1
|
Su LD, Chiu CY, Gaston D, Hogan CA, Miller S, Simon DW, Thakur KT, Yang S, Piantadosi A. Clinical Metagenomic Next-Generation Sequencing for Diagnosis of Central Nervous System Infections: Advances and Challenges. Mol Diagn Ther 2024; 28:513-523. [PMID: 38992308 DOI: 10.1007/s40291-024-00727-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/13/2024]
Abstract
Central nervous system (CNS) infections carry a substantial burden of morbidity and mortality worldwide, and accurate and timely diagnosis is required to optimize management. Metagenomic next-generation sequencing (mNGS) has proven to be a valuable tool in detecting pathogens in patients with suspected CNS infection. By sequencing microbial nucleic acids present in a patient's cerebrospinal fluid, brain tissue, or samples collected outside of the CNS, such as plasma, mNGS can detect a wide range of pathogens, including rare, unexpected, and/or fastidious organisms. Furthermore, its target-agnostic approach allows for the identification of both known and novel pathogens. This is particularly useful in cases where conventional diagnostic methods fail to provide an answer. In addition, mNGS can detect multiple microorganisms simultaneously, which is crucial in cases of mixed infections without a clear predominant pathogen. Overall, clinical mNGS testing can help expedite the diagnostic process for CNS infections, guide appropriate management decisions, and ultimately improve clinical outcomes. However, there are key challenges surrounding its use that need to be considered to fully leverage its clinical impact. For example, only a few specialized laboratories offer clinical mNGS due to the complexity of both the laboratory methods and analysis pipelines. Clinicians interpreting mNGS results must be aware of both false negatives-as mNGS is a direct detection modality and requires a sufficient amount of microbial nucleic acid to be present in the sample tested-and false positives-as mNGS detects environmental microbes and their nucleic acids, despite best practices to minimize contamination. Additionally, current costs and turnaround times limit broader implementation of clinical mNGS. Finally, there is uncertainty regarding the best practices for clinical utilization of mNGS, and further work is needed to define the optimal patient population(s), syndrome(s), and time of testing to implement clinical mNGS.
Collapse
Affiliation(s)
- LingHui David Su
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA
| | - Charles Y Chiu
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA
- Department of Laboratory Medicine and Department of Medicine, Division of Infectious Diseases, University of California San Francisco, San Francisco, CA, USA
| | - David Gaston
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Catherine A Hogan
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steve Miller
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA
- Delve Bio, Inc., San Francisco, CA, USA
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Dennis W Simon
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA
- Department of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kiran T Thakur
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA
- Department of Neurology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA
| | - Shangxin Yang
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anne Piantadosi
- The Consortium for Clinical Metagenomics in Infectious Diseases, Nashville, TN, USA.
- Department of Pathology and Laboratory Medicine, and Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 101 Woodruff Circle, Atlanta, GA, USA.
| |
Collapse
|
2
|
Wang X, Xu H, Qin L, Wang H, Jiang Y, Liu H, Zhang M, Pang R, Wu W, Li W. Metagenomic next-generation sequencing of cerebrospinal fluid reveals etiological and microbiological features in patients with various central nervous system infections. FASEB J 2024; 38:e23812. [PMID: 39041354 DOI: 10.1096/fj.202400792r] [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: 04/09/2024] [Revised: 05/30/2024] [Accepted: 06/26/2024] [Indexed: 07/24/2024]
Abstract
The application of metagenomic next-generation sequencing (mNGS) in pathogens detection of cerebrospinal fluid (CSF) is limited because clinical, microbiological, and biological information are not well connected. We analyzed the 428 enrolled patients' clinical features, pathogens diagnostic efficiency of mNGS in CSF, microbial community structure and composition in CSF, and correlation of microbial and clinical biomarkers in CSF. General characteristics were unspecific but helpful in formulating a differential diagnosis. CSF mNGS has a higher detection rate (34.6%) compared to traditional methods (5.4%). mNGS detection rate was higher when the time from onset to CSF collection was ≤20 days, the CSF leukocytes count was >200 × 106/L, the CSF protein concentration was >1.3 g/L, or CSF glucose concentration was ≤2.5 mmol/L in non-postoperative bacterial CNS infections (CNSi). CSF was not strictly a sterile environment, and the potential pathogens may contribute to the dysbiosis of CSF microbiome. Furthermore, clinical biomarkers were significantly relevant to CNS pathogens. Clinical data are helpful in choosing a proper opportunity to obtain an accurate result of mNGS, and can speculate whether the mNGS results are correct or not. Our study is a pioneering study exploring the CSF microbiome in different CNSIs.
Collapse
Affiliation(s)
- Xiaojuan Wang
- Department of Neurology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| | - Huan Xu
- Vision Medicals Center for Infection Diseases, Guangzhou, China
| | - Lingzhi Qin
- Department of Neurology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| | - Huimin Wang
- Special Ward, Xinxiang Central Hospital, Xinxiang, China
| | - Yushu Jiang
- Department of Neurology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| | - Huiqin Liu
- Department of Neurology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| | - Milan Zhang
- Department of Neurology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| | - Rui Pang
- Department of Neurology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| | - Wencai Wu
- Vision Medicals Center for Infection Diseases, Guangzhou, China
| | - Wei Li
- Department of Neurology, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan University, Zhengzhou, China
| |
Collapse
|
3
|
Bergevin MD, Ng V, Sadeghieh T, Menzies P, Ludwig A, Mubareka S, Clow KM. A Scoping Review on the Epidemiology of Orthobunyaviruses in Canada, in the Context of Human, Wildlife, and Domestic Animal Host Species. Vector Borne Zoonotic Dis 2024; 24:249-264. [PMID: 38206763 DOI: 10.1089/vbz.2023.0109] [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] [Indexed: 01/13/2024] Open
Abstract
Background: Mosquito-borne orthobunyaviruses in Canada are a growing public health concern. Orthobunyaviral diseases are commonly underdiagnosed and in Canada, likely underreported as surveillance is passive. No vaccines or specific treatments exist for these disease agents. Further, climate change is facilitating habitat expansion for relevant reservoirs and vectors, and it is likely that the majority of the Canadian population is susceptible to these viruses. Methods: A scoping review was conducted to describe the current state of knowledge on orthobunyavirus epidemiology in Canada. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline was used. Literature searches were conducted in six databases and in gray literature. The epidemiology of orthobunyaviruses was characterized for studies focusing on host species, including spatiotemporal patterns, risk factors, and climate change impact. Results: A total of 172 relevant studies were identified from 1734 citations from which 95 addressed host species, including humans, wildlife, and domestic animals including livestock. The orthobunyaviruses-Cache Valley virus (CVV), Jamestown Canyon virus (JCV), Snowshoe Hare virus (SHV), and La Crosse virus (LACV)-were identified, and prevalence was widespread across vertebrate species. CVV, JCV, and SHV were detected across Canada and the United States. LACV was reported only in the United States, predominantly the Mid-Atlantic and Appalachian regions. Disease varied by orthobunyavirus and was associated with age, environment, preexisting compromised immune systems, or livestock breeding schedule. Conclusion: Knowledge gaps included seroprevalence data in Canada, risk factor analyses, particularly for livestock, and disease projections in the context of climate change. Additional surveillance and mitigation strategies, especially accounting for climate change, are needed to guide future public health efforts to prevent orthobunyavirus exposure and disease.
Collapse
Affiliation(s)
- Michele D Bergevin
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Victoria Ng
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Guelph, Ontario, Canada
| | - Tara Sadeghieh
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Paula Menzies
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Antoinette Ludwig
- National Microbiology Laboratory Branch, Public Health Agency of Canada, St. Hyacinthe, Québec, Canada
| | - Samira Mubareka
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Katie M Clow
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| |
Collapse
|
4
|
Shepard JJ, Armstrong PM. Jamestown Canyon virus comes into view: understanding the threat from an underrecognized arbovirus. JOURNAL OF MEDICAL ENTOMOLOGY 2023; 60:1242-1251. [PMID: 37862091 DOI: 10.1093/jme/tjad069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/08/2023] [Accepted: 06/08/2023] [Indexed: 10/21/2023]
Abstract
This review examines the epidemiology, ecology, and evolution of Jamestown Canyon virus (JCV) and highlights new findings from the literature to better understand the virus, the vectors driving its transmission, and its emergence as an agent of arboviral disease. We also reanalyze data from the Connecticut Arbovirus Surveillance Program which represents the largest dataset on JCV infection in mosquitoes. JCV is a member of the California serogroup of the genus Orthobunyavirus, family Peribunyaviridae, and is found throughout much of temperate North America. This segmented, negative-sense RNA virus evolves predominately by genetic drift punctuated by infrequent episodes of genetic reassortment among novel strains. It frequently infects humans within affected communities and occasionally causes febrile illness and neuroinvasive disease in people. Reported human cases are relatively rare but are on the rise during the last 20 yr, particularly within the northcentral and northeastern United States. JCV appears to overwinter and reemerge each season by transovarial or vertical transmission involving univoltine Aedes (Diptera: Culicidae) species, specifically members of the Aedes communis (de Geer) and Ae. stimulans (Walker) Groups. The virus is further amplified in a mosquito-deer transmission cycle involving a diversity of mammalophilic mosquito species. Despite progress in our understanding of this virus, many aspects of the vector biology, virology, and human disease remain poorly understood. Remaining questions and future directions of research are discussed.
Collapse
Affiliation(s)
- John J Shepard
- Center for Vector Biology and Zoonotic Diseases, Department of Entomology, The Connecticut Agricultural Experiment Station, New Haven, CT 06511, USA
| | - Philip M Armstrong
- Center for Vector Biology and Zoonotic Diseases, Department of Entomology, The Connecticut Agricultural Experiment Station, New Haven, CT 06511, USA
| |
Collapse
|
5
|
Powers JA, Boroughs KL, Mikula S, Goodman CH, Davis EH, Thrasher EM, Hughes HR, Biggerstaff BJ, Calvert AE. Characterization of a monoclonal antibody specific to California serogroup orthobunyaviruses and development as a chimeric immunoglobulin M-positive control in human diagnostics. Microbiol Spectr 2023; 11:e0196623. [PMID: 37668403 PMCID: PMC10581219 DOI: 10.1128/spectrum.01966-23] [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: 05/10/2023] [Accepted: 07/18/2023] [Indexed: 09/06/2023] Open
Abstract
IMPORTANCE Orthobunyaviruses in the California serogroup cause severe neurological disease in children and adults. While these viruses are known to circulate widely in North America, their occurrence is rare. Serological testing for CSGVs is hindered by the limited availability and volumes of human-positive specimens needed as controls in serologic assays. Here, we described the development of a murine monoclonal antibody cross-reactive to CSGVs engineered to contain the variable regions of the murine antibody on the backbone of human IgM. The chimeric IgM produced from the stably expressing HEK293 cell line was evaluated for use as a surrogate human-positive control in a serologic diagnostic test.
Collapse
Affiliation(s)
- Jordan A. Powers
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Karen L. Boroughs
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Sierra Mikula
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Christin H. Goodman
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Emily H. Davis
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Elisa M. Thrasher
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Holly R. Hughes
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Brad J. Biggerstaff
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Amanda E. Calvert
- Division of Vector-Borne Diseases, U.S. Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| |
Collapse
|
6
|
Bloch KC, Glaser C, Gaston D, Venkatesan A. State of the Art: Acute Encephalitis. Clin Infect Dis 2023; 77:e14-e33. [PMID: 37485952 DOI: 10.1093/cid/ciad306] [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: 02/01/2023] [Indexed: 07/25/2023] Open
Abstract
Encephalitis is a devastating neurologic disease often complicated by prolonged neurologic deficits. Best practices for the management of adult patients include universal testing for a core group of etiologies, including herpes simplex virus (HSV)-1, varicella zoster virus (VZV), enteroviruses, West Nile virus, and anti-N-methyl-D-aspartate receptor (anti-NMDAR) antibody encephalitis. Empiric acyclovir therapy should be started at presentation and in selected cases continued until a second HSV-1 polymerase chain reaction test is negative. Acyclovir dose can be increased for VZV encephalitis. Supportive care is necessary for other viral etiologies. Patients in whom no cause for encephalitis is identified represent a particular challenge. Management includes repeat brain magnetic resonance imaging, imaging for occult malignancy, and empiric immunomodulatory treatment for autoimmune conditions. Next-generation sequencing (NGS) or brain biopsy should be considered. The rapid pace of discovery regarding autoimmune encephalitis and the development of advanced molecular tests such as NGS have improved diagnosis and outcomes. Research priorities include development of novel therapeutics.
Collapse
Affiliation(s)
- Karen C Bloch
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carol Glaser
- California Department of Public Health, Richmond, California, USA
| | - David Gaston
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Arun Venkatesan
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
7
|
Piantadosi A, Shariatzadeh N, Bombin A, Arkun K, Alexandrescu S, Kleinschmidt-DeMasters BK, Solomon IH. Double-stranded RNA immunohistochemistry as a screening tool for viral encephalitis. Am J Clin Pathol 2023; 160:210-219. [PMID: 37141170 PMCID: PMC10392367 DOI: 10.1093/ajcp/aqad039] [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: 10/27/2022] [Accepted: 03/17/2023] [Indexed: 05/05/2023] Open
Abstract
OBJECTIVES Viral infections of the central nervous system can be challenging to diagnose because of the wide range of causative agents and nonspecific histologic features. We sought to determine whether detection of double-stranded RNA (dsRNA), produced during active RNA and DNA viral infections, could be used to select cases for metagenomic next-generation sequencing (mNGS) from formalin-fixed, paraffin-embedded brain tissue. METHODS Eight commercially available anti-dsRNA antibodies were optimized for immunohistochemistry (IHC) and the top antibody tested in a series of cases with confirmed viral infections (n = 34) and cases with inflammatory brain lesions of unclear etiology (n = 62). RESULTS Among known positives, anti-dsRNA IHC produced a strong cytoplasmic or nuclear staining pattern for Powassan virus, West Nile virus, rabies virus, JC polyoma virus, and adenovirus while failing to detect Eastern equine encephalitis virus, Jamestown Canyon virus, or any herpesvirus. All the unknown cases were negative by anti-dsRNA IHC, while mNGS detected rare viral reads (0.3-1.3 reads per million total reads) in 2 cases (3%), with only 1 having potential clinical significance. CONCLUSIONS Anti-dsRNA IHC can effectively identify a subset of clinically relevant viral infections but not all. The absence of staining should not exclude cases from mNGS if sufficient clinical and histologic suspicion exists.
Collapse
Affiliation(s)
- Anne Piantadosi
- Department of Pathology and Laboratory Medicine and Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, US
| | - Nima Shariatzadeh
- Department of Pathology and Laboratory Medicine and Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, US
| | - Andrei Bombin
- Department of Pathology and Laboratory Medicine and Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, US
| | - Knarik Arkun
- Department of Pathology and Laboratory Medicine, Tufts University School of Medicine, Boston, MA, US
| | - Sanda Alexandrescu
- Department of Pathology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, US
| | | | - Isaac H Solomon
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, US
| |
Collapse
|
8
|
Kapadia RK, Staples JE, Gill CM, Fischer M, Khan E, Laven JJ, Panella A, Velez JO, Hughes HR, Brault A, Pastula DM, Gould CV. Severe Arboviral Neuroinvasive Disease in Patients on Rituximab Therapy: A Review. Clin Infect Dis 2023; 76:1142-1148. [PMID: 36103602 PMCID: PMC10011006 DOI: 10.1093/cid/ciac766] [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: 07/01/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 11/12/2022] Open
Abstract
With increasing use of rituximab and other B-cell depleting monoclonal antibodies for multiple indications, infectious complications are being recognized. We summarize clinical findings of patients on rituximab with arboviral diseases identified through literature review or consultation with the Centers for Disease Control and Prevention. We identified 21 patients on recent rituximab therapy who were diagnosed with an arboviral disease caused by West Nile, tick-borne encephalitis, eastern equine encephalitis, Cache Valley, Jamestown Canyon, and Powassan viruses. All reported patients had neuroinvasive disease. The diagnosis of arboviral infection required molecular testing in 20 (95%) patients. Median illness duration was 36 days (range, 12 days to 1 year), and 15/19 (79%) patients died from their illness. Patients on rituximab with arboviral disease can have a severe or prolonged course with an absence of serologic response. Patients should be counseled about mosquito and tick bite prevention when receiving rituximab and other B-cell depleting therapies.
Collapse
Affiliation(s)
- Ronak K Kapadia
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, USA
- Division of Neurology, Department of Clinical Neurosciences, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - J Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Christine M Gill
- University of Iowa, Carver College of Medicine, Department of Neurology, Iowa City, Iowa, USA
| | - Marc Fischer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Ezza Khan
- Hunterdon Infectious Disease Specialists, Flemington, New Jersey, USA
| | - Janeen J Laven
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Amanda Panella
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Jason O Velez
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Holly R Hughes
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Aaron Brault
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Daniel M Pastula
- Neuro-Infectious Diseases Group, Department of Neurology and Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, Colorado, USA
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Carolyn V Gould
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| |
Collapse
|
9
|
Al-Heeti O, Wu EL, Ison MG, Saluja RK, Ramsey G, Matkovic E, Ha K, Hall S, Banach B, Wilson MR, Miller S, Chiu CY, McCabe M, Bari C, Zimler RA, Babiker H, Freeman D, Popovitch J, Annambhotla P, Lehman JA, Fitzpatrick K, Velez JO, Davis EH, Hughes HR, Panella A, Brault A, Staples JE, Gould CV, Tanna S. Transfusion-Transmitted Cache Valley Virus Infection in a Kidney Transplant Recipient With Meningoencephalitis. Clin Infect Dis 2023; 76:e1320-e1327. [PMID: 35883256 PMCID: PMC9880244 DOI: 10.1093/cid/ciac566] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/06/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Cache Valley virus (CVV) is a mosquito-borne virus that is a rare cause of disease in humans. In the fall of 2020, a patient developed encephalitis 6 weeks following kidney transplantation and receipt of multiple blood transfusions. METHODS After ruling out more common etiologies, metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) was performed. We reviewed the medical histories of the index kidney recipient, organ donor, and recipients of other organs from the same donor and conducted a blood traceback investigation to evaluate blood transfusion as a possible source of infection in the kidney recipient. We tested patient specimens using reverse-transcription polymerase chain reaction (RT-PCR), the plaque reduction neutralization test, cell culture, and whole-genome sequencing. RESULTS CVV was detected in CSF from the index patient by mNGS, and this result was confirmed by RT-PCR, viral culture, and additional whole-genome sequencing. The organ donor and other organ recipients had no evidence of infection with CVV by molecular or serologic testing. Neutralizing antibodies against CVV were detected in serum from a donor of red blood cells received by the index patient immediately prior to transplant. CVV neutralizing antibodies were also detected in serum from a patient who received the co-component plasma from the same blood donation. CONCLUSIONS Our investigation demonstrates probable CVV transmission through blood transfusion. Clinicians should consider arboviral infections in unexplained meningoencephalitis after blood transfusion or organ transplantation. The use of mNGS might facilitate detection of rare, unexpected infections, particularly in immunocompromised patients.
Collapse
Affiliation(s)
- Omar Al-Heeti
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - En-Ling Wu
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael G Ison
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rasleen K Saluja
- Blood Bank and Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Pathology, Carle Foundation Hospital, Urbana, Illinois, USA
| | - Glenn Ramsey
- Blood Bank and Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Eduard Matkovic
- Blood Bank and Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kevin Ha
- Blood Bank and Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Versiti Blood Center of Illinois, Aurora, Illinois, USA
| | - Scott Hall
- Versiti Blood Center of Illinois, Aurora, Illinois, USA
| | - Bridget Banach
- Department of Pathology, Northwestern Medicine Delnor Hospital, Geneva, Illinois, USA
| | - Michael R Wilson
- Weill Institute for Neurosciences, Department of Neurology, University of California–San Francisco, San Francisco, California, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California–San Francisco, San Francisco, California, USA
- University of California–San Francisco Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California–San Francisco, San Francisco, California, USA
- University of California–San Francisco Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA
| | - Muniba McCabe
- Florida Department of Health, Jacksonville, Florida, USA
| | - Chowdhury Bari
- Florida Department of Health, Jacksonville, Florida, USA
| | - Rebecca A Zimler
- Florida Department of Health, Jacksonville, Florida, USA
- Florida Department of Health, Tallahassee, Florida, USA
| | - Hani Babiker
- Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | - Debbie Freeman
- Illinois Department of Public Health, Springfield, Illinois, USA
| | | | - Pallavi Annambhotla
- Office of Blood, Organ and Other Tissue Safety, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer A Lehman
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Kelly Fitzpatrick
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Jason O Velez
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Emily H Davis
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Holly R Hughes
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Amanda Panella
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Aaron Brault
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - J Erin Staples
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Carolyn V Gould
- Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Sajal Tanna
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
10
|
Morsli M, Lavigne JP, Drancourt M. Direct Metagenomic Diagnosis of Community-Acquired Meningitis: State of the Art. Front Microbiol 2022; 13:926240. [PMID: 35865915 PMCID: PMC9294516 DOI: 10.3389/fmicb.2022.926240] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Current routine diagnosis of community-acquired meningitis (CAM) by multiplex real-time polymerase chain reaction (RT-PCR) is limited in the number of tested pathogens and their full characterisation, requiring additional in vitro investigations to disclose genotype and antimicrobial susceptibility. We reviewed 51 studies published through December 2021 reporting metagenomic next generation sequencing (mNGS) directly applied to the cerebrospinal fluid (CSF). This approach, potentially circumventing the above-mentioned limitations, indicated 1,248 investigated patients, and 617 patients dually investigated by routine diagnosis and mNGS, in whom 116 microbes were detected, including 50 by mNGS only, nine by routine methods only, and 57 by both routine methods and mNGS. Of 217 discordant CSF findings, 103 CSF samples were documented by mNGS only, 87 CSF samples by routine methods only, and 27 CSF samples in which the pathogen identified by mNGS was different than that found using routine methods. Overall, mNGS allowed for diagnosis and genomic surveillance of CAM causative pathogens in real-time, with a cost which is competitive with current routine multiplex RT-PCR. mNGS could be implemented at point-of-care (POC) laboratories as a part of routine investigations to improve the diagnosis and molecular epidemiology of CAM, particularly in the event of failure of routine assays.
Collapse
Affiliation(s)
- Madjid Morsli
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Jean Philippe Lavigne
- VBIC, INSERM U1047, Université de Montpellier, Service de Microbiologie et Hygiène Hospitalière, CHU Nîmes, Nîmes, France
| | - Michel Drancourt
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille Université, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
- Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Marseille, IHU Méditerranée Infection, Marseille, France
- *Correspondence: Michel Drancourt,
| |
Collapse
|
11
|
Dieme C, Kramer LD, Ciota AT. Vector competence of Anopheles quadrimaculatus and Aedes albopictus for genetically distinct Jamestown Canyon virus strains circulating in the Northeast United States. Parasit Vectors 2022; 15:226. [PMID: 35739573 PMCID: PMC9229909 DOI: 10.1186/s13071-022-05342-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Jamestown Canyon virus (JCV; Peribunyaviridae, Orthobunyavirus) is a mosquito-borne pathogen belonging to the California serogroup. The virus is endemic in North America and increasingly recognized as a public health concern. In this study, we determined the vector competence of Anopheles (An.) quadrimaculatus and Aedes (Ae.) albopictus for five JCV strains belonging to the two lineages circulating in the Northeast. METHODS An. quadrimaculatus and Ae. albopictus were fed blood meals containing two lineage A strains and three lineage B strains. Vector competence of both mosquito species was evaluated at 7- and 14-days post-feeding (dpf) by testing for virus presence in bodies, legs, and saliva. RESULTS Our results demonstrated that Ae. albopictus mosquitoes are a competent vector for both lineages, with similar transmission levels for all strains tested. Variable levels of infection (46-83%) and dissemination (17-38%) were measured in An. quadrimaculatus, yet no transmission was detected for the five JCV strains evaluated. CONCLUSIONS Our results demonstrate that establishment of Ae. albopictus in the Northeast could increase the risk of JCV but suggest An. quadrimaculatus are not a competent vector for JCV.
Collapse
Affiliation(s)
- Constentin Dieme
- Institut Pasteur de Guinée, Conakry, Guinea. .,Wadsworth Center, New York State Department of Health, Slingerlands, NY, USA.
| | - Laura D Kramer
- Wadsworth Center, New York State Department of Health, Slingerlands, NY, USA.,Department of Biomedical Sciences, School of Public Health, State University of New York at Albany, Albany, NY, USA
| | - Alexander T Ciota
- Wadsworth Center, New York State Department of Health, Slingerlands, NY, USA.,Department of Biomedical Sciences, School of Public Health, State University of New York at Albany, Albany, NY, USA
| |
Collapse
|
12
|
Laboratory Validation of a Real-Time RT-PCR Assay for the Detection of Jamestown Canyon Virus. Pathogens 2022; 11:pathogens11050536. [PMID: 35631056 PMCID: PMC9146205 DOI: 10.3390/pathogens11050536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022] Open
Abstract
The neuroinvasive disease caused by Jamestown Canyon virus (JCV) infection is rare. However, increasing incidence and widespread occurrence of the infection make JCV a growing public health concern. Presently, clinical diagnosis is achieved through serological testing, and mosquito pool surveillance requires virus isolation and identification. A rapid molecular detection test, such as real-time RT-PCR, for diagnosis and surveillance of JCV has not been widely utilized. To enhance testing and surveillance, here, we describe the development and validation of a real-time RT-PCR test for the detection of JCV RNA. Three primer and probe sets were evaluated for analytical sensitivity and specificity. One probe set, JCV132FAM, was found to be the most sensitive test detecting 7.2 genomic equivalents/µL. While less sensitive, a second probe set JCV231cFAM was the most specific test with limited detection of Keystone virus at high RNA loads. Taken together, these data indicate both probe sets can be utilized for a primary sensitive screening assay and a secondary specific confirmatory assay. While both primer and probe sets detected high viral loads of Keystone virus, these assays did not detect any virus in the California encephalitis virus clade, including negative detection of the medically important La Crosse virus (LACV) and snowshoe hare virus (SSHV). The real-time RT-PCR assay described herein could be utilized in diagnosis and surveillance in regions with co-circulation of JCV and LACV or SSHV to inform public health action.
Collapse
|
13
|
Harrar D, Mondok L, Adams S, Farias-Moeller R. Zebras Seize the Day. Crit Care Clin 2022; 38:349-373. [DOI: 10.1016/j.ccc.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
14
|
Ciccone EJ, Markmann AJ, Srinivas ML, Levinson KJ, Miller MB, van Duin D, Gay CL. Encephalitis Caused by Jamestown Canyon Virus in a Liver Transplant Patient, North Carolina, USA, 2017. Open Forum Infect Dis 2022; 9:ofac031. [PMID: 35187195 PMCID: PMC8849263 DOI: 10.1093/ofid/ofac031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/27/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
We describe the first documented case of Jamestown Canyon Virus (JCV) in North Carolina, which occurred in a liver transplant patient who presented acutely with headache, aphasia, and confusion. This is also the first report of recovery from JCV encephalitis following treatment with intravenous immune globulin.
Collapse
Affiliation(s)
- Emily J Ciccone
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Alena J Markmann
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Megan L Srinivas
- Broadlawns Medical Center, Des Moines, Iowa, USA and Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Kara J Levinson
- Tennessee Department of Health, Division of Laboratory Services, Nashville, TN, USA
| | - Melissa B Miller
- Clinical Microbiology Laboratory, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA and Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - David van Duin
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Cynthia L Gay
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| |
Collapse
|
15
|
Davar K, Wilson MR, Miller S, Chiu CY, Vijayan T. A Rare Bird: Diagnosis of Psittacosis Meningitis by Clinical Metagenomic Next-Generation Sequencing. Open Forum Infect Dis 2021; 8:ofab555. [PMID: 34934772 PMCID: PMC8683260 DOI: 10.1093/ofid/ofab555] [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: 06/09/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Psittacosis is a zoonotic infectious disease caused by the transmission of Chlamydia psittaci; it often presents as a pulmonary infection but rarely as disseminated disease. Because diagnoses of psittacosis are often underreported due to infrequent pathogen-specific testing, clinical metagenomic next-generation sequencing may be helpful to diagnose such an uncommon syndrome.
Collapse
Affiliation(s)
- K Davar
- Department of Medicine, Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California, USA
| | - M R Wilson
- Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - S Miller
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA
| | - C Y Chiu
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA.,Department of Medicine, Division of Infectious Diseases, University of California San Francisco, San Francisco, California, USA
| | - T Vijayan
- Department of Medicine, Division of Infectious Diseases, University of California Los Angeles, Los Angeles, California, USA
| |
Collapse
|
16
|
Intrathecal inflammatory responses in the absence of SARS-CoV-2 nucleic acid in the CSF of COVID-19 hospitalized patients. J Neurol Sci 2021; 430:120023. [PMID: 34678659 PMCID: PMC8489278 DOI: 10.1016/j.jns.2021.120023] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/06/2021] [Accepted: 09/30/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Little is known about CSF profiles in patients with acute COVID-19 infection and neurological symptoms. Here, CSF was tested for SARS-CoV-2 RNA and inflammatory cytokines and chemokines and compared to controls and patients with known neurotropic pathogens. METHODS CSF from twenty-seven consecutive patients with COVID-19 and neurological symptoms was assayed for SARS-CoV-2 RNA using quantitative reverse transcription PCR (RT-qPCR) and unbiased metagenomic sequencing. Assays for blood brain barrier (BBB) breakdown (CSF:serum albumin ratio (Q-Alb)), and proinflammatory cytokines and chemokines (IL-6, IL-8, IL-15, IL-16, monocyte chemoattractant protein -1 (MCP-1) and monocyte inhibitory protein - 1β (MIP-1β)) were performed in 23 patients and compared to CSF from patients with HIV-1 (16 virally suppressed, 5 unsuppressed), West Nile virus (WNV) (n = 4) and 16 healthy controls (HC). RESULTS Median CSF cell count for COVID-19 patients was 1 white blood cell/μL; two patients were infected with a second pathogen (Neisseria, Cryptococcus neoformans). No CSF samples had detectable SARS-CoV-2 RNA by either detection method. In patients with COVID-19 only, CSF IL-6, IL-8, IL-15, and MIP-1β levels were higher than HC and suppressed HIV (corrected-p < 0.05). MCP-1 and MIP-1β levels were higher, while IL-6, IL-8, IL-15 were similar in COVID-19 compared to WNV patients. Q-Alb correlated with all proinflammatory markers, with IL-6, IL-8, and MIP-1β (r ≥ 0.6, p < 0.01) demonstrating the strongest associations. CONCLUSIONS Lack of SARS-CoV-2 RNA in CSF is consistent with pre-existing literature. Evidence of intrathecal proinflammatory markers in a subset of COVID-19 patients with BBB breakdown despite minimal CSF pleocytosis is atypical for neurotropic pathogens.
Collapse
|
17
|
d'Humières C, Salmona M, Dellière S, Leo S, Rodriguez C, Angebault C, Alanio A, Fourati S, Lazarevic V, Woerther PL, Schrenzel J, Ruppé E. The Potential Role of Clinical Metagenomics in Infectious Diseases: Therapeutic Perspectives. Drugs 2021; 81:1453-1466. [PMID: 34328626 PMCID: PMC8323086 DOI: 10.1007/s40265-021-01572-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 12/24/2022]
Abstract
Clinical metagenomics (CMg) is the process of sequencing nucleic acid of clinical samples to obtain clinically relevant information such as the identification of microorganisms and their susceptibility to antimicrobials. Over the last decades, sequencing and bioinformatic solutions supporting CMg have much evolved and an increasing number of case reports and series covering various infectious diseases have been published. Metagenomics is a new approach to infectious disease diagnosis that is currently being developed and is certainly one of the most promising for the coming years. However, most CMg studies are retrospective, and few address the potential impact CMg could have on patient management, including initiation, adaptation, or cessation of antimicrobials. In this narrative review, we have discussed the potential role of CMg in bacteriology, virology, mycology, and parasitology. Several reports and case-series confirm that CMg is an innovative tool with which one can (i) identify more microorganisms than with conventional methods in a single test, (ii) obtain results within hours, and (iii) tailor the antimicrobial regimen of patients. However, the cost-efficiency of CMg and its real impact on patient management are still to be determined.
Collapse
Affiliation(s)
- Camille d'Humières
- Université de Paris, IAME, INSERM, 75018, Paris, France.,AP-HP, Hôpital Bichat, Laboratoire de Bactériologie, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Maud Salmona
- Unité de Paris, INSERM U976, Insight Team, 75010, Paris, France.,AP-HP, Hôpital Saint-Louis, Laboratoire de Virologie, 75010, Paris, France
| | - Sarah Dellière
- AP-HP, Hôpital Saint-Louis, Laboratoire de Parasitologie-Mycologie, 75010, Paris, France.,Molecular Mycology Unit, Institut Pasteur, CNRS UMR2000, 75015, Paris, France
| | - Stefano Leo
- Faculty of Medicine, CMU, University of Geneva, Geneva, Switzerland.,Service of Infectious Diseases, Genomic Research Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Rodriguez
- Département de Microbiologie, AP-HP, Hôpital Henri Mondor, 94000, Créteil, France.,INSERM U955, Université Paris-Est, 94000, Créteil, France
| | - Cécile Angebault
- Département de Microbiologie, AP-HP, Hôpital Henri Mondor, 94000, Créteil, France.,Université Paris Est Créteil, Ecole Nationale Vétérinaire d'Alfort, USC ANSES, EA7380 Dynamic, 94000, Créteil, France
| | - Alexandre Alanio
- AP-HP, Hôpital Saint-Louis, Laboratoire de Parasitologie-Mycologie, 75010, Paris, France.,Molecular Mycology Unit, Institut Pasteur, CNRS UMR2000, 75015, Paris, France
| | - Slim Fourati
- Département de Microbiologie, AP-HP, Hôpital Henri Mondor, 94000, Créteil, France.,INSERM U955, Université Paris-Est, 94000, Créteil, France
| | - Vladimir Lazarevic
- Faculty of Medicine, CMU, University of Geneva, Geneva, Switzerland.,Service of Infectious Diseases, Genomic Research Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Paul-Louis Woerther
- Département de Microbiologie, AP-HP, Hôpital Henri Mondor, 94000, Créteil, France.,Université Paris Est Créteil, Ecole Nationale Vétérinaire d'Alfort, USC ANSES, EA7380 Dynamic, 94000, Créteil, France
| | - Jacques Schrenzel
- Faculty of Medicine, CMU, University of Geneva, Geneva, Switzerland.,Service of Infectious Diseases, Genomic Research Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Etienne Ruppé
- Université de Paris, IAME, INSERM, 75018, Paris, France. .,AP-HP, Hôpital Bichat, Laboratoire de Bactériologie, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France.
| |
Collapse
|
18
|
Rituximab. REACTIONS WEEKLY 2021. [PMCID: PMC8062814 DOI: 10.1007/s40278-021-94833-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
19
|
Coleman KJ, Chauhan L, Piquet AL, Tyler KL, Pastula DM. An Overview of Jamestown Canyon Virus Disease. Neurohospitalist 2021; 11:277-278. [PMID: 34163560 DOI: 10.1177/19418744211005948] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kyle J Coleman
- Neuro-Infectious Diseases Group, Division of Infectious Diseases, Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Lakshmi Chauhan
- Neuro-Infectious Diseases Group, Division of Infectious Diseases, Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Amanda L Piquet
- Neuro-Infectious Diseases Group, Division of Infectious Diseases, Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kenneth L Tyler
- Neuro-Infectious Diseases Group, Division of Infectious Diseases, Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Immunology-Microbiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Daniel M Pastula
- Neuro-Infectious Diseases Group, Division of Infectious Diseases, Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| |
Collapse
|