; 7CHU, Angers, France
- Published
- 2009
14. Tinea pedis in European marathon runners
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M Baspeyras, I. Accoceberry, B. Couprie, François-Xavier Weill, Claire Lacroix, Mazouz Benderdouche, M Feuilhade de Chauvin, Francis Derouin, and P de La Salmonière
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Adult ,Male ,medicine.medical_specialty ,Population ,Dermatology ,medicine.disease_cause ,Asymptomatic ,Running ,Age Distribution ,Risk Factors ,Epidemiology ,Confidence Intervals ,Odds Ratio ,Prevalence ,Medicine ,Humans ,Trichophyton ,Prospective Studies ,Sex Distribution ,education ,Probability ,education.field_of_study ,Analysis of Variance ,biology ,business.industry ,Tinea Pedis ,Middle Aged ,biology.organism_classification ,Trichophyton interdigitale ,Europe ,Infectious Diseases ,Case-Control Studies ,Dermatophyte ,Female ,medicine.symptom ,business ,human activities ,Asymptomatic carrier ,Foot (unit) - Abstract
Background Epidemiological studies suggest that 15% of the population in industrial countries suffer from tinea pedis (athlete’s foot) and that persons who do sports are a high-risk population. Objective To investigate the responsibility of dermatophytes in interdigital lesions of the feet in European marathon runners and to identify associated risk factors. Subjects and methods Runners of the 14th Medoc Marathon (n = 147) were interviewed on risk factors for tinea pedis and underwent physical and mycological examinations. Results Interdigital lesions of the feet were found in 66 runners (45%). A dermatophyte was isolated in 45 runners (31%), 12 of whom were asymptomatic. Trichophyton interdigitale and T. rubrum accounted for 49% and 35.5%, respectively, of the cases of tinea pedis. Thirty-three (22%) of the 102 runners free of dermatophyte infection had lesions resembling those of tinea pedis. Increasing age and use of communal bathing facilities were predictive of T. rubrum culture. Conclusions Marathon runners are at high risk for tinea pedis, but dermatophytes are responsible for only half of the foot lesions found in runners. The existence of asymptomatic carriers calls for prophylactic measures.
- Published
- 2002
15. Echinocandins Susceptibility Patterns of 2,787 Yeast Isolates: Importance of the Thresholds for the Detection of FKS Mutations
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Desnos-Ollivier, Marie, Bretagne, Stéphane, Lortholary, Olivier, Dromer, Françoise, French Mycoses Study Group, The, Mycologie moléculaire - Molecular Mycology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals (CNRMA), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), This work was supported by Santé Publique France and Institut Pasteur., Members of the French Mycoses Study Group who contributed to the data are, in alphabetical order of the cities, all the French microbiologists and mycologists who sent isolates for characterization of unusual antifungal susceptibility profiles or to contribute to the ongoing surveillance program on the epidemiology of invasive fungal infections in France (YEASTS and RESSIF programs): N. Brieu (CH Aix), T. Chouaki, C. Damiani, A. Totet (CHU Amiens), J. P. Bouchara, D. Chabasse, M. Pihet (CHU Angers), S. Bland (CH Annecy), V. Blanc (CH Antibes), S. Branger (CH Avignon), A. P. Bellanger, L. Millon (CHU Besançon), C. Plassart (CH Beauvais), I. Poilane (Hôpital Jean Verdier, Bondy), I. Accoceberry, L. Delhaes, B. Couprie, F. Gabriel (CH Bordeaux), J. Dunand, A. L. Roux, V. Sivadon-Tardy (Hôpital Ambroise Paré, Boulogne Billancourt), F. Laurent (CH, Bourg en Bresse), S. Legal, E. Moalic, G. Nevez, D. Quinio (CHU Brest), M. Cariou (CH Bretagne Sud), J. Bonhomme, C. Duhamel (CHU, Caen), B. Podac (CH, Chalon sur Saône), S. Lechatch (CH, Charleville-Mézières), C. Soler (Hopital d’Instruction des armées, Clamart), M. Cambon, C. Nourrisson, P. Poirier, D. Pons (CHU, Clermont Ferrand), O. Augereau, I. Grawey (CH, Colmar), N. Fauchet (CHIC, Créteil), A. Bonnin, F. Dalle (CHU, Dijon), P. Cahen, P. Honderlick (CMC, Foch), N. Desbois, C. Miossec (CHU, Fort de France), J. L. Hermann (Hôpital Raymond Poincaré, Garches), M. Cornet, R. Grillot, B. Lebeau, D. Maubon, H. Pelloux (CHU, Grenoble), M. Nicolas (CHU, Guadeloupe), C. Aznar, D. Blanchet, J. F. Carod, M. Demar, (CHU, Guyane), A. Angoulvant (Hôpital Bicêtre, le Kremlin Bicêtre), C. Ciupek (CH, Le Mans), A. Gigandon (Hôpital Marie Lannelongue, Le Plessis Robinson), B. Bouteille (CH Limoges), E. Frealle, D. Poulain, B. Sendid (CHU Lille), D. Dupont, J. Menotti, F. Persat, M.-A. Piens, M. Wallon (CHU, Lyon), C. Cassagne, S. Ranque (CHU, Marseille), T. Benoit-Cattin, L. Collet (CH Mayotte), A. Fiacre (CH Meaux), N. Bourgeois, L. Lachaud, P. Rispail, Y. Sterkers (CHU, Montpellier), M. Machouart (CHU, Nancy), F. Gay-Andrieu, P. Lepape, F. Morio (CHU, Nantes), O. Moquet (CH, Nevers), S. Lefrançois (Hôpital Américain, Neuilly), M. Sasso (CHU, Nimes), F. Reibel (GH, Nord-Essone), M. Gari-Toussaint, L. Hasseine (CHU Nice), L. Bret, D. Poisson (CHR Orléans), S. Brun (Hôpital Avicenne, Paris), C. Bonnal, C. Chochillon, S. Houzé (Hôpital Bichat, Paris), A. Paugam (Hôpital Cochin, Paris), N. Ait-Ammar, F. Botterel, R. Chouk (CHU Henri Mondor, Paris), M. E. Bougnoux, E. Sitterle (Hôpital Necker, Paris), A. Fekkar, R. Piarroux (Hôpital Pitié Salpêtrière, Paris), J. Guitard, C. Hennequin, J.-L. Poirot (Hôpital St Antoine, Paris), M. Gits-Muselli, S. Hamane, C. Lacroix (Hôpital Saint Louis, Paris), S. Bonacorsi, P. Mariani (Hôpital Robert Debré, Paris), D. Moissenet (Hôpital Trousseau, Paris), C. Kauffmann-Lacroix, A. Minoza, E. Perraud, M. H. Rodier (CHU Poitiers), G. Colonna (CH, Porto Vecchio), A. Huguenin, D. Toubas (CHU Reims), S. Chevrier, J. P. Gangneux, F. Robert-Gangneux, C. Guigen (CHU Rennes), O. Belmonte, G. Hoarau, M. C. Jaffar Bandjee, J. Jaubert, S. Picot, N. Traversier (CHU Réunion), L. Favennec, G. Gargala (CHU, Rouen), N. Godineau, C. Tournus (CH, St Denis), C. Mahinc, H. Raberin (CHU, St Etienne), V. Letscher Bru (CHU, Strasbourg), S. Cassaing (CHU, Toulouse), P. Patoz (CH Tourcoing), E. Bailly, J. Chandenier, G. Desoubeaux (CHU Tours), F. Moreau (CH Troyes), P. Munier (CH Valence), E. Mazars (CH Valenciennes), O. Eloy (CH Versailles), E. Chachaty (Institut Gustave Roussy, Villejuif), and and members of the NRCMA (Institut Pasteur, Paris): A. Bertho, C. Blanc, A. Boullié, C. Gautier, V. Geolier, D. Hoinard, and D. Raoux-Barbot for technical help, and K. Boukris-Sitbon, F. Lanternier, A. Alanio, and D. Garcia-Hermoso for their expertise and contribution to the surveillance programs.
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Pharmacology ,Antifungal Agents ,[SDV]Life Sciences [q-bio] ,yeasts ,Microbial Sensitivity Tests ,antifungal resistance ,Anidulafungin ,bacterial infections and mycoses ,rare yeast ,common yeast ,Echinocandins ,Lipopeptides ,Infectious Diseases ,Susceptibility ,Caspofungin ,Drug Resistance, Fungal ,Mutation ,Micafungin ,polycyclic compounds ,FKS mutation ,Humans ,Candidiasis, Invasive ,Pharmacology (medical) ,MIC distribution - Abstract
International audience; Since echinocandins are recommended as first line therapy for invasive candidiasis, detection of resistance, mainly due to alteration in FKS protein, is of main interest. EUCAST AFST recommends testing both MIC of anidulafungin and micafungin, and breakpoints (BPs) have been proposed to detect echinocandin-resistant isolates. We analyzed MIC distribution for all three available echinocandins of 2,787 clinical yeast isolates corresponding to 5 common and 16 rare yeast species, using the standardized EUCAST method for anidulafungin and modified for caspofungin and micafungin (AM3-MIC). In our database, 64 isolates of common pathogenic species were resistant to anidulafungin, according to the EUCAST BP, and/or to caspofungin, using our previously published threshold (AM3-MIC ≥ 0.5 mg/L). Among these 64 isolates, 50 exhibited 21 different FKS mutations. We analyzed the capacity of caspofungin AM3-MIC and anidulafungin MIC determination in detecting isolates with FKS mutation. They were always identified using caspofungin AM3-MIC and the local threshold while some isolates were misclassified using anidulafungin MIC and EUCAST threshold. However, both methods misclassified four wild-type C. glabrata as resistant. Based on a large data set from a single center, the use of AM3-MIC testing for caspofungin looks promising in identifying non-wild-type C. albicans, C. tropicalis and P. kudiravzevii isolates, but additional multicenter comparison is mandatory to conclude on the possible superiority of AM3-MIC testing compared to the EUCAST method.
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- 2022
16. Azoles susceptibility profiles of more than 9,000 clinical yeast isolates belonging to 40 common and rare species
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Olivier Lortholary, Françoise Dromer, Stéphane Bretagne, Marie Desnos-Ollivier, Mycologie moléculaire - Molecular Mycology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), 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), Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université Paris Cité (UPCité), Institut Pasteur and Santé Publique France., Members of the French Mycoses Study group who contributed to the data are in alphabetical order of the cities, all the French microbiologists and mycologists who sent isolates for characterization of unusual antifungal susceptibility profiles or to contribute to the ongoing surveillance program on the epidemiology of invasive fungal infections in France (YEASTS and RESSIF programs): N. Brieu (CH Aix), T. Chouaki, C. Damiani, A. Totet (CHU Amiens, J. P. Bouchara, M. Pihet (CHU Angers), S. Bland (CH Annecy), V. Blanc (CH Antibes), S. Branger (CH Avignon), A. P. Bellanger, L. Million (CHU Besançon), C. Plassart (CH Beauvais), I. Poilane (hôpital Jean Verdier, Bondy), I. Accoceberry, L. Delhaes, F. Gabriel (CH Bordeaux), A. L. Roux, V. Sivadon-Tardy (hôpital Ambroise Paré, Boulogne Billancourt), F. Laurent (CH, Bourg en Bresse), S. Legal, E. Moalic, G. Nevez, D. Quinio (CHU Brest), M. Cariou (CH Bretagne Sud), J. Bonhomme (CHU, Caen), B. Podac (CH, Chalon sur Saône), S. Lechatch (CH, Charleville-Mézières), C. Soler (hopital d’Instruction des armées, Clamart), P. Poirier, C. Nourrisson (CHU, Clermont Ferrand), O. Augereau (CH, Colmar), N. Fauchet (CHIC, Créteil), F. Dalles (CHU, Dijon), P. Cahen (CMC, Foch), N. Desbois, C. Miossec (CHU, Fort de France), J. L. Hermann (hôpital Raymond Poincaré, Garches), M. Cornet, D. Maubon, H. Pelloux (CHU, Grenoble), M. Nicolas (CHU,Guadeloupe), C. Aznar, D. Blanchet, J. F. Carod, M. Demar, (CHU, Guyane), A. Angoulvant (hôpital Bicêtre, le Kremlin Bicêtre), C. Ciupek (CH, Le Mans), A. Gigandon (hôpital Marie Lannelongue, Le Plessis Robinson), B. Bouteille (CH Limoges), E. Frealle, B. Sendid (CHU Lille), D. Dupont, J. Menotti, F. Persat, M. Wallon (CHU, Lyon), C. Cassagne, S. Ranque (CHU, Marseille), T. Benoit-Cattin, L. Collet (CH Mayotte), A. Fiacre (CH Meaux), N. Bourgeois, L. Lachaud (CHU, Montpellier), M. Machouart (CHU, Nancy), P. Lepape, F. Morio (CHU, Nantes), O. Moquet (CH, Nevers), S. Lefrançois (hôpital Américain, Neuilly), M. Sasso (CHU, Nimes), F. Reibel (GH, Nord-Essone), M. Gari-Toussaint, L. Hasseine (CHU Nice), L. Bret, D. Poisson (CHR Orléans), S. Brun (hôpital Avicenne, Paris), C. Bonnal, S. Houze (hôpital Bichat, Paris), A. Paugam (hôpital Cochin, Paris), E. Dannaoui (HEGP, Paris), N. Ait-Ammar, F. Botterel, R. Chouk (CHU Henri Mondor, Paris), M. E. Bougnoux, E. Sitterle (hôpital Necker, Paris), A. Fekkar, R. Piarroux (hôpital Pitié Salpêtrière, Paris), J. Guitard, C. Hennequin (hôpital St Antoine, Paris), M. Gits-Muselli, S. Hamane (hôpital Saint Louis, Paris), S. Bonacorsi, P. Mariani (hôpital Robert Debré, Paris), D. Moissenet (hôpital Trousseau, Paris), A. Minoza, E. Perraud, M. H. Rodier (CHU Poitiers), G. Colonna (CH, Porto Vecchio), D. Toubas (CHU Reims), J. P. Gangneux, F. Robert-Gangneux (CHU Rennes), O. Belmonte, G. Hoarau, M. C. Jaffar Bandjee, J. Jaubert, S. Picot, N. Traversier (CHU Réunion), L. Favennec, G. Gargala (CHU, Rouen), C. Tournus (CH, St Denis), H. Raberin (CHU, St Etienne), V. Letscher Bru (CHU, Strasbourg), S. Cassaing (CHU, Toulouse), P. Patoz (CH Tourcoing), E. Bailly, G. Desoubeaux (CHU Tours), F. Moreau (CH Troyes), P. Munier (CH Valence), E. Mazars (CH Valenciennes), O. Eloy (CH Versailles), E. Chachaty (Institut Gustave Roussy, Villejuif), and members of the NRCMA (Institut Pasteur, Paris): A. Boullié, C. Gautier, V. Geolier, C. Blanc, D. Hoinard and D. Raoux-Barbot for technical help, and K. Boukris-Sitbon, F. Lanternier, A. Alanio, D. Garcia-Hermoso for their expertise and contribution to the surveillance programs., Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur [Paris], and Université de Paris (UP)
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Serotype ,Azoles ,Antifungal Agents ,Microbial Sensitivity Tests ,Candida parapsilosis ,Rhodotorula mucilaginosa ,Pichia ,Microbiology ,Candida tropicalis ,03 medical and health sciences ,0302 clinical medicine ,Drug Resistance, Fungal ,Pharmacology (medical) ,030212 general & internal medicine ,Candida albicans ,[SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology ,Pharmacology ,chemistry.chemical_classification ,0303 health sciences ,biology ,Candida glabrata ,030306 microbiology ,Broth microdilution ,Rhodotorula ,biology.organism_classification ,3. Good health ,Infectious Diseases ,chemistry ,Susceptibility ,Saccharomycetales ,Azole ,France - Abstract
Invasive yeast infections represent a major global public health issue, and only few antifungal agents are available. Azoles are one of the classes of antifungals used for treatment of invasive candidiasis. The determination of antifungal susceptibility profiles using standardized methods is important to identify resistant isolates and to uncover the potential emergence of intrinsically resistant species. Here, we report data on 9,319 clinical isolates belonging to 40 pathogenic yeast species recovered in France over 17 years. The antifungal susceptibility profiles were all determined at the National Reference Center for Invasive Mycoses and Antifungals based on the EUCAST broth microdilution method. The centralized collection and analysis allowed us to describe the trends of azole susceptibility of isolates belonging to common species, confirming the high susceptibility for Candida albicans (n = 3,295), Candida tropicalis (n = 641), and Candida parapsilosis (n = 820) and decreased susceptibility for Candida glabrata (n = 1,274) and Pichia kudriavzevii (n = 343). These profiles also provide interesting data concerning azole susceptibility of Cryptococcus neoformans species complex, showing comparable MIC distributions for the three species but lower MIC(50)s and MIC(90)s for serotype D (n = 208) compared to serotype A (n = 949) and AD hybrids (n = 177). Finally, these data provide useful information for rare and/or emerging species, such as Clavispora lusitaniae (n = 221), Saprochaete clavata (n = 184), Meyerozyma guilliermondii complex (n = 150), Candida haemulonii complex (n = 87), Rhodotorula mucilaginosa (n = 55), and Wickerhamomyces anomalus (n = 36).
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- 2021
17. Is there still a place for serum galactomannan in the diagnosis of invasive aspergillosis in children at high risk and under antifungal prophylaxis?
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Gerard R, Gabriel F, Accoceberry I, Imbert S, Ducassou S, Angoso M, and Jubert C
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- Humans, Retrospective Studies, Child, Male, Female, Child, Preschool, Adolescent, Infant, Invasive Pulmonary Aspergillosis diagnosis, Invasive Pulmonary Aspergillosis prevention & control, Aspergillosis diagnosis, Aspergillosis prevention & control, Aspergillosis blood, Sensitivity and Specificity, Predictive Value of Tests, Mannans blood, Galactose analogs & derivatives, Antifungal Agents therapeutic use
- Abstract
Background: The performance of serum galactomannan (GM) for the diagnosis of invasive aspergillosis (IA) has been studied mainly in adults. Paediatric data are scarce and based on small and heterogeneous cohorts., Objective: To evaluate the performance of serum GM for the diagnosis of IA in a paediatric oncologic population at high risk of IA and to clarify the impact of antifungal prophylaxis on this test., Methods: We performed a retrospective study from January 2014 to December 2020 in the paediatric oncologic haematologic department of the University Hospital of Bordeaux. The diagnosis of IA was made using the recommendations of the EORTC and the MSGERC., Results: Among the 329 periods at high risk of IA in 222 patients, the prevalence of IA was 1.8% (3 proven and 3 probable IA). In the total population, the sensitivity, and the positive predictive value (PPV) were respectively 50% and 17.6%. Under antifungal prophylaxis, the sensitivity and PPV dropped, respectively, to 33.3% and 14.3%. In this group, the post-test probability of IA was 2% for a negative serum GM and only 14%., Conclusion: In this large cohort of children at high risk of IA, the incidence of IA is low and the diagnostic performance of GM is poor, especially in the case of mould-active prophylaxis. Screening should be targeted rather than systematic and should be reserved for patients at highest risk for IA without mould-active prophylaxis. Combination with other tests such as Aspergillus PCR would increase the accuracy of GM in screening setting., (© 2024 The Author(s). Mycoses published by Wiley‐VCH GmbH.)
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- 2024
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18. Severe kerion Celsi caused by Trichophyton quinckeanum: Severe kerion Celsi due to Trichophyton quinckeanum.
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Lefranc M, Fourmond S, Jabet A, Normand AC, Girard D, Accoceberry I, Gabriel F, Delhaes L, and Imbert S
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- Child, Female, Humans, Adolescent, Trichophyton genetics, Antifungal Agents therapeutic use, Arthrodermataceae, Tinea Capitis diagnosis, Tinea Capitis drug therapy, Tinea Capitis microbiology
- Abstract
We report a severe case of kerion Celsi of the scalp in a previously healthy 13-year-old girl due to Trichophyton quinckeanum, an emerging dermatophyte species in Europe. The species was definitely identified by DNA sequencing and the patient was successfully treated by oral terbinafine for 6 weeks. Kerion Celsi is a severe inflammatory form of tinea capitis, which is characterised by a purulent discharge and alopecia [1]. It typically occurs in children infected with zoophilic dermatophytes, such as Trichophyton mentagrophytes, and an increasing number of cases caused by other Trichophyton species has recently been reported [2]. Herein we report a severe case of kerion Celsi of the scalp caused by the emerging species Trichophyton quinckeanum, which was successfully treated by oral antifungal., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 SFMM. Published by Elsevier Masson SAS. All rights reserved.)
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- 2024
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19. Rapamycin and caspofungin show synergistic antifungal effects in caspofungin-susceptible and caspofungin-resistant Candida strains in vitro.
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Lefranc M, Accoceberry I, Fitton-Ouhabi V, Biteau N, and Noël T
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- Caspofungin pharmacology, Sirolimus pharmacology, Echinocandins pharmacology, Candida albicans, Microbial Sensitivity Tests, Drug Resistance, Fungal genetics, Lipopeptides pharmacology, Antifungal Agents pharmacology, Antifungal Agents therapeutic use, Candida
- Abstract
Objectives: Caspofungin is an echinocandin antifungal agent that inhibits synthesis of glucan required for the fungal cell wall. Resistance is mediated by mutation of Fks1 glucan synthase, among which S645P is the most common resistance-associated polymorphism. Rapamycin is a macrolide that inhibits the mechanistic target of rapamycin (mTOR) protein kinase activity. This study investigated the interaction between rapamycin and caspofungin in inhibiting the growth of WT Candida albicans and Fks1 S645P mutant clinical isolate, and WT Candida lusitaniae and genetically engineered isogenic strain with Fks1 S645P mutation at equivalent position., Methods: Interactions between caspofungin and rapamycin were evaluated using the microdilution chequerboard method in liquid medium. The results were analysed using the Loewe additivity model (FIC index, FICI) and the Bliss independence model (response surface, RS, analysis)., Results: Synergy between rapamycin and caspofungin was shown for C. albicans and C. lusitaniae strains by RS analysis of the chequerboard tests. Synergy was observed in strains susceptible and resistant to caspofungin. Weak subinhibitory concentrations of rapamycin were sufficient to restore caspofungin susceptibility., Conclusions: We report here, for the first time, synergy between caspofungin and rapamycin in Candida species. Synergy was shown for strains susceptible and resistant to caspofungin. This study highlights the possible implication of the TOR pathway in sensing antifungal-mediated cell wall stress and in modulating the cellular response to echinocandins in Candida yeasts., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2024
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20. Pneumocystis in the era of prophylaxis: do the guidelines have to change?
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Nunes J, Issa N, Dupuis A, Accoceberry I, and Pedeboscq S
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- Adult, Humans, Retrospective Studies, Trimethoprim, Sulfamethoxazole Drug Combination, Pneumocystis, Pneumocystis carinii, Pneumonia, Pneumocystis drug therapy, Pneumonia, Pneumocystis prevention & control
- Abstract
Purpose: In the era of effective prophylaxis, the objective of this study was to describe pneumocystis pneumonia (PCP) patients' profile and evaluate the consistency of clinical situations encountered with the recommended indications for prophylaxis., Methods: This was a single-centre, retrospective study. All adults (> 18 years) with a definitive diagnosis of PCP were included. Data were collected from patients' electronic medical files., Results: The study examined the medical files of 225 patients diagnosed with PCP and treated between 1 January, 2015, and 30 June, 2020. More than 95% of the patients were not on anti-PCP prophylaxis at the time of PCP diagnosis. There were 32 (14%) deaths before the end of PCP treatment, mainly in auto-immune disease (30%) and solid tumours (38%) groups unlike the solid-organ transplants group, among whom deaths were infrequent. Indeed, 48% of our cohort (n = 107) had both corticosteroid (CS) therapy, immunosuppressive or immunomodulatory treatment, and lymphopaenia and could have been considered at high risk for PCP. Trimethoprim/sulfamethoxazole was administered as first-line PCP curative treatment in 95% of the patients. Toxicities of this drug led to treatment interruption in 25% of the patients (except death)., Conclusions: This study found a high number of PCP cases over 5 years. Unsurprisingly, most of the patients were immunosuppressed, with risk factors for PCP already described in the literature. This large number of PCP cases should be avoidable and, consequently, questions arise. Faced with these data, prophylaxis should be common sense for immunocompromised patients with risk factors, even if formalised recommendations do not exist., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
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- 2022
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21. Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France.
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Tardieu L, Divard G, Lortholary O, Scemla A, Rondeau É, Accoceberry I, Agbonon R, Alanio A, Angoulvant A, Albano L, Attias P, Bellanger AP, Bertrand D, Bonhomme J, Botterel F, Bouvier N, Buchler M, Chouaki T, Crépin T, Durieux MF, Desoubeaux G, Doppelt G, Favennec L, Fekkar A, Fourdinier O, Frimat M, Gangneux JP, Garandeau C, Hasseine L, Hennequin C, Iriart X, Kamar N, Kaminski H, Kormann R, Lachaud L, Legendre C, Le Quintrec Donnette M, Leroy J, Levi C, Machouart M, Marx D, Menotti J, Moal V, Morio F, Mrozek N, Nicolas M, Poirier P, Peraldi MN, Poussot B, Ranque S, Rerolle JP, Sendid B, Snanoudj R, Tourret J, Vasse M, Vigneau C, Villard O, Mesnard L, Lanternier F, and Rafat C
- Abstract
Cryptococcosis is the third most common cause of invasive fungal infection in solid organ transplant recipients and cryptococcal meningitis (CM) its main clinical presentation. CM outcomes, as well as its clinical features and radiological characteristics, have not yet been considered on a large scale in the context of kidney transplantation (KT). We performed a nationwide retrospective study of adult patients diagnosed with cryptococcosis after KT between 2002 and 2020 across 30 clinical centers in France. We sought to describe overall and graft survival based on whether KT patients with cryptococcosis developed CM or not. Clinical indicators of CNS involvement and brain radiological characteristics were assessed. Eighty-eight cases of cryptococcosis were diagnosed during the study period, with 61 (69.3%) cases of CM. Mortality was high (32.8%) at 12 months (M12) but not significantly different whether or not patients presented with CM. Baseline hyponatremia and at least one neurological symptom were independently associated with CM (p < 0.001). Positive serum cryptococcal antigen at diagnosis was also significantly associated with CM (p < 0.001). On magnetic resonance imaging (MRI), three patterns of brain injury were identified: parenchymal, meningeal, and vascular lesions. Although CM does not affect graft function directly, it entails a grim prognosis.
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- 2022
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22. Fungal Vascular Graft and Endograft Infections are Frequently Associated with Aorto-Enteric Fistulas.
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Puges M, Bérard X, Caradu C, Accoceberry I, Gabriel F, and Cazanave C
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- Aged, Aortic Diseases mortality, Aortic Diseases surgery, Female, Humans, Male, Middle Aged, Mycoses mortality, Prosthesis-Related Infections microbiology, Prosthesis-Related Infections mortality, Aortic Diseases complications, Blood Vessel Prosthesis adverse effects, Intestinal Fistula epidemiology, Mycoses complications, Prosthesis-Related Infections complications, Vascular Fistula epidemiology
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- 2021
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23. Identification of Predictive Markers and Outcomes of Late-onset Pneumocystis jirovecii Pneumonia in Kidney Transplant Recipients.
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Kaminski H, Belliere J, Burguet L, Del Bello A, Taton B, Poirot-Mazères S, Accoceberry I, Delhaes L, Visentin J, Gregori M, Iriart X, Charpentier E, Couzi L, Kamar N, and Merville P
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- Case-Control Studies, Humans, Retrospective Studies, Transplant Recipients, Kidney Transplantation adverse effects, Pneumocystis carinii, Pneumonia, Pneumocystis drug therapy, Pneumonia, Pneumocystis epidemiology
- Abstract
Background: In the era of prophylaxis, Pneumocystis pneumonia (PCP) has become a late-onset opportunistic infection requiring indications for prolonged prophylaxis to be defined. The primary objective of our study was therefore to evaluate risk factors associated with late-onset PCP. The secondary objective was to assess the impact of this infection on graft and patient survival., Methods: We conducted a French case-control study in Bordeaux and Toulouse center by matching 1 case to 1-2 controls from the same center based on the transplant date and the type of induction treatment., Results: Seventy cases and 134 controls were included. PCP occurred at a median of 3 years after transplantation. The total lymphocyte count and CD4+ and CD8+ T-lymphocyte values were lower in the cases than in their matched controls on the day of infection and annually up to 4 years earlier. The covariables independently associated with PCP were the total lymphocyte count 1 year before Pneumocystis, mTOR inhibitors used as maintenance immunosuppressive drugs, and the administration of corticosteroid boluses used in acute rejection. A total lymphocyte count threshold <1000/µL offered the best predictive value for infection occurrence. PCP was associated with high incidence of graft loss and patient death (30% and 17% respectively, 3 years after PCP)., Conclusions: Pneumocystis pneumonia has dramatic consequences in kidney transplant recipients; a targeted prophylaxis based on simple criteria, such as chronic lymphopenia and/or history of corticosteroid boluses, could be useful to avoid life-threatening complications., (© 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.)
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- 2021
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24. Multicenter Comparative Assessment of the TIB MolBiol Toxoplasma gondii Detection Kit and Four Laboratory-Developed PCR Assays for Molecular Diagnosis of Toxoplasmosis.
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Brenier-Pinchart MP, Robert-Gangneux F, Accoceberry I, Pichard S, Garnaud C, Fricker-Hidalgo H, Lévêque MF, Hoarau G, Pelloux H, Bastien P, Sterkers Y, and Varlet-Marie E
- Subjects
- Humans, Molecular Diagnostic Techniques methods, Molecular Diagnostic Techniques standards, Quality Control, Reproducibility of Results, Sensitivity and Specificity, Polymerase Chain Reaction methods, Polymerase Chain Reaction standards, Reagent Kits, Diagnostic standards, Toxoplasma genetics, Toxoplasmosis diagnosis, Toxoplasmosis parasitology
- Abstract
Toxoplasmosis can be a life-threatening infection, particularly during pregnancy and in immunocompromised patients. The biological diagnosis of toxoplasmosis is challenging and has been revolutionized by molecular detection methods. This article summarizes the data of a multicenter study involving four centers to assess the performances of a commercial PCR assay as compared with four in-house PCR assays using Toxoplasma gondii standards, 20 external quality control specimens, and 133 clinical samples. This clinical cohort includes well-characterized clinical samples corresponding to different clinical situations: confirmed congenital toxoplasmosis (44 samples), toxoplasmosis in immunocompromised patients (25 samples), and chorioretinitis (5 samples). Furthermore, 59 samples from patients without toxoplasmosis were included as negative controls. The analytical sensitivities of the five methods tested were very similar; and the limit of Toxoplasma DNA detection was around 0.01 T. gondii genome per reaction for all the methods. The overall concordance between the commercial PCR and the four in-house PCR assays was 97.7% (130/133). The clinical sensitivity and specificity were >98% and could be increased for the commercial kit when PCR was performed in multiplicate to detect low parasitic loads. In conclusion, the commercial PCR assay shows suitable performances to diagnose the different clinical forms of toxoplasmosis., (Copyright © 2021 Association for Molecular Pathology and American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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25. Antifungal susceptibility testing practices in mycology laboratories in France, 2018.
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Bellanger AP, Persat F, Foulet F, Bonnal C, Accoceberry I, Angebault C, Angoulvant A, Augereau O, Bailly E, Bert F, Bonhomme J, Bouchara JP, Bougnoux ME, Bourdeau P, Bouteille B, Brun S, Brunet K, Camin-Ravenne AM, Cassaing S, Chouaki T, Cornet M, Costa D, Desbois N, Dorin J, Fekkar A, Fiacre A, Fréalle E, Gangneux JP, Guillot J, Guitard J, Hasseine L, Huguenin A, Lachaud L, Larréché S, Lavergne RA, Le Gal S, Le Govic Y, Letscher-Bru V, Machouart M, Mazars E, Nourrisson C, Paugam A, Ranque S, Risco-Castillo V, Sasso M, Sautour M, Sendid B, Senghor Y, Botterel F, and Dannaoui E
- Subjects
- Disk Diffusion Antimicrobial Tests methods, Disk Diffusion Antimicrobial Tests standards, Disk Diffusion Antimicrobial Tests statistics & numerical data, Drug Resistance, Fungal, France, History, 21st Century, Humans, Laboratory Proficiency Testing methods, Laboratory Proficiency Testing statistics & numerical data, Professional Practice standards, Quality Control, Surveys and Questionnaires, Antifungal Agents therapeutic use, Laboratories standards, Laboratories statistics & numerical data, Microbial Sensitivity Tests methods, Microbial Sensitivity Tests standards, Microbial Sensitivity Tests statistics & numerical data, Mycology history, Mycology methods, Mycology standards, Mycology statistics & numerical data, Professional Practice statistics & numerical data
- Abstract
A survey of mycology laboratories for antifungal susceptibility testing (AFST) was undertaken in France in 2018, to better understand the difference in practices between the participating centers and to identify the difficulties they may encounter as well as eventual gaps with published standards and guidelines. The survey captured information from 45 mycology laboratories in France on how they perform AFST (number of strains tested, preferred method, technical and quality aspects, interpretation of the MIC values, reading and interpretation difficulties). Results indicated that 86% of respondents used Etest as AFST method, with a combination of one to seven antifungal agents tested. Most of the participating laboratories used similar technical parameters to perform their AFST method and a large majority used, as recommended, internal and external quality assessments. Almost all the participating mycology laboratories (98%) reported difficulties to interpret the MIC values, especially when no clinical breakpoints are available. The survey highlighted that the current AFST practices in France need homogenization, particularly for MIC reading and interpretation., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
- Published
- 2020
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26. A poisoned bouquet from Peru.
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Vermorel A, Issa N, Gabriel F, Accoceberry I, Valenzuela G, Darrigade AS, and Camou F
- Subjects
- Antifungal Agents therapeutic use, Fatal Outcome, Female, Humans, Middle Aged, Mucorales cytology, Mucormycosis drug therapy, Mucormycosis microbiology, Mucormycosis pathology, Sporangia cytology, Mucorales isolation & purification, Mucormycosis diagnosis
- Published
- 2019
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27. Guidelines for antifungal therapies in intensive care unit patients: not so bad!
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Boyer A, Cadier G, Accoceberry I, Lhomme E, Ricard C, Gruson D, and Blanchard E
- Subjects
- Humans, Intensive Care Units, Antifungal Agents therapeutic use, Critical Illness, Invasive Fungal Infections drug therapy, Practice Guidelines as Topic
- Published
- 2019
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28. Challenging SNP impact on caspofungin resistance by full-length FKS1 allele replacement in Candida lusitaniae.
- Author
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Accoceberry I, Couzigou C, Fitton-Ouhabi V, Biteau N, and Noël T
- Subjects
- Alleles, Candida genetics, Glucosyltransferases genetics, Microbial Sensitivity Tests, Recombination, Genetic, Antifungal Agents pharmacology, Candida drug effects, Candida enzymology, Caspofungin pharmacology, Drug Resistance, Fungal, Glucosyltransferases metabolism, Polymorphism, Single Nucleotide
- Abstract
Objectives: A strain of the opportunistic pathogenic yeast Candida lusitaniae was genetically engineered for full-length replacement of the FKS1 gene encoding the target of echinocandin antifungals in order to assess the impact of FKS mutations on echinocandin resistance and reduced echinocandin susceptibility (RES)., Methods: FKS1 allelic exchange was achieved by transforming C. lusitaniae with two DNA fragments covering the entire FKS1 ORF. Both fragments overlap a 40 bp region where SNPs or small indels of interest were inserted. To target integration at the FKS1 locus, each DNA fragment was fused with split auxotrophic markers of which complementary truncated parts were previously inserted into the chromosomal regions flanking FKS1, allowing selection on minimal medium., Results: Three SNPs described in the FKS1 hotspot (HS) regions HS1 or HS2 of clinical isolates of Candida albicans were expressed at an equivalent position in C. lusitaniae and were confirmed to confer either reduced susceptibility (F641V) or full resistance (S645P and R1361G) to caspofungin. The F659 deletion reported in an FKS2 allele of Candida glabrata and the naturally occurring P660A substitution in FKS1 of Candida parapsilosis were shown to confer a 256-fold and 6-fold increase in caspofungin MIC, respectively, when introduced into an FKS1 allele of C. lusitaniae., Conclusions: We have successfully developed a C. lusitaniae strain for the expression of full-length FKS1 alleles harbouring known mutations contributing to reduced susceptibility or resistance to caspofungin, thus opening the way for the screening of other FKS1/FKS2 mutations potentially involved in RES., (© The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
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29. Pneumocystosis and quantitative PCR.
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Issa N, Gabriel F, Baulier G, Mourissoux G, Accoceberry I, Guisset O, and Camou F
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- Adult, Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, Pneumonia, Pneumocystis diagnosis, Real-Time Polymerase Chain Reaction
- Abstract
Objective: Pneumocystis pneumonia (PCP) is now predominantly observed in immunosuppressed non-HIV-infected patients. The sensitivity of the PCR is here higher than direct examination (DE) of respiratory secretions because the infection is caused by a lower inoculum of Pneumocystis jirovecii (P. jirovecii). The objective of our retrospective study was to assess the contribution of quantitative PCR (qPCR) in the diagnosis of PCP., Patients and Methods: All patients hospitalized for PCP suspicion with a positive qPCR were included. Irrespective of the qPCR value, patients were initially classified into two groups (infection and colonization [PCP ruled out]) based on clinical, radiological, and microbiological data. Both groups were then compared based on the qPCR value., Results: Between 2013 and 2016, 150 patients were included; 75% of them were not infected with HIV. The diagnosis of PCP was retained for 129 patients and rejected for 21 patients. The DE was negative in 60% of PCP cases. The median value of qPCR was 76,650copies/mL among infected patients and 3220copies/mL among colonized patients. The threshold corresponding to a specificity of 100% was 56,000copies/mL. The optimal value to distinguish an infection from a colonization was 10,100copies/mL., Conclusion: Our study confirms the diagnostic value of the qPCR in immunosuppressed patients, especially when the DE is negative. When the qPCR is˂56,000copies/mL, the result should be interpreted based on the clinical context and paraclinical examinations., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)
- Published
- 2018
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30. Comparison of Genus Specific PCR and Culture with or without Sonication for Microbiological Diagnosis of Vascular Graft Infection.
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Puges M, Pereyre S, Bérard X, Accoceberry I, Le Roy C, Stecken L, Pinaquy JB, Desclaux A, Dupon M, Bébéar C, and Cazanave C
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Sensitivity and Specificity, Bacteriological Techniques, Blood Vessel Prosthesis adverse effects, Polymerase Chain Reaction methods, Prosthesis-Related Infections diagnosis, Prosthesis-Related Infections therapy
- Abstract
Objectives: Vascular graft infections (VGIs) are severe and require prolonged adequate antimicrobial therapy. However, up to 45% of conventional cultures are negative. Sonication and genus specific PCRs for microbiological diagnosis of VGI was evaluated., Methods: Samples were prospectively obtained from explanted vascular grafts in Bordeaux University Hospital. Conventional bacterial cultures with and without prior sonication of samples were performed. A genus specific PCR assay panel, targeting the most frequent bacteria involved in VGI (Staphylococcus, Streptococcus, Enterococcus, and Enterobacteriaceae), was also applied to sonicate fluids. The performance of these three diagnostic strategies was compared., Results: Forty-five patients (118 samples) were included between July 2014 and October 2015. Six patients had no infection and 39 had a VGI. Sensitivities of graft culture, sonicate fluid culture, and genus specific PCR were 85.7%, 89.7%, and 79.5%, respectively. Specificities were 100%, 100%, and 83.3%, respectively. Sonicate fluid culture was positive for five graft samples (from four patients) with negative culture without sonication. Four VGIs were detected by PCR only (3 patients had previously received antibiotics). For 15 patients with positive graft cultures, PCR identified at least one additional bacterium compared with culture, thus 30 additional bacteria for all included patients. By combining sonicate fluid culture and PCR, a microbiological diagnosis was obtained for all patients with VGI., Conclusions: There was no statistical difference between performances of culture with and without sonication and genus specific PCR. However, combining sonicate fluid cultures and PCR may be the best strategy for microbiological diagnostic of VGI., (Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)
- Published
- 2018
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31. Toxoplasmosis in Transplant Recipients, Europe, 2010-2014.
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Robert-Gangneux F, Meroni V, Dupont D, Botterel F, Garcia JMA, Brenier-Pinchart MP, Accoceberry I, Akan H, Abbate I, Boggian K, Bruschi F, Carratalà J, David M, Drgona L, Djurković-Djaković O, Farinas MC, Genco F, Gkrania-Klotsas E, Groll AH, Guy E, Hirzel C, Khanna N, Kurt Ö, Junie LM, Lazzarotto T, Len O, Mueller NJ, Munoz P, Pana ZD, Roilides E, Stajner T, van Delden C, Villena I, Pelloux H, and Manuel O
- Subjects
- Adult, Europe epidemiology, Humans, Middle Aged, Retrospective Studies, Risk Factors, Transplant Recipients, Hematopoietic Stem Cell Transplantation adverse effects, Organ Transplantation adverse effects, Toxoplasmosis epidemiology, Toxoplasmosis etiology
- Abstract
Transplantation activity is increasing, leading to a growing number of patients at risk for toxoplasmosis. We reviewed toxoplasmosis prevention practices, prevalence, and outcomes for hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT; heart, kidney, or liver) patients in Europe. We collected electronic data on the transplant population and prevention guidelines/regulations and clinical data on toxoplasmosis cases diagnosed during 2010-2014. Serologic pretransplant screening of allo-hematopoietic stem cell donors was performed in 80% of countries, screening of organ donors in 100%. SOT recipients were systematically screened in 6 countries. Targeted anti-Toxoplasma chemoprophylaxis was heterogeneous. A total of 87 toxoplasmosis cases were recorded (58 allo-HSCTs, 29 SOTs). The 6-month survival rate was lower among Toxoplasma-seropositive recipients and among allo-hematopoietic stem cell and liver recipients. Chemoprophylaxis improved outcomes for SOT recipients. Toxoplasmosis remains associated with high mortality rates among transplant recipients. Guidelines are urgently needed to standardize prophylactic regimens and optimize patient management.
- Published
- 2018
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32. Breakthrough invasive aspergillosis and diagnostic accuracy of serum galactomannan enzyme immune assay during acute myeloid leukemia induction chemotherapy with posaconazole prophylaxis.
- Author
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Calmettes C, Gabriel F, Blanchard E, Servant V, Bouchet S, Kabore N, Forcade E, Leroyer C, Bidet A, Latrabe V, Leguay T, Vigouroux S, Tabrizi R, Breilh D, Accoceberry I, de Lara MT, Pigneux A, Milpied N, and Dumas PY
- Abstract
Posaconazole prophylaxis has demonstrated efficacy in the prevention of invasive aspergillosis during prolonged neutropenia following acute myeloid leukemia induction chemotherapy. Antifungal treatment decreases serum galactomannan enzyme immunoassay diagnostic accuracy that could delay the diagnosis and treatment. We retrospectively studied patients with acute myeloid leukemia who underwent intensive chemotherapy and antifungal prophylaxis by posaconazole oral suspension. Clinical, radiological, microbiological features and treatment response of patients with invasive aspergillosis that occurred despite posaconazole prophylaxis were analyzed. Diagnostic accuracy of serum galactomannan assay according to posaconazole plasma concentrations has been performed. A total of 288 patients with acute myeloid leukemia, treated by induction chemotherapy, who received posaconazole prophylaxis for more than five days were included in the present study. The incidence of invasive aspergillosis was 8% with 12 (4.2%), 8 (2.8%) and 3 (1%), possible, probable and proven invasive aspergillosis, respectively. Posaconazole plasma concentration was available for 258 patients. Median duration of posaconazole treatment was 17 days, and median posaconazole plasma concentration was 0.5 mg/L. None of patients with invasive aspergillosis and posaconazole concentration ≥ 0.5 mg/L had a serum galactomannan positive test. Sensitivity of serum galactomannan assay to detect probable and proven invasive aspergillosis was 81.8%. Decreasing the cut-off value for serum galactomannan optical density index from 0.5 to 0.3 increased sensitivity to 90.9%. In a homogenous cohort of acute myeloid leukemia patients during induction chemotherapy, increasing the posaconazole concentration decreases the sensitivity of serum galactomannan assay., Competing Interests: CONFLICTS OF INTEREST The authors declare no conflicts of interest.
- Published
- 2018
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33. [Sporotrichosis in France].
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Larsabal M, Gabriel F, Pajaniapadeatchy E, Rougeron A, Accoceberry I, Garcia-Hermoso D, and Saunier A
- Subjects
- France, Humans, Male, Middle Aged, Sporotrichosis diagnosis
- Published
- 2018
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34. 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.
- Published
- 2018
35. Species Identification and In Vitro Antifungal Susceptibility of Aspergillus terreus Species Complex Clinical Isolates from a French Multicenter Study.
- Author
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Imbert S, Normand AC, Ranque S, Costa JM, Guitard J, Accoceberry I, Bonnal C, Fekkar A, Bourgeois N, Houzé S, Hennequin C, Piarroux R, Dannaoui E, and Botterel F
- Subjects
- Amphotericin B pharmacology, Azoles pharmacology, Echinocandins pharmacology, Humans, Itraconazole pharmacology, Microbial Sensitivity Tests, Antifungal Agents pharmacology, Aspergillus drug effects, Aspergillus genetics
- Abstract
Aspergillus section Terrei is a species complex currently comprised of 14 cryptic species whose prevalence in clinical samples as well as antifungal susceptibility are poorly known. The aims of this study were to investigate A. Terrei clinical isolates at the species level and to perform antifungal susceptibility analyses by reference and commercial methods. Eighty-two clinical A. Terrei isolates were collected from 8 French university hospitals. Molecular identification was performed by sequencing parts of beta-tubulin and calmodulin genes. MICs or minimum effective concentrations (MECs) were determined for 8 antifungal drugs using both EUCAST broth microdilution (BMD) methods and concentration gradient strips (CGS). Among the 79 A. Terrei isolates, A. terreus stricto sensu ( n = 61), A. citrinoterreus ( n = 13), A. hortai ( n = 3), and A. alabamensis ( n = 2) were identified. All strains had MICs of ≥1 mg/liter for amphotericin B, except for two isolates (both A. hortai ) that had MICs of 0.25 mg/liter. Four A. terreus isolates were resistant to at least one azole drug, including one with pan-azole resistance, yet no mutation in the CYP51A gene was found. All strains had low MECs for the three echinocandins. The essential agreements (EAs) between BMD and CGS were >90%, except for those of amphotericin B (79.7%) and itraconazole (73.4%). Isolates belonging to the A section Terrei identified in clinical samples show wider species diversity beyond the known A. terreus sensu stricto Azole resistance inside the section Terrei is uncommon and is not related to CYP51A mutations here. Finally, CGS is an interesting alternative for routine antifungal susceptibility testing., (Copyright © 2018 American Society for Microbiology.)
- Published
- 2018
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36. [Aspergillus fumigatus prosthetic bone and joint infections].
- Author
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de Faucal S, Wirth G, Dutronc H, Gabriel F, Accoceberry I, and Dupon M
- Subjects
- Abscess microbiology, Abscess surgery, Aged, Anti-Bacterial Agents therapeutic use, Antifungal Agents therapeutic use, Arthritis, Infectious drug therapy, Arthritis, Infectious microbiology, Arthroplasty, Replacement, Hip, Aspergillosis drug therapy, Aspergillosis microbiology, Coinfection drug therapy, Coinfection microbiology, Debridement, Diabetes Mellitus, Type 2 complications, Disease Susceptibility, Female, Hip Prosthesis microbiology, Humans, Male, Neoplasms complications, Osteotomy adverse effects, Prosthesis-Related Infections drug therapy, Staphylococcal Infections drug therapy, Staphylococcal Infections microbiology, Staphylococcal Infections surgery, Surgical Wound Dehiscence surgery, Surgical Wound Infection microbiology, Tibia surgery, Arthritis, Infectious etiology, Aspergillosis etiology, Aspergillus fumigatus isolation & purification, Hip Prosthesis adverse effects, Prosthesis-Related Infections microbiology
- Published
- 2018
- Full Text
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37. Toward the Standardization of Mycological Examination of Sputum Samples in Cystic Fibrosis: Results from a French Multicenter Prospective Study.
- Author
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Coron N, Pihet M, Fréalle E, Lemeille Y, Pinel C, Pelloux H, Gargala G, Favennec L, Accoceberry I, Durand-Joly I, Dalle F, Huet F, Fanton A, Boldron A, Loeuille GA, Domblides P, Coltey B, Pin I, Llerena C, Troussier F, Person C, Marguet C, Wizla N, Thumerelle C, Turck D, Bui S, Fayon M, Duhamel A, Prévotat A, Wallaert B, Leroy S, Bouchara JP, and Delhaes L
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, France, Humans, Male, Middle Aged, Prospective Studies, Young Adult, Cystic Fibrosis complications, Fungi classification, Fungi isolation & purification, Lung Diseases, Fungal diagnosis, Microbiological Techniques methods, Microbiological Techniques standards, Sputum microbiology
- Abstract
Fungal respiratory colonization of cystic fibrosis (CF) patients emerges as a new concern; however, the heterogeneity of mycological protocols limits investigations. We first aimed at setting up an efficient standardized protocol for mycological analysis of CF sputa that was assessed during a prospective, multicenter study: "MucoFong" program (PHRC-06/1902). Sputa from 243 CF patients from seven centers in France were collected over a 15-month period and submitted to a standardized protocol based on 6 semi-selective media. After mucolytic pretreatment, sputa were plated in parallel on cycloheximide-enriched (ACT37), erythritol-enriched (ERY37), benomyl dichloran-rose bengal (BENO37) and chromogenic (CAN37) media incubated at 37 °C and on Sabouraud-chloramphenicol (SAB27) and erythritol-enriched (ERY27) media incubated at 20-27 °C. Each plate was checked twice a week during 3 weeks. Fungi were conventionally identified; time for detection of fungal growth was noted for each species. Fungal prevalences and media performances were assessed; an optimal combination of media was determined using the Chi-squared automatic interaction detector method. At least one fungal species was isolated from 81% of sputa. Candida albicans was the most prevalent species (58.8%), followed by Aspergillus fumigatus (35.4%). Cultivation on CAN37, SAB27, ACT37 and ERY27 during 16 days provided an optimal combination, detecting C. albicans, A. fumigatus, Scedosporium apiospermum complex and Exophiala spp. with sensitivities of 96.5, 98.8, 100 and 100%. Combination of these four culture media is recommended to ensure the growth of key fungal pathogens in CF respiratory specimens. The use of such consensual protocol is of major interest for merging results from future epidemiological studies.
- Published
- 2018
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38. A CTG Clade Candida Yeast Genetically Engineered for the Genotype-Phenotype Characterization of Azole Antifungal Resistance in Human-Pathogenic Yeasts.
- Author
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Accoceberry I, Rougeron A, Biteau N, Chevrel P, Fitton-Ouhabi V, and Noël T
- Subjects
- Candida classification, Humans, Microbial Sensitivity Tests, Mutation genetics, Phylogeny, Antifungal Agents pharmacology, Candida drug effects, Candida genetics, Drug Resistance, Fungal genetics, Fluconazole pharmacology, Sterol 14-Demethylase genetics
- Abstract
A strain of the opportunistic pathogenic yeast Candida lusitaniae was genetically modified for use as a cellular model for assessing by allele replacement the impact of lanosterol C14α-demethylase ERG11 mutations on azole resistance. Candida lusitaniae was chosen because it is susceptible to azole antifungals, it belongs to the CTG clade of yeast, which includes most of the Candida species pathogenic for humans, and it is haploid and easily amenable to genetic transformation and molecular modeling. In this work, allelic replacement is targeted at the ERG11 locus by the reconstitution of a functional auxotrophic marker in the 3' intergenic region of ERG11 Homologous and heterologous ERG11 alleles are expressed from the resident ERG11 promoter of C. lusitaniae , allowing accurate comparison of the phenotypic change in azole susceptibility. As a proof of concept, we successfully expressed in C. lusitaniae different ERG11 alleles, either bearing or not bearing mutations retrieved from a clinical context, from two phylogenetically distant yeasts, C. albicans and Kluyveromyces marxianus Candida lusitaniae constitutes a high-fidelity expression system, giving specific Erg11p-dependent fluconazole MICs very close to those observed with the ERG11 donor strain. This work led us to characterize the phenotypic effect of two kinds of mutation: mutation conferring decreased fluconazole susceptibility in a species-specific manner and mutation conferring fluconazole resistance in several yeast species. In particular, a missense mutation affecting amino acid K143 of Erg11p in Candida species, and the equivalent position K151 in K. marxianus , plays a critical role in fluconazole resistance., (Copyright © 2017 American Society for Microbiology.)
- Published
- 2017
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39. Molecular Diagnosis of Invasive Aspergillosis and Detection of Azole Resistance by a Newly Commercialized PCR Kit.
- Author
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Dannaoui E, Gabriel F, Gaboyard M, Lagardere G, Audebert L, Quesne G, Godichaud S, Verweij PE, Accoceberry I, and Bougnoux ME
- Subjects
- Aspergillus fumigatus drug effects, Cytochrome P-450 Enzyme System genetics, Drug Resistance, Fungal, Fungal Proteins genetics, Humans, Invasive Pulmonary Aspergillosis microbiology, Multiplex Polymerase Chain Reaction methods, RNA, Ribosomal, 28S genetics, Reagent Kits, Diagnostic, Sensitivity and Specificity, Antifungal Agents pharmacology, Aspergillus fumigatus isolation & purification, Azoles pharmacology, Invasive Pulmonary Aspergillosis diagnosis, Microbiological Techniques methods, Molecular Diagnostic Techniques methods, Real-Time Polymerase Chain Reaction methods
- Abstract
Aspergillus fumigatus is the main species responsible for aspergillosis in humans. The diagnosis of aspergillosis remains difficult, and the rapid emergence of azole resistance in A. fumigatus is worrisome. The aim of this study was to validate the new MycoGENIE A. fumigatus real-time PCR kit and to evaluate its performance on clinical samples for the detection of A. fumigatus and its azole resistance. This multiplex assay detects DNA from the A. fumigatus species complex by targeting the multicopy 28S rRNA gene and specific TR
34 and L98H mutations in the single-copy-number cyp51A gene of A. fumigatus The specificity of cyp51A mutation detection was assessed by testing DNA samples from 25 wild-type or mutated clinical A. fumigatus isolates. Clinical validation was performed on 88 respiratory samples obtained from 62 patients and on 69 serum samples obtained from 16 patients with proven or probable aspergillosis and 13 patients without aspergillosis. The limit of detection was <1 copy for the Aspergillus 28S rRNA gene and 6 copies for the cyp51A gene harboring the TR34 and L98H alterations. No cross-reactivity was detected with various fungi and bacteria. All isolates harboring the TR34 and L98H mutations were accurately detected by quantitative PCR (qPCR) analysis. With respiratory samples, qPCR results showed a sensitivity and specificity of 92.9% and 90.1%, respectively, while with serum samples, the sensitivity and specificity were 100% and 84.6%, respectively. Our study demonstrated that this new real-time PCR kit enables sensitive and rapid detection of A. fumigatus DNA and azole resistance due to TR34 and L98H mutations in clinical samples., (Copyright © 2017 American Society for Microbiology.)- Published
- 2017
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40. AFM combined to ATR-FTIR reveals Candida cell wall changes under caspofungin treatment.
- Author
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Quilès F, Accoceberry I, Couzigou C, Francius G, Noël T, and El-Kirat-Chatel S
- Subjects
- Echinocandins, Lipopeptides, Microbial Sensitivity Tests, Antifungal Agents pharmacology, Candida drug effects, Caspofungin pharmacology, Cell Wall drug effects, Microscopy, Atomic Force, Spectroscopy, Fourier Transform Infrared
- Abstract
Fungal pathogens from Candida genus are responsible for severe life-threatening infections and the antifungal arsenal is still limited. Caspofungin, an antifungal drug used for human therapy, acts as a blocking agent of the cell wall synthesis by inhibiting the β-1,3-glucan-synthase encoded by FKS genes. Despite its efficiency, the number of genetic mutants that are resistant to caspofungin is increasing. An important challenge to improve antifungal therapy is to understand cellular phenomenon that are associated with drug resistance. Here we used atomic force microscopy (AFM) combined to Fourier transform infrared spectroscopy in attenuated total reflection mode (ATR-FTIR) to decipher the effect of low and high drug concentration on the morphology, mechanics and cell wall composition of two Candida strains, one susceptible and one resistant to caspofungin. Our results confirm that caspofungin induces a dramatic cell wall remodelling via activation of stress responses, even at high drug concentration. Additionally, we highlighted unexpected changes related to drug resistance, suggesting that caspofungin resistance associated with FKS gene mutations comes from a combination of effects: (i) an overall remodelling of yeast cell wall composition; and (ii) cell wall stiffening through chitin synthesis. This work demonstrates that AFM combined to ATR-FTIR is a valuable approach to understand at the molecular scale the biological mechanisms associated with drug resistance.
- Published
- 2017
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41. Validation of a New Web Application for Identification of Fungi by Use of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.
- Author
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Normand AC, Becker P, Gabriel F, Cassagne C, Accoceberry I, Gari-Toussaint M, Hasseine L, De Geyter D, Pierard D, Surmont I, Djenad F, Donnadieu JL, Piarroux M, Ranque S, Hendrickx M, and Piarroux R
- Subjects
- Algorithms, Dermatomycoses microbiology, Humans, Mycological Typing Techniques instrumentation, Software, Arthrodermataceae classification, Databases, Factual, Dermatomycoses diagnosis, Mycological Typing Techniques methods, Online Systems, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization methods
- Abstract
Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry has emerged as a reliable technique to identify molds involved in human diseases, including dermatophytes, provided that exhaustive reference databases are available. This study assessed an online identification application based on original algorithms and an extensive in-house reference database comprising 11,851 spectra (938 fungal species and 246 fungal genera). Validation criteria were established using an initial panel of 422 molds, including dermatophytes, previously identified via DNA sequencing (126 species). The application was further assessed using a separate panel of 501 cultured clinical isolates (88 mold taxa including dermatophytes) derived from five hospital laboratories. A total of 438 (87.35%) isolates were correctly identified at the species level, while 26 (5.22%) were assigned to the correct genus but the wrong species and 37 (7.43%) were not identified, since the defined threshold of 20 was not reached. The use of the Bruker Daltonics database included in the MALDI Biotyper software resulted in a much higher rate of unidentified isolates (39.76 and 74.30% using the score thresholds 1.7 and 2.0, respectively). Moreover, the identification delay of the online application remained compatible with real-time online queries (0.15 s per spectrum), and the application was faster than identifications using the MALDI Biotyper software. This is the first study to assess an online identification system based on MALDI-TOF spectrum analysis. We have successfully applied this approach to identify molds, including dermatophytes, for which diversity is insufficiently represented in commercial databases. This free-access application is available to medical mycologists to improve fungal identification., (Copyright © 2017 American Society for Microbiology.)
- Published
- 2017
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42. Genome Sequence of the Yeast Clavispora lusitaniae Type Strain CBS 6936.
- Author
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Durrens P, Klopp C, Biteau N, Fitton-Ouhabi V, Dementhon K, Accoceberry I, Sherman DJ, and Noël T
- Abstract
Clavispora lusitaniae , an environmental saprophytic yeast belonging to the CTG clade of Candida , can behave occasionally as an opportunistic pathogen in humans. We report here the genome sequence of the type strain CBS 6936. Comparison with sequences of strain ATCC 42720 indicates conservation of chromosomal structure but significant nucleotide divergence., (Copyright © 2017 Durrens et al.)
- Published
- 2017
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43. Multicenter Comparison of the Etest and EUCAST Methods for Antifungal Susceptibility Testing of Candida Isolates to Micafungin.
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Bougnoux ME, Dannaoui E, Accoceberry I, Angoulvant A, Bailly E, Botterel F, Chevrier S, Chouaki T, Cornet M, Dalle F, Datry A, Dupuis A, Fekkar A, Gangneux JP, Guitard J, Hennequin C, Le Govic Y, Le Pape P, Maubon D, Ranque S, Sautour M, Sendid B, and Chandenier J
- Subjects
- Candida genetics, Drug Resistance, Fungal genetics, Micafungin, Microbial Sensitivity Tests, Antifungal Agents pharmacology, Candida drug effects, Echinocandins pharmacology, Lipopeptides pharmacology
- Abstract
In vitro susceptibility of 933 Candida isolates, from 16 French hospitals, to micafungin was determined using the Etest in each center. All isolates were then sent to a single center for determination of MICs by the EUCAST reference method. Overall essential agreement between the two tests was 98.5% at ±2 log2 dilutions and 90.2% at ±1 log2 dilutions. Categorical agreement was 98.2%. The Etest is a valuable alternative to EUCAST for the routine determination of micafungin MICs in medical mycology laboratories., (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)
- Published
- 2016
- Full Text
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44. Saprochaete clavata invasive infection in a patient with severe aplastic anemia: Efficacy of voriconazole and liposomal amphotericin B with adjuvant granulocyte transfusions before neutrophil recovery following allogeneic bone marrow transplantation.
- Author
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Favre S, Rougeron A, Levoir L, Pérard B, Milpied N, Accoceberry I, Gabriel F, and Vigouroux S
- Abstract
We report a case of a 27-year old man with severe aplastic anemia who developed a Saprochaete clavata (Geotrichum clavatum) disseminated invasive infection shortly prior a scheduled allogeneic bone marrow transplantation. Treatment with a combination of voriconazole, liposomal amphotericin B and adjuvant granulocyte transfusions was successful before neutrophil recovery.
- Published
- 2016
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45. Trichosporon faecale invasive infection in a patient with severe aplastic anemia: Efficacy of voriconazole and liposomal amphotericin B before neutrophil recovery.
- Author
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Pérard B, Rougeron A, Favre S, Accoceberry I, Vigouroux S, Mohr C, and Milpied N
- Abstract
We report a case of a 51-year old man with a severe aplastic anemia who developed an invasive trichosporonosis to Trichosporon faecale with fungemia and skin lesions during severe neutropenia. The treatment was successful before neutrophil recovery with a combination of voriconazole and liposomal amphotericin B.
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- 2015
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46. Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study.
- Author
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Robert-Gangneux F, Sterkers Y, Yera H, Accoceberry I, Menotti J, Cassaing S, Brenier-Pinchart MP, Hennequin C, Delhaes L, Bonhomme J, Villena I, Scherer E, Dalle F, Touafek F, Filisetti D, Varlet-Marie E, Pelloux H, and Bastien P
- Subjects
- France epidemiology, Humans, Prevalence, Retrospective Studies, Survival Analysis, Toxoplasma genetics, Toxoplasmosis diagnosis, Toxoplasmosis parasitology, Toxoplasmosis pathology, Immunocompromised Host, Microbiological Techniques, Molecular Diagnostic Techniques, Polymerase Chain Reaction, Toxoplasma isolation & purification, Toxoplasmosis epidemiology
- Abstract
Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV(+); the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome., (Copyright © 2015, American Society for Microbiology. All Rights Reserved.)
- Published
- 2015
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47. A Fox2-dependent fatty acid ß-oxidation pathway coexists both in peroxisomes and mitochondria of the ascomycete yeast Candida lusitaniae.
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Gabriel F, Accoceberry I, Bessoule JJ, Salin B, Lucas-Guérin M, Manon S, Dementhon K, and Noël T
- Subjects
- Blotting, Western, Candida growth & development, Candidiasis metabolism, Candidiasis microbiology, Carbon metabolism, Cells, Cultured, Enoyl-CoA Hydratase genetics, Immunoenzyme Techniques, Microscopy, Immunoelectron, Mutation genetics, Oxidation-Reduction, RNA, Messenger genetics, Real-Time Polymerase Chain Reaction, Reverse Transcriptase Polymerase Chain Reaction, Candida metabolism, Enoyl-CoA Hydratase metabolism, Fatty Acids chemistry, Fatty Acids metabolism, Mitochondria metabolism, Peroxisomes metabolism
- Abstract
It is generally admitted that the ascomycete yeasts of the subphylum Saccharomycotina possess a single fatty acid ß-oxidation pathway located exclusively in peroxisomes, and that they lost mitochondrial ß-oxidation early during evolution. In this work, we showed that mutants of the opportunistic pathogenic yeast Candida lusitaniae which lack the multifunctional enzyme Fox2p, a key enzyme of the ß-oxidation pathway, were still able to grow on fatty acids as the sole carbon source, suggesting that C. lusitaniae harbored an alternative pathway for fatty acid catabolism. By assaying 14Cα-palmitoyl-CoA consumption, we demonstrated that fatty acid catabolism takes place in both peroxisomal and mitochondrial subcellular fractions. We then observed that a fox2Δ null mutant was unable to catabolize fatty acids in the mitochondrial fraction, thus indicating that the mitochondrial pathway was Fox2p-dependent. This finding was confirmed by the immunodetection of Fox2p in protein extracts obtained from purified peroxisomal and mitochondrial fractions. Finally, immunoelectron microscopy provided evidence that Fox2p was localized in both peroxisomes and mitochondria. This work constitutes the first demonstration of the existence of a Fox2p-dependent mitochondrial β-oxidation pathway in an ascomycetous yeast, C. lusitaniae. It also points to the existence of an alternative fatty acid catabolism pathway, probably located in peroxisomes, and functioning in a Fox2p-independent manner.
- Published
- 2014
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48. Deletion of the uracil permease gene confers cross-resistance to 5-fluorouracil and azoles in Candida lusitaniae and highlights antagonistic interaction between fluorinated nucleotides and fluconazole.
- Author
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Gabriel F, Sabra A, El-Kirat-Chatel S, Pujol S, Fitton-Ouhabi V, Brèthes D, Dementhon K, Accoceberry I, and Noël T
- Subjects
- Azoles pharmacology, Biological Transport, Candida genetics, Candida metabolism, Crosses, Genetic, Drug Antagonism, Drug Resistance, Fungal, Flucytosine pharmacology, Fluorouracil pharmacology, Fungal Proteins metabolism, Microbial Sensitivity Tests, Nucleobase Transport Proteins metabolism, Nucleotide Transport Proteins metabolism, Sterol 14-Demethylase genetics, Sterol 14-Demethylase metabolism, Uracil pharmacology, Uridine analogs & derivatives, Uridine pharmacology, Antifungal Agents pharmacology, Candida drug effects, Fungal Proteins genetics, Gene Deletion, Gene Expression Regulation, Fungal, Nucleobase Transport Proteins genetics, Nucleotide Transport Proteins genetics
- Abstract
We characterized two additional membrane transporters (Fur4p and Dal4p) of the nucleobase cation symporter 1 (NCS1) family involved in the uptake transport of pyrimidines and related molecules in the opportunistic pathogenic yeast Candida lusitaniae. Simple and multiple null mutants were constructed by gene deletion and genetic crosses. The function of each transporter was characterized by supplementation experiments, and the kinetic parameters of the uptake transport of uracil were measured using radiolabeled substrate. Fur4p specifically transports uracil and 5-fluorouracil. Dal4p is very close to Fur4p and transports allantoin (glyoxyldiureide). Deletion of the FUR4 gene confers resistance to 5-fluorouracil as well as cross-resistance to triazoles and imidazole antifungals when they are used simultaneously with 5-fluorouracil. However, the nucleobase transporters are not involved in azole uptake. Only fluorinated pyrimidines, not pyrimidines themselves, are able to promote cross-resistance to azoles by both the salvage and the de novo pathway of pyrimidine synthesis. A reinterpretation of the data previously obtained led us to show that subinhibitory doses of 5-fluorocytosine, 5-fluorouracil, and 5-fluorouridine also were able to trigger resistance to fluconazole in susceptible wild-type strains of C. lusitaniae and of different Candida species. Our results suggest that intracellular fluorinated nucleotides play a key role in azole resistance, either by preventing azoles from targeting the lanosterol 14-alpha-demethylase or its catalytic site or by acting as a molecular switch for the triggering of efflux transport., (Copyright © 2014, American Society for Microbiology. All Rights Reserved.)
- Published
- 2014
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49. Two missense mutations, E123Q and K151E, identified in the ERG11 allele of an azole-resistant isolate of Candida kefyr recovered from a stem cell transplant patient for acute myeloid leukemia.
- Author
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Couzigou C, Gabriel F, Biteau N, Fitton-Ouhabi V, Noël T, and Accoceberry I
- Abstract
We report on the first cloning and nucleotide sequencing of an ERG11 allele from a clinical isolate of Candida kefyr cross-resistant to azole antifungals. It was recovered from a stem cell transplant patient, in an oncohematology unit exhibiting unexpected high prevalence of C. kefyr. Two amino acid substitutions were identified: K151E, whose role in fluconazole resistance was already demonstrated in Candida albicans, and E123Q, a new substitution never described so far in azole-resistant Candida yeast.
- Published
- 2014
- Full Text
- View/download PDF
50. Evaluation of two matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems for the identification of Candida species.
- Author
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Lacroix C, Gicquel A, Sendid B, Meyer J, Accoceberry I, François N, Morio F, Desoubeaux G, Chandenier J, Kauffmann-Lacroix C, Hennequin C, Guitard J, Nassif X, and Bougnoux ME
- Subjects
- Candida chemistry, Candidiasis diagnosis, Candidiasis microbiology, Humans, Prospective Studies, Candida classification, Candida isolation & purification, Microbiological Techniques methods, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization methods
- Abstract
Candida spp. are responsible for severe infections in immunocompromised patients and those undergoing invasive procedures. The accurate identification of Candida species is important because emerging species can be associated with various antifungal susceptibility spectra. Conventional methods have been developed to identify the most common pathogens, but have often failed to identify uncommon species. Several studies have reported the efficiency of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for the identification of clinically relevant Candida species. In this study, we evaluated two commercially available MALDI-TOF systems, Andromas™ and Bruker Biotyper™, for Candida identification in routine diagnosis. For this purpose, we investigated 1383 Candida isolates prospectively collected in eight hospital laboratories during routine practice. MALDI-TOF MS results were compared with those obtained using conventional phenotypic methods. Analysis of rDNA gene sequences with internal transcribed regions or D1-D2 regions is considered the reference standard for identification. Both MALDI-TOF MS systems could accurately identify 98.3% of the isolates at the species level (1359/1383 for Andromas™; 1360/1383 for Bruker Biotyper™) vs. 96.5% for conventional techniques. Furthermore, whereas conventional methods failed to identify rare or emerging species, these were correctly identified by MALDI-TOF MS. Both MALDI-TOF MS systems are accurate and cost-effective alternatives to conventional methods for mycological identification of clinically relevant Candida species and should improve the diagnosis of fungal infections as well as patient management., (© 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.)
- Published
- 2014
- Full Text
- View/download PDF
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