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Paccoud O, Desnos-Ollivier M, Persat F, Demar M, Boukris-Sitbon K, Bellanger AP, Bonhomme J, Bonnal C, Botterel F, Bougnoux ME, Brun S, Cassaing S, Cateau E, Chouaki T, Cornet M, Dannaoui E, Desbois-Nogard N, Durieux MF, Favennec L, Fekkar A, Gabriel F, Gangneux JP, Guitard J, Hasseine L, Huguenin A, Le Gal S, Letscher-Bru V, Mahinc C, Morio F, Nicolas M, Poirier P, Ranque S, Roosen G, Rouges C, Roux AL, Sasso M, Alanio A, Lortholary O, Lanternier F. Features of cryptococcosis among 652 HIV-seronegative individuals in France: a cross-sectional observational study (2005-2020). Clin Microbiol Infect 2024:S1198-743X(24)00162-9. [PMID: 38556212 DOI: 10.1016/j.cmi.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/20/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES We aimed to describe features and outcomes of cryptococcosis among HIV-seronegative individuals in a large surveillance network for cryptococcosis in France. METHODS We included incident cases of cryptococcosis in HIV-seronegative individuals from 2005 to 2020. We compared patient characteristics, disease presentations, cryptococcal antigen results, and induction antifungal treatments according to underlying disease. We examined factors associated with 90-day mortality. Among patients with disseminated infections, we investigated whether receipt of flucytosine and polyene combination was associated with lower mortality. RESULTS Among 652 individuals, 209 (32.1%) had malignancy, 130 (19.9%) were solid-organ transplant recipients, 204 (31.3%) had other immunocompromising conditions, and 109 (16.7%) had no reported underlying factor. The commonest presentations were disseminated infections (63.3%, 413/652) and isolated pulmonary infections (25.3%, 165/652). Solid-organ transplant patients were most likely to have disseminated infections and a positive serum cryptococcal antigen result. Patients with malignancy were older and less likely to receive a flucytosine-containing regimen for disseminated infections than others (58.7%, 78/133 vs. 73.2%, 194/265; p 0.029). The crude 90-day case-fatality ratio was 27.2% (95% CI, 23.5%-31.1%). Age ≥60 years (aOR: 2.75 [1.78-4.26]; p < 0.001), meningitis/fungaemia (aOR: 4.79 [1.80-12.7]; p 0.002), and malignancy (aOR: 2.4 [1.14-5.07]; p 0.02) were associated with higher 90-day mortality. Receipt of flucytosine and polyene combination was associated with lower 90-day mortality (aOR: 0.40 [0.23-0.71]; p 0.002) in multivariable analysis and inverse probability of treatment weighted analysis (aOR: 0.45 [0.25-0.80]; p 0.006). DISCUSSION HIV-seronegative individuals with cryptococcosis comprise a wide range of underlying conditions with different presentations and outcomes, requiring a tailored approach to diagnosis and management.
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Affiliation(s)
- Olivier Paccoud
- Université Paris Cité, Department of Infectious Diseases and Tropical Medicine, Necker - Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), IHU Imagine, 75014 Paris, France.
| | - Marie Desnos-Ollivier
- Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France
| | - Florence Persat
- UR3738 Centre pour l'lnnovation en Cancérologie de Lyon, Team Inflammation and Immunity of the Respiratory Epithelium, Claude Bernard University-Lyon 1, 69495 Pierre Bénite, France; Department of Medical Mycology and Parasitology, Institute of Infectious Agents, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - Magalie Demar
- Laboratoire Hospitalo-Universitaire de Parasito-Mycologie, Centre hospitalier de Cayenne Guyane, Cayenne, France
| | - Karine Boukris-Sitbon
- Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France
| | - Anne-Pauline Bellanger
- CHU de Besançon, Laboratoire de Parasitologie-Mycologie, UMR Chrono-Environnement/CNRS 6249, F-25000, Besançon, France
| | - Julie Bonhomme
- Laboratoire de Parasitologie-Mycologie, CHU de Caen, ToxEMAC-ABTE, Unicaen Université Normandie, Caen, France
| | - Christine Bonnal
- Laboratory of Parasitology-Mycology, Bichat-Claude Bernard University Hospital, AP-HP, 75018 Paris, France
| | - Françoise Botterel
- Unité de Parasitologie - Mycologie, Département des agents infectieux, AP-HP, Dynamyc research Unit, UPEC, France
| | - Marie-Elisabeth Bougnoux
- Unité de Parasitologie-Mycologie, Service de Microbiologie Clinique, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, INRAE USC2019, Unité Biologie et Pathogénicité Fongiques, Paris, France
| | - Sophie Brun
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Sophie Cassaing
- Department of Parasitology and Mycology, Toulouse University Hospital, Restore-FLAMES, Toulouse III University, France
| | - Estelle Cateau
- Laboratoire de Parasitologie-Mycologie - CHU de Poitiers, Ecologie et Biologie des Interactions UMR CNRS 7267, France
| | - Taieb Chouaki
- Service de Parasitologie Mycologie Médicales, CHU Amiens Picardie 80054, Amiens, France; Inserm U1285, Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France
| | - Muriel Cornet
- Université Grenoble Alpes, CNRS, UMR 5525, CHU Grenoble Alpes, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
| | - Eric Dannaoui
- Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France; Unité de Parasitologie-Mycologie, Service de Microbiologie Clinique, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France
| | - Nicole Desbois-Nogard
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique, France
| | | | - Loïc Favennec
- French National Cryptosporidiosis Reference Center, CHU de Rouen, Rouen, Normandie, France; EA 7510, UFR Santé, University of Rouen Normandy, Rouen, France
| | - Arnaud Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013, Paris, France; Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, F-75013, Paris, France
| | - Frederic Gabriel
- Laboratoire de Parasitologie-Mycologie, CHU de Bordeaux, F-33000 Bordeaux, France
| | - Jean-Pierre Gangneux
- Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Laboratory of Parasitology and Medical Mycology, European Confederation of Medical Mycology (ECMM) Excellence Center, Centre National de Référence Aspergilloses Chroniques, Rennes Teaching Hospital, F-35000 Rennes, France
| | - Juliette Guitard
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Paris, France
| | - Lilia Hasseine
- Parasitologie - Mycologie, Hôpital de l'Archet, CHU Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | - Antoine Huguenin
- Université de Reims Champagne Ardenne, ESCAPE EA7510, Laboratoire de Parasitologie-Mycologie, Pôle de Biologie Pathologie, CHU de Reims, Rue du Général Koening, Reims, France
| | - Solène Le Gal
- CHU de Brest, Laboratoire de Parasitologie-Mycologie, Univ Brest, Univ Angers, Infections Respiratoires Fongiques, F-29200, Brest, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et Mycologie Médicale, Les Hôpitaux Universitaires de Strasbourg, Institut de Parasitologie et Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France
| | - Caroline Mahinc
- Centre Hospitalier Universitaire de Saint Etienne, Service de Parasitologie Mycologie, Saint Etienne, France
| | - Florent Morio
- Nantes Université, CHU Nantes, Cibles et Médicaments des Infections et de l'Immunité, UR1155, Nantes, France
| | - Muriel Nicolas
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
| | - Philippe Poirier
- Université Clermont Auvergne, Inserm, 3IHP, Centre Hospitalier Universitaire Clermont-Ferrand, Service de Parasitologie-Mycologie, Clermont-Ferrand, France
| | - Stéphane Ranque
- Aix-Marseille Université, IHU Méditerranée Infection, AP-HM, IRD, SSA, VITROME, 13005 Marseille, France
| | | | - Célia Rouges
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne-Laure Roux
- Université Paris-Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-Le-Bretonneux, France; AP-HP, GHU Paris Saclay, Hôpital Ambroise Paré, Microbiology Department, Boulogne-Billancourt, France
| | - Milène Sasso
- Laboratoire de Parasitologie-Mycologie, CHU Nîmes & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France
| | - Alexandre Alanio
- Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France; Laboratoire de Parasitologie-Mycologie, AP-HP, Hôpital Saint-Louis, F-75010 Paris, France
| | - Olivier Lortholary
- Université Paris Cité, Department of Infectious Diseases and Tropical Medicine, Necker - Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), IHU Imagine, 75014 Paris, France; Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France
| | - Fanny Lanternier
- Université Paris Cité, Department of Infectious Diseases and Tropical Medicine, Necker - Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), IHU Imagine, 75014 Paris, France; Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France
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Imbert S, Normand AC, Costa D, Gabriel F, Lachaud L, Schuttler C, Cassaing S, Mahinc C, Hasseine L, Demar M, Brun S, Bonnal C, Moreno-Sabater A, Becker P, Piarroux R, Fekkar A. Multicentric Analysis of the Species Distribution and Antifungal Susceptibility of Clinical Isolates from Aspergillus Section Circumdati. Antimicrob Agents Chemother 2023; 67:e0146222. [PMID: 36892306 PMCID: PMC10112188 DOI: 10.1128/aac.01462-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/05/2023] [Indexed: 03/10/2023] Open
Abstract
The clinical involvement and antifungal susceptibility of Aspergillus section Circumdati are poorly known. We analyzed 52 isolates, including 48 clinical isolates, belonging to 9 species inside the section Circumdati. The whole section exhibited, by the EUCAST reference method, a poor susceptibility to amphotericin B, but species/series-specific patterns were observed for azole drugs. This underlines the interest in getting an accurate identification inside the section Circumdati to guide the choice of antifungal treatment in clinical practice.
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Affiliation(s)
- S. Imbert
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
- Sorbonne Université, Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Paris, France
| | - A. C. Normand
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
| | - D. Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie Mycologie, Rouen, France
| | - F. Gabriel
- Centre Hospitalier Universitaire de Bordeaux, Service de Parasitologie Mycologie, Bordeaux, France
| | - L. Lachaud
- Centre Hospitalier Universitaire de Montpellier, Service de Parasitologie Mycologie, Montpellier, France
| | | | - S. Cassaing
- Centre Hospitalier Universitaire de Toulouse, Service de Parasitologie Mycologie, Toulouse, France
| | - C. Mahinc
- Centre Hospitalier Universitaire de Saint Etienne, Service de Parasitologie Mycologie, Saint Etienne, France
| | - L. Hasseine
- Centre Hospitalier Universitaire de Nice, Service de Parasitologie Mycologie, Nice, France
| | - M. Demar
- Centre Hospitalier de Cayenne, Département de Parasitologie Mycologie, Cayenne, French Guiana
| | - S. Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie Mycologie, Bobigny, France
| | - C. Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie Mycologie, Paris, France
| | - A. Moreno-Sabater
- AP-HP, Hôpital Saint-Antoine, Service de Parasitologie Mycologie, Paris, France
| | - P. Becker
- Service of Mycology and Aerobiology, BCCM/IHEM Fungal Collection, Brussels, Belgium
| | - R. Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
| | - A. Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
- Sorbonne Université, Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Paris, France
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3
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Mercier V, Letscher-Bru V, Bougnoux ME, Delhaes L, Botterel F, Maubon D, Dalle F, Alanio A, Houzé S, Dannaoui E, Cassagne C, Cassaing S, Durieux MF, Fekkar A, Bouchara JP, Gangneux JP, Bonhomme J, Dupont D, Costa D, Sendid B, Chouaki T, Bourgeois N, Huguenin A, Brun S, Mahinc C, Hasseine L, Le Gal S, Bellanger AP, Bailly E, Morio F, Nourrisson C, Desbois-Nogard N, Perraud-Cateau E, Debourgogne A, Yéra H, Lachaud L, Sasso M. Gradient concentration strip-specific epidemiological cut-off values of antifungal drugs in various yeast species and five prevalent Aspergillus species complexes. Clin Microbiol Infect 2022; 29:652.e9-652.e15. [PMID: 36509375 DOI: 10.1016/j.cmi.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 10/16/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine the epidemiological cut-off values (ECVs) of ten antifungal agents in a wide range of yeasts and Aspergillus spp. using gradient concentration strips. METHODS The minimum inhibitory concentrations for amphotericin B, anidulafungin, caspofungin, micafungin, flucytosine, fluconazole, itraconazole, isavuconazole, posaconazole, and voriconazole, determined with gradient concentration strips at 35 French microbiology laboratories between 2002 and 2020, were retrospectively collected. Then, the ECVs were calculated using the iterative method and a cut-off value of 97.5%. RESULTS Minimum inhibitory concentrations were available for 17 653 clinical isolates. In total, 48 ECVs (including 32 new ECVs) were determined: 29 ECVs for frequent yeast species (e.g. Candida albicans and itraconazole/flucytosine, and Candida glabrata species complex [SC] and flucytosine) and rare yeast species (e.g. Candida dubliniensis, Candida inconspicua, Saccharomyces cerevisiae, and Cryptococcus neoformans) and 19 ECVs for Aspergillusflavus SC, Aspergillusfumigatus SC, Aspergillusnidulans SC, Aspergillusniger SC, and Aspergillusterreus SC. CONCLUSIONS These ECVs can be added to the already available gradient concentration strip-specific ECVs to facilitate minimum inhibitory concentration interpretation and streamline the identification of nonwild type isolates.
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Affiliation(s)
- Victor Mercier
- Laboratoire de Parasitologie-Mycologie, CHU Nîmes & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et Mycologie Médicale, Les Hôpitaux Universitaires de Strasbourg, Institut de Parasitologie et Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France
| | - Marie-Elisabeth Bougnoux
- Laboratoire de Parasitologie-Mycologie, Hôpital Necker Enfants Malades, AP-HP, Unité Biologie et Pathogénicité Fongiques, Institut Pasteur, Université de Paris, INRAE, USC2019, Paris, France
| | - Laurence Delhaes
- Laboratoire de Parasitologie-Mycologie, CHU de Bordeaux, Inserm U1045, Université de Bordeaux, Bordeaux, France
| | - Francoise Botterel
- Laboratoire de Parasitologie-Mycologie, CHU Henri Mondor, AP-HP, Paris, France
| | - Danièle Maubon
- Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - Frédéric Dalle
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire Gérard Mack, UMR PAM Univ Bourgogne Franche-Comté - AgroSup Dijon - Equipe Vin, Aliment, Microbiologie, Stress, Dijon, France
| | - Alexandre Alanio
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, Institut Pasteur, Université Paris Cité, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, UMR2000, Paris, France
| | - Sandrine Houzé
- Université Paris Cité, IRD, MERIT, F 75006 Paris et Service de Parasitologie, AP-HP, Hôpital Bichat, Paris, France
| | - Eric Dannaoui
- Laboratoire de Parasitologie-Mycologie, département de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, Université de Paris Cité, Faculté de Médecine, Paris, France
| | - Carole Cassagne
- Laboratoire de Parasitologie-Mycologie, AP-MH, IHU Méditerranée Infection, Aix Marseille Univ., Marseille, France
| | - Sophie Cassaing
- Service de Parasitologie-Mycologie, CHU Toulouse, Université Paul Sabatier, Toulouse, France
| | | | - Arnaud Fekkar
- Laboratoire de Parasitologie-Mycologie, AP-HP La Pitié-Salpêtrière, France. Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, F-75013, Paris, France
| | | | - Jean-Pierre Gangneux
- Laboratoire de Parasitologie-Mycologie, CHU de Rennes, Institut de Recherche en Santé Environnement et Travail, UMR U1085 Inserm-Université Rennes 1, Rennes, France
| | - Julie Bonhomme
- Laboratoire de Microbiologie, CHU Caen, Université de Normandie Unicaen, ToxEMAC-ABTE, Caen, France
| | - Damien Dupont
- Laboratoire de Parasitologie-Mycologie Médicale, Hospices Civils de Lyon, Institut des Agents Infectieux, Université Lyon 1, Lyon, France
| | - Damien Costa
- Département de Parasitologie-Mycologie, CHU de Rouen, France
| | - Boualem Sendid
- Service de Parasitologie-Mycologie, CHU Lille, Inserm U1285, CNRS UMR 8576, Université de Lille, Lille, France
| | - Taieb Chouaki
- Laboratoire de Mycologie-Parasitologie, CHU d'Amiens-Picardie, Amiens, France
| | - Nathalie Bourgeois
- Service de Parasitologie-Mycologie, CHU de Montpellier, & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France
| | - Antoine Huguenin
- Laboratoire de Parasitologie-Mycologie, CHU de Rennes, Université de Reims Champagne Ardenne, ESCAPE EA7510, Reims, France
| | - Sophie Brun
- Service de Parasitologie-Mycologie, Hôpital Universitaire Avicenne, AP-HP, Bobigny, France
| | - Caroline Mahinc
- Unité de Parasitologie-Mycologie, Laboratoire des Agents Infectieux et d'Hygiène CHU de St-Etienne, Saint Priest en Jarez, France
| | | | - Solène Le Gal
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, France
| | | | - Eric Bailly
- Service de Parasitologie-Mycologie, CHU de Tours, France
| | - Florent Morio
- Laboratoire de Parasitologie et Mycologie, Nantes Université, CHU de Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR1155, Nantes, France
| | - Céline Nourrisson
- Service de Parasitologie-Mycologie, 3IHP, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nicole Desbois-Nogard
- Laboratoire de Parasitologie-Mycologie, CHU de la Martinique, Fort de France, Martinique, France
| | - Estelle Perraud-Cateau
- Laboratoire de Parasitologie-Mycologie, CHU de Poitiers, Écologie et Biologie des Interactions UMR CNRS 7267 - equipe Microbiologie de l'Eau, Poitiers, France
| | - Anne Debourgogne
- Laboratoire de Microbiologie, CHRU de Nancy, UR 7300 Stress Immunité Pathogène, Université de Lorraine, Vandoeuvre les Nancy, France
| | - Hélène Yéra
- Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre Université Paris Cité, Institut Cochin (U1016 Inserm/UMR8104 CNRS/UMR-S8104), Paris, France
| | - Laurence Lachaud
- Service de Parasitologie-Mycologie, CHU de Montpellier, & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France
| | - Milène Sasso
- Laboratoire de Parasitologie-Mycologie, CHU Nîmes & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France.
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Gillardie ML, Babba O, Mahinc C, Duthel M, de Bengy C, Morineaud C, Rivollier E, Flori P. Molecular approach to the epidemiology of urinary schistosomiasis in France. PLoS Negl Trop Dis 2021; 15:e0009515. [PMID: 34228747 PMCID: PMC8284649 DOI: 10.1371/journal.pntd.0009515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 07/16/2021] [Accepted: 05/28/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The diagnosis of urogenital schistosomiasis is based on the complementarity of serological technique and microscopic examination (ME). Between 2015 and 2019, the number of urinary schistosomiasis tests received in our laboratory increased sharply from 300 to 900 per year. Therefore, we wanted to evaluate the reliability of urine microscopic examination (ME, reference and routine technique) from urine sample by comparing it to other techniques (antigenic technique and PCR). To this end, we optimized two real-time PCRs targeting respectively Schistosoma haematobium (Sh) and Schistosoma mansoni (Sm). METHODOLOGY/PRINCIPAL FINDINGS 914 urine samples from 846 patients suspected of urogenital schistosomiasis were prescribed and analyzed by PCR and also by antigenic technique for the first 143 samples. The antigenic technique evaluated was Schisto POC-CCA, Rapid Medical Diagnostics. These results (antigenic technique and PCR) were compared to ME which was performed from all urines. The percentage of 14% (128/914) positive cases with the PCR technique and the percentage of 6.0% (54/914) positive cases with ME is significantly different (Chi 2 test, p<0.001). These 128 positive PCRs correspond to 120 different patients, 88.3% (106/120) of them were young migrants and 11.7% (14/120) were French patients returning from travel. Among these migrants, more than 75% (80/106) came from French-speaking West Africa. In addition, the Schisto POC-CCA showed a specificity of 39% (46/117), too poor to be used as a screening tool in low or non-endemic areas. CONCLUSION/SIGNIFICANCE Targeted Sh and Sm PCRs in urine are reliable techniques compared to ME (reference technique). In view of our results, we decided to screen urinary schistosomiasis by direct ME always coupled by the PCR technique, which has shown better reliability criteria.
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Affiliation(s)
- Marie-Laure Gillardie
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Oussama Babba
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Caroline Mahinc
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Maureen Duthel
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Claire de Bengy
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Clotilde Morineaud
- Department of Public Health, University Hospital of Poitiers, Poitiers, France
| | - Elisabeth Rivollier
- Department PASS, University Hospital of Saint-Etienne, Saint Etienne, France
| | - Pierre Flori
- University of Saint-Etienne, GIMAP-EA-3064, Saint Etienne, France
- Parasitology and Mycology, department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
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Normand AC, Imbert S, Brun S, Al-Hatmi AMS, Chryssanthou E, Cassaing S, Schuttler C, Hasseine L, Mahinc C, Costa D, Bonnal C, Ranque S, Sautour M, Rubio E, Delhaes L, Riat A, Sendid B, Kristensen L, Brandenberger M, Guitard J, Packeu A, Piarroux R, Fekkar A. Clinical Origin and Species Distribution of Fusarium spp. Isolates Identified by Molecular Sequencing and Mass Spectrometry: A European Multicenter Hospital Prospective Study. J Fungi (Basel) 2021; 7:jof7040246. [PMID: 33806102 PMCID: PMC8064482 DOI: 10.3390/jof7040246] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 01/30/2023] Open
Abstract
Fusarium spp. are widespread environmental fungi as well as pathogens that can affect plants, animals and humans. Yet the epidemiology of human fusariosis is still cloudy due to the rapidly evolving taxonomy. The Mass Spectrometry Identification database (MSI) has been developed since 2017 in order to allow a fast, accurate and free-access identification of fungi by matrix-assisted laser desorption ionization—time of flight (MALDI-TOF) mass spectrometry. Taking advantage of the MSI database user network, we aim to study the species distribution of Fusarium spp. isolates in an international multicenter prospective study. This study also allowed the assessment of the abilities of miscellaneous techniques to identify Fusarium isolates at the species level. The identification was performed by PCR-sequencing and phylogenic-tree approach. Both methods are used as gold standard for the evaluation of mass spectrometry. Identification at the species complex was satisfactory for all the tested methods. However, identification at the species level was more challenging and only 32% of the isolates were correctly identified with the National Center for Biotechnology Information (NCBI) DNA database, 20% with the Bruker MS database and 43% with the two MSI databases. Improvement of the mass spectrometry database is still needed to enable precise identification at the species level of any Fusarium isolates encountered either in human pathology or in the environment.
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Affiliation(s)
- Anne-Cécile Normand
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Correspondence: ; Tel.: +33-142160113
| | - Sébastien Imbert
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6525 Nijmegen, The Netherlands;
| | - Sophie Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
| | - Abdullah M. S. Al-Hatmi
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6525 Nijmegen, The Netherlands;
- Natural & Medical Sciences Research Center, Department of Microbiology, University of Nizwa, Nizwa 616, Oman
| | - Erja Chryssanthou
- Division of Clinical Microbiology, Karolinska Institutet, Department of Laboratory Medicine, 171 77 Stockholm, Sweden;
| | - Sophie Cassaing
- CHU Toulouse, Service de Parasitologie-Mycologie, 31000 Toulouse, France;
| | | | - Lilia Hasseine
- CHU de Nice, Service de Parasitologie Mycologie, 06200 Nice, France;
| | - Caroline Mahinc
- CHU de Saint Etienne, Service de Parasitologie Mycologie, 42000 Saint Etienne, France;
| | - Damien Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie Mycologie, 76000 Rouen, France;
| | - Christine Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie Mycologie, 75018 Paris, France;
| | - Stéphane Ranque
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, 13005 Marseille, France;
| | - Marc Sautour
- CHU de Dijon, Service de Parasitologie Mycologie, 21079 Dijon, France;
| | - Elisa Rubio
- Department of Microbiology, ISGlobal Barcelona Institute for Global Health, Barcelona, Spain CDB, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
| | - Laurence Delhaes
- CHU de Bordeaux, Groupe Hospitalier Pellegrin, Service de Mycologie, 33404 Bordeaux, France;
| | - Arnaud Riat
- Laboratory of bacteriology, Division of Laboratory Medicine, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland;
| | - Boualem Sendid
- Department Parasitology-Mycology, CHU de Lille, 59000 Lille, France;
| | - Lise Kristensen
- Department of Clinical Microbiology, Aarhus University Hospital, 8200 Aarhus, Denmark;
| | | | - Juliette Guitard
- Centre de Recherche Saint-Antoine, Inserm, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Sorbonne Université, 75012 Paris, France;
| | - Ann Packeu
- Sciensano, BCCM/IHEM collection, Mycology and Aerobiology Unit, 1000 Brussels, Belgium;
| | - Renaud Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Inserm, Institut Pierre Louis d’Epidemiologie et de Santé Publique, Sorbonne Université, 75571 Paris, France
| | - Arnaud Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Cimi-Paris, Sorbonne Université, 75005 Paris, France
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Schein F, Munoz-Pons H, Mahinc C, Grange R, Cathébras P, Flori P. Fatal aspergillosis complicating severe SARS-CoV-2 infection: A case report. J Mycol Med 2020; 30:101039. [PMID: 32861584 PMCID: PMC7440034 DOI: 10.1016/j.mycmed.2020.101039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 01/16/2023]
Abstract
As aspergillosis is a well-known complication of severe influenza, we suggest that SARS-CoV-2 might be a risk factor for invasive aspergillosis (IA). We report the case of an 87 year-old woman, with no history of immune deficit, admitted in our emergency room for severe respiratory distress. Coronavirus disease 2019 (COVID-19) diagnosis was confirmed by a SARS-CoV-2 reverse transcriptase polymerase chain reaction (PCR) on nasal swab. On day 14, pulmonary examination deteriorated with haemoptysis and a major increase of inflammatory response. A computed tomography (CT) scan revealed nodules highly suggestive of IA. Aspergillus antigen was found highly positive in sputum and blood, as was Aspergillusspp PCR on serum. Sputum cultures remained negative for Aspergillus. This patient died rapidly from severe respiratory failure, despite the addition of voriconazole. Considering SARS-CoV-2 acute respiratory distress syndrome (ARDS) as an acquired immunodeficiency, we report here a new case of "probable" IA based on clinical and biological arguments, in accordance with the last consensus definition of invasive fungal disease. On a routine basis, we have detected 30% of aspergillosis carriage (positive culture and antigen in tracheal secretions) in critically ill patients with COVID-19 in our centre. Further studies will have to determine whether sputum or tracheal secretions should be systematically screened for fungal investigations in intensive care unit (ICU) COVID-19 patients to early diagnose and treat aspergillosis.
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Affiliation(s)
- F Schein
- Department of internal medicine, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - H Munoz-Pons
- Department of internal medicine, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - C Mahinc
- Laboratory of infectious agents, Parasitology-Mycology Section, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - R Grange
- Department of Radiology, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - P Cathébras
- Department of internal medicine, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - P Flori
- Laboratory of infectious agents, Parasitology-Mycology Section, University Hospital of Saint-Étienne, Saint-Étienne, France.
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