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De Wals P, Desjardins M. Minimal interval for the administration of a pneumococcal polysaccharide vaccine following the administration of a pneumococcal conjugate vaccine. Vaccine 2024; 42:2933-2936. [PMID: 38346915 DOI: 10.1016/j.vaccine.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 12/29/2023] [Accepted: 02/02/2024] [Indexed: 04/22/2024]
Affiliation(s)
- Philippe De Wals
- Department of Social and Preventive Medicine, Laval University, Quebec City, Canada; Quebec National Public Health Institute, Quebec City, Canada.
| | - Michaël Desjardins
- Division of Infectious Diseases, Montreal University Hospital, Montreal, Canada; Department of Microbiology, Infectiology and Immunology, Faculty of Medicine, Montreal University
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2
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Deceuninck G, Brousseau N, Lefebvre B, Quach C, Tapiero B, Bui YG, Desjardins M, De Wals P. Effectiveness of thirteen-valent pneumococcal conjugate vaccine to prevent serotype 3 invasive pneumococcal disease in Quebec in children, Canada. Vaccine 2023; 41:5486-5489. [PMID: 37524629 DOI: 10.1016/j.vaccine.2023.07.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/08/2023] [Revised: 07/04/2023] [Accepted: 07/24/2023] [Indexed: 08/02/2023]
Abstract
In the province of Quebec, Canada, a 2 + 1 dose pneumococcal conjugate vaccine (PCV) program for children was implemented in 2004. PCV7 was replaced by PCV10 in 2009, by PCV13 in 2011 and by PCV10 in 2018, without catch-up in all instances. The objective was to estimate PCV13 effectiveness to prevent serotype 3 invasive pneumococcal disease in children aged less than 5 years, using 2010-2018 mandatory notification and laboratory surveillance data, an indirect cohort design and multivariate logistic regression models. A total of 29 cases of serotype 3 and 290 non-vaccine serotype cases as controls were analysed. Overall vaccine effectiveness (≥1 dose) was estimated at 59% [-39% to 88%]. During the first year after the last dose effectivness was 88% [47% to 97%] whereas no protection was observed thereafter. There was no trend towards increased effectiveness with the number of doses. PCV13 protection against serotype 3 IPD seems to be short-lived.
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Affiliation(s)
- Geneviève Deceuninck
- Centre de recherche du Centre hospitalier universitaire de Québec, Équipe de recherche en vaccination, Québec, QC, Canada; Institut National de Santé Publique du Québec, Direction des risques biologiques, Québec, QC, Canada.
| | - Nicholas Brousseau
- Centre de recherche du Centre hospitalier universitaire de Québec, Équipe de recherche en vaccination, Québec, QC, Canada; Institut National de Santé Publique du Québec, Direction des risques biologiques, Québec, QC, Canada
| | - Brigitte Lefebvre
- Institut national de santé publique du Québec, Laboratoire de santé publique du Québec, Sainte-Anne-de-Bellevue, QC, Canada
| | - Caroline Quach
- Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, QC, Canada; Division of Medical microbiology, Clinical Department of Laboratory Medicine, CHU Sainte-Justine, Montreal, QC, Canada
| | - Bruce Tapiero
- Service des maladies infectieuses, CHU Sainte-Justine, Montréal, QC, Canada
| | - Yen-Giang Bui
- Institut National de Santé Publique du Québec, Direction des risques biologiques, Québec, QC, Canada
| | - Michaël Desjardins
- Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, QC, Canada; Division of Infectious Diseases, Centre hospitalier de l'Université de Montréal, Qc, Canada
| | - Philippe De Wals
- Centre de recherche du Centre hospitalier universitaire de Québec, Équipe de recherche en vaccination, Québec, QC, Canada; Institut National de Santé Publique du Québec, Direction des risques biologiques, Québec, QC, Canada; Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada; Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
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3
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Côté JM, Desjardins M, Murray PT. Does Vancomycin-Piperacillin-Tazobactam Cause Pseudo-AKI, True Nephrotoxicity, or Both? Chest 2023; 164:273-274. [PMID: 37558318 DOI: 10.1016/j.chest.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Jean-Maxime Côté
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada; CHUM Research Center (CRCHUM), Montreal, QC, Canada; Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
| | - Michaël Desjardins
- Faculty of Medicine, University of Montreal, Montreal, QC, Canada; CHUM Research Center (CRCHUM), Montreal, QC, Canada; Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Patrick T Murray
- Faculty of Medicine, University College Dublin, Dublin, Ireland; Mater Misericordiae University Hospital, Dublin, Ireland
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4
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Desjardins M, Cunningham P, Mitre X, Pierre D, Montesano C, Woods T, Oganezova K, Krauss JH, Von SS, Kupelian JA, Li X, Gothing JA, Kleinjan JA, Zhou G, Piantadosi S, Sherman AC, Walsh SR, Issa NC, Kaufman RM, Baden LR. Immunogenicity of quadrivalent meningococcal conjugate vaccine in frequent platelet donors. Blood 2023; 142:202-209. [PMID: 37172200 DOI: 10.1182/blood.2022019482] [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: 12/27/2022] [Revised: 04/21/2023] [Accepted: 04/21/2023] [Indexed: 05/14/2023] Open
Abstract
Frequent plateletpheresis is associated with severe lymphopenia of uncertain clinical significance. We assessed the functional impact of frequent platelet donations and associated lymphopenia on the response to neoantigens. We conducted a prospective study of 102 platelet donors (HIV uninfected) who were naive to meningococcal vaccination recruited at Brigham and Women's Hospital. One dose of quadrivalent meningococcal conjugate vaccine was administered. Seroresponse was defined as a fourfold increase of serum bactericidal antibody titers and seroprotection was defined as postvaccination titers of ≥1:8, for each of the 4 vaccine antigens (A, C, W, and Y). Mean age of participants was 61 years, 69% were male, and medial number of platelet donations in prior year was 14 (interquartile range, 4-20). Frequent platelet donors had a low CD4 count (14% with ≤200/μL and 34% with ≤350/μL). Seroresponse rates varied from 68% for serogroup Y to 86% for serogroup A and were higher for participants with baseline titers of <1:8. Postvaccination seroprotection rates varied from 76% for serogroup Y to 96% for serogroup A. After adjustments for age, sex, and frequent donations, lower total lymphocyte or lower CD4 counts were not associated with lower responses. These data suggest no impairment by plateletpheresis-associated lymphopenia on response to these neoantigens. This trial was registered at www.clinicaltrials.gov as #NCT04224311.
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Affiliation(s)
- Michaël Desjardins
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
- Division of Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Phoebe Cunningham
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Xhoi Mitre
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Djenane Pierre
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Christina Montesano
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Tenaizus Woods
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Karina Oganezova
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jonathan H Krauss
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Salena S Von
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - John A Kupelian
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Xiaofang Li
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jon A Gothing
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jane A Kleinjan
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Guohai Zhou
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA
| | | | - Amy C Sherman
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Stephen R Walsh
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Nicolas C Issa
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Richard M Kaufman
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Lindsey R Baden
- Division of Infectious Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Pei J, Recinto SJ, MacDonald A, Gavino C, Trudeau LE, Desjardins M, Stratton JA, Gruenheid S. A24 INVESTIGATING THE IMPACT OF PARKINSON’S DISEASE-ASSOCIATED GENES ON INTESTINAL HOMEOSTASIS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991100 DOI: 10.1093/jcag/gwac036.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Intestinal epithelial cells (IECs) provide an essential physical barrier between harsh luminal contents and underlying host tissue. The maintenance of intestinal homeostasis in this rapidly renewing tissue must be intricately regulated through the proliferation and differentiation of intestinal stem cells (ISCs). Dysregulation of this system results in the loss of barrier function, causing pathologies in both intestinal and extra-intestinal diseases. While Parkinson’s Disease (PD) is primarily a neurodegenerative disorder, there is increasing evidence linking PD progression and gastrointestinal dysfunction. For instance, constipation and increased bowel permeability are frequently observed years prior to development of motor dysfunction in PD, people with inflammatory bowel disease are more likely to develop PD, and a positive correlation exists between gastrointestinal infections and PD incidence. Our group recently developed a model to investigate the role of the gut in PD, demonstrating that mice with genetic ablation of the PD-associated gene Pink1 exhibited motor phenotypes only when previously infected with Gram-negative Citrobacter rodentium intestinal bacteria. As Pink1 and other PD-associated genes are expressed in IECs, we hypothesize that PD-associated gene mutations directly affect the epithelium and impact early PD pathophysiology. Purpose Investigate the impact of Pink1 and other PD-associated genes in IECs under steady state and infection. Method Single-cell RNA sequencing was performed on IECs isolated from Pink1 WT and KO mice, at steady state and following in vivo C. rodentium infection. Mice were sacrificed at an early timepoint of infection (day 6) to elucidate transcriptional differences between epithelial lineages of each genotype. Additionally, ex vivo colonoids were derived from primary mouse tissue and treated with lipopolysaccharide (LPS) to determine how PINK1 loss-of-function affects the inflammatory response of the epithelium. Result(s) Our data revealed that loss-of-function of PINK1 profoundly affected the ISC compartment and several epithelial lineages. Specifically, ISCs from infected Pink1 KO mice demonstrated differentially regulated proliferative and cell cycle genes, while transit amplifying cells showed dysregulated expression of tight junction genes, and enterocytes displayed differentially expressed oxidative damage and apoptotic genes. Preliminary data from colonoids showed that Pink1 KO mice, when stimulated with LPS, had increased pro-inflammatory cytokine gene expression. Conclusion(s) In Pink1 KO intestinal epithelial cells, there is indeed an altered cellular response upon infection in vivo and LPS treatment ex vivo. However, more information is needed to decern the mechanistic role of IECs in PD. By investigating the role of PD genes in the gastrointestinal tract, these studies carry important implications for understanding the initiation and progression of PD. Disclosure of Interest None Declared
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Affiliation(s)
- J Pei
- Microbiology and Immunology
| | - S J Recinto
- Integrated Program in Neuroscience, McGill University
| | - A MacDonald
- Integrated Program in Neuroscience, McGill University
| | | | | | - M Desjardins
- Département de pathologie et biologie cellulaire, Université de Montréal , Montreal, Canada
| | - J A Stratton
- Integrated Program in Neuroscience, McGill University
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Tolan NV, DeSimone MS, Fernandes MD, Lewis JE, Simmons DP, Schur PH, Brigl M, Tanasijevic MJ, Desjardins M, Sherman AC, Baden LR, Snyder M, Melanson SE. Lessons learned: A look back at the performance of nine COVID-19 serologic assays and their proposed utility. Clin Biochem 2023; 117:60-68. [PMID: 36878344 PMCID: PMC9985916 DOI: 10.1016/j.clinbiochem.2023.03.003] [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: 10/11/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Serologic assays for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been proposed to assist with the acute diagnosis of infection, support epidemiological studies, identify convalescent plasma donors, and evaluate vaccine response. METHODS We report an evaluation of nine serologic assays: Abbott (AB) and Epitope (EP) IgG and IgM, EUROIMMUN (EU) IgG and IgA, Roche anti-N (RN TOT) and anti-S (RS TOT) total antibody, and DiaSorin (DS) IgG. We evaluated 291 negative controls (NEG CTRL), 91 PCR positive (PCR POS) patients (179 samples), 126 convalescent plasma donors (CPD), 27 healthy vaccinated donors (VD), and 20 allogeneic hematopoietic stem cell transplant (HSCT) recipients (45 samples). RESULTS We observed good agreement with the method performance claims for specificity (93-100%) in NEG CTRL but only 85% for EU IgA. The sensitivity claims in the first 2 weeks of symptom onset was lower (26-61%) than performance claims based on > 2 weeks since PCR positivity. We observed high sensitivities (94-100%) in CPD except for AB IgM (77%), EP IgM (0%). Significantly higher RS TOT was observed for Moderna vaccine recipients then Pfizer (p-values < 0.0001). A sustained RS TOT response was observed for the five months following vaccination. HSCT recipients demonstrated significantly lower RS TOT than healthy VD (p < 0.0001) at dose 2 and 4 weeks after. CONCLUSIONS Our data suggests against the use of anti-SARS-CoV-2 assays to aid in acute diagnosis. RN TOT and RS TOT can readily identify past-resolved infection and vaccine response in the absence of native infection. We provide an estimate of expected antibody response in healthy VD over the time course of vaccination for which to compare antibody responses in immunosuppressed patients.
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Affiliation(s)
- Nicole V Tolan
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
| | - Mia S DeSimone
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Maria D Fernandes
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States
| | - Joshua E Lewis
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Daimon P Simmons
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Peter H Schur
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Manfred Brigl
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Milenko J Tanasijevic
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Michaël Desjardins
- Harvard Medical School, Boston, MA, United States; Brigham and Women's Hospital, Department of Medicine, Division of Infectious Diseases, Boston, MA, United States
| | - Amy C Sherman
- Harvard Medical School, Boston, MA, United States; Brigham and Women's Hospital, Department of Medicine, Division of Infectious Diseases, Boston, MA, United States
| | - Lindsey R Baden
- Harvard Medical School, Boston, MA, United States; Brigham and Women's Hospital, Department of Medicine, Division of Infectious Diseases, Boston, MA, United States
| | | | - Stacy Ef Melanson
- Brigham and Women's Hospital, Department of Pathology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
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7
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Boutin CA, Desjardins M, Luong ML. Fungal infection and chronic lung allograft dysfunction: A dangerous combination. Transpl Infect Dis 2022; 24:e13987. [PMID: 36380580 DOI: 10.1111/tid.13987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Catherine-Audrey Boutin
- 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.,Division of Infectious Disease, Department of Medicine, University of Montreal Hospital Center, Montreal, Quebec, Canada
| | - Michaël Desjardins
- Division of Infectious Disease, Department of Medicine, University of Montreal Hospital Center, Montreal, Quebec, Canada
| | - Me-Linh Luong
- Division of Infectious Disease, Department of Medicine, University of Montreal Hospital Center, Montreal, Quebec, Canada
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8
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Follmann D, Janes HE, Buhule OD, Zhou H, Girard B, Marks K, Kotloff K, Desjardins M, Corey L, Neuzil KM, Miller JM, El Sahly HM, Baden LR. Antinucleocapsid Antibodies After SARS-CoV-2 Infection in the Blinded Phase of the Randomized, Placebo-Controlled mRNA-1273 COVID-19 Vaccine Efficacy Clinical Trial. Ann Intern Med 2022; 175:1258-1265. [PMID: 35785530 PMCID: PMC9258784 DOI: 10.7326/m22-1300] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Immunoassays for determining past SARS-CoV-2 infection have not been systematically evaluated in vaccinated persons in comparison with unvaccinated persons. OBJECTIVE To evaluate antinucleocapsid antibody (anti-N Ab) seropositivity in mRNA-1273 (Moderna) vaccinees with breakthrough SARS-CoV-2 infection. DESIGN Nested substudy of a phase 3 randomized, double-blind, placebo-controlled vaccine efficacy trial. (ClinicalTrials.gov: NCT04470427). SETTING 99 sites in the United States, July 2020 through March 2021. PARTICIPANTS Participants were aged 18 years or older, had no known history of SARS-CoV-2 infection, and were at risk for SARS-CoV-2 infection or severe COVID-19. Substudy participants were diagnosed with SARS-CoV-2 infection during the trial's blinded phase. INTERVENTION 2 mRNA-1273 or placebo injections 28 days apart. MEASUREMENTS Nasopharyngeal swabs from days 1 and 29 (vaccination days) and from symptom-prompted illness visits were tested for SARS-CoV-2 via polymerase chain reaction (PCR). Serum samples from days 1, 29, and 57 and the participant decision visit (PDV, when participants were informed of treatment assignment; median day 149) were tested for anti-N Abs by the Elecsys immunoassay. RESULTS Among 812 participants with PCR-confirmed COVID-19 illness during the blinded phase of the trial (through March 2021), seroconversion to anti-N Abs (median of 53 days after diagnosis) occurred in 21 of 52 mRNA-1273 vaccinees (40% [95% CI, 27% to 54%]) versus 605 of 648 placebo recipients (93% [CI, 92% to 95%]). Each 1-log increase in SARS-CoV-2 viral copies at diagnosis was associated with 90% higher odds of anti-N Ab seroconversion (odds ratio, 1.90 [CI, 1.59 to 2.28]). LIMITATION The scope was restricted to mRNA-1273 vaccinees and the Elecsys assay, the sample size was small, data on Delta and Omicron infections were lacking, and the analysis did not address a prespecified objective of the trial. CONCLUSION Vaccination status should be considered when interpreting seroprevalence and seropositivity data based solely on anti-N Ab testing. PRIMARY FUNDING SOURCE National Institute of Allergy and Infectious Diseases of the National Institutes of Health.
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Affiliation(s)
- Dean Follmann
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (D.F., O.D.B.)
| | - Holly E Janes
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington (H.E.J.)
| | - Olive D Buhule
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (D.F., O.D.B.)
| | - Honghong Zhou
- Moderna, Cambridge, Massachusetts (H.Z., B.G., J.M.M.)
| | | | | | - Karen Kotloff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland (K.K., K.M.N.)
| | - Michaël Desjardins
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, and Division of Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (M.D.)
| | - Lawrence Corey
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, and Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington (L.C.)
| | - Kathleen M Neuzil
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland (K.K., K.M.N.)
| | | | - Hana M El Sahly
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas (H.M.E.)
| | - Lindsey R Baden
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (L.R.B.)
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Sherman AC, Desjardins M, Cheng CA, Bausk B, Izaguirre N, Zhou G, Krauss J, Tolan N, Walt DR, Soiffer R, Ho VT, Issa NC, Baden LR. Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines in Allogeneic Hematopoietic Stem Cell Transplant Recipients: Immunogenicity and Reactogenicity. Clin Infect Dis 2022; 75:e920-e923. [PMID: 34726754 PMCID: PMC8689898 DOI: 10.1093/cid/ciab930] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Indexed: 01/19/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 messenger RNA vaccine-induced humoral response and reactogenicity profile are described in allogeneic hematopoietic stem cell transplant (HSCT) recipients. Findings showed that 75.0% (by Simoa assay) or 80.0% (by Roche assay) of the HSCT cohort had a positive antibody response on series completion, compared with 100% in the healthy cohort.
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Affiliation(s)
- Amy C Sherman
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Michaël Desjardins
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Division of Infectious Diseases, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Chi-An Cheng
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USAand
- Harvard Medical School, Boston, Massachusetts, USA
| | - Bruce Bausk
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Natalie Izaguirre
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Guohai Zhou
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Nicole Tolan
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - David R Walt
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USAand
- Harvard Medical School, Boston, Massachusetts, USA
| | - Robert Soiffer
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Vincent T Ho
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Nicolas C Issa
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Lindsey R Baden
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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10
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Sherman AC, Crombie JL, Cheng CA, Desjardins M, Zhou G, Ometoruwa O, Rooks R, Senussi Y, McDonough M, Guerrero LI, Kupelian J, Doss-Gollin S, Smolen KK, van Haren SD, Armand P, Levy O, Walt DR, Baden LR, Issa NC. Immunogenicity of a three-dose primary series of mRNA COVID-19 vaccines in patients with lymphoid malignancies. Open Forum Infect Dis 2022; 9:ofac417. [PMID: 36043177 PMCID: PMC9384786 DOI: 10.1093/ofid/ofac417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 05/04/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients with lymphoid malignancies are at risk for poor COVID-19 related outcomes and have reduced vaccine-induced immune responses. Currently a three-dose primary regimen of mRNA vaccines is recommended in the U.S. for immunocompromised hosts.
Methods
A prospective cohort study of healthy adults (n = 27) and patients with lymphoid malignancies (n = 94) was conducted, with longitudinal follow-up through completion of a two or three-dose primary mRNA COVID vaccine series, respectively. Humoral responses were assessed in all participants, and cellular immunity in a subset of participants.
Results
The rate of seroconversion (68.1% v. 100%) and the magnitude of peak anti-S IgG titer (median anti-S IgG 32.4, IQR 0.48-75.0 v. 72.6, IQR 51.1-100.1; p = 0.0202) were both significantly lower in patients with lymphoid malignancies as compared to the healthy cohort. However, peak titers of patients with lymphoid malignancies who responded to vaccination were similar to healthy cohort titers (median anti-S IgG 64.3, IQR 23.7 - 161.5, p = 0.7424). The third dose seroconverted 7/41 (17.1%) patients who were seronegative after the first two doses. Although most patients with lymphoid malignancies produced vaccine-induced T-cell responses in the subset studied, B-cell frequencies were low with minimal memory cell formation.
Conclusions
A three-dose primary mRNA series enhanced anti-S IgG responses to titers equivalent to healthy adults in patients with lymphoid malignancies who were seropositive after the first two doses and seroconverted 17.1% who were seronegative after the first two doses. T-cell responses were present, raising the possibility that the vaccines may confer some cell-based protection even if not measurable by anti-S IgG.
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Affiliation(s)
- Amy C Sherman
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Jennifer L Crombie
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Chi An Cheng
- Harvard Medical School , Boston, MA, 02115 , USA
- Department of Pathology, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University , Boston, MA, 02115 , USA
| | - Michaël Desjardins
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Division of Infectious Diseases, Centre Hospitalier de l’Université de Montréal , Montreal, Qc , Canada
| | - Guohai Zhou
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
| | - Omolola Ometoruwa
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
| | - Rebecca Rooks
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
| | - Yasmeen Senussi
- Harvard Medical School , Boston, MA, 02115 , USA
- Department of Pathology, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University , Boston, MA, 02115 , USA
| | | | | | - John Kupelian
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
| | - Simon Doss-Gollin
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
| | - Kinga K Smolen
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Simon D van Haren
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Philippe Armand
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Ofer Levy
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital , Boston, MA 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
- Broad Institute of MIT & Harvard , Cambridge, 02142, MA USA
| | - David R Walt
- Harvard Medical School , Boston, MA, 02115 , USA
- Department of Pathology, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University , Boston, MA, 02115 , USA
| | - Lindsey R Baden
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
| | - Nicolas C Issa
- Division of Infectious Diseases, Brigham and Women’s Hospital , Boston, MA, 02115 , USA
- Dana-Farber Cancer Institute , Boston, MA, 02115 , USA
- Harvard Medical School , Boston, MA, 02115 , USA
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11
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Tolan NV, Sherman AC, Zhou G, Nabel KG, Desjardins M, Melanson S, Kanjilal S, Moheed S, Kupelian J, Kaufman RM, Ryan ET, LaRocque RC, Branda JA, Dighe AS, Abraham J, Baden LR, Charles RC, Turbett SE. The Effect of Vaccine Type and SARS-CoV-2 Lineage on Commercial SARS-CoV-2 Serologic and Pseudotype Neutralization Assays in mRNA Vaccine Recipients. Microbiol Spectr 2022; 10:e0021122. [PMID: 35311584 PMCID: PMC9045317 DOI: 10.1128/spectrum.00211-22] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/20/2022] [Indexed: 12/24/2022] Open
Abstract
The use of anti-spike (S) serologic assays as surrogate measurements of SARS-CoV-2 vaccine induced immunity will be an important clinical and epidemiological tool. The characteristics of a commercially available anti-S antibody assay (Roche Elecsys anti-SARS-CoV-2 S) were evaluated in a cohort of vaccine recipients. Levels were correlated with pseudotype neutralizing antibodies (NAb) across SARS-CoV-2 variants. We recruited adults receiving a two-dose series of mRNA-1273 or BNT162b2 and collected serum at scheduled intervals up to 8 months post-first vaccination. Anti-S and NAb levels were measured, and correlation was evaluated by (i) vaccine type and (ii) SARS-CoV-2 variant (wild-type, Alpha, Beta, Gamma, and three constructs Day 146*, Day 152*, and RBM-2). Forty-six mRNA vaccine recipients were enrolled. mRNA-1273 vaccine recipients had higher peak anti-S and NAb levels compared with BNT162b2 (P < 0.001 for anti-S levels; P < 0.05 for NAb levels). When anti-S and NAb levels were compared, there was good correlation (all r values ≥ 0.85) in both BNT162b2 and mRNA-1273 vaccine recipients across all evaluated variants; however, these correlations were nonlinear in nature. Lower correlation was identified between anti-S and NAb for the Beta variant (r = 0.88) compared with the wild-type (WT) strain (r = 0.94). Finally, the degree of neutralizing activity at any given anti-S level was lower for each variant compared with that of the WT strain, (P < 0.001). Although the Roche anti-S assay correlates well with NAb levels, this association is affected by vaccine type and SARS-CoV-2 variant. These variables must be considered when interpreting anti-S levels. IMPORTANCE We evaluated anti-spike antibody concentrations in healthy mRNA vaccinated individuals and compared these concentrations to values obtained from pseudotype neutralization assays targeting SARS-CoV-2 variants of concern to determine how well anti-spike antibodies correlate with neutralizing titers, which have been used as a marker of immunity from COVID-19 infection. We found high peak anti-spike concentrations in these individuals, with significantly higher levels seen in mRNA-1273 vaccine recipients. When we compared anti-spike and pseudotype neuralization titers, we identified good correlation; however, this correlation was affected by both vaccine type and variant, illustrating the difficulty of applying a "one size fits all" approach to anti-spike result interpretation. Our results support CDC recommendations to discourage anti-spike antibody testing to assess for immunity after vaccination and cautions providers in their interpretations of these results as a surrogate of protection in COVID-vaccinated individuals.
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Affiliation(s)
- Nicole V. Tolan
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Amy C. Sherman
- Department of Medicine, Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Guohai Zhou
- Department of Medicine, Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Michaël Desjardins
- Department of Medicine, Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Stacy Melanson
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Sanjat Kanjilal
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Serina Moheed
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - John Kupelian
- Department of Medicine, Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Richard M. Kaufman
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Edward T. Ryan
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Regina C. LaRocque
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - John A. Branda
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Anand S. Dighe
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jonathan Abraham
- Department of Medicine, Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Lindsey R. Baden
- Department of Medicine, Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Richelle C. Charles
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sarah E. Turbett
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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12
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Côté JM, Desjardins M, Cailhier JF, Murray PT, Beaubien Souligny W. Risk of acute kidney injury associated with anti-pseudomonal and anti-MRSA antibiotic strategies in critically ill patients. PLoS One 2022; 17:e0264281. [PMID: 35271615 PMCID: PMC8912201 DOI: 10.1371/journal.pone.0264281] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/07/2022] [Indexed: 12/23/2022] Open
Abstract
Background An increased risk of acute kidney injury (AKI) with the widely prescribed piperacillin-tazobactam(PTZ)-vancomycin combination in hospitalized patients has recently been reported, but evidence in ICU patients remain uncertain. This study evaluates the association between the exposure of various broad-spectrum antibiotic regimens with Pseudomonas and/or methicillin-resistance Staphylococcus aureus (MRSA) coverage and the risk of AKI in critically ill patients. Methods and findings A retrospective cohort study based on the publicly available MIMIC-III database reporting hospitalization data from ICU patients from a large academic medical center between 2001 and 2012. Adult patients receiving an anti-pseudomonal or an anti-MRSA agent in the ICU for more than 24-hours were included. Non-PTZ anti-pseudomonal agents were compared to PTZ; non-vancomycin agents covering MRSA were compared to vancomycin; and their combinations were compared to the PTZ-vancomycin combination. The primary outcome was defined as new or worsening AKI within 7 days of the antibiotic exposure using an adjusted binomial generalized estimating equation. Overall, 18 510 admissions from 15 673 individual patients, cumulating 169 966 days of antibiotherapy were included. When compared to PTZ, exposure to another anti-pseudomonal agent was associated with lower AKI risk (OR, 0.85; 95% CI, 0.80–0.91; p < .001). When compared to vancomycin, exposure to another anti-MRSA was also associated with lower AKI risk (OR, 0.71; 95% CI, 0.64–0.80; p < .001). Finally, when compared to the PTZ-vancomycin combination, exposure to another regimen with a similar coverage was associated with an even lower risk (OR, 0.63; 95% CI; 0.54–0.73; p < .001). A sensitivity analysis of patients with high illness severity showed similar results. Conclusions These results suggest that the risk of AKI in ICU patients requiring antibiotherapy may be partially mitigated by the choice of antibiotics administered. Further clinical trials are required to confirm these findings.
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Affiliation(s)
- Jean-Maxime Côté
- Division of Nephrology, Centre hospitalier de l’Université de Montréal, Montréal, Canada
- Centre de recherche du centre hospitalier de l’Université de Montréal, Montréal, Canada
- Clinical Research Centre, University College Dublin, Dublin, Ireland
- * E-mail:
| | - Michaël Desjardins
- Centre de recherche du centre hospitalier de l’Université de Montréal, Montréal, Canada
- Division of Infectious disease, Brigham and Women’s Hospital, Boston, MA, United States of America
- Division of Microbiology and Infectious disease, Centre hospitalier de l’Université de Montréal, Montréal, Canada
| | - Jean-François Cailhier
- Division of Nephrology, Centre hospitalier de l’Université de Montréal, Montréal, Canada
- Centre de recherche du centre hospitalier de l’Université de Montréal, Montréal, Canada
- Institut du Cancer de Montréal, Montréal, Canada
| | - Patrick T. Murray
- Clinical Research Centre, University College Dublin, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - William Beaubien Souligny
- Division of Nephrology, Centre hospitalier de l’Université de Montréal, Montréal, Canada
- Centre de recherche du centre hospitalier de l’Université de Montréal, Montréal, Canada
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13
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Sherman AC, Desjardins M, Baden LR. Vaccine-Induced Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Response and the Path to Accelerating Development (Determining a Correlate of Protection). Clin Lab Med 2022; 42:111-128. [PMID: 35153045 PMCID: PMC8563351 DOI: 10.1016/j.cll.2021.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As new public health challenges relating to COVID-19 emerge, such as variant strains, waning vaccine efficacy over time, and decreased vaccine efficacy for special populations (immunocompromised hosts), it is important to determine a correlate of protection (CoP) to allow accurate bridging studies for special populations and against variants of concern. Large-scale phase 3 clinical trials are inefficient to rapidly assess novel vaccine candidates for variant strains or special populations, because these trials are slow and costly. Defining a practical CoP will aid in efficiently conducting future assessments to further describe protection for individuals and on a population level for surveillance.
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Affiliation(s)
- Amy C. Sherman
- Division of Infectious Diseases, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA,Harvard Medical School, Boston, MA 02115, USA,Corresponding author. Division of Infectious Diseases, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA
| | - Michaël Desjardins
- Division of Infectious Diseases, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA,Harvard Medical School, Boston, MA 02115, USA,Division of Infectious Diseases, Centre Hospitalier de l’Université de Montréal, 1000 Rue Saint-Denis, Bureau F06.1102b, Montreal, Quebec H2X 0C1, Canada
| | - Lindsey R. Baden
- Division of Infectious Diseases, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA,Harvard Medical School, Boston, MA 02115, USA
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14
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Nabel KG, Clark SA, Shankar S, Pan J, Clark LE, Yang P, Coscia A, McKay LGA, Varnum HH, Brusic V, Tolan NV, Zhou G, Desjardins M, Turbett SE, Kanjilal S, Sherman AC, Dighe A, LaRocque RC, Ryan ET, Tylek C, Cohen-Solal JF, Darcy AT, Tavella D, Clabbers A, Fan Y, Griffiths A, Correia IR, Seagal J, Baden LR, Charles RC, Abraham J. Structural basis for continued antibody evasion by the SARS-CoV-2 receptor binding domain. Science 2022; 375:eabl6251. [PMID: 34855508 PMCID: PMC9127715 DOI: 10.1126/science.abl6251] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/29/2021] [Indexed: 12/19/2022]
Abstract
Many studies have examined the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants on neutralizing antibody activity after they have become dominant strains. Here, we evaluate the consequences of further viral evolution. We demonstrate mechanisms through which the SARS-CoV-2 receptor binding domain (RBD) can tolerate large numbers of simultaneous antibody escape mutations and show that pseudotypes containing up to seven mutations, as opposed to the one to three found in previously studied variants of concern, are more resistant to neutralization by therapeutic antibodies and serum from vaccine recipients. We identify an antibody that binds the RBD core to neutralize pseudotypes for all tested variants but show that the RBD can acquire an N-linked glycan to escape neutralization. Our findings portend continued emergence of escape variants as SARS-CoV-2 adapts to humans.
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MESH Headings
- Angiotensin-Converting Enzyme 2/chemistry
- Angiotensin-Converting Enzyme 2/metabolism
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/immunology
- BNT162 Vaccine/immunology
- Betacoronavirus/immunology
- COVID-19/immunology
- COVID-19/virology
- Cross Reactions
- Cryoelectron Microscopy
- Crystallography, X-Ray
- Epitopes
- Evolution, Molecular
- Humans
- Immune Evasion
- Models, Molecular
- Mutation
- Polysaccharides/analysis
- Protein Binding
- Protein Domains
- Receptors, Coronavirus/chemistry
- Receptors, Coronavirus/metabolism
- SARS-CoV-2/genetics
- SARS-CoV-2/immunology
- Spike Glycoprotein, Coronavirus/chemistry
- Spike Glycoprotein, Coronavirus/genetics
- Spike Glycoprotein, Coronavirus/immunology
- Viral Pseudotyping
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Affiliation(s)
- Katherine G. Nabel
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Sarah A. Clark
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Sundaresh Shankar
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Junhua Pan
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Lars E. Clark
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Pan Yang
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Adrian Coscia
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Lindsay G. A. McKay
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA 02118, USA
| | - Haley H. Varnum
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Vesna Brusic
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Nicole V. Tolan
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Guohai Zhou
- Center for Clinical Investigation, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Michaël Desjardins
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Division of Infectious Diseases, Department of Medicine, Centre Hospitalier de l’Université de Montréal, Montreal QC H2X 0C1, Canada
| | - Sarah E. Turbett
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sanjat Kanjilal
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA
| | - Amy C. Sherman
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Anand Dighe
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Regina C. LaRocque
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Edward T. Ryan
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
| | - Casey Tylek
- AbbVie Bioresearch Center, Worcester, MA 01605, USA
| | | | | | | | | | - Yao Fan
- AbbVie Bioresearch Center, Worcester, MA 01605, USA
| | - Anthony Griffiths
- Department of Microbiology and National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA 02118, USA
| | | | - Jane Seagal
- AbbVie Bioresearch Center, Worcester, MA 01605, USA
| | - Lindsey R. Baden
- Center for Clinical Investigation, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Massachusetts Consortium on Pathogen Readiness, Boston, MA, USA
| | - Richelle C. Charles
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jonathan Abraham
- Department of Microbiology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Massachusetts Consortium on Pathogen Readiness, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
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15
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Desjardins M, Mitre X, Sherman AC, Walsh SR, Cheng MP, Kanjilal S, Ho VT, Baden LR, Issa NC. Safety of Live-Attenuated Measles, Mumps, and Rubella Vaccine Administered Within 2 Years of Hematopoietic Cell Transplant. Open Forum Infect Dis 2021; 8:ofab504. [PMID: 34909436 PMCID: PMC8664685 DOI: 10.1093/ofid/ofab504] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/29/2021] [Indexed: 01/04/2023] Open
Abstract
Background Measles, mumps, and rubella (MMR) vaccine is a live-attenuated vaccine usually contraindicated within the first 2 years of hematopoietic cell transplant (HCT). The objective of this study was to assess the safety of MMR vaccine when administered within 2 years of HCT. Methods We conducted a retrospective review of patients who received MMR vaccination within 2 years of an autologous or allogeneic HCT, mostly in the context of the 2019 measles outbreak. Adverse reactions were collected for 42 days postvaccination, and all hospitalizations and deaths following vaccination were reviewed. Results A total of 129 patients (75 autologous and 54 allogeneic HCT) were vaccinated 300–729 days after HCT (median, 718 days), and 39 (30%) of these were vaccinated earlier than 23 months post-transplant. Ten adverse reactions in 7 patients (5%) were identified within 42 days of vaccination: 6 respiratory tract infections (3 with fever) and 1 rash. The rash was seen in a 37-year-old female who had an allogeneic HCT 542 days before vaccination. She presented with a centrifugal maculopapular rash, confirmed to be caused by the vaccine strain rubella virus. She fully recovered. No other vaccine-associated illness was identified in the cohort after a median follow-up of 676 days. Conclusions MMR vaccine appears to be well tolerated in select HCT recipients when given between 300 and 729 days after transplant. An uncomplicated case of vaccine-associated rubella illness was seen after vaccination. Assessment of potential risks and benefits of MMR vaccination given within 2 years of HCT remains important.
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Affiliation(s)
- Michaël Desjardins
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - Xhoi Mitre
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Amy C Sherman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Stephen R Walsh
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Matthew P Cheng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Division of Infectious Disease, McGill University Health Centre, Montreal, Québec, Canada
| | - Sanjat Kanjilal
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Population Medicine, Harvard Pilgrim Healthcare Institute & Harvard Medical School, Boston, Massachusetts, USA
| | - Vincent T Ho
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Lindsey R Baden
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nicolas C Issa
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
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16
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Mitre X, Feeley M, Sherman AC, Walsh SR, Cheng M, Kanjilal S, Ho VT, Baden LR, Issa NC, Desjardins M. 100. Safety Analysis of Live-Attenuated Measles, Mumps, Rubella Vaccine Among Hematopoietic Cell Transplant Recipients Vaccinated Within Two Years of Transplant. Open Forum Infect Dis 2021. [PMCID: PMC8644540 DOI: 10.1093/ofid/ofab466.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/17/2022] Open
Abstract
Background Measles, mumps and rubella (MMR) vaccine is a live-attenuated vaccine usually contraindicated within the first two years of hematopoietic cell transplant (HCT). During the 2019 measles outbreak at our center, the benefits of administering MMR vaccine within the first two years after HCT were weighed against the potential risks. Methods We conducted a retrospective review of patients who received MMR vaccination within two years of an autologous or allogeneic HCT. Patients’ demographics, date and type of HCT, underlying hematologic disease, type of immunosuppressive therapy and date of MMR vaccination were extracted from the electronic medical record. Adverse reactions that could be related to the vaccine were collected for up to 42 days post-vaccination and all hospitalizations and deaths following vaccination were reviewed. Results A total of 129 patients (75 autologous and 54 allogeneic HCT) were vaccinated between 300-729 days after HCT (median of 718 days). The median age at vaccination was 61 years old, 57% of the patients were male and 43% were on immunosuppressive therapy, 87% of whom were on maintenance therapy for multiple myeloma after auto-HCT. Seven patients (5%) had adverse reactions within 42 days of vaccination: six had respiratory tract infections (three with associated fever) and one had a rash leading to a brief hospitalization. This was a 37-year-old female who had an allogeneic HCT 542 days prior to MMR vaccination. She presented with a centrifugal maculopapular rash that was confirmed to be caused by the vaccine strain rubella virus (Fig 1). She fully recovered without sequalae. There was no other vaccine-associated illness identified in the cohort, after a median follow-up of 676 days. ![]()
Conclusion MMR vaccine appears to be well tolerated in selected HCT recipients when given earlier than 2 years after transplant. No attributable severe outcomes or deaths were described. A mild uncomplicated case of vaccine-associated rubella illness was seen after vaccination. In the setting of a measles outbreak, assessment of potential risks and benefits of MMR vaccination given within two years of HCT remains important. Disclosures Stephen R. Walsh, MDCM, Janssen Vaccines (Scientific Research Study Investigator)Regeneron (Scientific Research Study Investigator)Sanofi Pasteur (Scientific Research Study Investigator) Matthew Cheng, MD, GEn1E Lifesciences (Advisor or Review Panel member)Kanvas Biosciences (Board Member, Shareholder)nplex biosciences (Advisor or Review Panel member) Sanjat Kanjilal, MD, MPH, GlaskoSmithKline (Advisor or Review Panel member) Nicolas C. Issa, MD, AiCuris (Scientific Research Study Investigator)Astellas (Scientific Research Study Investigator)GSK (Scientific Research Study Investigator)Merck (Scientific Research Study Investigator)
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Affiliation(s)
- Xhoi Mitre
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Amy C Sherman
- Harvard Medical School/Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Matthew Cheng
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Sanjat Kanjilal
- Harvard Medical School and Harvard Pilgrim Healthcare Institute, Jamaica Plain, MA
| | - Vincent T Ho
- Dana-Farber Cancer Institute, Boston, Massachusetts
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17
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Bausk BP, Sherman AC, Desjardins M, Izaguirre NE, Cheng CA, Powell M, Senussi Y, Gilboa T, Krauss JH, Dirr B, Power E, Joyce A, Stewart L, Ometoruwa O, Novack LA, Evans B, Woods T, Tong A, Walt D, Soiffer R, Ho VT, Issa NC, Baden LR. 25. Immunogenicity and Reactogenicity of COVID-19 mRNA Vaccines in Allogeneic Stem Cell Transplant Recipients. Open Forum Infect Dis 2021. [PMCID: PMC8644500 DOI: 10.1093/ofid/ofab466.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/20/2022] Open
Abstract
Background Allogeneic stem cell transplant (SCT) recipients are at an increased risk of poor outcomes from COVID-19. While the mRNA-1273 (Moderna) and BNT162b2 (Pfizer) COVID-19 mRNA vaccines are highly immunogenic in the general population, the immune response in SCT recipients is poorly understood. We characterized the immunogenicity and reactogenicity of COVID-19 mRNA vaccines in a cohort of SCT patients. Methods We performed a prospective cohort study of 16 allogeneic SCT patients and 23 healthy controls. Blood samples for both cohorts were collected prior to first vaccination (baseline), at the time of second vaccination, and approximately 28 days post-second vaccination. Anti-Spike (S), anti-S1, anti-receptor binding domain (RBD), and anti-Nucleocapsid (N) IgG levels were measured quantitatively from plasma using a multiplexed single molecule array (Simoa) immunoassay. Reactogenicity was captured for the SCT cohort via a self-reported post-vaccination diary for 7 days after each dose. Results Demographics and SCT recipients’ characteristics are shown in Table 1. In the SCT cohort, we observed a significantly lower anti-S (p< 0.0001), S1 (p< 0.0001), and RBD (p< 0.0001) IgG responses as compared to healthy controls, both at the time of dose 2 and 28 days post-vaccine series (Fig 1). Overall, 62.5% of SCT recipients were responders after vaccine series completion, as compared to 100% of healthy controls (Fig 2). While no patients had a reported history of COVID-19 diagnosis, 2 patients in the SCT cohort had elevated anti-S IgG levels and 1 showed elevated anti-N at baseline. 10/16 participants in the SCT cohort completed at least one post-vaccination diary. Local and systemic reactions were reported by 67% and 22% of participants, respectively, after dose 1, and 63% and 50% after dose 2 (Figure 3). All reported events were mild. Table 1: Demographics ![]()
Figure 1: Plasma IgG Titers ![]()
Anti-Spike (A), anti-S1 (B), anti-RBD (C), and anti-nucleocapsid (D) IgG titers were measured at baseline, time of second dose, and approximately 28 days after second vaccination. IgG levels were measured quantitatively using multiplexed single molecule array (Simoa) immunoassays, and are reported as Normalized Average Enzymes per Bead (AEB). Allogeneic stem cell transplant recipients (mauve) showed significantly lower anti-S, S1, and RBD IgG responses as compared to healthy controls (mint). Low titers of anti-N IgG demonstrates no history of COVID-19 natural infection during the course of the study. Figure 3. Solicited Local and Systemic Adverse Events ![]()
10 allogeneic stem cell transplant recipients completed at least one diary for 7 days after vaccination. Reactions after dose 1 are shown in light blue, and reactions after dose 2 are shown in dark blue. Local reactions (A) were reported by 67% (6/9) of participants after dose 1, and 63% (5/8) after dose 2. Systemic reactions (B) were reported by 22% (2/9) of participants after dose 1, and 50% (4/8) after dose 2. All reported events were mild (Grade 1). Conclusion Among SCT recipients, mRNA COVID-19 vaccines were well-tolerated but less immunogenic than in healthy controls. Further study is warranted to better understand heterogeneous characteristics that may affect the immune response in order to optimize COVID-19 vaccination strategies for SCT recipients. Figure 2: Response Rate to COVID-19 Vaccination ![]()
An internally validated threshold for responders was established using pre-pandemic sera from healthy adults. A positive antibody response was was defined as individuals with anti-Spike IgG levels above the 1.07 Normalized AEB threshold. Disclosures Amy Joyce, NP, Kadmon (Advisor or Review Panel member) Lewis A. Novack, MS, Lumicell Inc. (Scientific Research Study Investigator, Research Grant or Support)Precision Healing, Inc. (Scientific Research Study Investigator, Research Grant or Support) David Walt, PhD, Quanterix Corporation (Board Member, Shareholder) Robert Soiffer, MD, alexion (Consultant)gilead (Advisor or Review Panel member)jazz (Advisor or Review Panel member)juno/bms (Advisor or Review Panel member)kiadis (Board Member)precision bioscience (Consultant)Rheos (Consultant)takeda (Consultant) Nicolas C. Issa, MD, AiCuris (Scientific Research Study Investigator)Astellas (Scientific Research Study Investigator)GSK (Scientific Research Study Investigator)Merck (Scientific Research Study Investigator)
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Affiliation(s)
| | - Amy C Sherman
- Harvard Medical School/Brigham and Women’s Hospital, Boston, Massachusetts
| | | | | | - Chi-An Cheng
- Brigham and Women’s Hospital, Boston, Massachusetts
| | - Megan Powell
- BWH Division of Infectious Diseases, Boston, Massachusetts
| | | | - Tal Gilboa
- Brigham and Womens' hospital, Brookline, Massachusetts
| | | | - Bonnie Dirr
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Elyssa Power
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Amy Joyce
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Lisa Stewart
- Dana Farber Cancer Institute, Boston, Massachusetts
| | | | | | | | | | | | - David Walt
- Harvard Medical School/Brigham and Women’s Hospital/Wyss Institute, Boston, Massachusetts
| | | | - Vincent T Ho
- Dana-Farber Cancer Institute, Boston, Massachusetts
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18
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Izaguirre NE, Sherman AC, Crombie J, Desjardins M, Cheng CA, Gilboa T, Powell M, Bausk BP, Abasciano N, Baker P, McDonough M, Armand P, Walt D, Issa NC, Baden LR. 586. Immunogenicity of COVID-19 mRNA Vaccines in Patients with Lymphoid Malignancies. Open Forum Infect Dis 2021. [PMCID: PMC8644561 DOI: 10.1093/ofid/ofab466.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/29/2022] Open
Abstract
Background Patients with lymphoid malignancies are at high risk of severe COVID-19 disease and were not included in the phase 3 mRNA vaccine trials. Many patients with lymphoid malignancies receive immunosuppressive therapies, including B-cell depleting agents, that may negatively impact humoral response to vaccination. Methods We recruited patients with lymphoid malignancies and healthy participants who planned to receive two doses of SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273). Blood was drawn at baseline, prior to second dose of vaccine, and 28 days after last vaccination. Disease characteristics and therapies were extracted from patients’ electronic medical record. An ultrasensitive, single molecule array (Simoa) assay detected anti-Spike (S), anti-S1, anti-receptor binding domain (RBD), and anti-Nucleocapsid (N) IgG from plasma at each timepoint. Results 23 healthy participants and 37 patients with lymphoid malignancies were enrolled (Table 1). Low titers of anti-N (Fig 1A) demonstrate no prior exposure or acquisition of COVID-19 before vaccination or during the study. 37.8% of the lymphoid malignancy cohort responded to the vaccine, using an internally validated AEB cutoff of 1.07. A significantly higher magnitude of anti-S (p< 0.0001), anti-S1 (p< 0.0001) and anti-RBD (p< 0.0001) are present in the healthy as compared to lymphoid malignancy cohort at the second dose and day 28 post-series (Fig 1B, Fig 1C and Fig 1D). Anti-S IgG titers were compared between the healthy cohort, treatment naïve, and treatment experienced groups (Fig 2). The treatment naïve cohort had high titers by series completion which were not significantly different from the healthy cohort (p=0.2259), although the treatment experienced group had significantly decreased titers (p< 0.0001). Of the 20 patients who had received CD20 therapy, there was no clear correlation of anti-S IgG response with time from CD20 therapy, although most patients who received CD20 therapies within 12 months from the vaccine had no response (Figure 3). Table 1. Demographics ![]()
Figure 1. Anti-N, Anti-S, Anti-S1, Anti-RBD and Anti-N Ig G for healthy v. lymphoid malignancy cohort ![]()
The dotted line at 1.07 marks in an internally validated threshold to mark anti-S IgG response. The black bars denote median with 95% CI. Figure 2: Anti-S IgG for healthy v. treatment naïve v. treatment experienced ![]()
The dotted line at 1.07 marks in an internally validated threshold to mark antibody response. The black bars denote median with 95% CI. Conclusion The vaccine-induced immune response was poor among treatment-experienced patients with lymphoid malignancies, especially among those who received CD20 therapies within 12 months. Figure 3. Months from CD20 therapy v. anti-S IgG titers ![]()
The dotted line at 1.07 marks in an internally validated threshold to mark antibody response. Disclosures Jennifer Crombie, MD, AbbVie (Grant/Research Support)Bauer (Grant/Research Support)Karyopharm (Consultant)MorphoSys (Consultant) Philippe Armand, MD PhD, ADCT, Celgene, Morphosys, Daiichi, Miltenyi, Tessa, C4, Genmab, Enterome, Regeneron, Genentech, Epizyme, Astra Zeneca (Consultant, Sorry to put them all in, hope you can deconvolute for me)Affimed, Adaptive, BMS, Merck, Kite, IGM, Genentech (Research Grant or Support, Institutional research funding) David Walt, PhD, Quanterix Corporation (Board Member, Shareholder) Nicolas C. Issa, MD, AiCuris (Scientific Research Study Investigator)Astellas (Scientific Research Study Investigator)GSK (Scientific Research Study Investigator)Merck (Scientific Research Study Investigator)
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Affiliation(s)
| | - Amy C Sherman
- Harvard Medical School/Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Chi-An Cheng
- Brigham and Women’s Hospital, Boston, Massachusetts
| | - Tal Gilboa
- Brigham and Womens' Hospital, Brookline, Massachusetts
| | - Megan Powell
- BWH Division of Infectious Diseases, Boston, Massachusetts
| | | | | | - Peter Baker
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | | | - David Walt
- Harvard Medical School/Brigham and Women's Hospital/Wyss Institute, Boston, Massachusetts
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19
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Cunningham PH, Mitre X, Pierre D, Montesano C, Woods T, Oganezova K, Krauss JH, Von SS, Kupelian JA, Gothing JA, Jane K, Caldara LA, Sherman AC, Walsh SR, Kaufman RM, Baden LR, Desjardins M. 996. CD4+ T-Cell Lymphopenia Associated with Frequent Plateletpheresis in Healthy Donors. Open Forum Infect Dis 2021. [PMCID: PMC8644967 DOI: 10.1093/ofid/ofab466.1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/03/2022] Open
Abstract
Background Frequent plateletpheresis using the Time Accel leukoreduction system chamber may result in lymphopenia in healthy donors, with increased donation in the previous year associated with CD4+ T-cell count of less than 200 cells/µL. However, this finding has not been replicated and the clinical significance of plateletpheresis-associated lymphopenia remains unclear. Methods A prospective observational study of healthy plateletpheresis donors aged 18 or older who donated at least once in the previous 365 days was conducted at the Kraft Blood Center at Brigham and Women’s Hospital/Dana Farber Cancer Institute, where the Time Accel system is used exclusively. Blood was drawn immediately before plateletpheresis or at least 2 weeks after the last donation to assess for total lymphocyte and CD4+ T-cell counts. Results A total of 86 participants were enrolled: 23 had 1-5 donations, 36 had 6-19 donations, and 27 had 20-24 donations within the previous 365 days (Figure 1). For the low-, medium-, and high-frequency donation groups, the median age was 53 years (IQR 43-64), 61 years (IQR 53-68), and 61 years (IQR 55-65), respectively. The median total lymphocyte count was 1.5 (IQR 1.3-1.9), 1.2 (IQR 0.9-1.5), 0.8 (IQR 0.6-0.9) 103 cells/µL, and the median CD4+ T-cell count was 648 (IQR 531-843), 525 (IQR 348-698), and 220 (IQR 184-347) cells/µL. CD4+ T-cell counts were < 200 cells/µL in 0/23 (0%), 3/36 (8%), and 9/27 (33%) participants across the three groups. Total lymphocyte and CD4+ T-cell counts were inversely correlated with the number of platelet donations in the prior 365 days, R2 = 0.384 (Fig 2) and 0.402 (Fig 3) respectively. ![]()
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Conclusion Frequent plateletpheresis using Time Accel leukoreduction system chamber is associated with CD4+ T-cell lymphopenia, with counts below 200 cells/µL seen in one third of those who donated 20-24 times in the previous year. Vaccine immunogenicity studies are ongoing to evaluate the clinical significance of this finding. Disclosures Stephen R. Walsh, MDCM, Janssen Vaccines (Scientific Research Study Investigator)Regeneron (Scientific Research Study Investigator)Sanofi Pasteur (Scientific Research Study Investigator)
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Affiliation(s)
| | - Xhoi Mitre
- Brigham and Women’s Hospital, Boston, Massachusetts
| | | | | | | | | | | | - Salena S Von
- Brigham and Women’s Hospital, Boston, Massachusetts
| | | | | | | | - Lise Ann Caldara
- Harvard Medical School/Brigham and Women’s Hospital, Jamaica Plain, Massachusetts
| | - Amy C Sherman
- Harvard Medical School/Brigham and Women’s Hospital, Jamaica Plain, Massachusetts
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20
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Mysore V, Cullere X, Settles ML, Ji X, Kattan MW, Desjardins M, Durbin-Johnson B, Gilboa T, Baden LR, Walt DR, Lichtman AH, Jehi L, Mayadas TN. Protective heterologous T cell immunity in COVID-19 induced by the trivalent MMR and Tdap vaccine antigens. Med 2021; 2:1050-1071.e7. [PMID: 34414383 PMCID: PMC8363466 DOI: 10.1016/j.medj.2021.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/25/2021] [Accepted: 08/06/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND T cells control viral infection, promote vaccine durability, and in coronavirus disease 2019 (COVID-19) associate with mild disease. We investigated whether prior measles-mumps-rubella (MMR) or tetanus-diphtheria-pertussis (Tdap) vaccination elicits cross-reactive T cells that mitigate COVID-19. METHODS Antigen-presenting cells (APC) loaded ex vivo with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MMR, or Tdap antigens and autologous T cells from COVID-19-convalescent participants, uninfected individuals, and COVID-19 mRNA-vaccinated donors were co-cultured. T cell activation and phenotype were detected by interferon-γ (IFN-γ) enzyme-linked immunospot (ELISpot) assays and flow cytometry. ELISAs (enzyme-linked immunosorbant assays) and validation studies identified the APC-derived cytokine(s) driving T cell activation. TCR clonotyping and single-cell RNA sequencing (scRNA-seq) identified cross-reactive T cells and their transcriptional profile. A propensity-weighted analysis of COVID-19 patients estimated the effects of MMR and Tdap vaccination on COVID-19 outcomes. FINDINGS High correlation was observed between T cell responses to SARS-CoV-2 (spike-S1 and nucleocapsid) and MMR and Tdap proteins in COVID-19-convalescent and -vaccinated individuals. The overlapping T cell population contained an effector memory T cell subset (effector memory re-expressing CD45RA on T cells [TEMRA]) implicated in protective, anti-viral immunity, and their detection required APC-derived IL-15, known to sensitize T cells to activation. Cross-reactive TCR repertoires detected in antigen-experienced T cells recognizing SARS-CoV-2, MMR, and Tdap epitopes had TEMRA features. Indices of disease severity were reduced in MMR- or Tdap-vaccinated individuals by 32%-38% and 20%-23%, respectively, among COVID-19 patients. CONCLUSIONS Tdap and MMR memory T cells reactivated by SARS-CoV-2 may provide protection against severe COVID-19. FUNDING This study was supported by a National Institutes of Health (R01HL065095, R01AI152522, R01NS097719) donation from Barbara and Amos Hostetter and the Chleck Foundation.
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Affiliation(s)
- Vijayashree Mysore
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Xavier Cullere
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Matthew L Settles
- Bioinformatics Core Facility in the Genome Center, University of California, Davis, Davis, CA 95616, USA
| | - Xinge Ji
- Quantitative Health Science Department, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Michael W Kattan
- Quantitative Health Science Department, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Michaël Desjardins
- Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | | | - Tal Gilboa
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Lindsey R Baden
- Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Andrew H Lichtman
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Lara Jehi
- Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Tanya N Mayadas
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
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21
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Forget MF, Del Degan S, Leblanc J, Tannous R, Desjardins M, Durand M, Vu TTM, Nguyen QD, Desmarais P. Delirium and Inflammation in Older Adults Hospitalized for COVID-19: A Cohort Study. Clin Interv Aging 2021; 16:1223-1230. [PMID: 34234422 PMCID: PMC8242147 DOI: 10.2147/cia.s315405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/10/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose The occurrence and predictors of delirium in older adults hospitalized for coronavirus disease 2019 (COVID-19) have not been well described. Highlighting the association with inflammatory markers may be useful for identifying delirium. This study aimed to determine the prevalence and incidence of delirium and explore its association with the C-reactive protein (CRP). Patients and Methods This cohort study of adults aged 65 and older with a COVID-19 diagnosis took place at an academic healthcare institution between April and May 2020. COVID-19 was diagnosed by positive nasopharyngeal swab. Serum levels of CRP were collected as a marker of systemic inflammation. The primary outcome was the prevalence and incidence of delirium. Delirium was diagnosed primarily during a patient's stay in hospital based on the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). To ensure that no delirium diagnosis was missed during hospital stay, clinical records were reviewed by clinicians with geriatric medicine training for retrospective diagnoses. Results A total of 127 patients aged 65 and older were hospitalized with a diagnosis of COVID-19. The median age was 82 years (IQR: 74–88), with 54 (43%) females. Overall, delirium was present in 62 (49%) patients: manifestations of delirium were present on the first day of hospitalization in 53 of these cases (86%), while 9 cases (14%) developed delirium during hospitalization. After controlling for age and sex, the mean CRP value over the first 3 days since arrival was associated with a higher risk of delirium (OR 1.35; 95% CI: 1.01–1.85) for every 50 mg/L increase. Conclusion In this cohort of older adults hospitalized for COVID-19, delirium was highly prevalent. An early increase in CRP levels should raise suspicion about the occurrence of delirium and could improve its diagnosis.
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Affiliation(s)
- Marie-France Forget
- Department of Medicine, Division of Geriatrics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Sophie Del Degan
- Department of Medicine, Division of Geriatrics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Julie Leblanc
- Department of Medicine, Division of Geriatrics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Rita Tannous
- Department of Medicine, Division of Geriatrics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Michaël Desjardins
- Department of Medicine, Division of Infectious Disease, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Madeleine Durand
- Department of Medicine, Division of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Innovation Hub, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Thien Tuong Minh Vu
- Department of Medicine, Division of Geriatrics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Department of Neurosciences, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Quoc Dinh Nguyen
- Department of Medicine, Division of Geriatrics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Innovation Hub, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Philippe Desmarais
- Department of Medicine, Division of Geriatrics, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.,Department of Neurosciences, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
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22
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Ogata AF, Cheng CA, Desjardins M, Senussi Y, Sherman AC, Powell M, Novack L, Von S, Li X, Baden LR, Walt DR. Circulating SARS-CoV-2 Vaccine Antigen Detected in the Plasma of mRNA-1273 Vaccine Recipients. Clin Infect Dis 2021; 74:715-718. [PMID: 34015087 PMCID: PMC8241425 DOI: 10.1093/cid/ciab465] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Indexed: 01/16/2023] Open
Abstract
SARS-CoV-2 proteins were measured in longitudinal plasma samples collected from
13 participants who received two doses of mRNA-1273 vaccine. 11 of 13
participants showed detectable levels of SARS-CoV-2 protein as early as day one
after first vaccine injection. Clearance of detectable SARS-CoV-2 protein
correlated with production of IgG and IgA.
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Affiliation(s)
- Alana F Ogata
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Chi-An Cheng
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Michaël Desjardins
- Harvard Medical School, Boston, MA, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.,Division of Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Yasmeen Senussi
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Amy C Sherman
- Harvard Medical School, Boston, MA, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Megan Powell
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Lewis Novack
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Salena Von
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Xiaofang Li
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, USA
| | - Lindsey R Baden
- Harvard Medical School, Boston, MA, USA.,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.,Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, USA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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23
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Mysore V, Cullere X, Settles ML, Ji X, Kattan MW, Desjardins M, Durbin-Johnson B, Gilboa T, Baden LR, Walt DR, Lichtman A, Jehi L, Mayadas TN. Protective heterologous T cell immunity in COVID-19 induced by MMR and Tdap vaccine antigens. bioRxiv 2021:2021.05.03.441323. [PMID: 33972940 PMCID: PMC8109200 DOI: 10.1101/2021.05.03.441323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
T cells are critical for control of viral infection and effective vaccination. We investigated whether prior Measles-Mumps-Rubella (MMR) or Tetanus-Diphtheria-pertussis (Tdap) vaccination elicit cross-reactive T cells that mitigate COVID-19. Using co-cultures of antigen presenting cells (APC) loaded with antigens and autologous T cells, we found a high correlation between responses to SARS-CoV-2 (Spike-S1 and Nucleocapsid) and MMR and Tdap vaccine proteins in both SARS-CoV-2 infected individuals and individuals immunized with mRNA-based SARS-CoV-2 vaccines. The overlapping T cell population contained effector memory T cells (TEMRA) previously implicated in anti-viral immunity and their activation required APC-derived IL-15. TCR- and scRNA-sequencing detected cross-reactive clones with TEMRA features among the cells recognizing SARS-CoV-2, MMR and Tdap epitopes. A propensity-weighted analysis of 73,582 COVID-19 patients revealed that severe disease outcomes (hospitalization and transfer to intensive care unit or death) were reduced in MMR or Tdap vaccinated individuals by 38-32% and 23-20% respectively. In summary, SARS-CoV-2 re-activates memory T cells generated by Tdap and MMR vaccines, which may reduce disease severity.
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24
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Choi B, Choudhary MC, Regan J, Sparks JA, Padera RF, Qiu X, Solomon IH, Kuo HH, Boucau J, Bowman K, Adhikari UD, Winkler ML, Mueller AA, Hsu TYT, Desjardins M, Baden LR, Chan BT, Walker BD, Lichterfeld M, Brigl M, Kwon DS, Kanjilal S, Richardson ET, Jonsson AH, Alter G, Barczak AK, Hanage WP, Yu XG, Gaiha GD, Seaman MS, Cernadas M, Li JZ. Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host. N Engl J Med 2020; 383:2291-2293. [PMID: 33176080 PMCID: PMC7673303 DOI: 10.1056/nejmc2031364] [Citation(s) in RCA: 826] [Impact Index Per Article: 206.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Bina Choi
- Brigham and Women's Hospital, Boston, MA
| | | | | | | | | | - Xueting Qiu
- Harvard T.H. Chan School of Public Health, Boston, MA
| | | | | | - Julie Boucau
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA
| | - Amy K Barczak
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA
| | | | - Xu G Yu
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA
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Cheng MP, Yansouni CP, Basta NE, Desjardins M, Kanjilal S, Paquette K, Caya C, Semret M, Quach C, Libman M, Mazzola L, Sacks JA, Dittrich S, Papenburg J. Serodiagnostics for Severe Acute Respiratory Syndrome-Related Coronavirus 2 : A Narrative Review. Ann Intern Med 2020; 173:450-460. [PMID: 32496919 PMCID: PMC7281623 DOI: 10.7326/m20-2854] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Accurate serologic tests to detect host antibodies to severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) will be critical for the public health response to the coronavirus disease 2019 pandemic. Many use cases are envisaged, including complementing molecular methods for diagnosis of active disease and estimating immunity for individuals. At the population level, carefully designed seroepidemiologic studies will aid in the characterization of transmission dynamics and refinement of disease burden estimates and will provide insight into the kinetics of humoral immunity. Yet, despite an explosion in the number and availability of serologic assays to test for antibodies against SARS-CoV-2, most have undergone minimal external validation to date. This hinders assay selection and implementation, as well as interpretation of study results. In addition, critical knowledge gaps remain regarding serologic correlates of protection from infection or disease, and the degree to which these assays cross-react with antibodies against related coronaviruses. This article discusses key use cases for SARS-CoV-2 antibody detection tests and their application to serologic studies, reviews currently available assays, highlights key areas of ongoing research, and proposes potential strategies for test implementation.
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Affiliation(s)
- Matthew P Cheng
- McGill University Health Centre and McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada (M.P.C.)
| | - Cedric P Yansouni
- McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Quebec, Canada (C.P.Y., M.S., M.L.)
| | - Nicole E Basta
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada (N.E.B.)
| | - Michaël Desjardins
- Brigham and Women's Hospital, Boston, Massachusetts, and Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (M.D.)
| | - Sanjat Kanjilal
- Brigham and Women's Hospital and Harvard Medical School & Harvard Pilgrim Healthcare Institute, Boston, Massachusetts (S.K.)
| | - Katryn Paquette
- Montreal Children's Hospital, Montreal, Quebec, Canada (K.P.)
| | - Chelsea Caya
- McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada (C.C.)
| | - Makeda Semret
- McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Quebec, Canada (C.P.Y., M.S., M.L.)
| | - Caroline Quach
- CHU Sainte-Justine, Université de Montréal, Montreal, Canada (C.Q.)
| | - Michael Libman
- McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and J.D. MacLean Centre for Tropical Diseases, McGill University, Montreal, Quebec, Canada (C.P.Y., M.S., M.L.)
| | - Laura Mazzola
- Foundation of Innovative New Diagnostics (FIND), Geneva, Switzerland (L.M., J.A.S.)
| | - Jilian A Sacks
- Foundation of Innovative New Diagnostics (FIND), Geneva, Switzerland (L.M., J.A.S.)
| | - Sabine Dittrich
- Foundation of Innovative New Diagnostics (FIND), Geneva, Switzerland, and Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (S.D.)
| | - Jesse Papenburg
- McGill Interdisciplinary Initiative in Infection and Immunity, School of Population and Global Health, McGill University, and Montreal Children's Hospital, Montreal, Quebec, Canada (J.P.)
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Cheng MP, Papenburg J, Desjardins M, Kanjilal S, Quach C, Libman M, Dittrich S, Yansouni CP. Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2: A Narrative Review. Ann Intern Med 2020; 172:726-734. [PMID: 32282894 PMCID: PMC7170415 DOI: 10.7326/m20-1301] [Citation(s) in RCA: 400] [Impact Index Per Article: 100.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Diagnostic testing to identify persons infected with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection is central to control the global pandemic of COVID-19 that began in late 2019. In a few countries, the use of diagnostic testing on a massive scale has been a cornerstone of successful containment strategies. In contrast, the United States, hampered by limited testing capacity, has prioritized testing for specific groups of persons. Real-time reverse transcriptase polymerase chain reaction-based assays performed in a laboratory on respiratory specimens are the reference standard for COVID-19 diagnostics. However, point-of-care technologies and serologic immunoassays are rapidly emerging. Although excellent tools exist for the diagnosis of symptomatic patients in well-equipped laboratories, important gaps remain in screening asymptomatic persons in the incubation phase, as well as in the accurate determination of live viral shedding during convalescence to inform decisions to end isolation. Many affluent countries have encountered challenges in test delivery and specimen collection that have inhibited rapid increases in testing capacity. These challenges may be even greater in low-resource settings. Urgent clinical and public health needs currently drive an unprecedented global effort to increase testing capacity for SARS-CoV-2 infection. Here, the authors review the current array of tests for SARS-CoV-2, highlight gaps in current diagnostic capacity, and propose potential solutions.
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Affiliation(s)
- Matthew P Cheng
- McGill University Health Centre and McGill Interdisciplinary Initiative in Infection and Immunity, Montreal, Quebec, Canada (M.P.C.)
| | - Jesse Papenburg
- McGill Interdisciplinary Initiative in Infection and Immunity and Montreal Children's Hospital, Montreal, Quebec, Canada (J.P.)
| | - Michaël Desjardins
- Brigham and Women's Hospital, Boston, Massachusetts, and Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada (M.D.)
| | - Sanjat Kanjilal
- Brigham and Women's Hospital, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (S.K.)
| | - Caroline Quach
- CHU Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada (C.Q.)
| | - Michael Libman
- McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and McGill University, Montreal, Quebec, Canada (M.L., C.P.Y.)
| | - Sabine Dittrich
- Foundation of Innovative New Diagnostics, Malaria and Fever Program, Geneva, Switzerland, and University of Oxford, Oxford, United Kingdom (S.D.)
| | - Cedric P Yansouni
- McGill University Health Centre, McGill Interdisciplinary Initiative in Infection and Immunity, and McGill University, Montreal, Quebec, Canada (M.L., C.P.Y.)
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Desjardins M, Lefebvre B, Lavallée C, Labbé AC, Mauffrey F, Martin I, Longtin J, Fortin C. Gradient diffusion susceptibility testing for Neisseria gonorrhoeae: an accurate alternative to agar dilution in high-MIC strains? Access Microbiol 2020; 2:acmi000116. [PMID: 32974579 PMCID: PMC7494190 DOI: 10.1099/acmi.0.000116] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/24/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction The correlation of antimicrobial susceptibility testing (AST) between agar dilution and gradient diffusion for Neisseria gonorrhoeae is not well established, especially in strains with high MICs. Aim The objective of this study was to evaluate the accuracy of gradient diffusion for N. gonorrhoeae. Methods Fifty strains of N. gonorrhoeae, all tested by the agar dilution method according to CLSI methods and confirmed to be genetically distinct using molecular typing (NG-MAST), were selected. Isolates with high MICs were targeted. Gradient diffusion was performed for ceftriaxone (CRO), cefixime (CFX), azithromycin (AZT), tetracycline (TET) and fosfomycin (FOS) using two different commercial antimicrobial strips on different culture media (a non-commercial GC agar base with 1 % defined growth supplement and two commercial media). The performance of agar gradient diffusion was assessed based on accuracy, using essential and category agreements (EA and CA). Results Essential and categorical agreement were over 90 % for CRO, CFX and AZT on the two commercial agar media tested. Category disagreements were seen for CFX and AZT, mostly just very major errors. For TET, EA ranged from 80 to 96 % and CA ranged from 38 to 76 %, most of the misclassifications being minor errors. Finally, EA for FOS ranged between 80 and 98 %. Conclusion Gradient diffusion is an accurate and acceptable alternative for CRO, CFX and AZT. Caution is advised when MICs are reported by gradient diffusion approach breakpoints because of the possibility of very major errors. The use of gradient diffusion is limited for TET because of the high rate of minor errors.
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Affiliation(s)
- Michaël Desjardins
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Medical Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | | | - Christian Lavallée
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Medical Microbiology and Infectious Diseases, Hôpital Maisonneuve-Rosemont, Montréal, Canada
| | - Annie-Claude Labbé
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Medical Microbiology and Infectious Diseases, Hôpital Maisonneuve-Rosemont, Montréal, Canada
| | | | - Irene Martin
- National Microbiology Laboratory, Winnipeg, Canada
| | - Jean Longtin
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Laboratoire de santé publique du Québec, Montréal, Canada
| | - Claude Fortin
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Medical Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
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Desjardins M, Sant N, Miron-Celis M, Gosal J, Jémus MF, Jémus-Gonzalez E. Impact of reduced incubation times on culture and susceptibility testing of urine cultures incubated in the BD Kiestra ReadA Compact incubators. Diagn Microbiol Infect Dis 2019; 96:114899. [PMID: 31672455 DOI: 10.1016/j.diagmicrobio.2019.114899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/21/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 02/07/2023]
Abstract
We determined the impact of reducing incubation times for urine cultures incubated in BD Kiestra ReadA Compact incubators. Urine samples (n = 348) were inoculated to solid media, incubated in the ReadA Compacts and processed at 12, 15, and 18 h. Colony size and identification by MALDI-TOF, growth, semi-quantitation, Vitek and disk diffusion susceptibilities from cultures incubated at 12 and 15 h were compared to 18 h. There was no impact on MALDI-TOF performed after 12 and 15 versus 18 h of incubation. Interpretation for 99% of urine cultures was identical at 15 and 18 h. There was no major or very major error for VitekII or disk diffusion testing with >94% and >92% overall agreement for Gram-negative and positives organisms, respectively. Therefore, reducing the maximum incubation times of primary cultures incubated in the ReadA Compacts from 18 h to 15 h did not impact outcomes.
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Affiliation(s)
- M Desjardins
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada; Eastern Ontario Regional Laboratory Association, Ottawa, Ontario Canada.
| | - N Sant
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada; Eastern Ontario Regional Laboratory Association, Ottawa, Ontario Canada
| | - M Miron-Celis
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - J Gosal
- University of Ottawa, Ottawa, Ontario, Canada
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Desjardins M, Boucoiran I, Paquet C, Laferrière C, Gosselin-Brisson A, Labbé AC, Martel-Laferrière V. Impact of Vaccination History on Serological Testing in Pregnant Women. J Obstet Gynaecol Can 2017; 40:405-409. [PMID: 29276161 DOI: 10.1016/j.jogc.2017.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Serological testing guidelines for vaccine-preventable infectious diseases in pregnant women are heterogeneous. It is unclear how vaccination history influences health care workers' (HCWs) attitudes about testing. The aim of this study was to describe current practices in screening for rubella, hepatitis B, and varicella-zoster virus (VZV) in pregnant women in the province of Québec. METHODS In 2015, an electronic survey was distributed to HCWs who followed the case of at least one pregnant woman in the previous year and who could be contacted by email by their professional association. RESULTS A total of 363 of 1084 (33%) participants were included in the analysis: general practitioners (57%), obstetrician-gynaecologists (20%), midwives (41%), and nurse practitioners (31%). For rubella, 48% of participants inquired about vaccination status, and of these, 98% offered serological testing for unvaccinated women versus 44% for vaccinated women. Similarly, of the 48% of participants who asked about hepatitis B vaccination status before offering testing, 96% ordered testing for hepatitis B surface antigen, 28% ordered testing for hepatitis B surface antibody, and 1% ordered no serological testing to unvaccinated women versus 72%, 46%, and 8%, respectively, for vaccinated women. Among the 81% of respondents who discussed VZV during prenatal care, 13% ordered serological testing if patients had a history of VZV infection, 87% if the VZV history was uncertain, and 19% if patients had a positive history of vaccination. CONCLUSION Asking about vaccination status influences HCWs' attitudes about serological testing for rubella, hepatitis B, and VZV. In the context of increasing vaccination coverage in women of child-bearing age, it is important to clarify the impact of vaccination status in serological screening guidelines in pregnant women.
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Affiliation(s)
- Michaël Desjardins
- Faculté de médecine, Université de Montréal, Montréal, QC; Centre hospitalier de l'Université de Montréal, Montréal, QC.
| | - Isabelle Boucoiran
- Faculté de médecine, Université de Montréal, Montréal, QC; Centre hospitalier universitaire Sainte-Justine, Montréal, QC
| | - Caroline Paquet
- Département d'anatomie, Section Sage-femme, Université du Québec à Trois-Rivières, Trois-Rivières, QC
| | - Céline Laferrière
- Faculté de médecine, Université de Montréal, Montréal, QC; Département d'anatomie, Section Sage-femme, Université du Québec à Trois-Rivières, Trois-Rivières, QC
| | | | - Annie-Claude Labbé
- Faculté de médecine, Université de Montréal, Montréal, QC; Centre intégré universitaire de santé et de services sociaux de l'est-de-l'île-de-Montréal, Montréal, QC
| | - Valérie Martel-Laferrière
- Faculté de médecine, Université de Montréal, Montréal, QC; Centre hospitalier de l'Université de Montréal, Montréal, QC; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC
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Desjardins M, Lefebvre B, Labbé AC, Martin I, Mauffrey F, Longtin J, Fortin C. Agar Gradient Diffusion Susceptibility Testing for Neisseria gonorrhoeae: A Reliable Alternative to Agar Dilution? Open Forum Infect Dis 2017. [PMCID: PMC5632223 DOI: 10.1093/ofid/ofx163.105] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Antimicrobial susceptibility testing by agar dilution, the gold-standard for determination of minimal inhibitory concentration (MIC) for N. gonorrhoeae, is a labor intensive technique usually performed in reference laboratories. Agar gradient diffusion is a simpler alternative to obtain MICs. However, correlation of N. gonorrhoeae MIC values obtained by the two methods is not well established. The objective of this study is to evaluate performance of agar gradient diffusion compared with agar dilution for N. gonorrhoeae.
Methods
Fifty strains of N. gonorrhoeae (34 isolates from clinical specimens; 14 WHO reference and two ATCC strains), all confirmed to be genetically distinct using molecular typing (NG-MAST), were selected. Isolates with known high MICs were targeted. Agar gradient diffusion MIC testing was done in a clinical laboratory on all strains for ceftriaxone, cefixime, and azithromycin while comparing two different commercial antimicrobial strips (bioMérieux, Alere) on three different culture media (BD, Oxoid, CLSI’s recommended medium). Agar dilution MIC testing according to CLSI was done at the Québec provincial reference laboratory on all strains. Performance of agar gradient diffusion was assessed by accuracy, using essential and categorical agreements, and by precision (reproducibility).
Results
When comparing agar dilution and agar gradient diffusion using bioMérieux strips on CLSI testing medium, essential agreements (within 1-log2 dilution) were 94, 88, and 82% for ceftriaxone, cefixime, and azithromycin, respectively. Categorical agreements were 100, 94, and 94%. Agar gradient diffusion, compared with agar dilution, had a tendency to under-estimate MIC for third-generation cephalosporins, not classifying 86% of isolates with decreased susceptibility (MIC 0.12–0.25 mg/l for ceftriaxone, 0.25 mg/l for cefixime) as such. Overall precision of agar gradient diffusion was 96%.
Conclusion
Agar gradient diffusion using bioMérieux strips on CLSI testing medium shows satisfactory accuracy compared with agar dilution for N. gonorrhoeae MIC testing of third-generation cephalosporins and azithromycin even in a carefully selected panel of strains.
Disclosures
M. Desjardins, bioMerieux: Research Contractor, Research support. BD: Research Contractor, Research support. Alere: Research Contractor, Research support. Oxoid: Research Contractor, Research support. C. Fortin, Alere: Research Contractor, Research support. bioMerieux: Research Contractor, Research support. BD: Research Contractor, Research support
Oxoid: Research Contractor, Research support
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Affiliation(s)
- Michaël Desjardins
- Microbiology and Infectiology, Université de Montréal, Montreal, QC, Canada
| | | | - Annie-Claude Labbé
- Microbiology, CIUSSS de l’est-de-l’île-de-Montréal, Montreal, QC, Canada
| | - Irene Martin
- National Microbiology Laboratory, Winnipeg, MB, Canada
| | - Florian Mauffrey
- Laboratoire de santé publique du Québec, Sainte-Anne-de-Bellevue, QC, Canada
| | - Jean Longtin
- Laboratoire De Santé Publique Du Québec, Inistitut national de santé publique du Québec, Sainte-Anne-de-Bellevue, QC, Canada
| | - Claude Fortin
- Microbiology, Infectious Diseases and Immunology, University of Montreal, Montréal, QC, Canada
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Marquis L, Julien S, Blanchette-Carrière C, Baril A, Desjardins M, Carr M, Paquette T, Soucy J, Montplaisir J, Nielsen T. 0732 NIGHTMARE DISTRESS IS NEGATIVELY CORRELATED WITH REGIONAL CEREBRAL BLOOD FLOW IN FRONTAL AREAS DURING AN IAPS PICTURE-VIEWING TASK. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.731] [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: 11/12/2022] Open
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Desjardins M, Baril A, Desautels A, Marquis L, Soucy J, Montplaisir J, Zadra A. 0738 EFFECTS OF SLEEP DEPRIVATION ON BRAIN PERFUSION PATTERNS IN SLEEPWALKERS’ WAKEFULNESS AND SLOW WAVE SLEEP. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.737] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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Duceppe MA, Elliott A, Para M, Poirier MC, Delisle M, Frenette AJ, Deckelbaum D, Razek T, Desjardins M, Bertrand JC, Bernard F, Rico P, Burry L, Williamson D, Perreault MM. Modifiable risk factors for delirium in critically ill trauma patients: a multicenter prospective study. Crit Care 2015. [PMCID: PMC4470827 DOI: 10.1186/cc14558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Desjardins M, Gaucher N, Curtis S, Le May S, Lebel D, Gouin S. 16: A Randomized Double-Blind Trial Comparing the Effect on Pain of an Oral Sucrose Solution Versus Placebo in Children One to Three Months Old Needing Venipuncture. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.6.e35-16] [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: 11/14/2022] Open
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Desjardins M, Godbout J, Montplaisir J, Carrier J, Zadra A. Analysis of eeg functional connectivity prior to somnambulism. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.763] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Karlowsky JA, Adam HJ, Desjardins M, Lagace-Wiens PRS, Hoban DJ, Zhanel GG, Zhanel GG, Hoban DJ, Adam HJ, Karlowsky JA, Baxter MR, Nichol KA, Lagace-Wiens PRS, Walkty A. Changes in fluoroquinolone resistance over 5 years (CANWARD 2007-11) in bacterial pathogens isolated in Canadian hospitals. J Antimicrob Chemother 2013; 68 Suppl 1:i39-46. [DOI: 10.1093/jac/dkt025] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Desjardins M, Clarke A, Alizadehfar R, Grenier D, Eisman H, Carr S, Vander Leek T, Teperman L, Higgins N, Joseph L, Shand G, Ben-Shoshan M. Comparison between Allergists and Non-allergists on Issues Related to Food-induced Anaphylaxis. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Slinger R, Desjardins M, Moldovan I, Harvey SB, Chan F. A rapid, high-resolution melting (HRM) multiplex PCR assay to detect macrolide resistance determinants in group A streptococcus. Int J Antimicrob Agents 2011; 38:183-5. [PMID: 21596529 DOI: 10.1016/j.ijantimicag.2011.04.003] [Citation(s) in RCA: 4] [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] [Received: 02/16/2011] [Revised: 04/08/2011] [Accepted: 04/13/2011] [Indexed: 10/18/2022]
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Dubeau S, Desjardins M, Pouliot P, Beaumont E, Gaudreau P, Ferland G, Lesage F. Biophysical model estimation of neurovascular parameters in a rat model of healthy aging. Neuroimage 2011; 57:1480-91. [PMID: 21549843 DOI: 10.1016/j.neuroimage.2011.04.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 04/11/2011] [Accepted: 04/14/2011] [Indexed: 11/27/2022] Open
Abstract
Neuronal, vascular and metabolic factors result in a deterioration of the cerebral hemodynamic response with age. The interpretation of neuroimaging studies in the context of aging is rendered difficult due to the challenge in untangling the composite effect of these modifications. In this work we integrate multimodal optical imaging in biophysical models to investigate vascular and metabolic changes occurring in aging. Multispectral intrinsic optical imaging of an animal model of healthy aging, the LOU/c rat, is used in combination with somatosensory stimulation to study the modifications of the hemodynamic response with increasing age. Results are fitted with three macroscopic biophysical models to extract parameters, providing a phenomenological description of vascular and metabolic changes. Our results show that 1) biophysical parameters are estimable from multimodal data and 2) parameter estimates in this population change with aging.
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Affiliation(s)
- S Dubeau
- Department of Electrical Engineering, École Polytechnique de Montréal, Montréal, QC, Canada
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Lina J, Matteau-Pelletier C, Dehaes M, Desjardins M, Lesage F. Wavelet-based estimation of the hemodynamic responses in diffuse optical imaging. Med Image Anal 2010; 14:606-16. [DOI: 10.1016/j.media.2010.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 04/14/2010] [Accepted: 04/23/2010] [Indexed: 11/24/2022]
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Kawchuk LM, Howard RJ, Kalischuk ML, Northover PR, Desjardins M, Spencer RCJ. First Report of Bronze Leaf Disease on Poplar in Alberta, Canada and Sequence of Apioplagiostoma populi. Plant Dis 2010; 94:377. [PMID: 30754220 DOI: 10.1094/pdis-94-3-0377a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Poplar (Populus spp.) is an important ornamental, windbreak, and pulp and wood product tree in Alberta and across western Canada because of its rapid growth, architecture, and hardiness. It is also a major component of native tree stands in the parkland area of the Canadian Prairies. Until recently in North America, infections of Apioplagiostoma populi (Cash & A.M. Waterman) Barr have only been documented in central Canada and the eastern and midwestern United States. Symptoms resembling bronze leaf disease (3) were observed in Alberta as early as 2003 and have been seen each subsequent year on an increasing number of Populus × canescens Smith, P. tremula L., and P. tremuloides Michx. trees from urban areas, shelterbelts, and nurseries. Foliar symptoms were observed in 10 to 50% of the tree canopy, and diseased leaves were bronze-colored with green and yellow petioles and veins. Disease symptoms became pronounced in mid-to-late summer with bronze to dark reddish brown leaves, while the petiole and the midrib remained green. Some symptomatic leaves remained attached to diseased trees throughout the fall and winter and continued the infectious disease cycle in the spring. As the disease advanced, A. populi colonized stem and branch tissues causing the leaves to wilt, discolor, and die shortly afterward. Diseased branches often died within the current season. Continued branch dieback resulted in significantly reduced aesthetic and commercial value. Survival of poplar arising from diseased clones was often less than 5 years. Bronze leaf disease symptoms have been reported on several Populus spp., and premature tree mortality represents a serious impediment to the continued use of this tree species (1). Attempts to isolate the causal agent of bronze leaf disease on artificial media have been unsuccessful (4). In the fall of 2008, leaves from symptomatic trees were collected and suspended outdoors in mesh bags to overwinter. Dark brown perithecia (150 to 200 × 100 to 150 μm) emerged the following spring from the lower and upper leaf surfaces. Asci were fusoid clavate, 30 to 40 × 10 to 14 μm with a conspicuous apical ring and contained hyaline two-celled ascospores 10 to 14 × 3 to 6 μm that were ellipsoid clavate with a relatively short basal cell. Nucleic acid was extracted from isolated perithecia and amplified by the polymerase chain reaction and oligonucleotides 5'GCATCGATGAAGAACGCAGC3' and 5'TCCTCCGCTTATTGATATGC3' specific for rDNA internal transcribed spacer (ITS) sequence (2). The cloned amplified sequence of the A. populi rDNA ITS region (GenBank Accession No. GU205341) showed considerable homology (>90% identity) to other Apioplagiostoma spp. In total, 33 independent leaf samples from nine trees exhibiting disease symptoms were positive for A. populi, producing an approximately 300-bp sequence not observed in any of the symptomless samples. Poplar and aspen have been extensively planted in rural and urban landscapes in western Canada over the past 100 years and continued spread of the bronze leaf disease pathogen threatens the viability of the shelterbelt, nursery, and processed wood industries. References: (1) E. K. Cash and A. M. Waterman. Mycologia 49:756, 1957. (2) A. H. Khadhair et al. Can. J. Plant Pathol. 20:55, 1998. (3) P. R. Northover and M. Desjardins. Plant Dis. 87:1538, 2003. (4) J. A. Smith et al. Plant Dis. 86:462, 2002.
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Affiliation(s)
- L M Kawchuk
- Agriculture and Agri-Food Canada, Lethbridge, AB, T1J 4B1, Canada
| | - R J Howard
- Alberta Agriculture and Rural Development, Crop Diversification Centre South, Brooks, AB T1R 1E6, Canada
| | - M L Kalischuk
- Department of Plant Pathology, Washington State University, Pullman 99164
| | - P R Northover
- Saskatchewan Ministry of Agriculture, Crop Protection Laboratory, Regina, SK S4N 6P6, Canada
| | - M Desjardins
- Manitoba Crop Diagnostic Centre, Winnipeg, MB R3T 5S6, Canada
| | - R C J Spencer
- Alberta Agriculture and Rural Development, Ag-Info Centre, Stettler, AB, T0C 2L0, Canada
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Goldfarb D, Harvey S, Jessamine K, Jessamine P, Toye B, Desjardins M. P70 Detection of plasmid mediated KPC-producing Klebsiella pneumo-niae in Ottawa, Canada: evidence of intra-hospital transmission. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70289-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Roy L, Desjardins M, Toye B. P111 Interpretation of Gram stains of positive blood cultures – frequency and types of errors. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70330-9] [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: 10/20/2022]
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Alvarez GG, Burns BF, Desjardins M, Salahudeen SR, AlRashidi F, Cameron DW. Blastomycosis in a young African man presenting with a pleural effusion. Can Respir J 2007; 13:441-4. [PMID: 17149463 PMCID: PMC2683332 DOI: 10.1155/2006/474968] [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] [Indexed: 11/17/2022] Open
Abstract
Blastomyces dermatitidis is a dimorphic fungus endemic to north-western Ontario, Manitoba and some parts of the United States. The fungus is also endemic to parts of Africa. Pulmonary and extrapulmonary findings of a 24-year-old African man who presented with weight loss, dry cough and chronic pneumonia not resolving with antibiotic treatment are presented. The unusual occurrence of pulmonary blastomycosis associated with skin lesions and a moderate pleural effusion is reported.
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Affiliation(s)
- G G Alvarez
- Department of Medicine, University of Ottawa, Ottawa, Ontario.
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Stuart LM, Boulais J, Charriere GM, Hennessy EJ, Brunet S, Jutras I, Goyette G, Rondeau C, Letarte S, Huang H, Ye P, Morales F, Kocks C, Bader JS, Desjardins M, Ezekowitz RAB. A systems biology analysis of the Drosophila phagosome. Nature 2006; 445:95-101. [PMID: 17151602 DOI: 10.1038/nature05380] [Citation(s) in RCA: 192] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Accepted: 10/24/2006] [Indexed: 11/08/2022]
Abstract
Phagocytes have a critical function in remodelling tissues during embryogenesis and thereafter are central effectors of immune defence. During phagocytosis, particles are internalized into 'phagosomes', organelles from which immune processes such as microbial destruction and antigen presentation are initiated. Certain pathogens have evolved mechanisms to evade the immune system and persist undetected within phagocytes, and it is therefore evident that a detailed knowledge of this process is essential to an understanding of many aspects of innate and adaptive immunity. However, despite the crucial role of phagosomes in immunity, their components and organization are not fully defined. Here we present a systems biology analysis of phagosomes isolated from cells derived from the genetically tractable model organism Drosophila melanogaster and address the complex dynamic interactions between proteins within this organelle and their involvement in particle engulfment. Proteomic analysis identified 617 proteins potentially associated with Drosophila phagosomes; these were organized by protein-protein interactions to generate the 'phagosome interactome', a detailed protein-protein interaction network of this subcellular compartment. These networks predicted both the architecture of the phagosome and putative biomodules. The contribution of each protein and complex to bacterial internalization was tested by RNA-mediated interference and identified known components of the phagocytic machinery. In addition, the prediction and validation of regulators of phagocytosis such as the 'exocyst', a macromolecular complex required for exocytosis but not previously implicated in phagocytosis, validates this strategy. In generating this 'systems-based model', we show the power of applying this approach to the study of complex cellular processes and organelles and expect that this detailed model of the phagosome will provide a new framework for studying host-pathogen interactions and innate immunity.
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Affiliation(s)
- L M Stuart
- Laboratory of Developmental Immunology, Massachusetts General Hospital/ Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA.
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Desjardins M, Guibord C, Lalonde B, Toye B, Ramotar K. Evaluation of the IDI-MRSA assay for detection of methicillin-resistant staphylococcus aureus from nasal and rectal specimens pooled in a selective broth. J Clin Microbiol 2006; 44:1219-23. [PMID: 16597841 PMCID: PMC1448652 DOI: 10.1128/jcm.44.4.1219-1223.2006] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.9] [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
Rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) by PCR can be performed directly from nasal specimens with the IDI-MRSA assay. To improve the efficiency of screening, we evaluated the performance of the IDI-MRSA assay for the detection of MRSA from pooled and unpooled specimens cultured in a selective broth. Of the 287 specimens evaluated, 71 were culture and PCR positive, 203 were culture and PCR negative, 3 were culture positive and PCR negative, 8 were culture negative and PCR positive, and 2 remained inhibited. A methicillin-susceptible Staphylococcus aureus isolate was recovered from five of the eight specimens with false-positive PCR results. Compared to the results of culture, the sensitivity, specificity, and positive and negative [corrected] predictive values of the IDI-MRSA assay for detection of MRSA from broth were 96%, 96%, 90%, and 98%, respectively. Following implementation of the IDI-MRSA assay, PCR-positive broths were subcultured for evaluation of assay performance. Of the 298 IDI-MRSA assay-positive broths, the results for 103 could not be confirmed by culture. A methicillin-susceptible S. aureus (MSSA) isolate was recovered from 77 of these 103 broths. Repeat testing by the IDI-MRSA assay directly with the MSSA isolates confirmed the original positive PCR result. The positive predictive value of the IDI-MRSA assay fell from 90% during the evaluation phase to 65% postimplementation. The IDI-MRSA assay performed well for the detection of MRSA from a selective broth compared to the performance of the detection of MRSA from culture. However, because of the burden associated with implementation of infection control precautions, cultures remain essential in confirming positive IDI-MRSA results.
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Affiliation(s)
- M Desjardins
- Division of Microbiology, The Ottawa Hospital, 501 Smyth Rd., Ottawa, Ontario K1H 8L6, Canada.
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Desjardins M, Delgaty KL, Ramotar K, Seetaram C, Toye B. Prevalence and mechanisms of erythromycin resistance in group A and group B Streptococcus: implications for reporting susceptibility results. J Clin Microbiol 2005; 42:5620-3. [PMID: 15583291 PMCID: PMC535282 DOI: 10.1128/jcm.42.12.5620-5623.2004] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.8] [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: 11/20/2022] Open
Abstract
Increased rates of erythromycin resistance among group B Streptococcus (GBS) and group A Streptococcus (GAS) have been reported. Cross-resistance to clindamycin may be present, depending on the mechanism of resistance. We determined the prevalence of macrolide-resistant determinants in GBS and GAS isolates to guide the laboratory reporting of erythromycin and clindamycin susceptibility. Susceptibilities were determined by the disk diffusion and broth microdilution methods. Inducible and constitutive resistance to clindamycin was determined by the double-disk diffusion method. The presence of the ermTR, ermB, and mefA genes was confirmed by PCR. Of the 338 GBS isolates, 55 (17%) were resistant to erythromycin, whereas 26 (8%) were resistant to clindamycin. The erm methylase gene was identified in 48 isolates, 22 of which had inducible resistance to clindamycin and 26 of which had constitutive resistance to clindamycin. The remaining seven resistant isolates had mefA. Of the 593 GAS isolates, 49 (8%) and 6 (1%) isolates were resistant to erythromycin and clindamycin, respectively. Erythromycin resistance was due to mefA in 33 isolates, whereas 14 isolates had erm-mediated resistance (9 isolates had inducible resistance and 5 isolates had constitutive resistance). In our population, erythromycin resistance in GAS was predominantly mediated by mefA and erythromycin resistance in GBS was predominantly mediated by erm. Regional differences in mechanisms of resistance need to be taken into consideration when deciding whether to report clindamycin susceptibility results on the basis of in vitro test results. Testing by the double-disk diffusion method would be an approach that could be used to address this issue, especially for GAS.
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Affiliation(s)
- M Desjardins
- Division of Microbiology, Department of Medicine, The Ottawa Hospital, 501 Smyth Rd., Ottawa, ON, Canada.
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Northover PR, Desjardins M. First Report of Bronze Leaf Disease on Hybrid Poplar (Populus × canescens 'Tower') Caused by Apioplagiostoma populi in Manitoba, Canada. Plant Dis 2003; 87:1538. [PMID: 30812406 DOI: 10.1094/pdis.2003.87.12.1538c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Poplars (Populus alba × P. tremula (P. × canescens) (Aiton) Smith cv. Tower) are common ornamental and windbreak trees in Manitoba and across the Canadian prairie provinces because of their rapid growth and columnar growth habit. Bronze leaf disease symptoms have been reported on five poplar species (P. alba, P. canescens, P. grandidentata, P. tremula, and P. tremuloides) (2), and the disease presents a significant barrier to the development and continued use of poplars (1). Elimination of tower poplars would represent a significant loss to the Canadian horticultural industry, and the costs incurred in the replacement of existing windbreaks would be high. In August 2002, we observed symptoms of bronze leaf disease on approximately 20-year-old tower poplars, ranging in height from 8 to 12 m at a tree nursery and golf course near Carman, Manitoba (49°30'N, 98°0'W). The leaf laminae of affected plants were chocolate brown, and the petioles and veins were yellow to light green. In the nursery windbreak, 70 trees had foliar symptoms on 30 to 80% of the canopy. At the golf course, eight trees had foliar symptoms on approximately 5 to 20% of the canopy. No fruiting structures were visible on leaf or shoot tissue, and no staining of vascular tissues was observed. Attempts to isolate the causal fungus of bronze leaf disease on artificial media have been unsuccessful (2). In October 2002, branches with symptomatic leaves were covered with netting, and the trapped leaves were left to overwinter. In March 2003, symptomatic leaves were brought to the laboratory and surface sterilized in 1% NaOCl for 1 min, rinsed with sterile water, and incubated at 18°C in moist chambers. After 2 weeks, dark brown, beaked, single perithecia that were 150 to 200 μm long × 150 μm wide emerged from the upper and lower leaf surfaces. Asci were fusoid clavate with a conspicuous apical ring and contained 4 or 6 spores. The two-celled, hyaline ascospores varied from 10.5 to 14.5 × 2 to 3 μm, the basal cell shorter than the apical cell. Leaf symptoms and microscopic fungal features matched those of Apioplagiostoma populi (Cash & A.M. Waterman) Barr, the cause of bronze leaf disease (1,2). Voucher specimens have been deposited in the U.S. National Fungus Collections (BPI 843385). To our knowledge, this is the first report of this fungus in western Canada, and the first confirmed report of this pathogen on tower poplar in Canada. References: (1) E. K. Cash and A. M. Waterman. Mycologia 49:756, 1957. (2) J. A. Smith et al. Plant Dis. 86:462, 2002.
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Affiliation(s)
- P R Northover
- Manitoba Agriculture and Food, Soils and Crops Branch, 65-3rd Av. NE, P.O. Box 1149, Carman, Manitoba, R0G 0J0, Canada
| | - M Desjardins
- Manitoba Agriculture and Food, Crop Diagnostic Centre, 201-545 University Crescent, Winnipeg, Manitoba, R3T 5S6, Canada
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Sauders BD, Wiedmann M, Desjardins M, Fenlon C, Davenport N, Hibbs JR, Morse DL. Recurrent Listeria monocytogenes infection: relapse or reinfection with a unique strain confirmed by molecular subtyping. Clin Infect Dis 2001; 33:257-9. [PMID: 11418887 DOI: 10.1086/321821] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2000] [Revised: 11/22/2000] [Indexed: 11/03/2022] Open
Abstract
We report a case of recurrent listeriosis for which molecular subtyping by automated ribotyping and pulsed-field gel electrophoresis confirmed either relapse of infection or reinfection due to a common source almost 9 months after initial infection due to a unique Listeria monocytogenes strain in a patient with colorectal cancer. This case report illustrates the potential use of molecular subtyping to further understand the pathogenesis and epidemiology of listeriosis and the potential for relapse of Listeria infections in humans.
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Affiliation(s)
- B D Sauders
- New York State Department of Health, Wadsworth Center, Albany, NY, USA
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