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Mori A, Matucci A, Pomari E, Accordini S, Piubelli C, Donini A, Nicolini L, Castilletti C. Urine: A Pitfall for Molecular Detection of Toscana Virus? An Analytical Proof-of-Concept Study. Viruses 2024; 16:98. [PMID: 38257798 PMCID: PMC10821263 DOI: 10.3390/v16010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Toscana virus (TOSV), a sandfly-borne virus, is an important etiological agent in human acute meningitis and meningoencephalitis in the Mediterranean area during the summer. However, the actual number of TOSV infections is underestimated. Laboratory confirmation is necessary because TOSV infection has overlapping clinical features with other neuro-invasive viral infections. Nowadays, the reference test for direct diagnosis in the acute phase of TOSV infection is the PCR based method for detecting TOSV in cerebrospinal fluid and/or plasma, serum, or blood. Although poorly employed, urine is another helpful biological matrix for TOSV detection. Urine is a matrix rich in PCR inhibitors that affect PCR efficiency; consequently, false negatives could be generated. To investigate the potential effect of urine PCR inhibitors on TOSV detection, we compared undiluted and diluted urine using 10-fold series of spiked TOSV. The results showed a significant improvement in TOSV detection performance in diluted urine (1 TCID50 vs. 1 × 104 TCID50 limit of detection and 101.35% vs. 129.62% efficiency, respectively, in diluted and undiluted urine). In conclusion, our data provide preliminary important insights into the use of diluted urine to limit the impact of the inhibitory effects of urine on the detection of TOSV in RT-PCR-based approaches.
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Affiliation(s)
| | | | - Elena Pomari
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (A.M.); (S.A.); (C.P.); (A.D.); (L.N.)
| | | | | | | | | | - Concetta Castilletti
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 37024 Verona, Italy; (A.M.); (S.A.); (C.P.); (A.D.); (L.N.)
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Gámbaro F, Pérez AB, Prot M, Agüera E, Baidaliuk A, Sánchez-Seco MP, Martínez-Martínez L, Vázquez A, Fernandez-Garcia MD, Simon-Loriere E. Untargeted metagenomic sequencing identifies Toscana virus in patients with idiopathic meningitis, southern Spain, 2015 to 2019. Euro Surveill 2023; 28:2200913. [PMID: 37943504 PMCID: PMC10636744 DOI: 10.2807/1560-7917.es.2023.28.45.2200913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/15/2023] [Indexed: 11/10/2023] Open
Abstract
BackgroundVarious pathogens, including bacteria, fungi, parasites, and viruses can lead to meningitis. Among viruses causing meningitis, Toscana virus (TOSV), a phlebovirus, is transmitted through sandfly bites. TOSV infection may be suspected if patients with enterovirus- and herpesvirus-negative aseptic (non-bacterial) meningitis recall recent insect bites. Other epidemiological factors (season, rural area) may be considered. The broad range of possible meningitis aetiologies poses considerable diagnosis challenges. Untargeted metagenomic next-generation sequencing (mNGS) can potentially identify pathogens, which are not considered or detected in routine diagnostic panels.AimIn this retrospective, single-centre observational study, we investigated mNGS usefulness to understand the cause of meningitis when conventional approaches fail.MethodsCerebrospinal fluid (CSF) samples from patients hospitalised in southern Spain in 2015-2019 with aseptic meningitis and no aetiology found by conventional testing, were subjected to mNGS. Patients' demographic characteristics had been recorded and physicians had asked them about recent insect bites. Obtained viral genome sequences were phylogenetically analysed.ResultsAmong 23 idiopathic cases, TOSV was identified in eight (all male; median age: 39 years, range: 15-78 years). Five cases lived in an urban setting, three occurred in autumn and only one recalled insect bites. Phylogenetic analysis of TOSV segment sequences supported one intra-genotype reassortment event.ConclusionsOur study highlights the usefulness of mNGS for identifying viral pathogens directly in CSF. In southern Spain, TOSV should be considered regardless of recalling of insect bites or other epidemiological criteria. Detection of a disease-associated reassortant TOSV emphasises the importance of monitoring the spread and evolution of phleboviruses in Mediterranean countries.
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Affiliation(s)
- Fabiana Gámbaro
- G5 Evolutionary Genomics of RNA Viruses, Institut Pasteur, Université Paris Cité, Paris, France
| | - Ana Belén Pérez
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Matthieu Prot
- G5 Evolutionary Genomics of RNA Viruses, Institut Pasteur, Université Paris Cité, Paris, France
| | - Eduardo Agüera
- Universidad de Córdoba, Córdoba, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Artem Baidaliuk
- G5 Evolutionary Genomics of RNA Viruses, Institut Pasteur, Université Paris Cité, Paris, France
| | - María Paz Sánchez-Seco
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Martínez-Martínez
- Universidad de Córdoba, Córdoba, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Ana Vázquez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - María Dolores Fernandez-Garcia
- These authors contributed equally to this work and share last authorship and correspondence
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
- National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Etienne Simon-Loriere
- These authors contributed equally to this work and share last authorship and correspondence
- G5 Evolutionary Genomics of RNA Viruses, Institut Pasteur, Université Paris Cité, Paris, France
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Benbetka C, Hachid A, Benallal KE, Khardine FA, Ayhan N, Bouredjoul N, Boulehbal WM, Bellila D, Khaldi A, Charrel R. Epidemiology, Isolation, and Genetic Characterization of Toscana Virus in Algerian Patients Displaying Neurological Infection, 2016-2018. IJID REGIONS 2023; 7:193-198. [PMID: 37123383 PMCID: PMC10131063 DOI: 10.1016/j.ijregi.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 05/02/2023]
Abstract
Purpose The current study reports the results of the diagnosis of neuro-invasive Toscana virus (TOSV) infection in Algeria between 2016 and 2018 and describes the first isolation of TOSV strain from human samples in North Africa. Materiel and methods Cerebrospinal fluid (CSF) and sera samples were obtained from 720 hospitalized patients displaying neurological infection symptoms of unknown etiology, of which 604 were screened for TOSV. The diagnosis was performed by serological and/or RT-PCR tests. In addition, TOSV was isolated in vivo and in vitro from CSF and genetically characterized. Results 23 cases of TOSV neurological infections were detected. Cases were located in 11 Wilayas (administrative provinces), mainly in northern Algeria. In addition, we report the isolation of TOSV strain belonging to lineage A from human samples with its complete coding sequence. Conclusion Even though the number of infections is probably underestimated, TOSV is endemic in Algeria, with several cases of neuro-invasive diseases in humans recorded each year. Therefore, the diagnosis of TOSV should be included in the differential diagnosis of neurological diseases, especially aseptic meningitis, during the period of activity of the phlebotomine vector. Further studies are required to measure precisely the nationwide prevalence of TOSV in Algeria.
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Affiliation(s)
- Chahrazed Benbetka
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Department of Immunology, Béni-Messous Teaching Hospital, University of Algiers, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
- Co-first authors.
| | - Aissam Hachid
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
- Co-first authors.
| | - Kamal Eddine Benallal
- Laboratory of Parasitic Eco-epidemiology and Population Genetics, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | - Fayez Ahmed Khardine
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | - Nazli Ayhan
- Unité des Virus Emergents, UVE: Aix Marseille Université, IRD 190, Inserm 1207, AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
| | - Nesrine Bouredjoul
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | | | - Djamila Bellila
- Faculty of Natural Sciences, University of Algiers 1, 16000, Algiers, Algeria
| | - Aldjia Khaldi
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
| | - Rémi Charrel
- Unité des Virus Emergents, UVE: Aix Marseille Université, IRD 190, Inserm 1207, AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
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Rossi B, Barreca F, Benvenuto D, Braccialarghe N, Campogiani L, Lodi A, Aguglia C, Cavasio RA, Giacalone ML, Kontogiannis D, Moccione M, Malagnino V, Andreoni M, Sarmati L, Iannetta M. Human Arboviral Infections in Italy: Past, Current, and Future Challenges. Viruses 2023; 15:v15020368. [PMID: 36851582 PMCID: PMC9963149 DOI: 10.3390/v15020368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
Arboviruses represent a public health concern in many European countries, including Italy, mostly because they can infect humans, causing potentially severe emergent or re-emergent diseases, with epidemic outbreaks and the introduction of endemic circulation of new species previously confined to tropical and sub-tropical regions. In this review, we summarize the Italian epidemiology of arboviral infection over the past 10 years, describing both endemic and imported arboviral infections, vector distribution, and the influence of climate change on vector ecology. Strengthening surveillance systems at a national and international level is highly recommended to be prepared to face potential threats due to arbovirus diffusion.
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Affiliation(s)
- Benedetta Rossi
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Filippo Barreca
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Domenico Benvenuto
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Neva Braccialarghe
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Laura Campogiani
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Alessandra Lodi
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Camilla Aguglia
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | | | - Maria Laura Giacalone
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Dimitra Kontogiannis
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Martina Moccione
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Vincenzo Malagnino
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Massimo Andreoni
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Loredana Sarmati
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Marco Iannetta
- Infectious Disease Clinic, Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
- Department of System Medicine Tor Vergata, University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Correspondence:
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Matusali G, D’Abramo A, Terrosi C, Carletti F, Colavita F, Vairo F, Savellini GG, Gandolfo C, Anichini G, Lalle E, Bordi L, Corpolongo A, Maritti M, Marchioni L, Capobianchi MR, Castilletti C, Cusi MG, Nicastri E. Infectious Toscana Virus in Seminal Fluid of Young Man Returning from Elba Island, Italy. Emerg Infect Dis 2022; 28:865-869. [PMID: 35318936 PMCID: PMC8962903 DOI: 10.3201/eid2804.211920] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We report detecting infectious Toscana virus in the seminal fluid of a 25-year-old man from Italy returning from Elba Island. The presence of infectious virus in human semen adds Toscana virus to the long list of viruses detected in this genital fluid and indicates a potential for sexual transmission.
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Riccò M, Peruzzi S. Epidemiology of Toscana Virus in Italy (2018-2020), a summary of available evidences. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021230. [PMID: 34487075 PMCID: PMC8477082 DOI: 10.23750/abm.v92i4.11463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/20/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Simona Peruzzi
- 2. AUSL-IRCCS di Reggio Emilia, Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, 42016 Guastalla (RE), Italy. .
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