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Alanio A, Gits-Muselli M, Guigue N, Denis B, Bergeron A, Touratier S, Hamane S, Bretagne S. Prospective comparison of (1,3)-beta-D-glucan detection using colorimetric and turbidimetric assays for diagnosing invasive fungal disease. Med Mycol 2021; 59:882-889. [PMID: 33877326 DOI: 10.1093/mmy/myab016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 12/30/2022] Open
Abstract
Serum (1→3)-β-D-glucan (BDG), an pan fungal antigen, is detected in some invasive fungal diseases (IFDs). We compared two commercial kits, the Fungitell assay (FA) (colorimetric) and the Wako assay (WA) (turbidimetric) over a 4-month period to prospectively test 171 patients who mainly had hematological conditions (62%) and experienced episodes (n = 175) of suspected invasive fungal infection. Twenty-three episodes due to BDG-producing fungi were diagnosed (pneumocystosis, n = 12; invasive aspergillosis, n = 5; candidemia, n = 3; invasive fusariosis, n = 2; hepato-splenic candidiasis, n = 1).Both assays provided similar areas under the curves (AUC = 0.9). Using the optimized positivity thresholds (≥120 pg/ml for FA and ≥ 4 pg/ml for WA), the sensitivity and specificity were 81.8% (CI95: 61.5-92.7), 94.8% (90.1-97.3) for FA and 81.8% (61.5-92.7), 95.4% (90.9-97.8) for WA. Negative predictive value was 97.3% (93.3-99.0) for both tests. If the manufacturer's positivity threshold (≥11 pg/ml) was applied, the WA sensitivity decreased to 50%. Among 71 patients with bacterial infections, 21.1% were FA-positive and 5.6% were WA-positive (p < 10-2).The WA performed similarly as compared to the FA with an optimized cutoff value. The WA is a single sample test that is clinically relevant when a prompt therapeutic decision is required. LAY SUMMARY Serum (1→3)-β-D-glucan testing is dominated by two kits including Fungitell colorimetric assay (FA) and the Wako turbidimetric assay (WA). We compared them prospectively and observed that they both perform similarly when selecting their optimal threshold (≥120 pg/ml for FA and ≥ 4 pg/ml for WA).
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Affiliation(s)
- Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France.,Université de Paris, 75006 Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR2000, 75724 Paris, France
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France.,Université de Paris, 75006 Paris, France
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France
| | - Blandine Denis
- Service de maladies infectieuses et tropicales, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France
| | - Anne Bergeron
- Service de Pneumologie, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France
| | - Sophie Touratier
- Pharmacie centrale, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France.,Université de Paris, 75006 Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR2000, 75724 Paris, France
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Assan F, Gottlieb J, Tubach F, Lebbah S, Guigue N, Hickman G, Pape E, Madrange M, Delaporte E, Sendid B, Aubin F, Derouin F, Bretagne S, Richette P, Smahi A, Sbidian E, Bachelez H. Anti-Saccharomyces cerevisiae IgG and IgA antibodies are associated with systemic inflammation and advanced disease in hidradenitis suppurativa. J Allergy Clin Immunol 2020; 146:452-455.e5. [DOI: 10.1016/j.jaci.2020.01.045] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/26/2020] [Accepted: 01/31/2020] [Indexed: 12/21/2022]
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Gits-Muselli M, Villiers S, Hamane S, Berçot B, Donay JL, Denis B, Guigue N, Alanio A, Bretagne S. Time to and differential time to blood culture positivity for assessing catheter-related yeast fungaemia: A longitudinal, 7-year study in a single university hospital. Mycoses 2019; 63:95-103. [PMID: 31630462 DOI: 10.1111/myc.13024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 04/24/2019] [Revised: 10/04/2019] [Accepted: 10/10/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Time to positivity (TTP) and differential time to positivity (DTTP) between central and peripheral blood cultures are commonly used for bacteraemia to evaluate the likelihood of central venous catheter (CVC)-related bloodstream infection. Few studies have addressed these approaches to yeast fungaemia. OBJECTIVES This study aimed to evaluate TTP and DTTP to assess CVC-related yeast fungaemia (CVC-RYF). PATIENTS/METHODS We retrospectively analysed the results from 105 adult patients with incident fungaemia, with CVC removed and cultured, collected from 2010 to 2017. The bottles were incubated in a BioMérieux BacT/ALERT 3D and kept for at least 5 days. RESULTS Of the 105 patients included, most were oncology patients (85.7%) and had of long-term CVC (79.6%); 32 (30.5%) had a culture-positive CVC (defined as CVC-RYF) with the same species as in blood culture, and 69.5% had culture-negative CVC (defined as non-CVC-RYF, NCVC-RYF). Candida albicans represented 46% of the episodes. The median TTP was statistically different between CVC-RYF and NCVC-RYF (16.8 hours interquartile range (IQR) [9.7-28.6] vs 29.4 hours [IQR 20.7-41.3]; P = .001). A TTP <10 hours had the best positive likelihood ratio (21.5) for CVC-RYF, although the sensitivity was only 28%. DTTP was available for 52 patients. A DTTP >5 hours had a sensitivity of 100% and a specificity of 71% for CVC-RYF. CONCLUSIONS Since the median TTP was 17 hours and the most performing DTTP >5 hours, these delays are too long to take a decision in the same operational day. More rapid methods for detecting infected catheters should be tested to avoid unnecessary CVC withdrawal.
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Affiliation(s)
- Maud Gits-Muselli
- Parasitology-Mycology Laboratory, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Paris-Diderot, Sorbonne Paris Cité University, Paris, France.,Molecular Mycology Unit, Institut Pasteur, Reference National Center of Invasive Mycoses and Antifungals, CNRS UMR2000, Paris, France
| | - Stéphane Villiers
- Anesthesiology Department, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Samia Hamane
- Parasitology-Mycology Laboratory, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Béatrice Berçot
- Microbiology Department, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Paris-Diderot, IAME UMR-1137, Sorbonne Paris Cité University, Paris, France
| | - Jean-Luc Donay
- Microbiology Department, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Blandine Denis
- Tropical and Infectious Diseases Department, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Nicolas Guigue
- Parasitology-Mycology Laboratory, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Alexandre Alanio
- Parasitology-Mycology Laboratory, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Paris-Diderot, Sorbonne Paris Cité University, Paris, France.,Molecular Mycology Unit, Institut Pasteur, Reference National Center of Invasive Mycoses and Antifungals, CNRS UMR2000, Paris, France
| | - Stéphane Bretagne
- Parasitology-Mycology Laboratory, Lariboisière Saint-Louis Fernand Widal Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Paris-Diderot, Sorbonne Paris Cité University, Paris, France.,Molecular Mycology Unit, Institut Pasteur, Reference National Center of Invasive Mycoses and Antifungals, CNRS UMR2000, Paris, France
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Sanosyan A, Daien C, Nutz A, Bollore K, Bedin AS, Morel J, Zimmermann V, Nocturne G, Peries M, Guigue N, Gottenberg JE, Van de Perre P, Mariette X, Tuaillon E. Discrepancy of Serological and Molecular Patterns of Circulating Epstein-Barr Virus Reactivation in Primary Sjögren's Syndrome. Front Immunol 2019; 10:1153. [PMID: 31191532 PMCID: PMC6549440 DOI: 10.3389/fimmu.2019.01153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 02/04/2019] [Accepted: 05/07/2019] [Indexed: 11/21/2022] Open
Abstract
Primary Sjögren's syndrome (pSS) is characterized by B cell hyperactivation, production of autoantibodies and increased risk of B cell lymphomas. Serological profile of Epstein-Barr virus (EBV) reactivation and increase EBV DNA levels in exocrine glands are observed in pSS, but whether these abnormalities are accompanied with disturbed systemic EBV control or have any association with pSS activity remains to be investigated. In this observational study, we initially explored anti-EBV antibodies and cell-free DNA in 395 samples from a cross-sectional plasma collection of pSS patients included in ASSESS French national cohort. Results were assessed in relation with disease activity. Further, to assess cell-associated EBV DNA we organized a case-control study including 20 blood samples from pSS patients followed in University Hospital Center of Montpellier. Results were compared with matched controls. Robust response against EBV early antigen (EA) was observed in pSS patients with anti-SSA/B (Sjögren's syndrome A and B) and anti-SSA autoantibodies compared to anti-SSA/B negatives (P < 0.01 and P = 0.01, respectively). Increased beta-2 microglobulin, kappa and lambda light chains, and immunoglobulin G levels were more frequently observed in anti-EA seropositive pSS subjects compared to anti-EA negative subjects (P < 0.001; P = 0.001; P = 0.003, respectively). Beta-2 microglobulin was independently associated with anti-EA positivity in multivariate analysis (P < 0.001). Plasma cell-free EBV DNA and EBV cellular reservoir was not different between pSS patients and controls. We conclude that serological evidence of EBV reactivation was more frequently observed and more strongly associated with anti-SSA/B status and B cell activation markers in pSS. However, serological profile of EBV reactivation was not accompanied by molecular evidence of systemic EBV reactivation. Our data indicated that EBV infection remains efficiently controlled in the blood of pSS patients.
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Affiliation(s)
- Armen Sanosyan
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, CHU Montpellier, Montpellier, France
| | - Claire Daien
- CHU Montpellier, Department of Rheumatology, Montpellier, France
- Institut de Génétique Moléculaire de Montpellier, Centre National de la Recherche Scientifique UMR 5535, Université de Montpellier, Montpellier, France
| | | | - Karine Bollore
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, CHU Montpellier, Montpellier, France
| | - Anne-Sophie Bedin
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, CHU Montpellier, Montpellier, France
| | - Jacques Morel
- CHU Montpellier, Department of Rheumatology, Montpellier, France
- Institut de Génétique Moléculaire de Montpellier, Centre National de la Recherche Scientifique UMR 5535, Université de Montpellier, Montpellier, France
| | - Valérie Zimmermann
- Institut de Génétique Moléculaire de Montpellier, Centre National de la Recherche Scientifique UMR 5535, Université de Montpellier, Montpellier, France
| | - Gaetane Nocturne
- Faculté de Médecine, Université Paris Sud, INSERM, U1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Le Kremlin-Bicêtre, France
| | - Marianne Peries
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, CHU Montpellier, Montpellier, France
| | - Nicolas Guigue
- Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Laboratory of Parasitology and Mycology, AP-HP, Paris, France
| | | | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, CHU Montpellier, Montpellier, France
| | - Xavier Mariette
- Faculté de Médecine, Université Paris Sud, INSERM, U1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Le Kremlin-Bicêtre, France
- Service de Rhumatologie AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, CHU Montpellier, Montpellier, France
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Guigue N, Léon L, Hamane S, Gits-Muselli M, Le Strat Y, Alanio A, Bretagne S. Corrigendum: Continuous Decline of Toxoplasma gondii Seroprevalence in Hospital: A 1997–2014 Longitudinal Study in Paris, France. Front Microbiol 2018; 9:2814. [PMID: 30538679 PMCID: PMC6277832 DOI: 10.3389/fmicb.2018.02814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/01/2018] [Indexed: 12/02/2022] Open
Affiliation(s)
- Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis, Lariboisière, Fernand-Widal, Paris, France
| | - Lucie Léon
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis, Lariboisière, Fernand-Widal, Paris, France
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis, Lariboisière, Fernand-Widal, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Yann Le Strat
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis, Lariboisière, Fernand-Widal, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis, Lariboisière, Fernand-Widal, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- *Correspondence: Stéphane Bretagne
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Guigue N, Léon L, Hamane S, Gits-Muselli M, Le Strat Y, Alanio A, Bretagne S. Continuous Decline of Toxoplasma gondii Seroprevalence in Hospital: A 1997-2014 Longitudinal Study in Paris, France. Front Microbiol 2018; 9:2369. [PMID: 30344515 PMCID: PMC6182058 DOI: 10.3389/fmicb.2018.02369] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 06/11/2018] [Accepted: 09/14/2018] [Indexed: 12/22/2022] Open
Abstract
Background: The protozoan Toxoplasma gondii presents a risk for reactivation of latent cysts in immunocompromised patients. Anti-T. gondii antibodies are therefore usually screened before chemotherapy or transplantation to propose prophylactic measures against this parasite. We analyzed the results obtained in our hospital to study the epidemiological trend of T. gondii infection. Methods: We collected all the anti-Toxoplasma antibody titers from January 1, 1997 to December 31, 2013 using the Platelia IgG ELISA assay (Bio-Rad). The results were classified as positive when titers reached a concentration of ≥10 UI/ml. Only the first result obtained at entry for each patient was considered. T. gondii seroprevalence was estimated using a multivariate logistic regression model accounting for age, sex, and year in which the sample was collected. Results: A total of 21,480 patient samples were analyzed. The seroprevalence continuously decreased over time, from 64.5% in 1997 to 54.7% in 2013 (i.e., an average of 1.3% per year, p < 0.001). The decrease was 5.0% per year for patients <20 years. After 2013, the model predicts that the seroprevalence would continuously decrease. We also observed a higher proportion of seropositive men than women in the 15- to 45-year-old group (58.5% versus 52.0%, p < 10-3). Conclusion: The overall seroprevalence of toxoplasmosis at our hospital showed an accelerating downward trend over 17 years. The reason for this continuous decline is likely associated with the lower parasite presence within meat. Thus, although young immunocompromised patients are increasingly less at risk of reactivation in the near future, older immunocompromised patients will remain at high risk of reactivation. The reasons of the higher prevalence in men remain to be explored.
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Affiliation(s)
- Nicolas Guigue
- Santé Publique France, French National Public Health Agency, Paris, France
| | - Lucie Léon
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Samia Hamane
- Santé Publique France, French National Public Health Agency, Paris, France
| | - Maud Gits-Muselli
- Santé Publique France, French National Public Health Agency, Paris, France.,Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis, Lariboisière, Fernand-Widal, Paris, France
| | - Yann Le Strat
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Alexandre Alanio
- Santé Publique France, French National Public Health Agency, Paris, France.,Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis, Lariboisière, Fernand-Widal, Paris, France
| | - Stéphane Bretagne
- Santé Publique France, French National Public Health Agency, Paris, France.,Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis, Lariboisière, Fernand-Widal, Paris, France
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Fréalle E, Valade S, Guigue N, Hamane S, Chabé M, Le Gal S, Damiani C, Totet A, Aliouat EM, Nevez G, Menotti J. Diffusion of Pneumocystis jirovecii in the surrounding air of patients with Pneumocystis colonization: frequency and putative risk factors. Med Mycol 2018; 55:568-572. [PMID: 27811179 DOI: 10.1093/mmy/myw113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/19/2016] [Indexed: 11/14/2022] Open
Abstract
In a prospective bicentric study, Pneumocystis jirovecii excretion and diffusion was explored in air samples collected in the rooms occupied by 17 Pneumocystis-colonized patients. P. jirovecii DNA was detected by real-time PCR in the air collected from 3 patients' rooms (17.6%), with identical genotypes in corresponding clinical and air samples. Pneumocystis DNA was detected for 2/3 patients with autoimmune disease treated with corticosteroids versus 1/6 patients with hematologic disease and 0/5 kidney transplant recipients. These data confirm the possible excretion of the fungus by Pneumocystis-colonized patients and thus bring additional arguments for the prevention of airborne transmission in hospital wards.
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Affiliation(s)
- Emilie Fréalle
- CHU Lille, Laboratory of Parasitology-Mycology, F-59000, Lille.,Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille
| | - Sandrine Valade
- Intensive Care Unit, Saint-Louis University Hospital, AP-HP and Paris-Diderot University, Sorbonne Paris Cité, Paris
| | - Nicolas Guigue
- Laboratory of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP and Paris-Diderot University, Sorbonne Paris Cité, Paris
| | - Samia Hamane
- Laboratory of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP and Paris-Diderot University, Sorbonne Paris Cité, Paris
| | - Magali Chabé
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille
| | - Solène Le Gal
- Laboratory of Parasitology-Mycology, GEIHP EA 3142, Brest University Hospital, Brest
| | - Céline Damiani
- Laboratory of Parasitology-Mycology, Amiens University Hospital and University of Picardie-Jules Verne, Amiens
| | - Anne Totet
- Laboratory of Parasitology-Mycology, Amiens University Hospital and University of Picardie-Jules Verne, Amiens
| | - El Moukhtar Aliouat
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille
| | - Gilles Nevez
- Laboratory of Parasitology-Mycology, GEIHP EA 3142, Brest University Hospital, Brest
| | - Jean Menotti
- Laboratory of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP and Paris-Diderot University, Sorbonne Paris Cité, Paris.,Environmental epidemiology unit, EA 4064, Paris-Descartes University, Sorbonne Paris Cité, Paris, France
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Gits-Muselli M, Benderdouche M, Hamane S, Mingui A, Feuilhade de Chauvin M, Guigue N, Picat MQ, Bourrat E, Petit A, Bagot M, Alanio A, Bretagne S. Continuous increase of Trichophyton tonsurans as a cause of tinea capitis in the urban area of Paris, France: a 5-year-long study. Med Mycol 2018; 55:476-484. [PMID: 27744309 DOI: 10.1093/mmy/myw107] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/22/2016] [Indexed: 12/14/2022] Open
Abstract
Tinea capitis (TC) is a highly contagious fungal infection of the scalp due to dermatophytes in children. To obtain information on the epidemiology of TC in the urban area of Paris, we analysed the microbiological results of 3090 patients seen with suspected TC from October 2010 to September 2015 at Saint Louis hospital, Paris, France. A peak of TC was observed in 3-6 year-old children, followed by a progressive decrease until 16 years of age. Of the 1311 positive cultures, 95% (1246) yielded one of the three anthropophilic species [Trichophyton tonsurans (33.5%), Trichophyton soudanense (38.3%), or Microsporum audouinii (28.2%)]. When considering one TC case per family, we observed a significant increase of T. tonsurans (P = .018) during these 5 years. The increase was more pronounced (P = .0047) in patients of West-African descent (n = 666), and was at the expense of M. audouinii and T. soudanense. On the other hand, the Caribbean patients (n = 85) remained predominantly (72.9%) infected by T. tonsurans. Our results show a better virulence of T. tonsurans over other species as already reported. Since T. tonsurans has not been reported in Africa, the infection of patients of West-African descent probably took place in the Paris area by exchanges with Caribbean patients. This increase of TC due to T. tonsurans was observed in the context of griseofulvin being the only licensed paediatric treatment for TC in France, which should deserve reappraisal because terbinafine may be more efficacious.
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Affiliation(s)
- Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.,Université Paris-Diderot, Sorbonne Paris Cité
| | - Mazouz Benderdouche
- Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Anselme Mingui
- Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Martine Feuilhade de Chauvin
- Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.,Université Paris-Diderot, Sorbonne Paris Cité
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Marie-Quitterie Picat
- Service de Biostatistique et Information Médicale, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Emmanuelle Bourrat
- Service de dermatologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP
| | - Antoine Petit
- Service de dermatologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP
| | - Martine Bagot
- Université Paris-Diderot, Sorbonne Paris Cité.,Service de dermatologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.,Université Paris-Diderot, Sorbonne Paris Cité.,Inserm U976.,Institut Pasteur, Molecular Mycology Unit, National Reference Center of Invasive Mycoses and Antifungals, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.,Université Paris-Diderot, Sorbonne Paris Cité.,Inserm U976.,Institut Pasteur, Molecular Mycology Unit, National Reference Center of Invasive Mycoses and Antifungals, Paris, France
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Denis B, Moatti H, Sicre de Fontbrune F, Resche-Rigon M, Boissel N, Touratier S, Peffault de la Tour R, Guigue N, Bretagne S, Molina J. Le screening systématique de l’antigène galactomannane sérique (GM) chez les patients asymptomatiques allogreffés de moelle sous prophylaxie efficace par posaconazole ou voriconazole devrait être remplacé par un screening ciblé chez les patients symptomatiques. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.309] [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: 12/01/2022]
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Azoulay E, Guigue N, Darmon M, Mokart D, Lemiale V, Kouatchet A, Mayaux J, Vincent F, Nyunga M, Bruneel F, Rabbat A, Bretagne S, Lebert C, Meert AP, Benoit D, Pene F. (1, 3)-β-D-glucan assay for diagnosing invasive fungal infections in critically ill patients with hematological malignancies. Oncotarget 2017; 7:21484-95. [PMID: 26910891 PMCID: PMC5008300 DOI: 10.18632/oncotarget.7471] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [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: 08/24/2015] [Accepted: 01/19/2016] [Indexed: 11/30/2022] Open
Abstract
Invasive fungal infections (IFIs) are life-threatening complications of hematological malignancies that must be diagnosed early to allow effective treatment. Few data are available on the performance of serum (1–3)-β-D-glucan (BG) assays for diagnosing IFI in patients with hematological malignancies admitted to the intensive care unit (ICU). In this study, 737 consecutive patients with hematological malignancies admitted to 17 ICUs routinely underwent a BG assay at ICU admission. IFIs were diagnosed using standard criteria applied by three independent specialists. Among the 737 patients, 439 (60%) required mechanical ventilation and 273 (37%) died before hospital discharge. Factors known to alter BG concentrations were identified in most patients. IFIs were documented in 78 (10.6%) patients (invasive pulmonary aspergillosis, n = 54; Pneumocystis jirovecii pneumonia, n = 13; candidemia, n = 13; and fusarium infections, n = 3). BG concentrations (pg/mL) were higher in patients with than without IFI (144 (77–510) vs. 50 (30–125), < 0.0001). With 80 pg/mL as the cutoff, sensitivity was 72%, specificity 65%, and area-under-the-curve 0.74 (0.68–0.79). Assuming a prevalence of 10%, the negative and positive predictive values were 94% and 21%. By multivariable analysis, factors independently associated with BG > 80 pg/mL were IFI, admission SOFA score, autologous bone-marrow or hematopoietic stem-cell transplantation, and microbiologically documented bacterial infection. In conclusion, in unselected critically ill hematology patients with factors known to affect serum BG, this biomarker showed only moderate diagnostic performance and rarely detected IFI. However, the negative predictive value was high. Studies are needed to assess whether a negative BG test indicates that antifungal de-escalation is safe.
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Affiliation(s)
- Elie Azoulay
- Medical ICU and Mycology Department, Saint-Louis Hospital, Paris, France
| | - Nicolas Guigue
- Medical ICU and Mycology Department, Saint-Louis Hospital, Paris, France
| | - Michael Darmon
- Medical-Surgical ICU, Saint-Etienne University Hospital, Saint-Étienne, France
| | - Djamel Mokart
- Medical-Surgical ICU Paoli Calmette Cancer Institute, Marseille, France
| | - Virginie Lemiale
- Medical ICU and Mycology Department, Saint-Louis Hospital, Paris, France
| | | | | | | | - Martine Nyunga
- Medical ICU and Mycology Department, Saint-Louis Hospital, Paris, France
| | - Fabrice Bruneel
- Medical ICU and Mycology Department, Saint-Louis Hospital, Paris, France
| | - Antoine Rabbat
- Medical ICU and Pulmonary Department, Cochin Hospital, Paris, France
| | - Stéphane Bretagne
- Medical ICU and Mycology Department, Saint-Louis Hospital, Paris, France
| | - Christine Lebert
- Medical-Surgical ICU, La Roche Sur Yon Hospital, La Roche Sur Yon, France
| | | | | | - Frédéric Pene
- Medical ICU and Pulmonary Department, Cochin Hospital, Paris, France
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Gottlieb J, Hickman G, Guigue N, Pape E, Lebbah S, Delaporte E, Sendid B, Aubin F, Tubach F, Bachelez H. Les anticorps Anti – Saccharomyces cerevisiae sont un biomarqueur de l’hidrosadénite suppurée modérée à sévère mais pas du psoriasis en plaque sévère. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.109] [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: 10/18/2022]
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12
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Alanio A, Menotti J, Gits-Muselli M, Hamane S, Denis B, Rafoux E, Peffault de la Tour R, Touratier S, Bergeron A, Guigue N, Bretagne S. Circulating Aspergillus fumigatus DNA Is Quantitatively Correlated to Galactomannan in Serum. Front Microbiol 2017; 8:2040. [PMID: 29163378 PMCID: PMC5671575 DOI: 10.3389/fmicb.2017.02040] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 06/19/2017] [Accepted: 10/05/2017] [Indexed: 12/20/2022] Open
Abstract
The performance of antigen galactomannan (GM) for diagnosing invasive aspergillosis (IA) is hampered by the occurrence of false-positive results. Quantitative PCR has been proposed to improve the diagnosis of IA. Therefore, we analyzed the value of performing a PCR test to the GM-positive serum sample. Using a quantitative PCR assay specific for Aspergillus fumigatus 28S ribosomal DNA, we retrospectively tested 422 GM-positive (Platelia Bio-Rad kit) serum samples collected over 1 year from 147 patients. The cases were classified based on EORTC criteria as “proven,” “probable,” and “no–IA” before availability of the PCR results. After exclusion of 65 samples for non-reproducibility of GM positivity (n = 62) or PCR inhibition (n = 3), 75 (21.0%) of the remaining 357 samples were PCR-positive. GM and fungal DNA showed a significantly positive correlation (p < 0.0001, R2 = 0.27, slope = 0.98 ± 0.19). At least one PCR-positive result was observed in 63.3% (31/49) of IA patients and in 13.2% (13/98) of non-IA patients (p < 0.0001). The PCR positivity was also associated with the presence of other microbiological criteria among the 44 patients with IA and complete mycological workup (p = 0.014), as well as a higher mortality rate at six months among the 135 patients with hematological conditions (p = 0.0198). Overall, we found a quantitative correlation between serum GM and circulating DNA with an increased likelihood of IA when both were positive. A PCR-positive result also supported a higher fungal load when GM was already positive. We advocate adding a PCR test for every confirmed GM-positive serum sample.
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Affiliation(s)
- Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, APHP, Paris, France.,Université Paris-Diderot, Université Sorbonne Paris Cité, Paris, France.,Unité de Mycologie Moléculaire, Institut Pasteur, CNRS URA 3012, Centre National de Référence des Mycoses Invasives et des Antifongiques, URA 3012, Paris, France
| | - Jean Menotti
- Laboratoire de Parasitologie-Mycologie, APHP, Paris, France.,Université Paris-Diderot, Université Sorbonne Paris Cité, Paris, France
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, APHP, Paris, France.,Université Paris-Diderot, Université Sorbonne Paris Cité, Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, APHP, Paris, France
| | - Blandine Denis
- Service de Maladie Infectieuses et Tropicales, AP-HP, Paris, France
| | | | - Régis Peffault de la Tour
- Université Paris-Diderot, Université Sorbonne Paris Cité, Paris, France.,Service d'Hématologie-Greffe de Moelle, APHP, Paris, France
| | | | - Anne Bergeron
- Université Paris-Diderot, Université Sorbonne Paris Cité, Paris, France.,Service de Pneumologie, APHP, Paris, France
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, APHP, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, APHP, Paris, France.,Université Paris-Diderot, Université Sorbonne Paris Cité, Paris, France.,Unité de Mycologie Moléculaire, Institut Pasteur, CNRS URA 3012, Centre National de Référence des Mycoses Invasives et des Antifongiques, URA 3012, Paris, France
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Gottlieb J, Hickman G, Guigue N, Pape E, Lebbah S, Delaporte E, Sendid B, Aubin F, Tubach F, Bachelez H. 353 Anti–Saccharomyces cerevisiae antibodies (ASCA) are biomarkers of moderate-to-severe hidradenitis suppurativa (HS), but not of severe plaque psoriasis: Results from a prospective, multicenter study. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.548] [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: 11/24/2022]
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Gantner P, Velay A, Guigue N, Barth H, Wendling MJ, Delaugerre C, Fafi-Kremer S. Performance of the Liaison® XL Murex recHTLV-I/II Immunoassay in the Detection of HTLV-1/2 Antibodies in Serum. Clin Lab 2017. [PMID: 28627820 DOI: 10.7754/clin.lab.2017.161026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Human T-cell lymphotropic virus type 1 and 2 (HTLV-1/2) immunoassays are used for blood screen- ing from blood products, milk, and organ donors. METHODS We assessed the performance of the DiaSorin Liaison® XL murex recHTLV-I/II immunoassay relative to the Abbott Architect® rHTLV-I/II immunoassay and with the Innogenetics immunoblot as confirmation. RESULTS A panel of HTLV positive (n = 66) and negative (n = 30) sera was tested in both techniques within the same freeze/thaw cycle. The specificity and sensitivity of DiaSorin immunoassay were 100% and 78.8%, respectively. Abbott and DiaSorin immunoassays showed a correlation in chemiluminiscent signals to cutoff (S/CO) (Pearson r = 0.92). Half of the samples (34/66) from the seropositive panel were not confirmed by immunoblot (S/CO < 5 in both techniques). CONCLUSIONS Our data confirmed that the DiaSorin Liaison® XL murex recHTLV-I/II immunoassay is an effective platform for HTLV screening. Due to false-positive reaction, especially for samples with low S/CO, each seropositive sample should be confirmed by immunoblot.
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Dellière S, Healey K, Gits-Muselli M, Carrara B, Barbaro A, Guigue N, Lecefel C, Touratier S, Desnos-Ollivier M, Perlin DS, Bretagne S, Alanio A. Fluconazole and Echinocandin Resistance of Candida glabrata Correlates Better with Antifungal Drug Exposure Rather than with MSH2 Mutator Genotype in a French Cohort of Patients Harboring Low Rates of Resistance. Front Microbiol 2016; 7:2038. [PMID: 28066361 PMCID: PMC5179511 DOI: 10.3389/fmicb.2016.02038] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [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: 10/15/2016] [Accepted: 12/05/2016] [Indexed: 11/21/2022] Open
Abstract
Candida glabrata is a major pathogenic yeast in humans that is known to rapidly acquire resistance to triazole and echinocandin antifungal drugs. A mutator genotype (MSH2 polymorphism) inducing a mismatch repair defect has been recently proposed to be responsible for resistance acquisition in C. glabrata clinical isolates. Our objectives were to evaluate the prevalence of antifungal resistance in a large cohort of patients in Saint-Louis hospital, Paris, France, some of whom were pre-exposed to antifungal drugs, as well as to determine whether MSH2 polymorphisms are associated with an increased rate of fluconazole or echinocandin resistance. We collected 268 isolates from 147 patients along with clinical data and previous antifungal exposure. Fluconazole and micafungin minimal inhibition concentrations (MICs) were tested, short tandem repeat genotyping was performed, and the MSH2 gene was sequenced. According to the European Committee on Antimicrobial Susceptibility breakpoints, 15.7% of isolates were resistant to fluconazole (MIC > 32 mg/L) and 0.7% were resistant to micafungin (MIC > 0.03 mg/L). A non-synonymous mutation within MSH2 occurred in 44% of the isolates, and 17% were fluconazole resistant. In comparison, fluconazole resistant isolates with no MSH2 mutation represented 15% (P = 0.65). MSH2 polymorphisms were associated with the short tandem repeat genotype. The rate of echinocandin resistance is low and correlates with prior exposure to echinocandin. The mutator genotype was not associated with enrichment in fluconazole resistance but instead corresponded to rare and specific genotypes.
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Affiliation(s)
- Sarah Dellière
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Kelley Healey
- Public Health Research Institute, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers Newark, NJ, USA
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-WidalParis, France; Université Paris Diderot, Sorbonne Paris CitéParis, France
| | - Bastien Carrara
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Alessandro Barbaro
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Christophe Lecefel
- Service de Pharmacie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Sophie Touratier
- Service de Pharmacie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Marie Desnos-Ollivier
- Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de la Recherche Scientifique, Centre National de Référence Mycoses Invasives et Antifongiques, URA3012 Paris, France
| | - David S Perlin
- Public Health Research Institute, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers Newark, NJ, USA
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-WidalParis, France; Université Paris Diderot, Sorbonne Paris CitéParis, France; Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de la Recherche Scientifique, Centre National de Référence Mycoses Invasives et Antifongiques, URA3012Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-WidalParis, France; Université Paris Diderot, Sorbonne Paris CitéParis, France; Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de la Recherche Scientifique, Centre National de Référence Mycoses Invasives et Antifongiques, URA3012Paris, France
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Valero C, Buitrago MJ, Gits-Muselli M, Benazra M, Sturny-Leclère A, Hamane S, Guigue N, Bretagne S, Alanio A. Copy Number Variation of Mitochondrial DNA Genes in Pneumocystis jirovecii According to the Fungal Load in BAL Specimens. Front Microbiol 2016; 7:1413. [PMID: 27672381 PMCID: PMC5018473 DOI: 10.3389/fmicb.2016.01413] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/25/2016] [Indexed: 01/09/2023] Open
Abstract
Pneumocystis jirovecii is an unculturable fungus and the causative agent of Pneumocystis pneumonia, a life-threatening opportunistic infection. Although molecular diagnosis is often based on the detection of mtLSU rRNA mitochondrial gene, the number of copies of mitochondrial genes had not been investigated. We developed and optimized six real-time PCR assays in order to determine the copy number of four mitochondrial genes (mtSSU rRNA, mtLSU rRNA, NAD1, and CYTB) in comparison to nuclear genome (DHPS and HSP70) and tested 84 bronchoalveolar fluids of patients at different stages of the infection. Unexpectedly, we found that copy number of mitochondrial genes varied from gene to gene with mtSSU rRNA gene being more represented (37 copies) than NAD1 (23 copies), mtLSU rRNA (15 copies) and CYTB (6 copies) genes compared to nuclear genome. Hierarchical clustering analysis (HCA) allowed us to define five major clusters, significantly associated with fungal load (p = 0.029), in which copy number of mitochondrial genes was significantly different among them. More importantly, copy number of mtLSU rRNA, NAD1, and CYTB but not mtSSU rRNA differed according to P. jirovecii physiological state with a decreased number of copies when the fungal load is low. This suggests the existence of a mixture of various subspecies of mtDNA that can harbor different amplification rates. Overall, we revealed here an unexpected variability of P. jirovecii mtDNA copy number that fluctuates according to P. jirovecii’s physiological state, except for mtSSU that is the most stable and the most present mitochondrial gene.
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Affiliation(s)
- Clara Valero
- Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III Madrid, Spain
| | - María José Buitrago
- Servicio de Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III Madrid, Spain
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique - Hôpitaux de ParisParis, France; Sorbonne Paris Cité, Université Paris DiderotParis, France
| | - Marion Benazra
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Institut Pasteur Paris, France
| | - Aude Sturny-Leclère
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Institut Pasteur Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique - Hôpitaux de Paris Paris, France
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique - Hôpitaux de Paris Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique - Hôpitaux de ParisParis, France; Sorbonne Paris Cité, Université Paris DiderotParis, France; Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Institut PasteurParis, France; CNRS URA3012Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique - Hôpitaux de ParisParis, France; Sorbonne Paris Cité, Université Paris DiderotParis, France; Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Institut PasteurParis, France; CNRS URA3012Paris, France
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Legrand M, Gits-Muselli M, Boutin L, Garcia-Hermoso D, Maurel V, Soussi S, Benyamina M, Ferry A, Chaussard M, Hamane S, Denis B, Touratier S, Guigue N, Fréalle E, Jeanne M, Shaal JV, Soler C, Mimoun M, Chaouat M, Lafaurie M, Mebazaa A, Bretagne S, Alanio A. Detection of Circulating Mucorales DNA in Critically Ill Burn Patients: Preliminary Report of a Screening Strategy for Early Diagnosis and Treatment. Clin Infect Dis 2016; 63:1312-1317. [PMID: 27535951 DOI: 10.1093/cid/ciw563] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [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: 05/02/2016] [Accepted: 07/13/2016] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Invasive wound mucormycosis (IWM) is associated with an extremely poor outcome among critically ill burn patients. We describe the detection of circulating Mucorales DNA (cmDNA) for the early diagnosis of IWM in those patients and report the potential value of detecting cmDNA for treatment guidance. METHODS Severely ill burn patients admitted to our tertiary referral center between October 2013 and February 2016 were included. Retrospective plasma samples were tested for the presence of cmDNA by quantitative real-time polymerase chain reaction (qPCR). Patients were then prospectively screened twice a week, and liposomal amphotericin-B therapy initiated based on a positive qPCR. The primary endpoint was the time between cmDNA detection and standard diagnosis. Secondary endpoints were the time from cmDNA detection and treatment initiation and mortality. RESULTS Seventy-seven patients (418 samples) were included. The average age was 46 (28-60) years, abbreviated burn severity index was 8 (7-10), and simplified acute physiology score was 33 (23-46). The total body surface area was 33% (22%-52%). cmDNA was detected 11 (4.5-15) days before standard diagnosis. The in-hospital mortality was 62% for patients with IWM and 24% for those without (P = .03). The mortality due to IWM was 80% during period A and 33% during period B (P = .46). CONCLUSIONS This study suggests that the detection of cmDNA allows earlier diagnosis of IWM in severely ill burn patients and earlier initiation of treatment. Further studies are needed to confirm the impact of earlier treatment initiation on patient outcome.
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Affiliation(s)
- Matthieu Legrand
- Anesthesiology, Critical Care and Burn Unit, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.,Université Paris Diderot, Sorbonne Paris Cité.,UMR 942, INSERM
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Louis Boutin
- Anesthesiology, Critical Care and Burn Unit, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Dea Garcia-Hermoso
- Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de Référence Mycoses Invasives et Antifongiques.,CNRS URA3012
| | - Véronique Maurel
- Anesthesiology, Critical Care and Burn Unit, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Sabri Soussi
- Anesthesiology, Critical Care and Burn Unit, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Mourad Benyamina
- Anesthesiology, Critical Care and Burn Unit, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Axelle Ferry
- Anesthesiology, Critical Care and Burn Unit, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Maïté Chaussard
- Anesthesiology, Critical Care and Burn Unit, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Blandine Denis
- Service de Maladies Infectieuses et Tropicales, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Sophie Touratier
- Pharmacie, Hôpital St-Louis, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Emilie Fréalle
- Univ. Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, CNRS, UMR 8204, Inserm, U1019, CHU Lille, Laboratoire de Parasitologie- Mycologie, Institut Pasteur de Lille
| | - Mathieu Jeanne
- CHU Lille, Centre de Traitement des Brûlés, Pôle d'Anesthésie-Réanimation, Lille
| | | | - Charles Soler
- Service de Biologie médicale, Hopital d'instruction des Armées, Clamart
| | - Maurice Mimoun
- Université Paris Diderot, Sorbonne Paris Cité.,Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Marc Chaouat
- Université Paris Diderot, Sorbonne Paris Cité.,Service de chirurgie plastique, reconstructrice, esthétique et traitement chirurgical des brûlés, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Matthieu Lafaurie
- Service de Maladies Infectieuses et Tropicales, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal
| | - Alexandre Mebazaa
- Anesthesiology, Critical Care and Burn Unit, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.,Université Paris Diderot, Sorbonne Paris Cité.,UMR 942, INSERM
| | - Stéphane Bretagne
- Université Paris Diderot, Sorbonne Paris Cité.,Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.,Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de Référence Mycoses Invasives et Antifongiques.,CNRS URA3012
| | - Alexandre Alanio
- Université Paris Diderot, Sorbonne Paris Cité.,Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.,Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de Référence Mycoses Invasives et Antifongiques.,CNRS URA3012
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Alanio A, Sturny-Leclère A, Benabou M, Guigue N, Bretagne S. Variation in copy number of the 28S rDNA of Aspergillus fumigatus measured by droplet digital PCR and analog quantitative real-time PCR. J Microbiol Methods 2016; 127:160-163. [DOI: 10.1016/j.mimet.2016.06.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 06/11/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
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Germi R, Guigue N, Lupo J, Semenova T, Grossi L, Vermeulen O, Epaulard O, de Fraipont F, Morand P. Methylation of Epstein-Barr virus Rta promoter in EBV primary infection, reactivation and lymphoproliferation. J Med Virol 2016; 88:1814-20. [PMID: 26990870 DOI: 10.1002/jmv.24524] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2016] [Indexed: 11/09/2022]
Abstract
During Epstein-Barr virus (EBV) latency, the EBV genome is largely silenced by methylation. This silencing is overturned during the switch to the lytic cycle. A key event is the production of the viral protein Zta which binds to three Zta-response elements (ZRE) from the Rta promoter (Rp), two of which (ZRE2 and ZRE3) include three CpG motifs methylated in the latent genome. The bisulphite pyrosequencing reaction was used to quantify the methylation of ZRE2, ZRE3a, and ZRE3b in EBV-positive cell lines and in ex vivo samples of EBV-related diseases, in order to assess whether the level of methylation in these ZREs could provide additional information to viral DNA load and serology in the characterization of EBV-associated diseases. In PBMC from two patients with infectious mononucleosis, over time Rp became increasingly methylated whereas EBV load decreased. In tonsil from patients with chronic tonsillitis, the methylation was less than in EBV-associated tumors, regardless of the viral load. This was even more striking when only the ZRE3a and ZRE3b were considered since some samples presented unbalanced profiles on ZRE2. EBV reactivation in cell culture showed that the reduction in the overall level of methylation was closely related to the production of unmethylated virions. Thus, an assessment of the level of methylation may help to better characterize EBV replication in PBMC and in biopsies with high EBV load, during infectious mononucleosis and EBV-associated cancers. J. Med. Virol. 88:1814-1820, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Raphaële Germi
- Univ. Grenoble Alpes UMI 3265 UJF-CNRS EMBL, UVHCI, Grenoble, France.,Department of Virology, Grenoble Alpes University Hospital, Grenoble, France
| | - Nicolas Guigue
- Univ. Grenoble Alpes UMI 3265 UJF-CNRS EMBL, UVHCI, Grenoble, France.,Department of Virology, Grenoble Alpes University Hospital, Grenoble, France
| | - Julien Lupo
- Univ. Grenoble Alpes UMI 3265 UJF-CNRS EMBL, UVHCI, Grenoble, France.,Department of Virology, Grenoble Alpes University Hospital, Grenoble, France
| | - Touyana Semenova
- Univ. Grenoble Alpes UMI 3265 UJF-CNRS EMBL, UVHCI, Grenoble, France.,Department of Virology, Grenoble Alpes University Hospital, Grenoble, France
| | - Laurence Grossi
- Univ. Grenoble Alpes UMI 3265 UJF-CNRS EMBL, UVHCI, Grenoble, France
| | - Odile Vermeulen
- Department of Cancer Clinical Chemistry, Grenoble Alpes University Hospital, Grenoble, France
| | - Olivier Epaulard
- Univ. Grenoble Alpes UMI 3265 UJF-CNRS EMBL, UVHCI, Grenoble, France.,Department of Infectious Diseases, Grenoble Alpes University Hospital, Grenoble, France
| | - Florence de Fraipont
- Department of Cancer Clinical Chemistry, Grenoble Alpes University Hospital, Grenoble, France
| | - Patrice Morand
- Univ. Grenoble Alpes UMI 3265 UJF-CNRS EMBL, UVHCI, Grenoble, France.,Department of Virology, Grenoble Alpes University Hospital, Grenoble, France
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Gits-Muselli M, Peraldi MN, de Castro N, Delcey V, Menotti J, Guigue N, Hamane S, Raffoux E, Bergeron A, Valade S, Molina JM, Bretagne S, Alanio A. New Short Tandem Repeat-Based Molecular Typing Method for Pneumocystis jirovecii Reveals Intrahospital Transmission between Patients from Different Wards. PLoS One 2015; 10:e0125763. [PMID: 25933203 PMCID: PMC4416908 DOI: 10.1371/journal.pone.0125763] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/26/2015] [Indexed: 12/26/2022] Open
Abstract
Pneumocystis pneumonia is a severe opportunistic infection in immunocompromised patients caused by the unusual fungus Pneumocystis jirovecii. Transmission is airborne, with both immunocompromised and immunocompetent individuals acting as a reservoir for the fungus. Numerous reports of outbreaks in renal transplant units demonstrate the need for valid genotyping methods to detect transmission of a given genotype. Here, we developed a short tandem repeat (STR)-based molecular typing method for P. jirovecii. We analyzed the P. jirovecii genome and selected six genomic STR markers located on different contigs of the genome. We then tested these markers in 106 P. jirovecii PCR-positive respiratory samples collected between October 2010 and November 2013 from 91 patients with various underlying medical conditions. Unique (one allele per marker) and multiple (more than one allele per marker) genotypes were observed in 34 (32%) and 72 (68%) samples, respectively. A genotype could be assigned to 55 samples (54 patients) and 61 different genotypes were identified in total with a discriminatory power of 0.992. Analysis of the allelic distribution of the six markers and minimum spanning tree analysis of the 61 genotypes identified a specific genotype (Gt21) in our hospital, which may have been transmitted between 10 patients including six renal transplant recipients. Our STR-based molecular typing method is a quick, cheap and reliable approach to genotype Pneumocystis jirovecii in hospital settings and is sensitive enough to detect minor genotypes, thus enabling the study of the transmission and pathophysiology of Pneumocystis pneumonia.
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Affiliation(s)
- Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Marie-Noelle Peraldi
- Service de transplantation rénale, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
| | - Nathalie de Castro
- Service de Maladie Infectieuses et tropicales, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Véronique Delcey
- Service de Médecine interne, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Hôpital Lariboisière, Paris, France
| | - Jean Menotti
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France
- CNRS URA3012, Paris, France
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Emmanuel Raffoux
- Service d’Hématologie adulte, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Anne Bergeron
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Service de Pneumologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Sandrine Valade
- Service de Réanimation, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Jean-Michel Molina
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Service de Maladie Infectieuses et tropicales, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France
- CNRS URA3012, Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
- Université Paris-Diderot, Sorbonne Cité, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France
- CNRS URA3012, Paris, France
- * E-mail:
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Guigue N, Lardeux S, Alanio A, Hamane S, Tabouret M, Bretagne S. Importance of operational factors in the reproducibility of Aspergillus galactomannan enzyme immune assay. PLoS One 2015; 10:e0124044. [PMID: 25860967 PMCID: PMC4393237 DOI: 10.1371/journal.pone.0124044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 03/10/2015] [Indexed: 11/18/2022] Open
Abstract
Background The Platelia Aspergillus Ag assay (Bio-Rad) is designed for detecting Aspergillus galactomannan (GM) and is widely used for diagnosing invasive aspergillosis but is hampered by variable occurrences of unreproducible positive results. Frequency and origin of these unreproducible results have not been formally studied. Methods Different technicians simultaneously performed four tests on 550 consecutive sera from adult patients (Test#1-Test#2 for extraction#1 and Test#3-Test#4 for extraction#2). The samples were classified as confirmed negative [all tests with GM optical density index (GM-ODI) <0.5], confirmed positive (all tests with GM-ODI ≥0.5), extraction unreproducible positive (Test#1 and Test#2 ODIs ≥0.5, and Test#3 and Test#4 GM-ODIs <0.5, or conversely), and ELISA unreproducible positive (only one test with GM-ODI ≥0.5). The samples with positive and negative GM-ODIs within the assay coefficient of variation values were classified as non-conclusive. Four similar additional tests were performed after ≤72h storage at 4°C and a new GM test after 8 months at -20°C. Results Five-hundred-twenty sera (94.5%) were confirmed negative, 15 (2.7%) confirmed positive, 4 (0.7%) extraction unreproducible positive, 6 (1.1%) ELISA unreproducible positive, and 5 (0.9%) non-conclusive. Upon retesting, the unreproducible positive results turned negative except for one which turned non-conclusive. The confirmed positive and non-conclusive had similar GM-ODIs (p>0.4) upon retesting after storage ≤72h at 4°C (n = 20) or eight months at -20°C (n = 17). Conclusions Operational unreproducible positives represent 33% of the GM-positive results and a second sample evaluation appears mandatory to avoid useless investigations or treatments. When operational artifacts are excluded, GM remains stable at standard storage conditions.
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Affiliation(s)
- Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, Groupe hospitalier Lariboisière-Saint Louis, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | | | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, Groupe hospitalier Lariboisière-Saint Louis, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- CNRS URA3012, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie-Mycologie, Groupe hospitalier Lariboisière-Saint Louis, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | | | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Groupe hospitalier Lariboisière-Saint Louis, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- CNRS URA3012, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Paris, France
- * E-mail:
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Guigue N, Alanio A, Menotti J, Castro ND, Hamane S, Peyrony O, LeGoff J, Bretagne S. Utility of adding Pneumocystis jirovecii DNA detection in nasopharyngeal aspirates in immunocompromised adult patients with febrile pneumonia. Med Mycol 2014; 53:241-7. [PMID: 25550391 PMCID: PMC7107570 DOI: 10.1093/mmy/myu087] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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] [Indexed: 11/21/2022] Open
Abstract
Detection of viral and bacterial DNA in nasopharyngeal aspirates (NPAs) is now a routine practice in emergency cases of febrile pneumonia. We investigated whether
Pneumocystis jirovecii
DNA could also be detected in these cases by conducting retrospective screening of 324 consecutive NPAs from 324 adult patients (198 or 61% were immunocompromised) admitted with
suspected pulmonary infections during the 2012 influenza epidemic season, using a real-time quantitative polymerase chain reaction (PCR) assay (PjqPCR), which targets the
P. jirovecii
mitochondrial large subunit ribosomal RNA gene. These NPAs had already been tested for 22 respiratory pathogens (18 viruses and 4 bacteria), but we found that 16 NPAs (4.9%) were PjqPCR-positive, making
P. jirovecii
the fourth most prevalent of the 23 microorganisms in the screen. Eleven of the 16 PjqPCR-positive patients were immunocompromised, and five had underlying pulmonary conditions. Nine NPAs were also positive for another respiratory pathogen. Six had PjqPCR-positive induced sputa less than 3 days after the NPA procedure, and five were diagnosed with pneumocystis pneumonia (four with chronic lymphoproliferative disorders and one AIDS patient). In all six available pairs quantification of
P. jirovecii
DNA showed fewer copies in NPA than in induced sputum and three PjqPCR-negative NPAs corresponded to PjqPCR-positive bronchoalveolar lavage fluids, underscoring the fact that a negative PjqPCR screen does not exclude a diagnosis of pneumocystosis. Including
P. jirovecii
DNA detection to the panel of microorganisms included in screening tests used for febrile pneumonia may encourage additional investigations or support use of anti-pneumocystis pneumonia prophylaxis in immunocompromised patients.
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Affiliation(s)
- Nicolas Guigue
- Laboratoire de Parasitologie et de Mycologie, APHP, Hôpital Saint Louis Université Paris Diderot, Sorbonne Paris Cité
| | - Alexandre Alanio
- Laboratoire de Parasitologie et de Mycologie, APHP, Hôpital Saint Louis Université Paris Diderot, Sorbonne Paris Cité CNRS URA3012 Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Paris, France
| | - Jean Menotti
- Laboratoire de Parasitologie et de Mycologie, APHP, Hôpital Saint Louis Université Paris Diderot, Sorbonne Paris Cité CNRS URA3012
| | - Nathalie De Castro
- Université Paris Diderot, Sorbonne Paris Cité Service de maladies infectieuses, APHP, Hôpital Saint Louis
| | - Samia Hamane
- Laboratoire de Parasitologie et de Mycologie, APHP, Hôpital Saint Louis
| | | | - Jérôme LeGoff
- Université Paris Diderot, Sorbonne Paris Cité Laboratoire de Microbiologie, APHP, Hôpital Saint Louis
| | - Stéphane Bretagne
- Laboratoire de Parasitologie et de Mycologie, APHP, Hôpital Saint Louis Université Paris Diderot, Sorbonne Paris Cité CNRS URA3012 Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, Paris, France
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Gits-Muselli M, Menotti J, Guigue N, Hamane S, Bretagne S, Alanio A. Nouvelle méthode de typage moléculaire de Pneumocystis jirovecii par analyse de marqueurs microsatellites. J Mycol Med 2014. [DOI: 10.1016/j.mycmed.2014.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Guigue N, Menotti J, Alanio A, Le Goff J, Bretagne S. Une PCR quantitative positive a Pneumocystis jirovecii dans une aspiration naso-pharyngée est évocatrice d’une pneumocystose pulmonaire chez des patients avec atteinte pulmonaire fébrile. J Mycol Med 2014. [DOI: 10.1016/j.mycmed.2014.01.047] [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: 10/25/2022]
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Hickman G, Pape E, Delaporte E, Aubin F, Sendid B, Tubach F, Guigue N, Derouin F, Garin Y, Petit A, Viguier M, Bachelez H. Étude prospective de prévalence des anticorps sériques anti Saccharomyces cerevisiae (ASCA) chez 71 patients atteints d’hidradénite suppurée (HS). Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.068] [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: 11/28/2022]
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Hédon B, Déchaud H, Galtler-Dereure F, Guigue N. F-007. How to evaluate the ovarian reserve in 1999? Hum Reprod 1999. [DOI: 10.1093/humrep/14.suppl_3.382] [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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Hédon B, Dechaud H, Galtier-Dereure F, Guigue N. [How to assess ovarian reserve in 1999?]. Contracept Fertil Sex 1999; 27:412-6. [PMID: 10431446] [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] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Fertility and results of infertility therapies are submitted to amajor drop in relation with the age of the female patient and her so-called ovarian reserve. Although there is no clear definition of what is exactly the ovarian reserve, the consequence of its decline is a greater difficulty to produce ovocytes with a capacity of becoming living embryos after fertilization. Several tests have been developed to assess the ovarian reserve in order to evaluate the prognosis of spontaneous fertility, the results of infertility therapy and assisted procreation techniques, and to make necessary technical adaptations. Basal determinations of FSH, estradiol and inhibin B at day 3 of the cycle an all reflect the ovarian potential, but only FSH reflects a decline infecundability reliable enough to be used as a screening test. Challenge tests such as the clomiphene citrate, the exogenous FSH or the GnRH challenge tests have the purpose to reveal an exaggerated liberation of FSH or an insufficient secretion of estradiol after stimulation. None of these tests have demonstrated a better sensibility together with a higher specificity and they should be considered as evaluating tools in specific cases only. In conclusion, assessing the ovarian reserve has become a clinical necessity in the following situations: ovulation defect, unexplained infertility, before undergoing ovarian stimulation for assisted procreation, in particular in women above the age of 35. This assessment can be made by determining the basal FSH level on day 3 of a cycle and should be renewed every year.
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Affiliation(s)
- B Hédon
- Service de Gynécologie-Obstétrique, Faculté de Médecine, Université Montpellier 1, Centre Hospitalier Universitaire A
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Biron C, Andréani H, Blanc P, Ramos J, Ducos J, Guigue N, Michel H, Larrey D, Schved JF. Prevalence of antiphospholipid antibodies in patients with chronic liver disease related to alcohol or hepatitis C virus: correlation with liver injury. J Lab Clin Med 1998; 131:243-50. [PMID: 9523848 DOI: 10.1016/s0022-2143(98)90096-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Antiphospholipid antibodies (APAs) have been reported in various clinical conditions. However, the pathogenesis and clinical significance of these antibodies are still unclear. The objective of this study was to assess the prevalence of APAs in patients with chronic alcohol- or hepatitis C virus (HCV)-related liver disease and to evaluate their relation to the underlying liver disease. We prospectively studied 201 patients referred to an hepato-gastroenterology department, including 77 patients with a history of alcohol abuse (group I) and 124 with chronic HCV infection (group II), and 107 healthy subjects (control population). Liver biopsy was performed in all patients. In cirrhotic patients, the severity of the liver disease was assessed with the use of Child's classification, as modified by Pugh. Several biologic parameters, including lupus anticoagulant and anticardiolipin antibodies, were determined. Forty-eight percent of patients in group I and 33% of those in group II had APAs. Among cirrhotic patients, APAs were more frequent in patients with Child grade B or C than in those with grade A severity. In patients with chronic HCV-related liver disease, a correlation was found between APA levels and liver fibrosis (P = 0.009); no relation was found between APA levels and histologic liver disease activity (P = 0.25). In the control group, one subject was APA-positive. None had lupus anticoagulant. APAs seem to be frequently associated with chronic liver disease of various causes. These results suggest further investigations on the potential role of these antibodies in fibrosis or liver injury.
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Affiliation(s)
- C Biron
- Department of Hepato-Gastroenterology, Hôpital Universitaire Saint Eloi, Montpellier, France
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