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Sevestre J, Marty P, Hubiche T, Pomares C, Delaunay P. Groundbreaking outpatient activity in medical entomology in France: An eight-year experience in a french university hospital. Infect Dis Now 2023; 53:104728. [PMID: 37295744 DOI: 10.1016/j.idnow.2023.104728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 03/21/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Arthropods are known to impair human health in various manners, acting as infectious disease vectors, or as simple nuisances. Even though considerable research is being produced in medical entomology, no reports on patient management in clinical entomology units are available in the literature. PATIENTS AND METHODS We retrospectively surveyed all the records from patients having consulted in our outpatient clinical entomology unit in Nice University Hospital from 2012 to 2020. For each patient, physical examination findings and treatment data were analyzed. RESULTS A total of 518 patients were analyzed in this study. Most were diagnosed with arthropod infestation (55.8%), the most common being Sarcoptes scabiei (35%), bedbugs (23%), Pyemotes dermatitis (17.6%) and flea infestation (15.9%). Along with symptomatic treatments, targeted environmental measures could be proposed for infested patients. For many of our patients, on the other hand, active infestation was ruled out. CONCLUSION Given today's lack of expertise in medical entomology, we advocate for the creation of medical entomology units in university hospitals, not only allowing fair and proportionate multidisciplinary management of patients in whom arthropod infestation is suspected, but also generating cost savings.
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Affiliation(s)
- Jacques Sevestre
- Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice, Nice, France.
| | - Pierre Marty
- Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice, Nice, France; C3M, INSERM 1065, Université de la Côte d'Azur, Nice, France
| | - Thomas Hubiche
- Service de Dermatologie, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Christelle Pomares
- Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice, Nice, France; C3M, INSERM 1065, Université de la Côte d'Azur, Nice, France
| | - Pascal Delaunay
- Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice, Nice, France
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Ngnindji-Youdje Y, Diarra AZ, Lontsi-Demano M, Berenger JM, Tchuinkam T, Parola P. MALDI-TOF MS identification of cattle ticks from Cameroon. Ticks Tick Borne Dis 2023; 14:102159. [PMID: 36907070 DOI: 10.1016/j.ttbdis.2023.102159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 02/09/2023] [Accepted: 02/26/2023] [Indexed: 03/12/2023]
Abstract
MALDI-TOF MS has recently been proposed as an accurate tool for arthropod identification, including ticks. In this study, we evaluate and confirm the ability of MALDI-TOF MS, to identify different tick species collected in Cameroon, considering other lines of evidence (morphology and molecular). A total of 1483 adult ticks were collected from cattle in five distinct sites in the Western Highland of Cameroon. Because of engorged status and/or absence of some morphological criteria, some Ixodes spp. and Rhipicephalus spp. were identified to the genus level only. Among those, 944 ticks (543 males and 401 females) were selected for the current work. They were classified into 5 genera and 11 species: Rhipicephalus (Boophilus) microplus (31.7%), Rhipicephalus lunulatus (26%), Amblyomma variegatum (23%), Rhipicephalus sanguineus s.l. (4.8%), of Haemaphysalis leachi group (4.6%), Hyalomma truncatum (2.6%), Hyalomma rufipes (1.7%), Rhipicephalus muhsamae (1.1%), Rhipicephalus (Boophilus) annulatus (0.6%), Rhipicephalus (Boophilus) decoloratus (0.3%), Ixodes rasus (0.1%), Ixodes spp. (0.2%) and Rhipicephalus spp. (3.3%). Tick legs were subjected to MALDI-TOF MS analyzes, and the spectra of 929 (98.4%) specimens were of good quality. Analysis of these spectra provided intra-species reproducibility and interspecies specificity of MS profiles obtained from the different species. Our in-house MALDI-TOF MS arthropod database was upgraded with spectra from 44 specimens of 10 different tick species. Blind testing of good quality spectra revealed that 99% agreed with the morphological identification. Of these, 96.9% had log score values (LSVs) between 1.73 and 2.57. MALDI-TOF MS also allowed to correct the morphological misidentification of 7 ticks, and to identify 32 engorged ticks that were not morphologically identifiable to the species level. This study supports MALDI-TOF MS as a reliable tool for tick identification and provides new data on tick species identification in Cameroon.
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Affiliation(s)
- Yannick Ngnindji-Youdje
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21 Boulevard Jean Moulin, Marseille 13005, France; IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; Vectors Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Faculty of Sciences of the University of Dschang, P.O. Box 067, Dschang, Cameroon
| | - Adama Zan Diarra
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21 Boulevard Jean Moulin, Marseille 13005, France; IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France
| | - Michel Lontsi-Demano
- Vectors Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Faculty of Sciences of the University of Dschang, P.O. Box 067, Dschang, Cameroon
| | - Jean-Michel Berenger
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21 Boulevard Jean Moulin, Marseille 13005, France; IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France
| | - Timoléon Tchuinkam
- Vectors Borne Diseases Laboratory of the Research Unit for Biology and Applied Ecology (VBID-RUBAE), Faculty of Sciences of the University of Dschang, P.O. Box 067, Dschang, Cameroon
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, 19-21 Boulevard Jean Moulin, Marseille 13005, France; IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France.
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Sevestre J, Lemrabott MAO, Bérenger JM, Zan Diarra A, Ould Mohamed Salem Boukhary A, Parola P. Detection of Arthropod-Borne Bacteria and Assessment of MALDI-TOF MS for the Identification of Field-Collected Immature Bed Bugs from Mauritania. INSECTS 2023; 14:69. [PMID: 36661997 PMCID: PMC9864073 DOI: 10.3390/insects14010069] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Human infestations by bed bugs have upsurged globally in recent decades, including in African countries, where recent reports pointed out an increase in infestation. Sympatric dwelling has been described for two species of bed bug parasitizing humans: Cimex hemipterus (the tropical bed bug) and C. lectularius. Identification of these two species is based on morphological characteristics, and gene sequencing, and may also rely on Matrix-Assisted Laser Desorption Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS). The present work aimed to assess whether MALDI-TOF MS was applicable for species level identification of immature stages of Cimex. Arthropods were collected in domestic settings in Nouakchott, Mauritania. Identification used morphological keys and MALDI-TOF MS identification was assessed for immature stages. Quantitative PCR and sequencing assays were used to detect arthropod-associated bacteria in each specimen. A total of 92 arthropods were collected, all morphologically identified as C. hemipterus (32 males, 14 females and 45 immature stages). A total of 35/45 specimens produced good quality MALDI-TOF MS spectra. Analysis allowed species level identification of all immature C. hemipterus after their spectra were entered into our in-house MALDI-TOF MS arthropod spectra database. Molecular screening allowed detection of Wolbachia DNA in each specimen. These results suggested that MALDI-TOF MS is a reliable tool for species level identification of Cimex specimens, including immature specimens. Future studies should assess this approach on larger panels of immature specimens for different Cimex species and focus on the precise staging of their different immature developmental stages.
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Affiliation(s)
- Jacques Sevestre
- Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
- IRD, AP-HM, SSA, VITROME, Aix Marseille University, 13005 Marseille, France
| | - Mohamed Aly Ould Lemrabott
- Unité de Recherche Génomes et Milieux, Faculté des Sciences et Techniques, Université de Nouakchott, Nouakchott BP 880, Mauritania
| | - Jean-Michel Bérenger
- Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
- IRD, AP-HM, SSA, VITROME, Aix Marseille University, 13005 Marseille, France
| | - Adama Zan Diarra
- Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
- IRD, AP-HM, SSA, VITROME, Aix Marseille University, 13005 Marseille, France
| | - Ali Ould Mohamed Salem Boukhary
- Unité de Recherche Génomes et Milieux, Faculté des Sciences et Techniques, Université de Nouakchott, Nouakchott BP 880, Mauritania
| | - Philippe Parola
- Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
- IRD, AP-HM, SSA, VITROME, Aix Marseille University, 13005 Marseille, France
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Babesiosis in Southeastern, Central and Northeastern Europe: An Emerging and Re-Emerging Tick-Borne Disease of Humans and Animals. Microorganisms 2022; 10:microorganisms10050945. [PMID: 35630388 PMCID: PMC9146636 DOI: 10.3390/microorganisms10050945] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 12/10/2022] Open
Abstract
There is now considerable evidence that in Europe, babesiosis is an emerging infectious disease, with some of the causative species spreading as a consequence of the increasing range of their tick vector hosts. In this review, we summarize both the historic records and recent findings on the occurrence and incidence of babesiosis in 20 European countries located in southeastern Europe (Bosnia and Herzegovina, Croatia, and Serbia), central Europe (Austria, the Czech Republic, Germany, Hungary, Luxembourg, Poland, Slovakia, Slovenia, and Switzerland), and northern and northeastern Europe (Lithuania, Latvia, Estonia, Iceland, Denmark, Finland, Sweden, and Norway), identified in humans and selected species of domesticated animals (cats, dogs, horses, and cattle). Recorded cases of human babesiosis are still rare, but their number is expected to rise in the coming years. This is because of the widespread and longer seasonal activity of Ixodes ricinus as a result of climate change and because of the more extensive use of better molecular diagnostic methods. Bovine babesiosis has a re-emerging potential because of the likely loss of herd immunity, while canine babesiosis is rapidly expanding in central and northeastern Europe, its occurrence correlating with the rapid, successful expansion of the ornate dog tick (Dermacentor reticulatus) populations in Europe. Taken together, our analysis of the available reports shows clear evidence of an increasing annual incidence of babesiosis across Europe in both humans and animals that is changing in line with similar increases in the incidence of other tick-borne diseases. This situation is of major concern, and we recommend more extensive and frequent, standardized monitoring using a “One Health” approach.
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Sevestre J, Benichou A, Rio V, Delaunay P, Gonfrier G, Martaresche C, Carlo V, Nakam S, Mondain V, Carles M, Jeandel PY, Durant J. Emergence of Lyme Disease on the French Riviera, a Retrospective Survey. Front Med (Lausanne) 2022; 9:737854. [PMID: 35391881 PMCID: PMC8981725 DOI: 10.3389/fmed.2022.737854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe French Riviera has been declared free of Lyme Borreliosis (LB) for years. Many patients are referred for presumed LB, sometimes with atypical clinical signs and/or doubtful serology, calling the diagnosis into question.MethodsPatients were assessed for LB diagnosis, depending on clinical presentation, laboratory findings, and further examination by other medical professionals.ResultsAmong 255 patients, 45 (18%) were classified as confirmed LB cases [including 28 ongoing LB (10%) and 17 past LB (8%)], and for 210 (82%) a Lyme borreliosis diagnosis was ruled out. Among ongoing LB, 56% had been exposed to or bitten by ticks, exclusively in rural locations of the Alpes-Maritimes. As a result of the diagnostic procedure, 132 (52%) patients had been treated. An alternative diagnosis was established for 134 (52%) patients, covering a wide range of conditions, including mainly psychological (28%) and neurological conditions (25%) or inflammatory and systemic diseases (22%).ConclusionsOur results strongly suggest the endemicity of LB in the Alpes-Maritimes region. Confirmed LB accounted for 18% of patients while 52% were diagnosed with other conditions.
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Affiliation(s)
- Jacques Sevestre
- Laboratory of Parasitology, Nice University Hospital, Nice, France
- IHU Méditerranée Infection, Marseille, France
| | - Antoine Benichou
- Department of Internal Medicine, Nice University Hospital, Nice, France
| | - Vanessa Rio
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - Pascal Delaunay
- Laboratory of Parasitology, Nice University Hospital, Nice, France
| | | | | | - Virginie Carlo
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - Sarah Nakam
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - Véronique Mondain
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | - Michel Carles
- Department of Infectious Diseases, Nice University Hospital, Nice, France
| | | | - Jacques Durant
- Department of Infectious Diseases, Nice University Hospital, Nice, France
- *Correspondence: Jacques Durant
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Vaca DJ, Dobler G, Fischer SF, Keller C, Konrad M, von Loewenich FD, Orenga S, Sapre SU, van Belkum A, Kempf VAJ. Contemporary diagnostics for medically relevant fastidious microorganisms belonging to the genera Anaplasma, Bartonella, Coxiella, Orientia, and Rickettsia. FEMS Microbiol Rev 2022; 46:6530194. [PMID: 35175353 PMCID: PMC9300619 DOI: 10.1093/femsre/fuac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 12/02/2022] Open
Abstract
Many of the human infectious pathogens—especially the zoonotic or vector-borne bacteria—are fastidious organisms that are difficult to cultivate because of their strong adaption to the infected host culminating in their near-complete physiological dependence on this environment. These bacterial species exhibit reduced multiplication rates once they are removed from their optimal ecological niche. This fact complicates the laboratory diagnosis of the disease and hinders the detection and further characterization of the underlying organisms, e.g. at the level of their resistance to antibiotics due to their slow growth. Here, we describe the current state of microbiological diagnostics for five genera of human pathogens with a fastidious laboratory lifestyle. For Anaplasma spp., Bartonella spp., Coxiella burnetii, Orientia spp. and Rickettsia spp., we will summarize the existing diagnostic protocols, the specific limitations for implementation of novel diagnostic approaches and the need for further optimization or expansion of the diagnostic armamentarium. We will reflect upon the diagnostic opportunities provided by new technologies including mass spectrometry and next-generation nucleic acid sequencing. Finally, we will review the (im)possibilities of rapidly developing new in vitro diagnostic tools for diseases of which the causative agents are fastidiously growing and therefore hard to detect.
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Affiliation(s)
- Diana J Vaca
- Institute of Medical Microbiology and Infection Control, Goethe University of Frankfurt, Germany
| | - Gerhard Dobler
- Department of Virology and Rickettsiology, Bundeswehr Institute of Microbiology, Germany
| | - Silke F Fischer
- National Consulting Laboratory for Coxiella burnetii, State Health Office Baden-Württemberg, Germany
| | | | - Maik Konrad
- National Consulting Laboratory for Coxiella burnetii, State Health Office Baden-Württemberg, Germany
| | | | | | | | | | - Volkhard A J Kempf
- Institute of Medical Microbiology and Infection Control, Goethe University of Frankfurt, Germany
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