1
|
Gantois N, Lesaffre A, Durand-Joly I, Bautin N, Le Rouzic O, Nseir S, Reboux G, Scherer E, Aliouat EM, Fry S, Gosset P, Fréalle E. Factors associated with Pneumocystis colonization and circulating genotypes in chronic obstructive pulmonary disease patients with acute exacerbation or at stable state and their homes. Med Mycol 2021; 60:6420247. [PMID: 34734270 DOI: 10.1093/mmy/myab070] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/20/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Pneumocystis jirovecii colonization is frequent during chronic obstructive pulmonary disease (COPD) and patients constitute potential contributors to its interhuman circulation. However, the existence of an environmental reservoir cannot be excluded. We assessed the prevalence and factors associated with Pneumocystis colonization during COPD, and studied circulation between patients and their domestic environment. Pneumocystis molecular detection and mtLSU genotyping were performed in oro-pharyngeal washes (OPW) sampled in 58 patients with COPD acute exacerbation, and in indoor dust, sampled in patients' homes using electrostatic dust collectors (EDCs). Lung and systemic inflammation was assessed. Pneumocystis carriage was evaluated in 28 patients after 18 months at stable state. Pneumocystis was detected in 11/58 OPWs during exacerbation (19.0%). Colonized patients presented a significantly lower body mass index, and higher serum IL-17 and CD62P. One patient presented positive detection of typable isolates in both OPW and EDC, with both isolates harboring mtLSU genotype 3. Pneumocystis genotype 1 was further detected in EDCs from three non-colonized patients and one colonized patient with non-typable isolate. Genotypes 1 and 2 were predominant in clinical isolates (both 42%), with genotype 3 representing 16% of isolates. Pneumocystis was detected in 3/28 patients at stable state (10.7%). These data suggest that Pneumocystis colonization could be facilitated by a lower BMI and be related to acute alteration of lung function during COPD exacerbation. It also suggests Th17 pathway and platelet activation could be involved in the anti-Pneumocystis response during colonization. Last, Pneumocystis detection in EDCs supports its potential persistence in indoor dust. LAY SUMMARY Chronic obstructive pulmonary disease patients tend to be more frequently colonized by Pneumocystis during exacerbation (19.0%) than at stable state (10.7%). Factors associated with colonization include lower BMI, higher IL-17, and CD62P. Pneumocystis detection in patients' dwellings suggests potential persistence in indoor dust.
Collapse
Affiliation(s)
- Nausicaa Gantois
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France
| | - Aymerick Lesaffre
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France
| | | | - Nathalie Bautin
- CHU Lille, Clinique des Maladies Respiratoires, F-59000 Lille, France
| | - Olivier Le Rouzic
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France.,CHU Lille, Clinique des Maladies Respiratoires, F-59000 Lille, France
| | - Saad Nseir
- CHU Lille, Pôle de Réanimation, F-59000 Lille, France
| | - Gabriel Reboux
- Chrono-Environnement UMR 6249 CNRS, Université de Bourgogne Franche-Comté & Service de Parasitologie-Mycologie, CHU de Besançon, F-25030 Besançon, France
| | - Emeline Scherer
- Chrono-Environnement UMR 6249 CNRS, Université de Bourgogne Franche-Comté & Service de Parasitologie-Mycologie, CHU de Besançon, F-25030 Besançon, France
| | - El Moukhtar Aliouat
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France
| | - Stéphanie Fry
- CHU Lille, Clinique des Maladies Respiratoires, F-59000 Lille, France
| | - Philippe Gosset
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France
| | - Emilie Fréalle
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000 Lille, France.,CHU Lille, Laboratoire de Parasitologie-Mycologie, F-59000 Lille, France
| |
Collapse
|
2
|
Lesaffre A, Durand-Joly I, Bautin N, Nseir S, Maillard H, Reboux G, Million L, Gantois N, Sendid B, Aliouat EM, Fry S, Dei-Cas E, Frealle E. Circulation de Pneumocystis entre les patients atteints de BPCO et leur environnement domestique. J Mycol Med 2015. [DOI: 10.1016/j.mycmed.2015.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
3
|
Roux A, Canet E, Valade S, Gangneux-Robert F, Hamane S, Lafabrie A, Maubon D, Debourgogne A, Le Gal S, Dalle F, Leterrier M, Toubas D, Pomares C, Bellanger AP, Bonhomme J, Berry A, Durand-Joly I, Magne D, Pons D, Hennequin C, Maury E, Roux P, Azoulay É. Pneumocystis jirovecii pneumonia in patients with or without AIDS, France. Emerg Infect Dis 2015; 20:1490-7. [PMID: 25148074 PMCID: PMC4178412 DOI: 10.3201/eid2009.131668] [Citation(s) in RCA: 192] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Immunosuppressed patients without AIDS had longer time to treatment and a higher rate of death than did patients with AIDS. Pneumocystis jirovecii pneumonia (PCP) in patients without AIDS is increasingly common. We conducted a prospective cohort study of consecutive patients with proven PCP; of 544 patients, 223 (41%) had AIDS (AIDS patients) and 321 (59%) had other immunosuppressive disorders (non-AIDS patients). Fewer AIDS than non-AIDS patients required intensive care or ventilation, and the rate of hospital deaths—17.4% overall—was significantly lower for AIDS versus non-AIDS patients (4% vs. 27%; p<0.0001). Multivariable analysis showed the odds of hospital death increased with older age, receipt of allogeneic bone marrow transplant, immediate use of oxygen, need for mechanical ventilation, and longer time to treatment; HIV-positive status or receipt of a solid organ transplant decreased odds for death. PCP is more often fatal in non-AIDS patients, but time to diagnosis affects survival and is longer for non-AIDS patients. Clinicians must maintain a high index of suspicion for PCP in immunocompromised patients who do not have AIDS.
Collapse
|
4
|
Vargas SL, Ponce CA, Gallo M, Pérez F, Astorga JF, Bustamante R, Chabé M, Durand-Joly I, Iturra P, Miller RF, Aliouat EM, Dei-Cas E. Near-universal prevalence of Pneumocystis and associated increase in mucus in the lungs of infants with sudden unexpected death. Clin Infect Dis 2012; 56:171-9. [PMID: 23074306 PMCID: PMC3526255 DOI: 10.1093/cid/cis870] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pneumocystis without obvious accompanying pathology is occasionally reported in autopsied infant lungs. Its prevalence and significance are unknown. Interestingly, this mild infection induces a strong activation of mucus secretion-related genes in young immunocompetent rodents that has not been explored in infants. Excess mucus is induced by multiple airway offenders through nonspecific pathways and would explain a cofactor role of Pneumocystis in respiratory disease. We undertook characterization of the prevalence of Pneumocystis and associated mucus in infant lungs. METHODS Samples from 128 infants (mean age, 101 days) who died suddenly and unexpectedly in Santiago during 1999-2004 were examined for Pneumocystis using nested polymerase chain reaction (nPCR) amplification of the P. jirovecii mtLSU ribosomal RNA gene and immunofluorescence microscopy (IF). Pneumocystis-negative infants 28 days and older and their age-closest positives were studied for MUC5AC expression and Pneumocystis burden by Western blot and quantitative PCR, respectively. RESULTS Pneumocystis DNA was detected by nPCR in 105 of the 128 infants (82.0%) and Pneumocystis organisms were visualized by IF in 99 (94.3%) of the DNA-positive infants. The infection was commonest at 3-4 months with 40 of 41 (97.6%) infants of that age testing positive. MUC5AC was significantly increased in Pneumocystis-positive tissue specimens (P = .013). Death was unexplained in 113 (88.3%) infants; Pneumocystis was detected in 95 (84.0%) of them vs 10 of 15 (66.7%) with explained death (P = .28). CONCLUSIONS A highly focal Pneumocystis infection associated to increased mucus expression is almost universally present in the lungs of infants dying unexpectedly in the community regardless of autopsy diagnosis.
Collapse
Affiliation(s)
- Sergio L Vargas
- Programa de Microbiología, Instituto de Ciencias Biomédicas, Facultad de Medicina Universidad de Chile, Santiago, Chile.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Abstract
Is Pneumocystis pneumonia (PcP) a transmissible fungal disease? Does nosocomial PcP occur? Is there Pneumocystis transmission in the community? These questions, which could not be tackled before the 2000s, may at present be approached using either noninvasive detection methods or experimental transmission models. Represented by a unique entity (P. carinii) for almost one century, the Pneumocystis genus was shown to contain several species, being P. jirovecii the sole species identified in humans hitherto. Molecular methods combined with cross infection experiments revealed strong host specificity that precludes Pneumocystis inter-species transmission. In contrast, respiratory transmission between mammals of a same species is usually highly active, even between immunocompetent hosts. Other transmission ways could also exist. New data show that human being is the unique P. jirovecii reservoir; it would constitute the sole infection source in both hospital and community.
Collapse
Affiliation(s)
- Magali Chabé
- Laboratoire de parasitologie-mycologie, faculté des sciences pharmaceutiques, université Lille-Nord-de-France, Lille, France
| | | | | |
Collapse
|
6
|
de Armas Y, Friaza V, Capó V, Durand-Joly I, Govín A, de La Horra C, Dei-Cas E, Calderón EJ. Low genetic diversity ofPneumocystis jiroveciiamong Cuban population based on two-locus mitochondrial typing. Med Mycol 2012; 50:417-20. [DOI: 10.3109/13693786.2011.607474] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
7
|
Lu Q, van den Ende AHGG, de Hoog GS, Li R, Accoceberry I, Durand-Joly I, Bouchara JP, Hernandez F, Delhaes L. Reverse line blot hybridisation screening of Pseudallescheria/Scedosporium species in patients with cystic fibrosis. Mycoses 2012; 54 Suppl 3:5-11. [PMID: 21995657 DOI: 10.1111/j.1439-0507.2011.02108.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The PCR-RLB (reverse line blot hybridisation) was applied as a molecular technique for the detection of members of Pseudallescheria and Scedosporium from sputum of patients with cystic fibrosis (CF). Fifty-nine sputum samples were collected from 52 CF patients, which were analysed by culture and PCR-RLB. Conventional and semi-selective culture yielded five positive samples, but the PCR-RLB hybridisation assay permitted the detection of members of Pseudallescheria/Scedosporium in 32 out of 52 patients (61.5%). In total, PCR-RLB yielded 47 positives. Pseudallescheria apiosperma was detected in 20 samples, while Pseudallescheria boydii and Pseudallescheria aurantiacum were detected in 17 and eight samples, respectively. Six samples gave a positive reaction with two distinct species-specific probes and one sample with three probes. In conclusion, the PCR-RLB assay described in this study allows the detection of Scedosporium spp. in CF sputum samples and the identification of Pseudallescheria apiosperma, P. boydii, S. aurantiacum, Scedosporium prolificans and Pseudallescheria minutispora.
Collapse
Affiliation(s)
- Q Lu
- Department of Dermatology, Peking University First Hospital, and Research Center for Medical Mycology, Peking University, Beijing, China
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Fréalle E, Lestrez C, Skierlak T, Melboucy D, Guery B, Durand-Joly I, Delhaes L, Loukili N. Fungal aero-decontamination efficacy of mobile air-treatment systems. Med Mycol 2011; 49:825-33. [PMID: 21526911 DOI: 10.3109/13693786.2011.575890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Immunosuppressed patients are at high risk of acquiring airborne fungal infections, mainly caused by Aspergillus species. Although HEPA filters are recommended to prevent environmental exposure, mobile air-treatment units can be an alternative. However, many different models of mobile units are available but there are few data on their fungal aero-decontamination efficacy and usefulness in the prevention of Aspergillus infections. Thus, we developed a challenge test, based on the aerosolization of 10(6) Aspergillus niger conidia, in order to compare the particle and fungal decontamination efficacy of the following four mobile air-treatment systems; Plasmair T2006, Mobil'Air 1200 (MA1200), Mobil'Air 600 (MA600) combined with Compact AirPur Mobile C250 (C250), and the prototype unit Compact AirPur Mobile 1800 (C1800). The use of all these air-treatment systems was able to significantly decrease the concentration of particles or fungal viable conidia. ISO7 was the maximum particle class reached within 20 min with the Plasmair T2006 and MA1200, 1 h by the combined MA600/C250, and 1 h and 30 min with the C1800. After 2 h, fungal counts were significantly lower with Plasmair T2006, MA1200 and the combined MA600/C250 (2.2 ± 1.9 to 5.0 ± 3.7 CFU/m(3)) than achieved with the C1800 (23.8 ± 12.8 CFU/m(3); P ≤ 6.0E-3). All the air-treatment systems were able to decrease aerial particle and fungal counts, but their efficacy was variable, depending on the units' air-treatment modalities and rates of air volume that was processed. This comparative study could be helpful in making an informed choice of mobile units, and in improving the prevention of air-transmitted fungal infections in non-protected areas.
Collapse
Affiliation(s)
- Emilie Fréalle
- CHRU de Lille & Faculté de Médecine de Lille-Biology and Diversity of Emerging Eukaryotic Pathogens (BDEEP), Pasteur Institute of Lille-Inserm U1019-CNRS UMR 8204-Université Lille Nord de France, Lille, France.
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Mekinian A, Durand-Joly I, Hatron PY, Moranne O, Denis G, Dei-Cas E, Morell-Dubois S, Lambert M, Launay D, Delhaes L, Hachulla E, Queyrel V. Pneumocystis jirovecii colonization in patients with systemic autoimmune diseases: prevalence, risk factors of colonization and outcome. Rheumatology (Oxford) 2010; 50:569-77. [DOI: 10.1093/rheumatology/keq314] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
10
|
Calderón EJ, Gutiérrez-Rivero S, Durand-Joly I, Dei-Cas E. Pneumocystisinfection in humans: diagnosis and treatment. Expert Rev Anti Infect Ther 2010; 8:683-701. [DOI: 10.1586/eri.10.42] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
11
|
Mekinian A, Queyrel V, Durand-Joly I, Moranne O, Denis G, Delhaes L, Morell-Dubois S, Lambert M, Launay D, Hachulla E, Hatron PY. PCR Pneumocystis jirovecii positive chez les patients atteints de maladie auto-immune : Pneumocystose pulmonaire ou simple colonisation ? Rev Med Interne 2010; 31:194-9. [DOI: 10.1016/j.revmed.2009.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 10/06/2009] [Accepted: 11/15/2009] [Indexed: 11/24/2022]
|
12
|
Leroy S, Conseil V, Coltey B, Lemeille Y, Dominique S, Gargala G, Domblides P, Accoceberry I, Loeuille G, Durand-Joly I, Fanton A, Vagnier O, Dalle F, Boldron A, Llerena C, Pinel C, Giniès J, Pihet M, Person C, Bouchara J, Wizla N, Marguet C, Favenne L, Bui S, Delhaes L. Evaluation and management of fungal risk in Cystic Fibrosis: first results of a national French study. J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
13
|
Soula F, Fréalle E, Durand-Joly I, Dutoit E, Rouland V, Renard E, Houfflin-Debarge V, Subtil D, Camus D, Dei-Cas E, Delhaes L. [Relevance of the toxoplasma IgG avidity test in the serological surveillance of pregnant women]. Ann Biol Clin (Paris) 2007; 65:257-64. [PMID: 17502297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Accepted: 02/07/2007] [Indexed: 05/15/2023]
Abstract
In addition to the serological systematic screening tests, kits to measure the avidity of toxoplasma IgG antibodies are currently available. Since high-avidity IgG toxoplasma antibodies have been shown to exclude recent infection, IgG avidity determination is especially useful in ruling out acute infection having occurred in the 3-4 prior months of pregnancy. We therefore compared the efficacy of two toxoplasma IgG avidity ELISA kits: SFRI (SFRI Laboratoire) and VIDAS Toxo-IgG avidity kit (bioMérieux). The agreement of the results from the 2 commercial assays were analysed using 55 serum samples, in terms of global mother-child Toxoplasma results and outcome, specially with light of the results of Toxoplasma antenatal, postnatal assays and of clinical follow up of children.
Collapse
Affiliation(s)
- F Soula
- Service de parasitologie-mycologie, CHRU de Lille - Faculté de Médecine, Université de Lille 2, and Clinique de gynécologie et obstétrique, Hôpital Jeanne de Flandre, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Sanchez CA, Sanchez CA, Chabé M, Moukhtar Aliouat E, Durand-Joly I, Gantois N, Conseil V, López C, Duriez T, Dei-Cas E, Vargas SL. Exploring transplacental transmission ofPneumocystisoryctolagiin first-time pregnant and multiparous rabbit does. Med Mycol 2007; 45:701-7. [DOI: 10.1080/13693780701531156] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
15
|
Dei-Cas E, Chabé M, Moukhlis R, Durand-Joly I, Aliouat EM, Stringer JR, Cushion M, Noël C, de Hoog GS, Guillot J, Viscogliosi E. Pneumocystis oryctolagisp. nov., an uncultured fungus causing pneumonia in rabbits at weaning: review of current knowledge, and description of a new taxon on genotypic, phylogenetic and phenotypic bases. FEMS Microbiol Rev 2006; 30:853-71. [PMID: 17064284 DOI: 10.1111/j.1574-6976.2006.00037.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The genus Pneumocystis comprises noncultivable, highly diversified fungal pathogens dwelling in the lungs of mammals. The genus includes numerous host-species-specific species that are able to induce severe pneumonitis, especially in severely immunocompromised hosts. Pneumocystis organisms attach specifically to type-1 epithelial alveolar cells, showing a high level of subtle and efficient adaptation to the alveolar microenvironment. Pneumocystis species show little difference at the light microscopy level but DNA sequences of Pneumocystis from humans, other primates, rodents, rabbits, insectivores and other mammals present a host-species-related marked divergence. Consistently, selective infectivity could be proven by cross-infection experiments. Furthermore, phylogeny among primate Pneumocystis species was correlated with the phylogeny of their hosts. This observation suggested that cophylogeny could explain both the current distribution of pathogens in their hosts and the speciation. Thus, molecular, ultrastructural and biological differences among organisms from different mammals strengthen the view of multiple species existing within the genus Pneumocystis. The following species were subsequently described: Pneumocystis jirovecii in humans, Pneumocystis carinii and Pneumocystis wakefieldiae in rats, and Pneumocystis murina in mice. The present work focuses on Pneumocystis oryctolagi sp. nov. from Old-World rabbits. This new species has been described on the basis of both biological and phylogenetic species concepts.
Collapse
|
16
|
Demanche C, Wanert F, Barthélemy M, Mathieu J, Durand-Joly I, Dei-Cas E, Chermette R, Guillot J. Molecular and serological evidence of Pneumocystis circulation in a social organization of healthy macaques (Macaca fascicularis). Microbiology (Reading) 2005; 151:3117-3125. [PMID: 16151222 DOI: 10.1099/mic.0.28059-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Simian populations represent valuable models for understanding the epidemiology of human pneumocystosis. The present study aims to describe the circulation of Pneumocystis organisms within a social organization of healthy crab-eating macaques (Macaca fascicularis) living in a natural setting in France. Animals were followed for up to 2 years. Deep nasal swab and blood samples were collected monthly from each animal under general anaesthesia. Environmental air was sampled for a 1 week period every month in the park where the macaques dwelt. Pneumocystis DNA was detected by nested-PCR of mitochondrial large subunit rRNA (mtLSU) gene in nasal swab and air samples. Anti-Pneumocystis IgG antibodies were detected in serum samples by indirect immuno-fluorescence assay. Pneumocystis DNA was detected in 168 of 500 swab samples examined (33.6 %). The number of macaques with detectable Pneumocystis DNA was highly variable from one month to another. Positive detection of Pneumocystis DNA was not related to the detection of serum anti-Pneumocystis antibody. During the second year of the study, Pneumocystis DNA was amplified more frequently from unweaned macaques than from adults or subadults. The mtLSU sequence showed marked polymorphism with eight Pneumocystis sequence types representing two distinct groups. On the whole, a constant and intensive circulation of Pneumocystis organisms within the community was observed. However, the implication of the various members of the colony was probably different and several levels of colonization by Pneumocystis may occur in immunocompetent macaques.
Collapse
Affiliation(s)
- Christine Demanche
- Equipe de Mycologie, UMR 956 INRA-AFSSA-ENVA-UPVM Biologie Moléculaire et Immunologie Parasitaires et Fongiques, Ecole Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94704 Maisons-Alfort, France
| | - Fanélie Wanert
- Centre de Primatologie, ULP Strasbourg, Fort Foch, Niederhausbergen, France
| | - Mathieu Barthélemy
- Laboratoire de Parasitologie, Université Pierre et Marie Curie, Paris VI, France
| | - Jérôme Mathieu
- Laboratoire d'Ecologie des Sols Tropicaux, UMR 137 BioSol, IRD/Paris VI, 32 avenue Henri Varagnat, 93143 Bondy Cedex, France
| | - Isabelle Durand-Joly
- EA3609-Parasitologie-Mycologie, Faculté de Médecine et CHRU de Lille and IFR-17-Ecologie du Parasitisme, Institut Pasteur de Lille, France
| | - Eduardo Dei-Cas
- EA3609-Parasitologie-Mycologie, Faculté de Médecine et CHRU de Lille and IFR-17-Ecologie du Parasitisme, Institut Pasteur de Lille, France
| | - René Chermette
- Equipe de Mycologie, UMR 956 INRA-AFSSA-ENVA-UPVM Biologie Moléculaire et Immunologie Parasitaires et Fongiques, Ecole Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94704 Maisons-Alfort, France
| | - Jacques Guillot
- Equipe de Mycologie, UMR 956 INRA-AFSSA-ENVA-UPVM Biologie Moléculaire et Immunologie Parasitaires et Fongiques, Ecole Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94704 Maisons-Alfort, France
| |
Collapse
|
17
|
Durand-Joly I, Chabé M, Soula F, Delhaes L, Camus D, Dei-Cas E. Molecular diagnosis ofPneumocystispneumonia. ACTA ACUST UNITED AC 2005; 45:405-10. [PMID: 16061360 DOI: 10.1016/j.femsim.2005.06.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2005] [Accepted: 06/20/2005] [Indexed: 11/20/2022]
Abstract
The detection of Pneumocystis DNA in clinical specimens by using PCR assays is leading to important advances in Pneumocystis pneumonia (PcP) clinical diagnosis, therapy and epidemiology. Highly sensitive and specific PCR tools improved the clinical diagnosis of PcP allowing an accurate, early diagnosis of Pneumocystis infection, which should lead to a decreased duration from onset of symptoms to treatment, a period with recognized impact on prognosis. This aspect has marked importance in HIV-negative immunocompromised patients, who develop often PcP with lower parasite rates than AIDS patients. The specific amplification of selected polymorphous sequences of Pneumocystis jirovecii genome, especially of internal transcribed spacer regions of the nuclear rRNA operon, has led to the identification of specific parasite genotypes which might be associated with PcP severity. Moreover, multi-locus genotyping revealed to be a useful tool to explore person-to-person transmission. Furthermore, PCR was recently used for detecting P. jirovecii dihydropteroate synthase gene mutations, which are apparently associated with sulfa drug resistance. PCR assays detected Pneumocystis-DNA in bronchoalveolar lavage fluid or biopsy specimens, but also in oropharyngeal washings obtained by rinsing of the mouth. This non-invasive procedure may reach 90%-sensitivity and has been used for monitoring the response to treatment in AIDS patients and for typing Pneumocystis isolates.
Collapse
|
18
|
Duboucher C, Gerbod D, Noël C, Durand-Joly I, Delgado-Viscogliosi P, Leclerc C, Pham S, Capron M, Dei-Cas E, Viscogliosi E. Frequency of trichomonads as coinfecting agents in Pneumocystis pneumonia. Acta Cytol 2005; 49:273-7. [PMID: 15966289 DOI: 10.1159/000326149] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To investigate the incidence of the association of Trichomonas and Pneumocystis in the lung. STUDY DESIGN Sixty-six bronchoalveolar lavage fluid (BALF) samples from immunocompromised patients with pneumocystosis were retrospectively examined microscopically. RESULTS Trichomonads were found as coinfecting agents in 60% of BALF samples. The frequency and abundance of trichomonads was increased, up to 100%, in cases rich in Pneumocystis. CONCLUSION The data suggest that pulmonary Trichomonas infection occurs frequently in the course of Pneumocystis pneumonia. The role of trichomonads in causing alveolar damage during Pneumocystis pneumonia is hypothetical.
Collapse
Affiliation(s)
- Christophe Duboucher
- Anatomic Pathology Laboratory, Service of Infectious and Tropical Diseases, Hôpital de Saint-Germainen-Laye, Saint-Germain-en-Laye, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Alfandari S, Leroy O, de Botton S, Yakoub-Agha I, Durand-Joly I, Leroy-Cotteau A, Beaucaire G. Prise en charge diagnostique et thérapeutique des infections à Aspergillus sp. chez le patient immunodéprimé. Recommandations du CHRU de Lille — version 4 — novembre 2004. Med Mal Infect 2005; 35:121-34. [PMID: 15911182 DOI: 10.1016/j.medmal.2005.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2004] [Accepted: 01/03/2005] [Indexed: 10/25/2022]
Abstract
Invasive aspergillosis is a severe complication in immunocompromised patients. The arrival of new antifungal agents motivated the redaction of guidelines, regularly updated, by a Lille University hospital multidisciplinary task force. These guidelines assess diagnostic and therapeutic issues. The main recommended diagnosis tool is the chest CT scan, ordered at the smallest suspicion and, also, measure of the blood and broncho alveolar lavage fluid galactomannan. Treatment guidelines assess prophylaxis, empirical and documented therapy. Primary prophylaxis is warranted in only two cases, pulmonary graft or stem cell transplant in patients with chronic GVH and receiving corticosteroids. Empirical therapy should use one of the available amphotericin B formulations, chosen according to the patient history. Caspofungin is another choice. Documented therapy, depending on presentation, can be a single drug or a combination. First line therapy for single drug is i.v. voriconazole. Lipid formulations of amphotericin B are another choice. A combination therapy can be used as a first line treatment, for multiple lesions, or as salvage therapy. It must include caspofungin, associated with liposomal amphotericin B or voriconazole. A tight cooperation with thoracic surgeons is recommended.
Collapse
Affiliation(s)
- S Alfandari
- Service de réanimation et maladies infectieuses, centre hospitalier Dron, 59208 Tourcoing, France.
| | | | | | | | | | | | | |
Collapse
|
20
|
Chabé M, Vargas SL, Eyzaguirre I, Aliouat EM, Follet-Dumoulin A, Creusy C, Fleurisse L, Recourt C, Camus D, Dei-Cas E, Durand-Joly I. Molecular typing of Pneumocystis jirovecii found in formalin-fixed paraffin-embedded lung tissue sections from sudden infant death victims. Microbiology 2004; 150:1167-1172. [PMID: 15133076 DOI: 10.1099/mic.0.26895-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Previous studies have provided histological evidence of an association between primary Pneumocystis infection and sudden infant death syndrome (SIDS). The aim of this work was to determine the species of clustered Pneumocystis organisms found in formalin-fixed paraffin-embedded (FFPE) lung tissue sections from Chilean sudden infant death (SID) victims. This approach needed first to optimize a DNA extraction method from such histological sections. For that purpose, the QIAamp DNA Isolation from Paraffin-Embedded Tissue method (Qiagen) was first tested on FFPE lung tissue sections of immunosuppressed Wistar rats inoculated with rat-derived PNEUMOCYSTIS: Successful DNA extraction was assessed by the amplification of a 346 bp fragment of the mitochondrial large subunit rRNA gene of the Pneumocystis species using a previously described PCR assay. PCR products were analysed by direct sequencing and sequences corresponding to Pneumocystis carinii were found in all the samples. This method was then applied to FFPE lung tissue sections from Chilean SID victims. Pneumocystis jirovecii was successfully identified in the three tested samples. In conclusion, an efficient protocol for isolating PCR-ready DNA from FFPE lung tissue sections was developed. It established that the Pneumocystis species found in the lungs of Chilean SID victims was P. jirovecii.
Collapse
Affiliation(s)
- M Chabé
- Ecology of Parasitism, EA-3609-IFR17, Pasteur Institute of Lille, 1 rue du Professeur-Calmette BP245, 59019 Lille, France
| | - S L Vargas
- Respiratory Infections Laboratory, Biomedical Sciences Institute, University of Chile School of Medicine, Independencia 1027, Santiago, Chile
| | - I Eyzaguirre
- Respiratory Infections Laboratory, Biomedical Sciences Institute, University of Chile School of Medicine, Independencia 1027, Santiago, Chile
| | - E M Aliouat
- Ecology of Parasitism, EA-3609-IFR17, Pasteur Institute of Lille, 1 rue du Professeur-Calmette BP245, 59019 Lille, France
| | - A Follet-Dumoulin
- Ecology of Parasitism, EA-3609-IFR17, Pasteur Institute of Lille, 1 rue du Professeur-Calmette BP245, 59019 Lille, France
| | - C Creusy
- Free Faculty of Medicine, Lille Catholic University, rue du Port, 59046 Lille, France
| | - L Fleurisse
- Free Faculty of Medicine, Lille Catholic University, rue du Port, 59046 Lille, France
| | - C Recourt
- Ecology of Parasitism, EA-3609-IFR17, Pasteur Institute of Lille, 1 rue du Professeur-Calmette BP245, 59019 Lille, France
| | - D Camus
- Parasitology-Mycology Service, Faculty of Medicine, Lille-2 University Hospital Center, 1 place Verdun, 59045 Lille, France
- Ecology of Parasitism, EA-3609-IFR17, Pasteur Institute of Lille, 1 rue du Professeur-Calmette BP245, 59019 Lille, France
| | - E Dei-Cas
- Parasitology-Mycology Service, Faculty of Medicine, Lille-2 University Hospital Center, 1 place Verdun, 59045 Lille, France
- Ecology of Parasitism, EA-3609-IFR17, Pasteur Institute of Lille, 1 rue du Professeur-Calmette BP245, 59019 Lille, France
| | - I Durand-Joly
- Parasitology-Mycology Service, Faculty of Medicine, Lille-2 University Hospital Center, 1 place Verdun, 59045 Lille, France
- Ecology of Parasitism, EA-3609-IFR17, Pasteur Institute of Lille, 1 rue du Professeur-Calmette BP245, 59019 Lille, France
| |
Collapse
|
21
|
Chabé M, Dei-Cas E, Creusy C, Fleurisse L, Respaldiza N, Camus D, Durand-Joly I. Immunocompetent hosts as a reservoir of pneumocystis organisms: histological and rt-PCR data demonstrate active replication. Eur J Clin Microbiol Infect Dis 2004; 23:89-97. [PMID: 14712369 DOI: 10.1007/s10096-003-1092-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The present study was conducted to further examine recent data suggesting that pneumocystosis could be transmitted between patients and healthcare workers in the hospital environment, as has been proven with Pneumocystis-infected SCID mice and immunocompetent Balb/c mice. Using an experimental design (i.e., SCID-Balb/c mouse airborne transmission system), the present work found that healthy host-to-healthy host transmission of Pneumocystis organisms can occur, and that 'second' healthy contacts are able to transmit the infectious organisms to immunocompromised hosts. Further tests designed to explore the behavior of Pneumocystis organisms in the lungs of immunocompetent hosts were performed using histological and molecular approaches (e.g. testing the expression of both cyclin-dependent serine-threonine kinase and heat-shock 70 protein in Pneumocystis). The results showed Pneumocystis organisms were able to replicate in the lungs of immunocompetent hosts, which indicates these hosts are a reservoir for Pneumocystis spp.
Collapse
Affiliation(s)
- M Chabé
- Ecology of Parasitism, Lille Pasteur Institute, 1 rue du Prof-Calmette BP245, 59019, Lille, France
| | | | | | | | | | | | | |
Collapse
|
22
|
Durand-Joly I, Alfandari S, Benchikh Z, Rodrigue M, Espinel-Ingroff A, Catteau B, Cordevant C, Camus D, Dei-Cas E, Bauters F, Delhaes L, De Botton S. Successful outcome of disseminated Fusarium infection with skin localization treated with voriconazole and amphotericin B-lipid complex in a patient with acute leukemia. J Clin Microbiol 2004; 41:4898-900. [PMID: 14532255 PMCID: PMC254322 DOI: 10.1128/jcm.41.10.4898-4900.2003] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A disseminated Fusarium oxysporum infection with skin localization was diagnosed in a woman with a relapse of B-acute leukemia during induction chemotherapy. The infection was refractory to amphotericin B-lipid complex alone but responded successfully when voriconazole was added.
Collapse
|
23
|
Demanche C, Wanert F, Herrenschmidt N, Moussu C, Durand-Joly I, Dei-Cas E, Chermette R, Guillot J. Influence of Climatic Factors on Pneumocys Carriage within a Socially Organized Group of Immunocompetent Macaques (Macaca fascicularis). J Eukaryot Microbiol 2003; 50 Suppl:611-3. [PMID: 14736182 DOI: 10.1111/j.1550-7408.2003.tb00649.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
As monkeys-derived Pneumocystis is closely related to P. jirovecii, simian populations should be considered as valuable models for the understanding of the epidemiology of human pneumocystosis. In the present study, the impact of environmental factors on the carriage of Pneumocystis was evaluated in socially organized group of immunocompetent macaques (Macaca fascicularis). The tribe, maintained in partial release at the Primatology Center of Strasbourg in France, comprised 29 animals at the end of the study. From December 2000 to November 2002, deep nasal swab samples were collected monthly from each animal under general anaesthesia. The presence of Pneumocystis DNA was assessed by nested PCR of mtLSU rRNA gene. No case of pneumocystosis was reported during the study. Pneumocystis DNA was detected in 166 out of 481 swab samples examined (34.5%). The number of macaques with detectable Pneumocystis DNA was highly variable from one month to another. However, Pnemocystis carriage was clearly correlated to the mean precipitation rates.
Collapse
|
24
|
Durand-Joly I, Soula F, Chabé M, Dalle JH, Lafitte JJ, Senechal M, Pinon A, Camus D, Dei-Cas E. Long-Term Colonization with Pneumocystis jirovecii in Hospital Staffs: A Challenge to Prevent Nosocomial Pneumocystosis. J Eukaryot Microbiol 2003; 50 Suppl:614-5. [PMID: 14736183 DOI: 10.1111/j.1550-7408.2003.tb00650.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Duboucher C, Noël C, Durand-Joly I, Gerbod D, Delgado-Viscogliosi P, Jouveshomme S, Leclerc C, Cartolano GL, Dei-Cas E, Capron M, Viscogliosi E. Pulmonary coinfection by Trichomonas vaginalis and Pneumocystis sp. as a novel manifestation of AIDS. Hum Pathol 2003; 34:508-11. [PMID: 12792927 DOI: 10.1016/s0046-8177(03)00088-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A 41-year-old man was hospitalized, presenting increasing dyspnea and extensive ground-glass opacities on chest X-ray. Infection by human immunodeficiency virus was confirmed. Cytologic examination of bronchoalveolar lavage fluid revealed numerous trichomonads and aggregates of Pneumocystis sp. Treatment was followed by rapid improvement of respiratory symptoms and chest X-ray. The trichomonad species found in the lungs was identified as Trichomonas vaginalis by small-subunit rRNA gene amplification and sequencing. With the exception of rare cases of contamination of newborn babies during delivery, T. vaginalis has never been found in lungs in healthy or immunocompromised adults. In the present case, T. vaginalis is found as coinfecting agent. Our data, like those found in the literature, suggest that trichomonads are overlooked parasites that may be regularly implicated in diverse human pathologies.
Collapse
Affiliation(s)
- Christophe Duboucher
- Department of Pathology, Pneumology, Infectioud Diseases and Bacteriology, Saint-Germain-en-Laye Hospital, Saint-Germain-en-Laye, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Laurans C, Durand-Joly I, Benchikh Z, Angelina D, Poher M, Camus D, Dei-Cas E, Delhaes L. [Necessity of postpartum serologic screening for congenital toxoplasmosis in women who are seronegative at the end of pregnancy]. Presse Med 2002; 31:1266-7. [PMID: 12238272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
|
27
|
Durand-Joly I, Aliouat EM, Recourt C, Guyot K, François N, Wauquier M, Camus D, Dei-Cas E. Pneumocystis carinii f. sp. hominis is not infectious for SCID mice. J Clin Microbiol 2002; 40:1862-5. [PMID: 11980979 PMCID: PMC130940 DOI: 10.1128/jcm.40.5.1862-1865.2002] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2001] [Revised: 01/08/2002] [Accepted: 02/25/2002] [Indexed: 11/20/2022] Open
Abstract
The infectious power of Pneumocystis carinii f. sp. hominis was explored by inoculating SCID mice intranasally with either P. carinii f. sp. hominis or P. carinii f. sp. muris isolates. Only mice inoculated with mouse parasites developed Pneumocystis pneumonia, as assessed by microscopy and PCR. These results suggest that humans do not contract pneumocystosis from animals.
Collapse
Affiliation(s)
- Isabelle Durand-Joly
- Ecologie du Parasitisme, Institut Pasteur de Lille, 1 rue du Prof-Calmette-BP 245, 59019 Lille, France.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Durand-Joly I, Wakefield AE, Palmer RJ, Denis CM, Creusy C, Fleurisse L, Ricard I, Gut JP, Dei-Cas E. Ultrastructural and molecular characterization of Pneumocystis carinii isolated from a rhesus monkey (Macaca mulatta). Med Mycol 2000; 38:61-72. [PMID: 10746229 DOI: 10.1080/mmy.38.1.61.72] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
High levels of heterogeneity have been observed among isolates of Pneumocystis carinii derived from different mammalian host species. We report the characterization of P. carinii isolated from a rhesus monkey (Macaca mulatta), which was immunosuppressed as a result of infection with a chimeric simian-human immunodeficiency virus (SHIVsbg). Histopathological examination showed evidence of severe P. carinii pneumonia with a large predominance of trophozoite forms. Alveolitis consisted of typical foamy, honeycomb exudate, with only a few alveolar macrophages. The lung inflammatory response was rather moderate without type-2 pneumocyte hyperplasia or collagenosis. P. carinii organisms were sometimes observed in the bronchiolar lumen. Ultrastructurally, macaque-derived P. carinii was more similar to human- or rabbit-derived parasites than to mouse-derived P. carinii. Molecular studies were carried out on the macaque-derived P. carinii DNA at two genetic loci: the genes encoding the mitochondrial large subunit ribosomal RNA (mt LSU rRNA) and the mitochondrial small subunit ribosomal RNA (mt SSU rRNA). Comparison of the DNA sequences with those from P. carinii isolated from eight other host species demonstrated that the macaque-derived P. carinii was genetically distinct at both loci, and was more closely related to human-derived P. carinii than to P. carinii derived from non-primate sources. We propose that macaque-derived P. carinii be named Pneumocystis carinii f.sp. macacae.
Collapse
Affiliation(s)
- I Durand-Joly
- Department of Microbiology of Ecosystems, Pasteur Institute of Lille, France
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Durand-Joly I, Wakefield AE, Palmer RJ, Denis CM, Creusy C, Fleurisse L, Ricard I, Gut JP, Dei-Cas E. Ultrastructural and molecular characterization of Pneumocystis carinii isolated from a rhesus monkey (Macaca mulatta). Med Mycol 2000. [DOI: 10.1080/714030897] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|