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De Paepe R, Normand AC, Uhrlaß S, Nenoff P, Piarroux R, Packeu A. Resistance Profile, Terbinafine Resistance Screening and MALDI-TOF MS Identification of the Emerging Pathogen Trichophyton indotineae. Mycopathologia 2024; 189:29. [PMID: 38483637 PMCID: PMC10940462 DOI: 10.1007/s11046-024-00835-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/25/2024] [Indexed: 03/17/2024]
Abstract
The emerging pathogen Trichophyton indotineae, often resistant to terbinafine (TRB), is known to cause severe dermatophytoses such as tinea corporis and tinea cruris. In order to achieve successful treatment for these infections, insight in the resistance profile of T. indotineae strains and rapid, reliable identification is necessary. In this research, a screening medium was tested on T. indotineae strains (n = 20) as an indication tool of TRB resistance. The obtained results were confirmed by antifungal susceptibility testing (AST) for TRB following the in vitro broth microdilution reference method. Additionally, AST was performed for eight other antifungal drugs: fluconazole, itraconazole, voriconazole, ketoconazole, griseofulvin, ciclopirox olamine, naftifine and amorolfine. Forty-five percent of the strains were confirmed to be resistant to terbinafine. The TRB resistant strains showed elevated minimal inhibitory concentration values for naftifine and amorolfine as well. DNA sequencing of the squalene epoxidase-encoding gene showed that TRB resistance was a consequence of missense point mutations in this gene, which led to amino acid substitutions F397L or L393F. MALDI-TOF MS was used as a quick, accurate identification tool for T. indotineae, as it can be challenging to distinguish it from closely related species such as Trichophyton mentagrophytes or Trichophyton interdigitale using morphological characteristics. While MALDI-TOF MS could reliably identify ≥ 95% of the T. indotineae strains (depending on the spectral library), it could not be used to successfully distinguish TRB susceptible from TRB resistant strains.
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Affiliation(s)
- Roelke De Paepe
- Mycology and Aerobiology Department, Sciensano, 1050, Brussels, Belgium.
| | - Anne-Cécile Normand
- Parasitology/Mycology Department, AP-HP, Hôpitaux de Paris, 75013, Paris, France
| | - Silke Uhrlaß
- Labopart Medical Laboratories Leipzig-Mölbis, 04571, Rötha OT Mölbis, Germany
| | - Pietro Nenoff
- Labopart Medical Laboratories Leipzig-Mölbis, 04571, Rötha OT Mölbis, Germany
| | - Renaud Piarroux
- Parasitology/Mycology Department, AP-HP, Hôpitaux de Paris, 75013, Paris, France
| | - Ann Packeu
- Mycology and Aerobiology Department, Sciensano, 1050, Brussels, Belgium
- BCCM/IHEM Fungal Collection, Mycology and Aerobiology Section, Sciensano, 1050, Brussels, Belgium
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Mohammad N, Huguenin A, Lefebvre A, Menvielle L, Toubas D, Ranque S, Villena I, Tannier X, Normand AC, Piarroux R. Nosocomial transmission of Aspergillus flavus in a neonatal intensive care unit: Long-term persistence in environment and interest of MALDI-ToF mass-spectrometry coupled with convolutional neural network for rapid clone recognition. Med Mycol 2024; 62:myad136. [PMID: 38142226 DOI: 10.1093/mmy/myad136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/28/2023] [Accepted: 12/21/2023] [Indexed: 12/25/2023] Open
Abstract
Aspergillosis of the newborn remains a rare but severe disease. We report four cases of primary cutaneous Aspergillus flavus infections in premature newborns linked to incubators contamination by putative clonal strains. Our objective was to evaluate the ability of matrix-assisted laser desorption/ionisation time of flight (MALDI-TOF) coupled to convolutional neural network (CNN) for clone recognition in a context where only a very small number of strains are available for machine learning. Clinical and environmental A. flavus isolates (n = 64) were studied, 15 were epidemiologically related to the four cases. All strains were typed using microsatellite length polymorphism. We found a common genotype for 9/15 related strains. The isolates of this common genotype were selected to obtain a training dataset (6 clonal isolates/25 non-clonal) and a test dataset (3 clonal isolates/31 non-clonal), and spectra were analysed with a simple CNN model. On the test dataset using CNN model, all 31 non-clonal isolates were correctly classified, 2/3 clonal isolates were unambiguously correctly classified, whereas the third strain was undetermined (i.e., the CNN model was unable to discriminate between GT8 and non-GT8). Clonal strains of A. flavus have persisted in the neonatal intensive care unit for several years. Indeed, two strains of A. flavus isolated from incubators in September 2007 are identical to the strain responsible for the second case that occurred 3 years later. MALDI-TOF is a promising tool for detecting clonal isolates of A. flavus using CNN even with a limited training set for limited cost and handling time.
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Affiliation(s)
- Noshine Mohammad
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Paris, France
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
| | - Antoine Huguenin
- Laboratoire de Parasitologie-Mycologie, Pôle de Biologie et de Pathologie, CHU de Reims, Reims, France
- Université de Reims Champagne Ardenne, ESCAPE EA7510, Reims, France
| | | | - Laura Menvielle
- CHU de Reims, Hôpital Américain, Service de réanimation néonatale, 45 rue Cognaq Jay, Reims, France
| | - Dominique Toubas
- Laboratoire de Parasitologie-Mycologie, Pôle de Biologie et de Pathologie, CHU de Reims, Reims, France
- Université de Reims Champagne Ardenne, ESCAPE EA7510, Reims, France
- Equipe Opérationnelle d'Hygiène, CHU de Reims, France
- CHU de Reims, Hôpital Américain, Service de réanimation néonatale, 45 rue Cognaq Jay, Reims, France
- BioSpecT (Translational BioSpectroscopy) EA 7506, SFR Santé, Université de Reims Champagne-Ardenne, Reims, France
| | - Stéphane Ranque
- IHU-Méditerranée Infection, Marseille, France
- Aix-Marseille Université, AP-HM, IRD, SSA, VITROME, Marseille, France
| | - Isabelle Villena
- Laboratoire de Parasitologie-Mycologie, Pôle de Biologie et de Pathologie, CHU de Reims, Reims, France
- Université de Reims Champagne Ardenne, ESCAPE EA7510, Reims, France
| | - Xavier Tannier
- Sorbonne Université, INSERM, Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et d'Ingénierie des connaissances en e-Santé, LIMICS, Paris, France
| | - Anne-Cécile Normand
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
| | - Renaud Piarroux
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Paris, France
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
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Jabet A, Normand AC, Brun S, Dannaoui E, Bachmeyer C, Piarroux R, Hennequin C, Moreno-Sabater A. Trichophyton indotineae, from epidemiology to therapeutic. J Mycol Med 2023; 33:101383. [PMID: 37031652 DOI: 10.1016/j.mycmed.2023.101383] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 11/12/2022] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023]
Abstract
Trichophyton indotineae is a newly described dermatophyte species. This fungal pathogen has recently emerged in India and is responsible for chronic or recurrent widespread superficial infections. Resistance to terbinafine is frequently associated to this pathogen and is related to point mutations in the gene encoding the squalene epoxidase. T. indotineae infections have been reported outside India, highlighting the risk of worldwide diffusion of this microorganism. Species identification and antifungal susceptibility determination are key points for infection control but still remain challenging. Systemic treatment is usually required and itraconazole is frequently prescribed in case of terbinafine resistance. This review summarizes main features of T. indotineae taxonomy, epidemiology, clinical manifestations, identification, antifungal profile, treatment and prevention.
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Affiliation(s)
- Arnaud Jabet
- Service de Parasitologie-Mycologie, Hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Service de Parasitologie-Mycologie, Hôpital La Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
| | - Anne-Cécile Normand
- Service de Parasitologie-Mycologie, Hôpital La Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - Sophie Brun
- Service de Parasitologie-Mycologie, Hôpital Avicenne, AP-HP, 93009 Bobigny, France
| | - Eric Dannaoui
- Unité de Parasitologie-Mycologie, Service de Microbiologie, Hôpital Necker, AP-HP, 75015 Paris, France; UR Dynamic 7380, UPEC, EnvA, USC ANSES, Faculté de Santé, 94000 Créteil, France; Faculté de Médecine, Université Paris Cité, 75006 Paris, France
| | - Claude Bachmeyer
- Service de Médecine interne, Hôpital Tenon, AP-HP, 75020 Paris, France
| | - Renaud Piarroux
- Service de Parasitologie-Mycologie, Hôpital La Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Sorbonne Université, 75013 Paris, France
| | - Christophe Hennequin
- Service de Parasitologie-Mycologie, Hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Centre de Recherche Saint-Antoine, CRSA, Inserm, Sorbonne Université, 75012 Paris, France
| | - Alicia Moreno-Sabater
- Service de Parasitologie-Mycologie, Hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Centre d'Immunologie et des Maladies Infectieuses, (CIMI-PARIS), Inserm U1135, Sorbonne, 75013 Paris, France
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Jabet A, Dellière S, Seang S, Chermak A, Schneider L, Chiarabini T, Teboul A, Hickman G, Bozonnat A, Brin C, Favier M, Tamzali Y, Chasset F, Barete S, Hamane S, Benderdouche M, Moreno-Sabater A, Dannaoui E, Hennequin C, Fekkar A, Piarroux R, Normand AC, Monsel G. Sexually Transmitted Trichophyton mentagrophytes Genotype VII Infection among Men Who Have Sex with Men. Emerg Infect Dis 2023; 29:1411-1414. [PMID: 37347803 PMCID: PMC10310379 DOI: 10.3201/eid2907.230025] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Transmission of dermatophytes, especially Trichophyton mentagrophytes genotype VII, during sexual intercourse has been recently reported. We report 13 such cases in France. All patients were male; 12 were men who have sex with men. Our findings suggest sexual transmission of this pathogen within a specific population, men who have sex with men.
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Nabet C, Brossas JY, Poignon C, Bouzidi A, Paris L, Touafek F, Varlet-Marie E, Sterkers Y, Passebosc-Faure K, Dardé ML, Piarroux R, Denis JA. Assessment of Droplet Digital PCR for the Detection and Absolute Quantification of Toxoplasma gondii: A Comparative Retrospective Study. J Mol Diagn 2023; 25:467-476. [PMID: 37068735 DOI: 10.1016/j.jmoldx.2023.03.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/16/2023] [Accepted: 03/30/2023] [Indexed: 04/19/2023] Open
Abstract
Accurate tools for Toxoplasma gondii detection and quantification can be valuable for the early and effective management of toxoplasmosis. Droplet digital PCR (ddPCR) is a next-generation end-point PCR technique with high performance. The objective of the study was to evaluate the performance of ddPCR for the detection and absolute quantification of T. gondii. From January 2019 to October 2020, DNA samples collected at the Laboratory of Parasitology and Mycology of Pitié-Salpêtrière Hospital in Paris were retrospectively analyzed by ddPCR and real-time quantitative PCR (qPCR). To detect T. gondii with the best sensitivity possible, the REP-529 multicopy target was used. For absolute quantification of T. gondii, a specific single-copy target of α-tubulin was designed. T. gondii detection by ddPCR and qPCR was strongly correlated (R2 = 0.93), with a total concordance of 96.7% (n = 145/150). Quantification of T. gondii using ddPCR was successful for 15 of 35 samples showing a parasite load ≥170 copies/mL of DNA eluate using the α-tubulin target. The qPCR REP-529 quantification based on a standard curve was approximate and dependent on the strain genotype, which led to an estimate of parasite copy number 14- to 160-fold superior to the ddPCR result. In total, ddPCR is an effective molecular method for T. gondii detection that shows equivalent performance to qPCR. For robust T. gondii quantification, ddPCR is clearly more accurate than semiquantitative qPCR methods.
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Affiliation(s)
- Cécile Nabet
- Sorbonne University, INSERM, Pierre-Louis Institute of Epidemiology and Public Health (IPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Parasitology and Mycology Department, Paris, France.
| | - Jean-Yves Brossas
- Sorbonne University, Parasitology and Mycology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Corentin Poignon
- Sorbonne University, Parasitology and Mycology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Amira Bouzidi
- Sorbonne University, INSERM, Research Unit on Cardiovascular and Metabolic Disease, Institut of Cardiometabolism and Nutrition (ICAN), Department of Endocrine Biochemistry and Oncology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Luc Paris
- Sorbonne University, Parasitology and Mycology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Feriel Touafek
- Sorbonne University, Parasitology and Mycology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Emmanuelle Varlet-Marie
- University of Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut de Rechercher pour le Développement (IRD), MiVEGEC, University Hospital of Montpellier, Molecular Biology Pole of the National Reference Centre (CNR) for Toxoplasmosis, Montpellier, France
| | - Yvon Sterkers
- University of Montpellier, Centre National de la Recherche Scientifique (CNRS), Institut de Rechercher pour le Développement (IRD), MiVEGEC, University Hospital of Montpellier, Molecular Biology Pole of the National Reference Centre (CNR) for Toxoplasmosis, Montpellier, France
| | - Karine Passebosc-Faure
- National Reference Centre (CNR) for Toxoplasmosis/Toxoplasma Biological Research Centre (BRC), Dupuytren University Hospital Centre, Limoges, France
| | - Marie-Laure Dardé
- National Reference Centre (CNR) for Toxoplasmosis/Toxoplasma Biological Research Centre (BRC), Dupuytren University Hospital Centre, Limoges, France; Limoges University, INSERM, University Hospital Centre Limoges, Institut de Recherche pour le Développement (IRD), Tropical Neuroepidemiology Unit, Institute of Epidemiology and Tropical Neurology, Limoges, France
| | - Renaud Piarroux
- Sorbonne University, INSERM, Pierre-Louis Institute of Epidemiology and Public Health (IPLESP), Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Parasitology and Mycology Department, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne University, INSERM, Saint-Antoine Research Centre, Cancer Biology and Therapeutics, Department of Endocrine Biochemistry and Oncology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
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Becker P, van den Eynde C, Baert F, D'hooge E, De Pauw R, Normand AC, Piarroux R, Stubbe D. Remarkable fungal biodiversity on northern Belgium bats and hibernacula. Mycologia 2023:1-15. [PMID: 37289484 DOI: 10.1080/00275514.2023.2213138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Bats can be affected by fungal pathogens such as Pseudogymnoascus destructans, the causative agent of the white-nose syndrome. Their body surface can also be colonized by fungal commensals or carry transient fungal species and participate in their dispersal. In this study, 114 bat specimens belonging to seven species were sampled from various locations in northern Belgium. Culture-based methods revealed an important mycological diversity, with a total of 209 different taxa out of the 418 isolates. Overall, a mean of 3.7 taxa per bat was recorded, but significant differences were observed between sampling sites and seasons. The mycobiomes were dominated by cosmopolitan and plant-associated species, in particular from the genera Cladosporium, Penicillium, and Aspergillus. Other species known to be related to bats or their environment, such as Apiotrichum otae, were also retrieved. Sampling of hibernacula indicated that diverse fungal species can inhabit these sites, including a yet undescribed Pseudogymnoascus species, distinct from Ps. destructans, namely, Ps. cavicola.
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Affiliation(s)
- Pierre Becker
- BCCM/IHEM Fungi Collection, Mycology and Aerobiology, Sciensano, Brussels 1050, Belgium
| | - Claudia van den Eynde
- Department of Enzootic, Vector-Borne and Bee Diseases, Sciensano, Brussels 1180, Belgium
| | - Frederik Baert
- BCCM/IHEM Fungi Collection, Mycology and Aerobiology, Sciensano, Brussels 1050, Belgium
| | - Elizabet D'hooge
- BCCM/IHEM Fungi Collection, Mycology and Aerobiology, Sciensano, Brussels 1050, Belgium
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, Brussels 1070, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent 9000, Belgium
| | - Anne-Cécile Normand
- INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Sorbonne Université, Paris 75013, France
| | - Renaud Piarroux
- INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Sorbonne Université, Paris 75013, France
| | - Dirk Stubbe
- BCCM/IHEM Fungi Collection, Mycology and Aerobiology, Sciensano, Brussels 1050, Belgium
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Zhou Y, Leahy K, Grose A, Lykins J, Siddiqui M, Leong N, Goodall P, Withers S, Ashi K, Schrantz S, Tesic V, Abeleda AP, Beavis K, Clouser F, Ismail M, Christmas M, Piarroux R, Limonne D, Chapey E, Abraham S, Baird I, Thibodeau J, Boyer K, Torres E, Conrey S, Wang K, Staat MA, Back N, Gomez Marin J, Peyron F, Houze S, Wallon M, McLeod R. Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more. medRxiv 2023:2023.04.26.23289132. [PMID: 37162985 PMCID: PMC10168490 DOI: 10.1101/2023.04.26.23289132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Congenital toxoplasmosis is a treatable, preventable disease, but untreated causes death, prematurity, loss of sight, cognition and motor function, and substantial costs worldwide. Methods/ Findings In our ongoing USA feasibility/efficacy clinical trial, data collated with other ongoing and earlier published results proved high performance of an Immunochromatographic-test(ICT) that enables accurate, rapid diagnosis/treatment, establishing new paradigms for care. Overall results from patient blood and/or serum samples tested with ICT compared with gold-standard-predicate-test results found ICT performance for 4606 sera/1876 blood, 99.3%/97.5% sensitive and 98.9%/99.7% specific. However, in the clinical trial the FDA-cleared-predicate test initially caused practical, costly problems due to false-positive-IgM results. For 58 persons, 3/43 seronegative and 2/15 chronically infected persons had false positive IgM predicate tests. This caused substantial anxiety, concerns, and required costly, delayed confirmation in reference centers. Absence of false positive ICT results contributes to solutions: Lyon and Paris France and USA Reference laboratories frequently receive sera with erroneously positive local laboratory IgM results impeding patient care. Therefore, thirty-two such sera referred to Lyon's Reference laboratory were ICT-tested. We collated these with other earlier/ongoing results: 132 of 137 USA or French persons had false positive local laboratory IgM results identified correctly as negative by ICT. Five false positive ICT results in Tunisia and Marseille, France, emphasize need to confirm positive ICT results with Sabin-Feldman-Dye-test or western blot. Separate studies demonstrated high performance in detecting acute infections, meeting FDA, CLIA, WHO ASSURED, CEMark criteria and patient and physician satisfaction with monthly-gestational-ICT-screening. Conclusions/Significance This novel paradigm using ICT identifies likely false positives or raises suspicion that a result is truly positive, rapidly needing prompt follow up and treatment. Thus, ICT enables well-accepted gestational screening programs that facilitate rapid treatment saving lives, sight, cognition and motor function. This reduces anxiety, delays, work, and cost at point-of-care and clinical laboratories. Author’s Summary Toxoplasmosis is a major health burden for developed and developing countries, causing damage to eyes and brain, loss of life and substantial societal costs. Prompt diagnosis in gestational screening programs enables treatment, thereby relieving suffering, and leading to > 14-fold cost savings for care. Herein, we demonstrate that using an ICT that meets WHO ASSURED-criteria identifying persons with/without antibody to Toxoplasma gondii in sera and whole blood with high sensitivity and specificity, is feasible to use in USA clinical practice. We find this new approach can help to obviate the problem of detection of false positive anti- T.gondii IgM results for those without IgG antibodies to T.gondii when this occurs in present, standard of care, predicate USA FDA cleared available assays. Thus, this accurate test facilitates gestational screening programs and a global initiative to diagnose and thereby prevent and treat T.gondii infection. This minimizes likelihood of false positives (IgG and/or IgM) while maintaining maximum sensitivity. When isolated IgM antibodies are detected, it is necessary to confirm and when indicated continue follow up testing in ∼2 weeks to establish seroconversion. Presence of a positive ICT makes it likely that IgM is truly positive and a negative ICT makes it likely that IgM will be a false positive without infection. These results create a new, enthusiastically-accepted, precise paradigm for rapid diagnosis and validation of results with a second-line test. This helps eliminate alarm and anxiety about false-positive results, while expediting needed treatment for true positive results and providing back up distinguishing false positive tests.
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Mohammad N, Normand AC, Nabet C, Godmer A, Brossas JY, Blaize M, Bonnal C, Fekkar A, Imbert S, Tannier X, Piarroux R. Improving the Detection of Epidemic Clones in Candida parapsilosis Outbreaks by Combining MALDI-TOF Mass Spectrometry and Deep Learning Approaches. Microorganisms 2023; 11:microorganisms11041071. [PMID: 37110493 PMCID: PMC10146746 DOI: 10.3390/microorganisms11041071] [Citation(s) in RCA: 2] [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: 03/14/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Identifying fungal clones propagated during outbreaks in hospital settings is a problem that increasingly confronts biologists. Current tools based on DNA sequencing or microsatellite analysis require specific manipulations that are difficult to implement in the context of routine diagnosis. Using deep learning to classify the mass spectra obtained during the routine identification of fungi by MALDI-TOF mass spectrometry could be of interest to differentiate isolates belonging to epidemic clones from others. As part of the management of a nosocomial outbreak due to Candida parapsilosis in two Parisian hospitals, we studied the impact of the preparation of the spectra on the performance of a deep neural network. Our purpose was to differentiate 39 otherwise fluconazole-resistant isolates belonging to a clonal subset from 56 other isolates, most of which were fluconazole-susceptible, collected during the same period and not belonging to the clonal subset. Our study carried out on spectra obtained on four different machines from isolates cultured for 24 or 48 h on three different culture media showed that each of these parameters had a significant impact on the performance of the classifier. In particular, using different culture times between learning and testing steps could lead to a collapse in the accuracy of the predictions. On the other hand, including spectra obtained after 24 and 48 h of growth during the learning step restored the good results. Finally, we showed that the deleterious effect of the device variability used for learning and testing could be largely improved by including a spectra alignment step during preprocessing before submitting them to the neural network. Taken together, these experiments show the great potential of deep learning models to identify spectra of specific clones, providing that crucial parameters are controlled during both culture and preparation steps before submitting spectra to a classifier.
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Affiliation(s)
- Noshine Mohammad
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, AP-HP, 75013 Paris, France
- INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Sorbonne Université, 75013 Paris, France
| | - Anne-Cécile Normand
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, AP-HP, 75013 Paris, France
| | - Cécile Nabet
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, AP-HP, 75013 Paris, France
- INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Sorbonne Université, 75013 Paris, France
| | - Alexandre Godmer
- CIMI-Paris, Centre d'Immunologie et des Maladies Infectieuses, UMR 1135, Sorbonne Université, 75013 Paris, France
- Département de Bactériologie, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 75012 Paris, France
| | - Jean-Yves Brossas
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, AP-HP, 75013 Paris, France
| | - Marion Blaize
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, AP-HP, 75013 Paris, France
- CIMI-Paris, Centre d'Immunologie et des Maladies Infectieuses, CNRS, INSERM, Sorbonne Université, 75013 Paris, France
| | - Christine Bonnal
- Service de Parasitologie Mycologie, Hôpital Bichat-Claude Bernard, AP-HP, 75018 Paris, France
| | - Arnaud Fekkar
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, AP-HP, 75013 Paris, France
- CIMI-Paris, Centre d'Immunologie et des Maladies Infectieuses, CNRS, INSERM, Sorbonne Université, 75013 Paris, France
| | - Sébastien Imbert
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Bordeaux, 33075 Bordeaux, France
| | - Xavier Tannier
- Sorbonne Université, Inserm, Laboratoire d'Informatique Médicale et d'Ingénierie des Connaissances en e-Santé, LIMICS, 75013 Paris, France
| | - Renaud Piarroux
- Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, AP-HP, 75013 Paris, France
- INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Sorbonne Université, 75013 Paris, France
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Imbert S, Normand AC, Costa D, Gabriel F, Lachaud L, Schuttler C, Cassaing S, Mahinc C, Hasseine L, Demar M, Brun S, Bonnal C, Moreno-Sabater A, Becker P, Piarroux R, Fekkar A. Multicentric Analysis of the Species Distribution and Antifungal Susceptibility of Clinical Isolates from Aspergillus Section Circumdati. Antimicrob Agents Chemother 2023; 67:e0146222. [PMID: 36892306 PMCID: PMC10112188 DOI: 10.1128/aac.01462-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/05/2023] [Indexed: 03/10/2023] Open
Abstract
The clinical involvement and antifungal susceptibility of Aspergillus section Circumdati are poorly known. We analyzed 52 isolates, including 48 clinical isolates, belonging to 9 species inside the section Circumdati. The whole section exhibited, by the EUCAST reference method, a poor susceptibility to amphotericin B, but species/series-specific patterns were observed for azole drugs. This underlines the interest in getting an accurate identification inside the section Circumdati to guide the choice of antifungal treatment in clinical practice.
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Affiliation(s)
- S. Imbert
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
- Sorbonne Université, Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Paris, France
| | - A. C. Normand
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
| | - D. Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie Mycologie, Rouen, France
| | - F. Gabriel
- Centre Hospitalier Universitaire de Bordeaux, Service de Parasitologie Mycologie, Bordeaux, France
| | - L. Lachaud
- Centre Hospitalier Universitaire de Montpellier, Service de Parasitologie Mycologie, Montpellier, France
| | | | - S. Cassaing
- Centre Hospitalier Universitaire de Toulouse, Service de Parasitologie Mycologie, Toulouse, France
| | - C. Mahinc
- Centre Hospitalier Universitaire de Saint Etienne, Service de Parasitologie Mycologie, Saint Etienne, France
| | - L. Hasseine
- Centre Hospitalier Universitaire de Nice, Service de Parasitologie Mycologie, Nice, France
| | - M. Demar
- Centre Hospitalier de Cayenne, Département de Parasitologie Mycologie, Cayenne, French Guiana
| | - S. Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie Mycologie, Bobigny, France
| | - C. Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie Mycologie, Paris, France
| | - A. Moreno-Sabater
- AP-HP, Hôpital Saint-Antoine, Service de Parasitologie Mycologie, Paris, France
| | - P. Becker
- Service of Mycology and Aerobiology, BCCM/IHEM Fungal Collection, Brussels, Belgium
| | - R. Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
| | - A. Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
- Sorbonne Université, Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Paris, France
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10
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Le Goff M, Kendjo E, Thellier M, Piarroux R, Boelle PY, Jauréguiberry S. Impact of Chemoprophylaxis on Plasmodium vivax and Plasmodium ovale Infection Among Civilian Travelers: A Nested Case-Control Study With a Counterfactual Approach on 862 Patients. Clin Infect Dis 2023; 76:e884-e893. [PMID: 35962785 DOI: 10.1093/cid/ciac641] [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: 04/18/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The impact of chemoprophylaxis targeting Plasmodium falciparum on Plasmodium vivax and Plasmodium ovale, which may remain quiescent as hypnozoites in the liver, is debated. METHODS We conducted a nested case-control analysis of the outcomes of P. vivax and P. ovale infections in imported malaria cases in France among civilian travelers from 1 January 2006, to 31 December 2017. Using adjusted logistic regression, we assessed the effect of chemoprophylaxis on the incubation period, time from symptoms to diagnosis, management, blood results, symptoms, and hospitalization duration. We analyzed the effect of blood-stage drugs (doxycycline, mefloquine, chloroquine, chloroquine-proguanil) or atovaquone-proguanil on the incubation period. We used a counterfactual approach to ascertain the causal effect of chemoprophylaxis on postinfection characteristics. RESULTS Among 247 P. vivax- and 615 P. ovale-infected travelers, 30% and 47%, respectively, used chemoprophylaxis, and 7 (3%) and 8 (1%) were severe cases. Chemoprophylaxis users had a greater risk of presenting symptoms >2 months after returning for both species (P. vivax odds ratio [OR], 2.91 [95% confidence interval {CI}, 1.22-6.95], P = .02; P. ovale OR, 2.28 [95% CI, 1.47-3.53], P < .001). Using drugs only acting on the blood stage was associated with delayed symptom onset after 60 days, while using atovaquone-proguanil was not. CONCLUSIONS Civilian travelers infected with P. vivax or P. ovale reporting chemoprophylaxis use, especially of blood-stage agents, had a greater risk of delayed onset of illness. The impact of chemoprophylaxis on the outcomes of infection with relapse-causing species calls for new chemoprophylaxis acting against erythrocytic and liver stages.
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Affiliation(s)
- Maëlle Le Goff
- Université de Bretagne Occidentale, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire La Cavale Blanche, Brest, France.,Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France
| | - Eric Kendjo
- Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France.,Centre National de Référence du Paludisme, Paris, France
| | - Marc Thellier
- Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France.,Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, Service de parasitologie, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Renaud Piarroux
- Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France.,Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, Service de parasitologie, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Pierre-Yves Boelle
- Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Inserm, Paris, France
| | - Stéphane Jauréguiberry
- Centre National de Référence du Paludisme, Paris, France.,Université de Paris Saclay, Service des maladies infectieuses et tropicales, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Le Kremlin Bicêtre, France.,Société Française de Médecine des Voyages, Paris, France.,Université de Paris Saclay, Centre de Recherche en Epidémiologie et Santé des Populations, Inserm, Villejuif, France
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11
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Hounmanou YMG, Njamkepo E, Rauzier J, Gallandat K, Jeandron A, Kamwiziku G, Porten K, Luquero F, Abedi AA, Rumedeka BB, Miwanda B, Michael M, Okitayemba PW, Saidi JM, Piarroux R, Weill FX, Dalsgaard A, Quilici ML. Genomic Microevolution of Vibrio cholerae O1, Lake Tanganyika Basin, Africa. Emerg Infect Dis 2023; 29:149-153. [PMID: 36573719 PMCID: PMC9796204 DOI: 10.3201/eid2901.220641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Africa's Lake Tanganyika basin is a cholera hotspot. During 2001-2020, Vibrio cholerae O1 isolates obtained from the Democratic Republic of the Congo side of the lake belonged to 2 of the 5 clades of the AFR10 sublineage. One clade became predominant after acquiring a parC mutation that decreased susceptibility to ciprofloxacin.
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12
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Debergh H, Becker P, Van den Eynde C, Baert F, D'hooge E, De Pauw R, Normand AC, Piarroux R, Stubbe D. P504 Screening of Belgian bats and hibernacula for the description of related fungal microbiomes and the detection of Pseudogymnoascus destructans. Med Mycol 2022. [PMCID: PMC9515947 DOI: 10.1093/mmy/myac072.p504] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM
Bats can be affected by fungal pathogens such as Pseudogymnoascus destructans, the causative agent of the white-nose syndrome. Their body surface can also be colonized by fungal commensals or carry transient fungal species and participate in their dispersal. The present study aimed to assess the presence of P. destructans in Northern Belgium, to describe the skin mycobiome of active bats during summer and autumn, and to analyze possible differences in fungal diversity among bat species, sampling sites, and seasons. In total, 114 bat specimens belonging to seven species were sampled from various localities. Culture-based methods revealed an important mycological diversity with 209 different taxa. Overall, a mean of 3.7 taxa per bat was recorded but significant differences were observed between sampling sites and seasons with a higher diversity in autumn as compared to summer. The mycobiomes were dominated by cosmopolitan and plant-associated species, in particular from the genera Cladosporium, Penicillium, and Aspergillus. Other species known to be related to bats or their environment, like Apiotrichum otae, were also retrieved. Although P. destructans was not detected, the sampling of the hibernacula indicated that they can be inhabited by diverse fungal species including a yet undescribed Pseudogymnoascus species, distinct from P. destructans, namely P. cavicola, sp. nov.
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Affiliation(s)
- Hanne Debergh
- BCCM/IHEM fungi collection , Mycology & Aerobiology, Sciensano, Brussels , Belgium
| | - Pierre Becker
- BCCM/IHEM fungi collection , Mycology & Aerobiology, Sciensano, Brussels , Belgium
| | | | - Frederik Baert
- BCCM/IHEM fungi collection , Mycology & Aerobiology, Sciensano, Brussels , Belgium
| | - Elizabet D'hooge
- BCCM/IHEM fungi collection , Mycology & Aerobiology, Sciensano, Brussels , Belgium
| | - Robby De Pauw
- Department of Epidemiology and Public Health , Sciensano, Brussels , Belgium
- Department of Rehabilitation Sciences , Ghent University, Ghent , Belgium
| | - Anne-Cécile Normand
- Sorbonne Université , INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris , France
| | - Renaud Piarroux
- Sorbonne Université , INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris , France
| | - Dirk Stubbe
- BCCM/IHEM fungi collection , Mycology & Aerobiology, Sciensano, Brussels , Belgium
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13
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Blaize M, Raoelina A, Kornblum D, Kamus L, Lampros A, Berger M, Demeret S, Constantin JM, Monsel A, Mayaux J, Luyt CE, Piarroux R, Fekkar A. Occurrence of Candidemia in Patients with COVID-19 Admitted to Five ICUs in France. J Fungi (Basel) 2022; 8:jof8070678. [PMID: 35887435 PMCID: PMC9320616 DOI: 10.3390/jof8070678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/16/2022] [Accepted: 06/24/2022] [Indexed: 12/26/2022] Open
Abstract
Whether severe COVID-19 is by itself a significant risk factor for the development of candidemia currently remains an open question as conflicting results have been published. We aim to assess the occurrence of candidemia in patients with severe COVID-19 admitted to the intensive care unit (ICU). We conducted a retrospective study on patients with severe SARS-CoV-2-related pneumonia admitted to 5 ICUs in France who were specifically screened for fungal complications between March 2020 and January 2021. The study population included a total of 264 patients; the median age was 56 years old and most of them were male (n = 186; 70.5%) and immunocompetent (n = 225; 87.5%), and 62.7% (n = 153/244) were on extracorporeal membrane oxygenation support. Microbiological analysis included 4864 blood culture samples and beta-glucan test performed on 975 sera. Candidemia was diagnosed in 13 (4.9%) patients. The species involved were mainly C. albicans (n = 6) and C. parapsilosis (n = 5). Almost all patients (12/13; 92.3%) had a colonization by yeasts. ICU mortality was not significantly impacted by the occurrence of candidemia. Unrelated positive beta-glucan tests were observed in 49 patients (23.4%), including 6 with mold infections and 43 with false positive results. In our series, patients with severe SARS-CoV-2-related pneumonia seemed at low risk of developing invasive candidiasis.
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Affiliation(s)
- Marion Blaize
- Sorbonne Université, INSERM, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Cimi-Paris, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France;
| | - Audrey Raoelina
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France; (A.R.); (D.K.); (L.K.); (A.L.); (M.B.); (R.P.)
| | - Dimitri Kornblum
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France; (A.R.); (D.K.); (L.K.); (A.L.); (M.B.); (R.P.)
| | - Laure Kamus
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France; (A.R.); (D.K.); (L.K.); (A.L.); (M.B.); (R.P.)
| | - Alexandre Lampros
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France; (A.R.); (D.K.); (L.K.); (A.L.); (M.B.); (R.P.)
| | - Marie Berger
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France; (A.R.); (D.K.); (L.K.); (A.L.); (M.B.); (R.P.)
| | - Sophie Demeret
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Réanimation Neurologique, F-75013 Paris, France;
| | - Jean-Michel Constantin
- Sorbonne Université, GRC 29, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Département d’Anesthésie Réanimation, F-75013 Paris, France;
| | - Antoine Monsel
- Sorbonne Université, INSERM, Immunology Immunopathology Immunotherapy (I3), Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Département d’Anesthésie Réanimation, F-75013 Paris, France;
| | - Julien Mayaux
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Réanimation Médicale, F-75013 Paris, France;
| | - Charles-Edouard Luyt
- Sorbonne Université, INSERM, Institute of Cardiometabolism and Nutrition, Assistance Publique–Hôpitaux de Paris (APHP), Médecine Intensive Réanimation-Institut de Cardiologie, F-75013 Paris, France;
| | - Renaud Piarroux
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France; (A.R.); (D.K.); (L.K.); (A.L.); (M.B.); (R.P.)
| | - Arnaud Fekkar
- Sorbonne Université, INSERM, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Cimi-Paris, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France;
- Correspondence: ; Tel.: +33-1-42-16-01-84
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14
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Piarroux R, Moore S, Rebaudet S. Cholera in Haiti. Presse Med 2022; 51:104136. [PMID: 35705115 DOI: 10.1016/j.lpm.2022.104136] [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] [Received: 03/21/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022] Open
Abstract
The cholera epidemic that hit Haiti from October 2010 to February 2019 was the world's deadliest of the last 25 years. Officially, the successive waves caused 9789 deaths, although numerous additional casualties could not be recorded. The origin of this epidemic has been the subject of a controversy involving two opposing theories. The first hypothesis, put forward by renowned American academics, was that the cholera epidemic originated from the environment, due to the proliferation and transmission of aquatic Vibrio cholerae bacteria driven by a confluence of circumstances, i.e., the earthquake followed by a hot summer and, ultimately, heavy rainfall and flooding. The alternative hypothesis, which was subsequently confirmed by epidemiological and genomic studies, attributed the epidemic to the recent importation of cholera by UN peacekeepers having recently arriving from Nepal, and to a river polluted with sewage. In late 2016, the Secretary General of the United Nations finally begged the Haitian people for forgiveness. This implicit recognition of the role of the UN in the cholera epidemic helped to fund the ongoing fight against it. Case-area targeted interventions aimed at interrupting cholera transmission were reinforced, which resulted in the extinction of the epidemic within two years. In the meantime, several phylogenetic studies on Vibrio cholerae during the seventh cholera pandemic demonstrated that local environmental and global epidemic Vibrio populations were distinct. These studies also showed that epidemics arose when the bacterium had diversified and that it had spread during transmission events associated with human travel.
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Affiliation(s)
- Renaud Piarroux
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.
| | | | - Stanislas Rebaudet
- Hôpital Européen, Aix Marseille Univ, INSERM, IRD, SESTIM, ISSPAM, Marseille, France
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15
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Chambrion C, Depond M, Angella L, Mouri O, Kendjo E, Fricot-Monsinjon A, Roussel C, Biligui S, Tantaoui I, Taieb A, Argy N, Houzé S, Piarroux R, Siriez JY, Jaureguiberry S, Larréché S, Théllier M, Cenac N, Buffet P, Ndour PA. Altered Subpopulations of Red Blood Cells and Post-treatment Anemia in Malaria. Front Physiol 2022; 13:875189. [PMID: 35480048 PMCID: PMC9037233 DOI: 10.3389/fphys.2022.875189] [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: 02/13/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
In acute malaria, the bulk of erythrocyte loss occurs after therapy, with a nadir of hemoglobin generally observed 3–7 days after treatment. The fine mechanisms leading to this early post-treatment anemia are still elusive. We explored pathological changes in RBC subpopulations by quantifying biochemical and mechanical alterations during severe malaria treated with artemisinin derivatives, a drug family that induce “pitting” in the spleen. In this study, the hemoglobin concentration dropped by 1.93 G/dl during therapy. During the same period, iRBC accounting for 6.12% of all RBC before therapy (BT) were replaced by pitted-RBC, accounting for 5.33% of RBC after therapy (AT). RBC loss was thus of 15.9%, of which only a minor part was due to the loss of iRBC or pitted-RBC. When comparing RBC BT and AT to normal controls, lipidomics revealed an increase in the cholesterol/phosphatidylethanolamine ratio (0.17 versus 0.24, p < 0.001) and cholesterol/phosphatidylinositol ratio (0.36 versus 0.67, p = 0.001). Using ektacytometry, we observed a reduced deformability of circulating RBC, similar BT and AT, compared to health control donors. The mean Elongation Index at 1.69Pa was 0.24 BT and 0.23 AT vs. 0.28 in controls (p < 0.0001). At 30Pa EI was 0.56 BT and 0.56 AT vs. 0.60 in controls (p < 0.001). The retention rate (rr) of RBC subpopulations in spleen-mimetic microsphere layers was higher for iRBC (rr = 20% p = 0.0033) and pitted-RBC (rr = 19%, p = 0.0031) than for healthy RBC (0.12%). Somewhat surprisingly, the post-treatment anemia in malaria results from the elimination of RBC that were never infected.
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Affiliation(s)
- Charlotte Chambrion
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
| | - Mallorie Depond
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
| | - Lucia Angella
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
| | - Oussama Mouri
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | - Eric Kendjo
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | | | - Camille Roussel
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
- Laboratoire d'Hématologie, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Sylvestre Biligui
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | - Ilhame Tantaoui
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | - Aida Taieb
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | - Nicolas Argy
- Centre National de Référence du Paludisme, Laboratoire de Parasitologie-Mycologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Sandrine Houzé
- Centre National de Référence du Paludisme, Laboratoire de Parasitologie-Mycologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Renaud Piarroux
- Sorbonne Université, Centre National de Référence du Paludisme, Hôpital Pitié-Salpêtriére, Paris, France
| | - Jean-Yves Siriez
- Service d'accueil des Urgences Pédiatriques, Hôpital Robert Debré, Paris, France
| | | | - Sébastien Larréché
- Département de Biologie Médicale, Hôpital d’Instruction Des Armées Bégin, Saint-Mandé, France
| | - Marc Théllier
- Sorbonne Université, Centre National de Référence du Paludisme, Hôpital Pitié-Salpêtriére, Paris, France
| | - Nicolas Cenac
- IRSD, INSERM, INRA, INPENVT, Université de Toulouse, Toulouse, France
| | - Pierre Buffet
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
| | - Papa Alioune Ndour
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
- *Correspondence: Papa Alioune Ndour,
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16
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Thellier M, Houzé S, Pradine B, Piarroux R, Musset L, Kendjo E. Assessment of electronic surveillance and knowledge, attitudes, and practice (KAP) survey toward imported malaria surveillance system acceptance in France. JAMIA Open 2022; 5:ooac012. [PMID: 35571356 PMCID: PMC9097633 DOI: 10.1093/jamiaopen/ooac012] [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: 05/28/2021] [Revised: 01/10/2022] [Accepted: 02/17/2022] [Indexed: 11/17/2022] Open
Abstract
Objective An electronic surveillance system was released to monitor morbidity and mortality
incidence of imported malaria cases, investigate autochthonous cases, and assess
chemosensitivity of Plasmodium isolates among travelers to and from
endemic areas. The aim of this study is to evaluate the use of an electronic
surveillance system for imported malaria in France. Materials and Methods Three main indicators were used to assess the online malaria web-based surveillance
system: (1) the quality of the surveillance system; (2) the capacity of the online
system to early warning in case of particular events of public health; (3) the
knowledge, attitude, and practice of online electronic system by practitioners of
malaria network in France. Results Overall, the median time onset a case is reported to the system decrease by 99%,
ranging from 227 days (144–309) to 2 days (1–6) in 2006 and 2020, respectively. Conclusion The online malaria surveillance system in France has demonstrated its effectiveness and
can therefore be extended to carry out numerous investigations linked to research on
malaria. We describe the surveillance activities of the imported malaria surveillance in travelers
from and to endemic areas in France caused by the bite of infected mosquitoes.
Furthermore, we evaluate how the participants to the network navigate, appreciate, and
report their diagnosed cases to the French National Reference Center for malaria. The main
findings are the stability of the network from 1996 through 2020; the reduction of the
time between the diagnosis and the declaration of the case in the database. This study
provides the effectiveness and ability of this surveillance system to carry out numerous
investigations linked to research on malaria and the willingness of their members to
participate in the surveillance of imported malaria.
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Affiliation(s)
- Marc Thellier
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
- Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Service de parasitologie, Paris, France
- AP-HP, Centre National de Référence du Paludisme, Paris, France
| | - Sandrine Houzé
- AP-HP, Centre National de Référence du Paludisme, Paris, France
- Parasitology and Mycology Laboratory, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - Bruno Pradine
- Unité Parasitologie et Entomologie, Institut de Recherche Biomédicale des Armées, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
- Aix Marseille Université, Marseille, France
- IRD, AP-HM, SSA, VITROME, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Renaud Piarroux
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
- AP-HP, Centre National de Référence du Paludisme, Paris, France
| | - Lise Musset
- Laboratoire de Parasitologie, WHO Collaborating Centre for Surveillance of Anti-Malarial Drug Resistance, Centre National de Référence du paludisme, Institut Pasteur de la Guyane, Cayenne, France
| | - Eric Kendjo
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
- Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Service de parasitologie, Paris, France
- AP-HP, Centre National de Référence du Paludisme, Paris, France
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17
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Jabet A, Normand AC, Moreno-Sabater A, Guillot J, Risco-Castillo V, Brun S, Demar M, Blaizot R, Nabet C, Packeu A, Piarroux R. Investigations upon the Improvement of Dermatophyte Identification Using an Online Mass Spectrometry Application. J Fungi (Basel) 2022; 8:jof8010073. [PMID: 35050013 PMCID: PMC8780538 DOI: 10.3390/jof8010073] [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: 12/17/2021] [Revised: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 12/10/2022] Open
Abstract
Online MALDI-TOF mass spectrometry applications, such as MSI-2, have been shown to help identify dermatophytes, but recurrent errors are still observed between phylogenetically close species. The objective of this study was to assess different approaches to reduce the occurrence of such errors by adding new reference spectra to the MSI-2 application. Nine libraries were set up, comprising an increasing number of spectra obtained from reference strains that were submitted to various culture durations on two distinct culture media: Sabouraud gentamicin chloramphenicol medium and IDFP Conidia medium. The final library included spectra from 111 strains of 20 species obtained from cultures on both media collected every three days after the appearance of the colony. The performance of each library was then analyzed using a cross-validation approach. The spectra acquisitions were carried out using a Microflex Bruker spectrometer. Diversifying the references and adding spectra from various culture media and culture durations improved identification performance. The percentage of correct identification at the species level rose from 63.4 to 91.7% when combining all approaches. Nevertheless, residual confusion between close species, such as Trichophyton rubrum, Trichophyton violaceum and Trichophyton soudanense, remained. To distinguish between these species, mass spectrometry identification should take into account basic morphological and/or clinico-epidemiological features.
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Affiliation(s)
- Arnaud Jabet
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Parasitologie Mycologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France; (A.J.); (C.N.); (R.P.)
- AP-HP, Hôpital Saint-Antoine, Service de Parasitologie Mycologie, Sorbonne Université, 75012 Paris, France;
| | - Anne-Cécile Normand
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Parasitologie Mycologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France; (A.J.); (C.N.); (R.P.)
- Correspondence:
| | - Alicia Moreno-Sabater
- AP-HP, Hôpital Saint-Antoine, Service de Parasitologie Mycologie, Sorbonne Université, 75012 Paris, France;
- Inserm, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris), AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Jacques Guillot
- Dynamic Research Group, Ecole Nationale Vétérinaire d’Alfort, UPEC, USC ANSES, 94700 Maisons-Alfort, France; (J.G.); (V.R.-C.)
- Department of Parasitology-Mycology, Ecole Nationale Vétérinaire, Agroalimentaire et de L’alimentation, Oniris, 44307 Nantes, France
| | - Veronica Risco-Castillo
- Dynamic Research Group, Ecole Nationale Vétérinaire d’Alfort, UPEC, USC ANSES, 94700 Maisons-Alfort, France; (J.G.); (V.R.-C.)
- Service de Parasitologie-Mycologie, Ecole Nationale Vétérinaire d’Alfort, Biopole Alfort, 94700 Maisons-Alfort, France
- Centre Hospitalier Universitaire Vétérinaire de la Faune Sauvage (Chuv-FS), Ecole nationale vétérinaire d’Alfort, 94700 Maisons-Alfort, France
| | - Sophie Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
| | - Magalie Demar
- EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana; (M.D.); (R.B.)
- Hôpital Andrée Rosemon, Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, 97300 Cayenne, French Guiana
| | - Romain Blaizot
- EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana; (M.D.); (R.B.)
- Service de Dermatologie, Cayenne Hospital, CEDEX 97300 Cayenne, French Guiana
| | - Cécile Nabet
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Parasitologie Mycologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France; (A.J.); (C.N.); (R.P.)
- Inserm, Institut Pierre Louis d’Epidemiologie et de Santé Publique, Sorbonne Université, 75571 Paris, France
| | - Ann Packeu
- Sciensano, BCCM/IHEM Collection, Mycology and Aerobiology Unit, 1000 Brussels, Belgium;
| | - Renaud Piarroux
- AP-HP (Assistance Publique-Hôpitaux de Paris), Service de Parasitologie Mycologie, Hôpital La Pitié-Salpêtrière, 75013 Paris, France; (A.J.); (C.N.); (R.P.)
- Inserm, Institut Pierre Louis d’Epidemiologie et de Santé Publique, Sorbonne Université, 75571 Paris, France
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18
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Jabet A, Brun S, Normand AC, Imbert S, Akhoundi M, Dannaoui E, Audiffred L, Chasset F, Izri A, Laroche L, Piarroux R, Bachmeyer C, Hennequin C, Sabater AM. Extensive Dermatophytosis Caused by Terbinafine-Resistant Trichophyton indotineae, France. Emerg Infect Dis 2022; 28:229-233. [PMID: 34932456 PMCID: PMC8714191 DOI: 10.3201/eid2801.210883] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Extensive dermatophytosis caused by terbinafine-resistant Trichophyton indotineae harboring Phe397Leu and Leu393Ser substitutions in the squalene epoxidase enzyme was diagnosed in France. Analysis of internal transcribed spacer sequences revealed the wide spread of this species in Asia and Europe. Detection of T. indotineae in animals suggests their possible role as reservoirs.
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19
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Roussel C, Ndour PA, Kendjo E, Larréché S, Taieb A, Henry B, Lebrun-Vignes B, Chambrion C, Argy N, Houzé S, Mouri O, Courtin D, Angoulvant A, Delacour H, Gay F, Siriez JY, Danis M, Bruneel F, Bouchaud O, Caumes E, Piarroux R, Thellier M, Jauréguiberry S, Buffet P. Intravenous Artesunate for the Treatment of Severe Imported Malaria: Implementation, Efficacy, and Safety in 1391 Patients. Clin Infect Dis 2021; 73:1795-1804. [PMID: 33581690 DOI: 10.1093/cid/ciab133] [Citation(s) in RCA: 6] [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: 11/06/2020] [Accepted: 02/11/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Intravenous artesunate is the World Health Organization-recommended first-line treatment for severe malaria worldwide, but it is still not fully licensed in Europe. Observational studies documenting its safety and efficacy in imported malaria are thus essential. METHODS We prospectively collected clinical and epidemiological features of 1391 artesunate-treated patients among 110 participant centers during the first 7 years (2011-2017) of a national program implemented by the French Drug Agency. RESULTS Artesunate became the most frequent treatment for severe malaria in France, rising from 9.9% in 2011 to 71.4% in 2017. Mortality was estimated at 4.1%. Treatment failure was recorded in 27 patients, but mutations in the Kelch-13 gene were not observed. Main reported adverse events (AEs) were anemia (136 cases), cardiac events (24, including 20 episodes of conduction disorders and/or arrhythmia), and liver enzyme elevation (23). Mortality and AEs were similar in the general population and in people with human immunodeficiency virus, who were overweight, or were pregnant, but the only pregnant woman treated in the first trimester experimented a hemorrhagic miscarriage. The incidence of post-artesunate-delayed hemolysis (PADH) was 42.8% when specifically assessed in a 98-patient subgroup, but was not associated with fatal outcomes or sequelae. PADH was twice as frequent in patients of European compared with African origin. CONCLUSIONS Artesunate was rapidly deployed and displayed a robust clinical benefit in patients with severe imported malaria, despite a high frequency of mild to moderate PADH. Further explorations in the context of importation should assess outcomes during the first trimester of pregnancy and collect rare but potentially severe cardiac AEs.
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Affiliation(s)
- Camille Roussel
- Biologie Intégrée du Globule Rouge, INSERM, Université de Paris, Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France
| | - Papa Alioune Ndour
- Biologie Intégrée du Globule Rouge, INSERM, Université de Paris, Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France
| | - Eric Kendjo
- Center National de Référence du Paludisme Paris, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Sébastien Larréché
- Département de biologie médicale, Hôpital d'Instruction Des Armées Bégin, Saint-Mandé, France
| | - Aida Taieb
- Center National de Référence du Paludisme Paris, Paris, France
| | - Benoît Henry
- Biologie Intégrée du Globule Rouge, INSERM, Université de Paris, Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Hôpital Necker Enfants Malades, Service des maladies infectieuses et tropicales, APHP, Center d'Infectiologie Necker-Pasteur, Institut Imagine, Paris, France
| | | | - Charlotte Chambrion
- Biologie Intégrée du Globule Rouge, INSERM, Université de Paris, Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France
| | - Nicolas Argy
- Center National de Référence du Paludisme Paris, Paris, France.,Université de Paris, MERIT, IRD, Paris, France.,Laboratoire de parasitologie-mycologie, Hôpital Bichat-Claude Bernard, APHP, Paris, France
| | - Sandrine Houzé
- Center National de Référence du Paludisme Paris, Paris, France.,Université de Paris, MERIT, IRD, Paris, France.,Laboratoire de parasitologie-mycologie, Hôpital Bichat-Claude Bernard, APHP, Paris, France
| | - Oussama Mouri
- Center National de Référence du Paludisme Paris, Paris, France.,Laboratoire de parasitologie-mycologie, Hôpital Pitié Salpêtrière, APHP, Paris, France
| | | | - Adela Angoulvant
- Laboratoire de Parasitologie-Mycologie, Hôpital Bicêtre, APHP, Kremlin Bicêtre, France.,GQE Le Moulon, INRA, CNRS, AgroParisTech, University Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Hervé Delacour
- Département de biologie médicale, Hôpital d'Instruction Des Armées Bégin, Saint-Mandé, France
| | - Frédérick Gay
- Center National de Référence du Paludisme Paris, Paris, France.,Laboratoire de parasitologie-mycologie, Hôpital Pitié Salpêtrière, APHP, Paris, France
| | - Jean-Yves Siriez
- Service d'accueil des urgences pédiatriques, Hôpital Robert Debré, Paris, France
| | - Martin Danis
- Center National de Référence du Paludisme Paris, Paris, France
| | - Fabrice Bruneel
- Service de réanimation, Center Hospitalier de Versailles, Hôpital André Mignot, Le Chesnay, France
| | - Olivier Bouchaud
- Service des maladies infectieuses et tropicales, Hôpital Avicenne, Bobigny, France
| | - Eric Caumes
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.,Service des maladies infectieuses et tropicales, Hôpital Pitié Salpêtrière, APHP, Paris, France.,Société Française de Médecine des Voyages, Paris, France
| | - Renaud Piarroux
- Center National de Référence du Paludisme Paris, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.,Laboratoire de parasitologie-mycologie, Hôpital Pitié Salpêtrière, APHP, Paris, France
| | - Marc Thellier
- Center National de Référence du Paludisme Paris, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.,Laboratoire de parasitologie-mycologie, Hôpital Pitié Salpêtrière, APHP, Paris, France
| | - Stéphane Jauréguiberry
- Center National de Référence du Paludisme Paris, Paris, France.,Société Française de Médecine des Voyages, Paris, France.,Service des maladies infectieuses et tropicales, Hôpital Bicêtre, APHP, Kremlin Bicêtre, France.,Université de Paris Saclay, INSERM, CESP (Centre de Recherche en Epidémiologie et Santé des Populations) Villejuif, France
| | - Pierre Buffet
- Biologie Intégrée du Globule Rouge, INSERM, Université de Paris, Université des Antilles, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Center National de Référence du Paludisme Paris, Paris, France
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20
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Abstract
This study describes the apparent discontinuation of cholera transmission in Haiti since February 2019. Because vulnerabilities persist and vaccination remains limited, our findings suggest that case-area targeted interventions conducted by rapid response teams played a key role. We question the presence of environmental reservoirs in Haiti and discuss progress toward elimination.
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21
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Imbert S, Cassaing S, Bonnal C, Normand AC, Gabriel F, Costa D, Blaize M, Lachaud L, Hasseine L, Kristensen L, Guitard J, Schuttler C, Raberin H, Brun S, Hendrickx M, Piarroux R, Fekkar A. Invasive aspergillosis due to Aspergillus cryptic species: A prospective multicentre study. Mycoses 2021; 64:1346-1353. [PMID: 34181773 DOI: 10.1111/myc.13348] [Citation(s) in RCA: 4] [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: 04/10/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Aspergillus cryptic species are increasingly recognised causes of Aspergillus diseases, including life-threatening invasive aspergillosis (IA). However, as their accurate identification remains challenging in a routine practice, few is known from a clinical and epidemiological perspective. Recently, the MSI application has emerged as a powerful tool for the detection and identification of Aspergillus cryptic species. We aimed to use to the network of users of the MSI application to conduct a multicentre prospective screening of Aspergillus cryptic species-related IA and analyse their epidemiological, clinical and mycological characteristics. METHODS Over a 27-month period, the clinical involvement of 369 Aspergillus cryptic isolates, from 13 French and Danish MSI application users, was prospectively analysed. Species identification was confirmed by DNA-sequencing and antifungal susceptibility testing was performed using EUCAST reference method. Fifty-one A fumigatus sensu stricto invasive cases were also analysed. RESULTS Fifteen cryptic isolates were responsible of IA. Eight species were involved, including 5 cases related to the species A sublatus. These species showed high rate of in vitro low susceptibility to antifungal drugs. In comparison with A fumigatus sensu stricto invasive cases, pre-exposure to azole drugs was significantly associated with cryptic IA (P = .02). DISCUSSION This study brings new insights in cryptic species related IA and underlines the importance to identify accurately at the species level these Aspergillus isolates. The increasing use of antifungal drugs might lead in the future to an epidemiologic shift with an emergence of resistant isolates involved in IA.
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Affiliation(s)
- Sebastien Imbert
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Université, INSERM, CNRS, Paris, France
| | - Sophie Cassaing
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Christine Bonnal
- Service de Parasitologie Mycologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Anne-Cecile Normand
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France
| | - Frederic Gabriel
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Damien Costa
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Marion Blaize
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Université, INSERM, CNRS, Paris, France
| | - Laurence Lachaud
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Lilia Hasseine
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Lise Kristensen
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Juliette Guitard
- Service de Parasitologie Mycologie, AP-HP, Hôpital Saint-Antoine, Paris, France
| | | | - Helene Raberin
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | - Sophie Brun
- Service de Parasitologie Mycologie, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Marijke Hendrickx
- Service of Mycology and Aerobiology, BCCM/IHEM Fungal Collection, Scientific Institute of Public Health, Brussels, Belgium
| | - Renaud Piarroux
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Arnaud Fekkar
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Université, INSERM, CNRS, Paris, France
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22
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Breurec S, Franck T, Njamkepo E, Mbecko JR, Rauzier J, Sanke-Waïgana H, Kamwiziku G, Piarroux R, Quilici ML, Weill FX. Seventh Pandemic Vibrio cholerae O1 Sublineages, Central African Republic. Emerg Infect Dis 2021; 27:262-266. [PMID: 33350910 PMCID: PMC7774542 DOI: 10.3201/eid2701.200375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Four cholera outbreaks were reported in the Central African Republic during 1997–2016. We show that the outbreak isolates were Vibrio cholerae O1 serotype Inaba from 3 seventh pandemic El Tor sublineages originating from West Africa (sublineages T7 and T9) or the African Great Lakes Region (T10).
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23
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Griffiths K, Moise K, Piarroux M, Gaudart J, Beaulieu S, Bulit G, Marseille JP, Jasmin PM, Namphy PC, Henrys JH, Piarroux R, Rebaudet S. Delineating and Analyzing Locality-Level Determinants of Cholera, Haiti. Emerg Infect Dis 2021; 27:170-181. [PMID: 33350917 PMCID: PMC7774537 DOI: 10.3201/eid2701.191787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Centre Department, Haiti, was the origin of a major cholera epidemic during 2010–2019. Although no fine-scale spatial delineation is officially available, we aimed to analyze determinants of cholera at the local level and identify priority localities in need of interventions. After estimating the likely boundaries of 1,730 localities by using Voronoi polygons, we mapped 5,322 suspected cholera cases reported during January 2015–September 2016 by locality alongside environmental and socioeconomic variables. A hierarchical clustering on principal components highlighted 2 classes with high cholera risk: localities close to rivers and unimproved water sources (standardized incidence ratio 1.71, 95% CI 1.02–2.87; p = 0.04) and urban localities with markets (standardized incidence ratio 1.69, 95% CI 1.25–2.29; p = 0.0006). Our analyses helped identify and characterize areas where efforts should be focused to reduce vulnerability to cholera and other waterborne diseases; these methods could be used in other contexts.
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24
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Mankouri F, Sereme Y, Michel M, Piarroux R, Pahus L, Chanez P, Vitte J, Gouitaa M. Immediate Hypersensitivity to Mealworm and Cricket: Beyond Shrimp and House Dust Mite Cross Reactivity. J Investig Allergol Clin Immunol 2021; 32:64-66. [PMID: 33978587 DOI: 10.18176/jiaci.0707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- F Mankouri
- Aix Marseille Univ, APHM, Clinique des bronches allergies et sommeil, Marseille, France
| | - Y Sereme
- Aix-Marseille Univ, IRD, APHM, MEPHI, Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | - M Michel
- Aix-Marseille Univ, IRD, APHM, MEPHI, Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | | | - L Pahus
- Aix Marseille Univ, APHM, Clinique des bronches allergies et sommeil, Marseille, France.,Aix Marseille Univ, CNRS, EFS, ADES - Marseille, France.,Aix Marseille Univ, INSERM U1263, INRA 1260 (C2VN), Marseille, France
| | - P Chanez
- Aix Marseille Univ, APHM, Clinique des bronches allergies et sommeil, Marseille, France.,Aix Marseille Univ, INSERM U1263, INRA 1260 (C2VN), Marseille, France
| | - J Vitte
- Aix-Marseille Univ, IRD, APHM, MEPHI, Marseille, France.,IHU Méditerranée Infection, Marseille, France
| | - M Gouitaa
- Aix Marseille Univ, APHM, Clinique des bronches allergies et sommeil, Marseille, France
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25
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Gaudart J, Landier J, Huiart L, Legendre E, Lehot L, Bendiane MK, Chiche L, Petitjean A, Mosnier E, Kirakoya-Samadoulougou F, Demongeot J, Piarroux R, Rebaudet S. Factors associated with the spatial heterogeneity of the first wave of COVID-19 in France: a nationwide geo-epidemiological study. Lancet Public Health 2021; 6:e222-e231. [PMID: 33556327 PMCID: PMC7864788 DOI: 10.1016/s2468-2667(21)00006-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/18/2020] [Accepted: 01/05/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The objective of this study was to better understand the factors associated with the heterogeneity of in-hospital COVID-19 morbidity and mortality across France, one of the countries most affected by COVID-19 in the early months of the pandemic. METHODS This geo-epidemiological analysis was based on data publicly available on government and administration websites for the 96 administrative departments of metropolitan France between March 19 and May 11, 2020, including Public Health France, the Regional Health Agencies, the French national statistics institute, and the Ministry of Health. Using hierarchical ascendant classification on principal component analysis of multidimensional variables, and multivariate analyses with generalised additive models, we assessed the associations between several factors (spatiotemporal spread of the epidemic between Feb 7 and March 17, 2020, the national lockdown, demographic population structure, baseline intensive care capacities, baseline population health and health-care services, new chloroquine and hydroxychloroquine dispensations, economic indicators, degree of urbanisation, and climate profile) and in-hospital COVID-19 incidence, mortality, and case fatality rates. Incidence rate was defined as the cumulative number of in-hospital COVID-19 cases per 100 000 inhabitants, mortality rate as the cumulative number of in-hospital COVID-19 deaths per 100 000, and case fatality rate as the cumulative number of in-hospital COVID-19 deaths per cumulative number of in-hospital COVID-19 cases. FINDINGS From March 19 to May 11, 2020, hospitals in metropolitan France notified a total of 100 988 COVID-19 cases, including 16 597 people who were admitted to intensive care and 17 062 deaths. There was an overall cumulative in-hospital incidence rate of 155·6 cases per 100 000 inhabitants (range 19·4-489·5), in-hospital mortality rate of 26·3 deaths per 100 000 (1·1-119·2), and in-hospital case fatality rate of 16·9% (4·8-26·2). We found clear spatial heterogeneity of in-hospital COVID-19 incidence and mortality rates, following the spread of the epidemic. After multivariate adjustment, the delay between the first COVID-19-associated death and the onset of the national lockdown was positively associated with in-hospital incidence (adjusted standardised incidence ratio 1·02, 95% CI 1·01-1·04), mortality (adjusted standardised mortality ratio 1·04, 1·02-1·06), and case fatality rates (adjusted standardised fatality ratio 1·01, 1·01-1·02). Mortality and case fatality rates were higher in departments with older populations (adjusted standardised ratio for populations with a high proportion older than aged >85 years 2·17 [95% CI 1·20-3·90] for mortality and 1·43 [1·08-1·88] for case fatality rate). Mortality rate was also associated with incidence rate (1·0004, 1·0002-1·001), but mortality and case fatality rates did not appear to be associated with baseline intensive care capacities. We found no association between climate and in-hospital COVID-19 incidence, or between economic indicators and in-hospital COVID-19 incidence or mortality rates. INTERPRETATION This ecological study highlights the impact of the epidemic spread, national lockdown, and reactive adaptation of intensive care capacities on the spatial distribution of COVID-19 morbidity and mortality. It provides information for future geo-epidemiological analyses and has implications for preparedness and response policies to current and future epidemic waves in France and elsewhere. FUNDING None.
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Affiliation(s)
- Jean Gaudart
- Aix Marseille University, National Institute of Health and Medical Research (INSERM), Institute of Research for Development (IRD), Economic and Social Sciences for Health and Medical Information Processing (SESSTIM), UMR1252, Marseille, France; Public Assistance Marseille Hospitals (APHM), Biostatistics and Information and Communication Technologies Service (BioSTIC), Marseille, France.
| | - Jordi Landier
- Aix Marseille University, National Institute of Health and Medical Research (INSERM), Institute of Research for Development (IRD), Economic and Social Sciences for Health and Medical Information Processing (SESSTIM), UMR1252, Marseille, France
| | | | - Eva Legendre
- Aix Marseille University, National Institute of Health and Medical Research (INSERM), Institute of Research for Development (IRD), Economic and Social Sciences for Health and Medical Information Processing (SESSTIM), UMR1252, Marseille, France
| | - Laurent Lehot
- Aix Marseille University, National Institute of Health and Medical Research (INSERM), Institute of Research for Development (IRD), Economic and Social Sciences for Health and Medical Information Processing (SESSTIM), UMR1252, Marseille, France
| | - Marc Karim Bendiane
- Aix Marseille University, National Institute of Health and Medical Research (INSERM), Institute of Research for Development (IRD), Economic and Social Sciences for Health and Medical Information Processing (SESSTIM), UMR1252, Marseille, France
| | - Laurent Chiche
- Internal Medicine and Clinical Research Unit, European Hospital Marseille, Marseille, France
| | - Aliette Petitjean
- Aix Marseille University, National Institute of Health and Medical Research (INSERM), Institute of Research for Development (IRD), Economic and Social Sciences for Health and Medical Information Processing (SESSTIM), UMR1252, Marseille, France
| | - Emilie Mosnier
- Aix Marseille University, National Institute of Health and Medical Research (INSERM), Institute of Research for Development (IRD), Economic and Social Sciences for Health and Medical Information Processing (SESSTIM), UMR1252, Marseille, France
| | - Fati Kirakoya-Samadoulougou
- Research Centre for Epidemiology, Biostatistics, and Research Clinic, School of Public Health, Free University of Brussels, Brussels, Belgium
| | | | - Renaud Piarroux
- Sorbonne University, INSERM, Pierre-Louis Institute of Epidemiology and Public Health (IPLESP), AP-HP, Laboratory of Parasitology and Mycologie, Pitié-Salpêtrière Hospital, Paris, France
| | - Stanislas Rebaudet
- European Hospital Marseille, Aix-Marseille University, INSERM, IRD, SESSTIM, IPLESP, Marseille, France
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26
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Normand AC, Imbert S, Brun S, Al-Hatmi AMS, Chryssanthou E, Cassaing S, Schuttler C, Hasseine L, Mahinc C, Costa D, Bonnal C, Ranque S, Sautour M, Rubio E, Delhaes L, Riat A, Sendid B, Kristensen L, Brandenberger M, Guitard J, Packeu A, Piarroux R, Fekkar A. Clinical Origin and Species Distribution of Fusarium spp. Isolates Identified by Molecular Sequencing and Mass Spectrometry: A European Multicenter Hospital Prospective Study. J Fungi (Basel) 2021; 7:jof7040246. [PMID: 33806102 PMCID: PMC8064482 DOI: 10.3390/jof7040246] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 01/30/2023] Open
Abstract
Fusarium spp. are widespread environmental fungi as well as pathogens that can affect plants, animals and humans. Yet the epidemiology of human fusariosis is still cloudy due to the rapidly evolving taxonomy. The Mass Spectrometry Identification database (MSI) has been developed since 2017 in order to allow a fast, accurate and free-access identification of fungi by matrix-assisted laser desorption ionization—time of flight (MALDI-TOF) mass spectrometry. Taking advantage of the MSI database user network, we aim to study the species distribution of Fusarium spp. isolates in an international multicenter prospective study. This study also allowed the assessment of the abilities of miscellaneous techniques to identify Fusarium isolates at the species level. The identification was performed by PCR-sequencing and phylogenic-tree approach. Both methods are used as gold standard for the evaluation of mass spectrometry. Identification at the species complex was satisfactory for all the tested methods. However, identification at the species level was more challenging and only 32% of the isolates were correctly identified with the National Center for Biotechnology Information (NCBI) DNA database, 20% with the Bruker MS database and 43% with the two MSI databases. Improvement of the mass spectrometry database is still needed to enable precise identification at the species level of any Fusarium isolates encountered either in human pathology or in the environment.
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Affiliation(s)
- Anne-Cécile Normand
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Correspondence: ; Tel.: +33-142160113
| | - Sébastien Imbert
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6525 Nijmegen, The Netherlands;
| | - Sophie Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
| | - Abdullah M. S. Al-Hatmi
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6525 Nijmegen, The Netherlands;
- Natural & Medical Sciences Research Center, Department of Microbiology, University of Nizwa, Nizwa 616, Oman
| | - Erja Chryssanthou
- Division of Clinical Microbiology, Karolinska Institutet, Department of Laboratory Medicine, 171 77 Stockholm, Sweden;
| | - Sophie Cassaing
- CHU Toulouse, Service de Parasitologie-Mycologie, 31000 Toulouse, France;
| | | | - Lilia Hasseine
- CHU de Nice, Service de Parasitologie Mycologie, 06200 Nice, France;
| | - Caroline Mahinc
- CHU de Saint Etienne, Service de Parasitologie Mycologie, 42000 Saint Etienne, France;
| | - Damien Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie Mycologie, 76000 Rouen, France;
| | - Christine Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie Mycologie, 75018 Paris, France;
| | - Stéphane Ranque
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, 13005 Marseille, France;
| | - Marc Sautour
- CHU de Dijon, Service de Parasitologie Mycologie, 21079 Dijon, France;
| | - Elisa Rubio
- Department of Microbiology, ISGlobal Barcelona Institute for Global Health, Barcelona, Spain CDB, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
| | - Laurence Delhaes
- CHU de Bordeaux, Groupe Hospitalier Pellegrin, Service de Mycologie, 33404 Bordeaux, France;
| | - Arnaud Riat
- Laboratory of bacteriology, Division of Laboratory Medicine, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland;
| | - Boualem Sendid
- Department Parasitology-Mycology, CHU de Lille, 59000 Lille, France;
| | - Lise Kristensen
- Department of Clinical Microbiology, Aarhus University Hospital, 8200 Aarhus, Denmark;
| | | | - Juliette Guitard
- Centre de Recherche Saint-Antoine, Inserm, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Sorbonne Université, 75012 Paris, France;
| | - Ann Packeu
- Sciensano, BCCM/IHEM collection, Mycology and Aerobiology Unit, 1000 Brussels, Belgium;
| | - Renaud Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Inserm, Institut Pierre Louis d’Epidemiologie et de Santé Publique, Sorbonne Université, 75571 Paris, France
| | - Arnaud Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Cimi-Paris, Sorbonne Université, 75005 Paris, France
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27
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Mandelbrot L, Kieffer F, Wallon M, Winer N, Massardier J, Picone O, Fuchs F, Benoist G, Garcia-Meric P, L'Ollivier C, Paris L, Piarroux R, Villena I, Peyron F. [Toxoplasmosis in pregnancy: Practical Management]. ACTA ACUST UNITED AC 2021; 49:782-791. [PMID: 33677120 DOI: 10.1016/j.gofs.2021.03.003] [Citation(s) in RCA: 6] [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: 11/01/2020] [Indexed: 11/28/2022]
Abstract
The burden of congenital toxoplasmosis has become small in France today, in particular as a result of timely therapy for pregnant women, fetuses and newborns. Thus, the French screening and prevention program has been evaluated and recently confirmed despite a decline over time in the incidence of toxoplasmosis. Serological diagnosis of maternal seroconversion is usually simple but can be difficult when the first trimester test shows the presence of IgM, requiring referral to an expert laboratory. Woman with confirmed seroconversion should be referred quickly to an expert center, which will decide with her on treatment and antenatal diagnosis. Although the level of proof is moderate, there is a body of evidence in favor of active prophylactic prenatal treatment started as early as possible (ideally within 3 weeks of seroconversion) to reduce the risk of maternal-fetal transmission, as well as symptoms in children. The recommended therapies to prevent maternal-fetal transmission are: (1) spiramycin in case of maternal infection before 14 gestational weeks; (2) pyrimethamine and sulfadiazine (P-S) with folinic acid in case of maternal infection at 14 WG or more. Amniocentesis is recommended to guide prenatal and neonatal care. If fetal infection is diagnosed by PCR on amniotic fluid, therapy with P-S should be initiated as early as possible or continued in order reduce the risk of damage to the brain or eyes. Further research is required to validate new approaches to preventing congenital toxoplasmosis.
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Affiliation(s)
- L Mandelbrot
- AP-HP hôpital Louis-Mourier service de gynécologie-obstétrique, 178, rue des Renouillers, 92700 Colombes France; Université de Paris, Paris, France; Inserm IAME-U1137, Paris, France; FHU PREMA, Paris, France.
| | - F Kieffer
- FHU PREMA, Paris, France; Assistance Publique-hôpitaux de Paris, hôpital Armand Trousseau, Service de néonatologie, Paris, France
| | - M Wallon
- Hospices Civils de Lyon, hôpital de la Croix-Rousse, service de parasitologie-Mycologie Médicale, Lyon, France; INSERM U1028-CNRS UMR 5292, université Claude-Bernard, université Lyon-1, Bron, France
| | - N Winer
- Centre hospitalier universitaire de Nantes, service de gynécologie-obstétrique, et NUN, INRA, UMR 1280, Phan Université de Nantes, 44000 Nantes, France
| | - J Massardier
- INSERM U1028-CNRS UMR 5292, université Claude-Bernard, université Lyon-1, Bron, France; Hospices civils de Lyon, hôpital de la Croix-Rousse, service de gynécologie-obstétrique, Lyon, France
| | - O Picone
- AP-HP hôpital Louis-Mourier service de gynécologie-obstétrique, 178, rue des Renouillers, 92700 Colombes France; Université de Paris, Paris, France; Inserm IAME-U1137, Paris, France; FHU PREMA, Paris, France
| | - F Fuchs
- Service de gynécologie obstétrique CHU de Montpellier, Hopital Arnaud de Villeneuve, 371, avenue du Doyen Gaston-Giraud, 34295 Montpellier Cedex 5, France; Inserm, CESP Centre de recherche en Epidémiologie et Santé des Populations, U1018, Reproduction et Développement de l'enfant, 94807 Villejuif, France; Institut Desbrest d'epidemiologie et de santé publique, UMR inserm - université de Montpellier, Montpellier, France
| | - G Benoist
- Obstetrics and gynecology, Caen university Hospital, 14000 Caen, France
| | - P Garcia-Meric
- Assistance Publique-hôpitaux de Marseille, service de médecine néonatale, hôpital de la Conception, Marseille, France
| | - C L'Ollivier
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, Marseille, France
| | - L Paris
- Assistance Publique-hôpitaux de Paris, hôpital Pitié-Salpêtrière, service de Parasitologie, Paris, France
| | - R Piarroux
- Assistance Publique-hôpitaux de Paris, hôpital Pitié-Salpêtrière, service de Parasitologie, Paris, France; Sorbonne Université, IPLESP UMR 1136, inserm, Paris, France
| | - I Villena
- Service de parasitologie-mycologie, centre national de référence de la toxoplasmose, centre de ressources biologiques toxoplasma, CHU Reims, Reims, France; EA 7510, laboratoire parasitologie-mycologie, université Reims Champagne -Ardenne, Reims, France
| | - F Peyron
- Hospices Civils de Lyon, hôpital de la Croix-Rousse, service de parasitologie-Mycologie Médicale, Lyon, France; INSERM U1028-CNRS UMR 5292, université Claude-Bernard, université Lyon-1, Bron, France
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28
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Affiliation(s)
- Renaud Piarroux
- Assistance Publique – Hôpitaux de Paris, Paris, France,IPLESP, Sorbonne Université, 27 rue Chaligny 75571 Paris Cedex 12, France,Corresponding author at: Service de parasitologie et mycologie, CHU La Pitié Salpêtrière, 83 Boulevard de l’Hôpital, 75013 Paris, France
| | - Jean Gaudart
- Aix Marseille Univ, INSERM, IRD, AP-HM, SESSTIM, UMR1252, La Timone, BioSTIC, 27, Boulevard Jean Moulin, 13005, Marseille, France
| | - Stanislas Rebaudet
- Aix Marseille Univ, INSERM, IRD, AP-HM, SESSTIM, UMR1252, La Timone, BioSTIC, 27, Boulevard Jean Moulin, 13005, Marseille, France,Hôpital Européen, 6, rue Désirée Clary, 13003 Marseille, France
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29
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Normand AC, Gabriel F, Riat A, Cassagne C, Bourgeois N, Huguenin A, Chauvin P, De Geyter D, Bexkens M, Rubio E, Hendrickx M, Ranque S, Piarroux R. Optimization of MALDI-ToF mass spectrometry for yeast identification: a multicenter study. Med Mycol 2021; 58:639-649. [PMID: 31579924 DOI: 10.1093/mmy/myz098] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/21/2019] [Accepted: 09/16/2019] [Indexed: 11/13/2022] Open
Abstract
Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-ToF MS) is routinely used in mycology laboratories to rapidly identify pathogenic yeasts. Various methods have been proposed to perform routine MS-based identification of clinically relevant species. In this study, we focused on Bruker technology and assessed the identification performance of three protocols: two pretreatment methods (rapid formic acid extraction directly performed on targets and full extraction using formic acid/acetonitrile in tubes) and a direct deposit protocol that omits the extraction step. We also examined identification performance using three target types (ground-steel, polished-steel, and biotargets) and two databases (Bruker and online MSI [biological-mass-spectrometry-identification application]) in a multicenter manner. Ten European centers participated in the study, in which a total of 1511 yeast isolates were analyzed. The 10 centers prospectively performed the three protocols on approximately 150 yeast isolates each, and the corresponding spectra were then assessed against two reference spectra databases (MSI and Bruker), with appropriate thresholds. Three centers evaluated the impact of the targets. Scores were compared between the various combinations, and identification accuracy was assessed. The protocol omitting the extraction step was inappropriate for yeast identification, while the full extraction method yielded far better results. Rapid formic acid extraction yielded variable results depending on the target, database and threshold. Selecting the optimal extraction method in combination with the appropriate target, database and threshold may enable simple and accurate identification of clinically relevant yeast samples. Concerning the widely used polished-steel targets, the full extraction method still ensured better scores and better identification rates.
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Affiliation(s)
- Anne-Cécile Normand
- Laboratoire de Parasitologie-Mycologie, de Parasitologie-Mycologie Hôpital Pitié Salpêtrière, 75013 Paris, France
| | - Frédéric Gabriel
- Mycologie, CHU de Bordeaux, Groupe Hospitalier Pellegrin, place Amélie Raba-Léon, 33000 Bordeaux, France
| | - Arnaud Riat
- Bacteriology Laboratory, Service of Laboratory Medicine, Department of Genetics, Laboratory Medicine and Pathology, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland
| | - Carole Cassagne
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, 13006 Marseille, France
| | | | - Antoine Huguenin
- EA 7510, ESCAPE, Laboratoire de Parasitologie-Mycologie, Université de Reims Champagne-Ardenne, 51100 Reims, France.,Laboratoire de Parasitologie Mycologie, CHU de Reims Hôpital Maison Blanche, 51100 Reims, France
| | - Pamela Chauvin
- Service de Parasitologie-Mycologie, Hôpital Purpan, 31059 Toulouse, France
| | - Deborah De Geyter
- Department Microbiology and Infection Prevention, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Michiel Bexkens
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Elisa Rubio
- Department of Clinical Microbiology, Hospital Clinic, 08036 Barcelona, Spain
| | - Marijke Hendrickx
- Sciensano, BCCM/IHEM collection, Mycology and Aerobiology Unit, 1050 Brussels, Belgium
| | - Stéphane Ranque
- Bacteriology Laboratory, Service of Laboratory Medicine, Department of Genetics, Laboratory Medicine and Pathology, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205 Geneva, Switzerland
| | - Renaud Piarroux
- Laboratoire de Parasitologie-Mycologie, de Parasitologie-Mycologie Hôpital Pitié Salpêtrière, 75013 Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
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30
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El Ket N, Kendjo E, Thellier M, Assoumou L, Potard V, Taieb A, Tantaoui I, Caumes E, Piarroux R, Roussel C, Buffet P, Costagliola D, Jauréguiberry S. Propensity Score Analysis of Artesunate Versus Quinine for Severe Imported Plasmodium falciparum Malaria in France. Clin Infect Dis 2021; 70:280-287. [PMID: 30874798 DOI: 10.1093/cid/ciz206] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 09/19/2018] [Accepted: 03/11/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Little is known on the use of artesunate compared with quinine for the treatment of imported malaria cases in nonendemic countries with a high level of care. Therefore, we compared the 2 treatments in terms of mortality and hospital and intensive care unit (ICU) discharge rates. METHODS We analyzed the cohort of all severe imported malaria patients reported to the French National Reference Center from 2011 to 2017. After controlling for differences between quinine- and artesunate-treated individuals using the inverse probability of treatment weighting method, 28-day mortality rate was compared between the groups as well as hospital and ICU discharge rates using Kaplan-Meier estimation and weighted Cox proportional hazard models. RESULTS Overall, 1544 patients were enrolled. Fifty patients died, 18 in the quinine group (n = 460) and 32 in the artesunate group (n = 1084), corresponding to death rates of 3.9% and 2.9%, respectively. No difference was evident between quinine and artesunate either in mortality or in hospital discharge rate, with hazard ratios (HRs) of 1.03 (95% confidence interval [CI], 0.47-2.25) and 1.12 (95% CI, 0.94-1.34), respectively. Artesunate was associated with a faster ICU discharge rate (HR, 1.18. 95% CI, 1.02-1.36). CONCLUSIONS In a country with a high level of care, artesunate was associated with a shorter length of stay in the ICU, which supports the actual therapeutic transition; however, no difference was found in terms of mortality or in hospital discharge rates between artesunate- and quinine-treated patients.
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Affiliation(s)
- Nermine El Ket
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France
| | - Eric Kendjo
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence du Paludisme, Hôpital Pitié-Salpêtrière, France
| | - Marc Thellier
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence du Paludisme, Hôpital Pitié-Salpêtrière, France.,Service de Parasitologie Mycologie, AP-HP, Hôpital Pitié-Salpêtrière, France
| | - Lambert Assoumou
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France
| | - Valérie Potard
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France
| | - Aida Taieb
- Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence du Paludisme, Hôpital Pitié-Salpêtrière, France.,Paris Diderot Université, INSERM, Biologie Intégrée du Globule Rouge, Institut National de la Transfusion Sanguine, France
| | - Ilhame Tantaoui
- Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence du Paludisme, Hôpital Pitié-Salpêtrière, France.,Paris Diderot Université, INSERM, Biologie Intégrée du Globule Rouge, Institut National de la Transfusion Sanguine, France
| | - Eric Caumes
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France.,Service de Maladies Infectieuses et Médecine Tropicale, AP-HP, Hôpital Pitié-Salpêtrière, France
| | - Renaud Piarroux
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence du Paludisme, Hôpital Pitié-Salpêtrière, France.,Service de Parasitologie Mycologie, AP-HP, Hôpital Pitié-Salpêtrière, France
| | - Camille Roussel
- Paris Diderot Université, INSERM, Biologie Intégrée du Globule Rouge, Institut National de la Transfusion Sanguine, France.,Paris Descartes Université, France
| | - Pierre Buffet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence du Paludisme, Hôpital Pitié-Salpêtrière, France.,Paris Diderot Université, INSERM, Biologie Intégrée du Globule Rouge, Institut National de la Transfusion Sanguine, France.,Paris Descartes Université, France
| | - Dominique Costagliola
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France
| | - Stéphane Jauréguiberry
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence du Paludisme, Hôpital Pitié-Salpêtrière, France.,Service de Maladies Infectieuses et Médecine Tropicale, AP-HP, Hôpital Pitié-Salpêtrière, France
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Kendjo E, Thellier M, Noël H, Jauréguiberry S, Septfons A, Mouri O, Gay F, Tantaoui I, Caumes E, Houzé S, Piarroux R. Mortality from malaria in France, 2005 to 2014. ACTA ACUST UNITED AC 2021; 25. [PMID: 32914747 PMCID: PMC7502900 DOI: 10.2807/1560-7917.es.2020.25.36.1900579] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Malaria is a notifiable disease in all European Union and European Economic Area countries except Belgium and France, where only autochthonous malaria is notifiable. Although morbidity caused by malaria has been assessed, little is known about mortality incidence. Objective Our aim was to estimate the number of imported malaria-related deaths in hospital in metropolitan France. Methods We matched individual deaths reported between 1 January 2005 and 31 December 2014 to the French National Reference Centre for malaria (FNRCm) with malaria-related deaths from two other sources: the French National Registry on medical causes of death and the French national hospital discharge database. A capture–recapture method with log-linear modelling was used. Age, sex and place of death stratification were applied to remove heterogeneity. Results The estimated malaria-related deaths in metropolitan France during the study period were 205 (95% confidence interval (CI): 191–219). The annual mean number of malaria-related deaths was estimated at 21 (95% CI: 19–22). The FNRCm malaria-related deaths surveillance had a 38% sensitivity (95% CI: 32–44). Among 161 in-hospital individual malaria-related deaths reported from three data sources, the sex ratio (male to female) was 2.6. Median age of the patients was 57 years, ranging from 1 to 89 years. Conclusion The pertinent finding of this report is that malaria-related death records were significantly more complete than case records. Therefore, data comparison of imported malaria morbidity and mortality between countries should imperatively be assessed using standard indicators weighted according to the completeness of health surveillance systems.
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Affiliation(s)
- Eric Kendjo
- AP-HP, Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Laboratoire de Parasitologie, Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Marc Thellier
- AP-HP, Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Laboratoire de Parasitologie, Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Harold Noël
- Santé Publique France, Direction des Maladies Infectieuses, Saint-Maurice, France
| | - Stéphane Jauréguiberry
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Service des Maladies Infectieuses, Hôpital Pitié-Salpêtrière, Paris, France.,AP-HP, Centre National de Référence du Paludisme, Paris, France
| | - Alexandra Septfons
- Santé Publique France, Direction des Maladies Infectieuses, Saint-Maurice, France
| | - Oussama Mouri
- AP-HP, Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Laboratoire de Parasitologie, Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Frédérick Gay
- AP-HP, Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Laboratoire de Parasitologie, Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Ilhame Tantaoui
- AP-HP, Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Laboratoire de Parasitologie, Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eric Caumes
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Service des Maladies Infectieuses, Hôpital Pitié-Salpêtrière, Paris, France
| | - Sandrine Houzé
- Université de Paris, MERIT, IRD, Paris, France.,Centre National de Référence du Paludisme, Hôpital Bichat, AP-HP, Paris, France
| | - Renaud Piarroux
- AP-HP, Centre National de Référence du Paludisme, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Laboratoire de Parasitologie, Mycologie, Hôpital Pitié-Salpêtrière, Paris, France
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- The members of the French imported malaria Study group are acknowledged at the end of this article
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32
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Rebaudet S, Gaudart J, Piarroux R. Cholera in Haiti. The Lancet Global Health 2020; 8:e1468. [DOI: 10.1016/s2214-109x(20)30430-7] [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] [Received: 09/03/2020] [Accepted: 09/23/2020] [Indexed: 11/26/2022] Open
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Imbert S, Normand AC, Cassaing S, Gabriel F, Kristensen L, Bonnal C, Lachaud L, Costa D, Guitard J, Hasseine L, Palous M, Piarroux M, Hendrickx M, Piarroux R, Fekkar A. Multicentric Analysis of the Species Distribution and Antifungal Susceptibility of Cryptic Isolates from Aspergillus Section Fumigati. Antimicrob Agents Chemother 2020; 64:e01374-20. [PMID: 32900686 PMCID: PMC7674026 DOI: 10.1128/aac.01374-20] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/03/2020] [Indexed: 12/19/2022] Open
Abstract
The antifungal susceptibility of Aspergillus cryptic species is poorly known. We assessed 51 isolates, belonging to seven Fumigati cryptic species, by the EUCAST reference method and the concentration gradient strip (CGS) method. Species-specific patterns were observed, with high MICs for azole drugs, except for Aspergillus hiratsukae and Aspergillus tsurutae, and high MICs for amphotericin B for Aspergillus lentulus and Aspergillus udagawae Essential and categorical agreements between EUCAST and CGS results were between 53.3 and 93.3%.
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Affiliation(s)
- S Imbert
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
- Sorbonne Université, INSERM, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Paris, France
| | - A C Normand
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
| | - S Cassaing
- Centre Hospitalier Universitaire de Toulouse, Service de Parasitologie-Mycologie, Toulouse, France
| | - F Gabriel
- Centre Hospitalier Universitaire de Bordeaux, Service de Parasitologie-Mycologie, Bordeaux, France
| | - L Kristensen
- Aarhus University Hospital, Department of Clinical Microbiology, Aarhus, Denmark
| | - C Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie-Mycologie, Paris, France
| | - L Lachaud
- Centre Hospitalier Universitaire de Montpellier, Service de Parasitologie-Mycologie, Montpellier, France
| | - D Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie-Mycologie, Rouen, France
| | - J Guitard
- AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Paris, France
| | - L Hasseine
- Centre Hospitalier Universitaire de Nice, Service de Parasitologie-Mycologie, Nice, France
| | - M Palous
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
| | - M Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - M Hendrickx
- Service of Mycology and Aerobiology, BCCM/IHEM Fungal Collection, Scientific Institute of Public Health, Brussels, Belgium
| | - R Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - A Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
- Sorbonne Université, INSERM, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Paris, France
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Nabet C, Imbert S, Normand AC, Blanchet D, Chanlin R, Becker P, Demar M, Piarroux R. Unexpected mould diversity in clinical isolates from French Guiana and associated identification difficulties. Med Mycol 2020; 59:myaa091. [PMID: 33111143 DOI: 10.1093/mmy/myaa091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/05/2020] [Accepted: 10/12/2020] [Indexed: 12/14/2022] Open
Abstract
New mold species are increasingly reported in invasive fungal infections. However, these fungi are often misdiagnosed or undiagnosed due to the use of inappropriate laboratory diagnostic tools. Tropical countries, such as French Guiana, harbor a vast diversity of environmental fungi representing a potential source of emerging pathogens. To assess the impact of this diversity on the accuracy of mold-infection diagnoses, we identified mold clinical isolates in French Guiana during a five-month follow-up using both microscopy and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. In total, 38.8% of the 98 obtained molds isolates could not be identified and required a DNA-based identification. Fungal diversity was high, including 46 species, 26 genera, and 13 orders. Fungal ecology was unusual, as Aspergillus species accounted for only 27% of all isolates, and the Nigri section was the most abundant out of the six detected Aspergillus sections. Macromycetes (orders Agaricales, Polyporales, and Russulales) and endophytic fungi accounted for respectively 11% and 14% of all isolates. Thus, in tropical areas with high fungal diversity, such as French Guiana, routine mold identification tools are inadequate. Molecular identifications, as well as morphological descriptions, are necessary for the construction of region-specific mass spectrum databases. These advances will improve the diagnosis and clinical management of new fungal infections. LAY SUMMARY In French Guiana, environmental fungal diversity may be a source of emerging pathogens. We evaluated microscopy and mass spectrometry to identify mold clinical isolates. With 39% of unidentified isolates, a region-specific mass spectrum database would improve the diagnosis of new fungal infections.
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Affiliation(s)
- C Nabet
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
| | - S Imbert
- Sorbonne Université, INSERM, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
| | - A C Normand
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
| | - D Blanchet
- Department of Parasitology-Mycology, Hôpital Andrée Rosemon, Cayenne, French Guiana
| | - R Chanlin
- Department of Parasitology-Mycology, Hôpital Andrée Rosemon, Cayenne, French Guiana
| | - P Becker
- Sciensano, BCCM/IHEM collection, Mycology and Aerobiology Unit, Brussels, Belgium
| | - M Demar
- Department of Parasitology-Mycology, Hôpital Andrée Rosemon, Cayenne, French Guiana
- EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, Université de Guyane, Cayenne, French Guiana
| | - R Piarroux
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
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35
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Pernet J, de Bonnières H, Breton C, Hirsch V, Molitor J, Boutolleau D, Piarroux R, Hausfater P. Retour d’expérience sur Covisan : un dispositif médicosocial pour casser les chaînes de transmission de la Covid-19. Ann Fr Med Urgence 2020. [DOI: 10.3166/afmu-2020-0266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Covisan a été mis en place à partir du 14 avril 2020 au niveau de quatre sites pilotes de l’Assistance publique-Hôpitaux de Paris (APHP) pour casser les chaînes de transmission au SARS-CoV-2 selon un modèle original déjà éprouvé en Haïti pour éliminer le choléra dans les années 2010. Le dispositif consiste en un dépistage systématique des cas possibles de Covid-19, un accompagnement dans leur confinement et une prise en charge de leurs proches. Des équipes mobiles se sont déplacées au domicile des cas contacts afin d’évaluer les possibilités d’un isolement au domicile, de proposer des aides matérielles (courses, blanchisserie, hébergement externalisé) et de dépister leurs proches. Au 17 juin 2020, 6 376 patients ont été orientés vers Covisan, parmi lesquels 153 avaient une RT-PCR (reverse transciptase polymerase chain reaction) positive au SARSCoV-2. Covisan a permis un partenariat ville–hôpital innovant, en impliquant de multiples acteurs (personnels soignants, administratifs, logisticiens, métiers de service). Les autorités sanitaires se sont d’ailleurs inspirées de ce modèle pour lutter contre l’épidémie en mettant en place le contact tracing. Covisan, qui a appris en marchant, a également rencontré quelques difficultés, en particulier au niveau de la gestion des différents statuts des personnels ainsi qu’au niveau de la communication interne et externe.
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Abstract
Face à la crise sanitaire provoquée par la pandémie de Covid-19 en France, Santé publique France a mis en place un système de surveillance évolutif fondé sur des définitions de cas possible, probable et confirmé. Le décompte quotidien se limite cependant aux cas confirmés par reverse transcriptase polymerase chain reaction ou sérologie SARS-CoV-2 (actuellement via la plateforme SI-DEP), aux cas hospitalisés (via le Système d’information pour le suivi des victimes d’attentats) et aux décès hospitaliers par Covid-19. Ce suivi de la circulation virale est forcément non exhaustif, et l’estimation de l’incidence est complétée par d’autres indicateurs comme les appels au 15, les recours à SOS Médecins, les passages dans les services d’accueil des urgences, les consultations de médecine de ville via le réseau Sentinelle. Le suivi de la mortalité non hospitalière s’est heurté aux délais de transmission des certificats de décès et au manque de diagnostic fiable. Seule la létalité hospitalière a pu être mesurée de manière fiable. Moyennant un certain nombre de précautions statistiques et d’hypothèses de travail, les modèles ont permis d’anticiper l’évolution de l’épidémie à partir de deux indicateurs essentiels : le ratio de reproduction R et le temps de doublement épidémique. En Île-de-France, l’Assistance publique– Hôpitaux de Paris a complété ce tableau de bord grâce à son entrepôt de données de santé et a ainsi pu modéliser de manière fine le parcours de soins des patients. L’ensemble de ces indicateurs a été essentiel pour assurer une planification de la réponse à la crise.
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Boëlle PY, Delory T, Maynadier X, Janssen C, Piarroux R, Pichenot M, Lemaire X, Baclet N, Weyrich P, Melliez H, Meybeck A, Lanoix JP, Robineau O. Trajectories of Hospitalization in COVID-19 Patients: An Observational Study in France. J Clin Med 2020; 9:E3148. [PMID: 33003375 PMCID: PMC7600846 DOI: 10.3390/jcm9103148] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 08/24/2020] [Revised: 09/20/2020] [Accepted: 09/27/2020] [Indexed: 12/16/2022] Open
Abstract
Describing the characteristics of COVID-19 patients in the hospital is of importance to assist in the management of hospital capacity in the future. Here, we analyze the trajectories of 1321 patients admitted to hospitals in northern and eastern France. We found that the time from onset to hospitalization decreased with age, from 7.3 days in the 20-65 year-olds to 4.5 in the >80 year-olds (p < 0.0001). Overall, the length of stay in the hospital was 15.9 days, and the death rate was 20%. One patient out of four was admitted to the intensive care unit (ICU) for approximately one month. The characteristics of trajectories changed with age: fewer older patients were admitted to the ICU and the death rate was larger in the elderly. Admission shortly after onset was associated with increased mortality (odds-ratio (OR) = 1.8, Confidence Interval (CI) 95% [1.3, 2.6]) as well as male sex (OR = 2.1, CI 95% [1.5, 2.9]). Time from admission within the hospital to the transfer to ICU was short. The age- and sex-adjusted mortality rate decreased over the course of the epidemic, suggesting improvement in care over time. In the SARS-CoV-2 epidemic, the urgent need for ICU at admission and the prolonged length of stay in ICU are a challenge for bed management and organization of care.
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Affiliation(s)
- Pierre-Yves Boëlle
- Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, Assistance Publique – Hôpitaux de Paris, 75012 Paris, France; (T.D.); (X.M.); (R.P.)
| | - Tristan Delory
- Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, Assistance Publique – Hôpitaux de Paris, 75012 Paris, France; (T.D.); (X.M.); (R.P.)
- Centre Hospitalier Annecy Genevois, 74370 Epagny–Metz-Tessy, France;
| | - Xavier Maynadier
- Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, Assistance Publique – Hôpitaux de Paris, 75012 Paris, France; (T.D.); (X.M.); (R.P.)
| | - Cécile Janssen
- Centre Hospitalier Annecy Genevois, 74370 Epagny–Metz-Tessy, France;
| | - Renaud Piarroux
- Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, Assistance Publique – Hôpitaux de Paris, 75012 Paris, France; (T.D.); (X.M.); (R.P.)
| | - Marie Pichenot
- Centre Hospitalier Victor Provot, 59100 Roubaix, France;
| | - Xavier Lemaire
- Service Maladies infectieuses, Centre Hospitalier de Douai, 59500 Douai, France;
| | - Nicolas Baclet
- Department of Infectious Diseases, Lille Catholic Hospitals, F-59160 Lille, France; (N.B.); (P.W.)
| | - Pierre Weyrich
- Department of Infectious Diseases, Lille Catholic Hospitals, F-59160 Lille, France; (N.B.); (P.W.)
| | - Hugues Melliez
- Service de médecine interne, Hôpital de la région de Saint-Omer, 62570 Helfaut, France;
| | - Agnès Meybeck
- Service Universitaire des maladies Infectieuses et du Voyageur, 59200 Tourcoing, France;
| | - Jean-Philippe Lanoix
- Service de Maladies Infectieuses et tropicales, CHU Amiens-Picardie, 80000 Amiens, France;
- AGIR UR UPJV 4294, CURS, Université Picardie Jules Verne, 80000 Amiens, France
| | - Olivier Robineau
- Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, Assistance Publique – Hôpitaux de Paris, 75012 Paris, France; (T.D.); (X.M.); (R.P.)
- Service Universitaire des maladies Infectieuses et du Voyageur, 59200 Tourcoing, France;
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Blaize M, Mayaux J, Nabet C, Lampros A, Marcelin AG, Thellier M, Piarroux R, Demoule A, Fekkar A. Fatal Invasive Aspergillosis and Coronavirus Disease in an Immunocompetent Patient. Emerg Infect Dis 2020; 26:1636-1637. [PMID: 32343223 PMCID: PMC7323532 DOI: 10.3201/eid2607.201603] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Invasive pulmonary aspergillosis is a complication in critically ill patients with acute respiratory distress syndrome, especially those with severe influenza pneumonia. We report a fatal case of invasive pulmonary aspergillosis in an immunocompetent patient in France who had severe coronavirus disease-associated pneumonia.
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D'hooge E, Becker P, Stubbe D, Normand AC, Piarroux R, Hendrickx M. Black aspergilli: A remaining challenge in fungal taxonomy? Med Mycol 2020; 57:773-780. [PMID: 30535052 DOI: 10.1093/mmy/myy124] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/18/2018] [Accepted: 10/24/2018] [Indexed: 12/14/2022] Open
Abstract
Aspergillus section Nigri is a taxonomically difficult but medically and economically important group. In this study, an update of the taxonomy of A. section Nigri strains within the BCCM/IHEM collection has been conducted. The identification accuracy of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was tested and the antifungal susceptibilities of clinical isolates were evaluated. A total of 175 strains were molecularly analyzed. Three regions were amplified (ITS, benA, and caM) and a multi-locus phylogeny of the combined loci was created by using maximum likelihood analysis. The in-house MALDI-TOF MS reference database was extended and an identification data set of 135 strains was run against a reference data set. Antifungal susceptibility was tested for voriconazole, itraconazole, and amphotericin B, using the EUCAST method. Phylogenetic analysis revealed 18 species in our data set. MALDI-TOF MS was able to distinguish between A. brasiliensis, A. brunneoviolaceus, A. neoniger, A. niger, A. tubingensis, and A. welwitschiae of A. sect. Nigri. In the routine clinical lab, isolates of A. sect. Nigri are often identified as A. niger. However, in the clinical isolates of our data set, A. tubingensis (n = 35) and A. welwitschiae (n = 34) are more common than A. niger (n = 9). Decreased antifungal susceptibility to azoles was observed in clinical isolates of the /tubingensis clade. This emphasizes the importance of identification up to species level or at least up to clade level in the clinical lab. Our results indicate that MALDI-TOF MS can be a powerful tool to replace classical morphology.
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Affiliation(s)
- Elizabet D'hooge
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Pierre Becker
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Dirk Stubbe
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Anne-Cécile Normand
- Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière et Sorbonne Université, Paris, France
| | - Renaud Piarroux
- Laboratoire de Parasitologie-Mycologie, Hôpital Pitié-Salpêtrière et Sorbonne Université, Paris, France
| | - Marijke Hendrickx
- BCCM/IHEM collection, Mycology and Aerobiology, Sciensano, J. Wytsmanstraat 14, 1050 Brussels, Belgium
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Dieng S, Ba EH, Cissé B, Sallah K, Guindo A, Ouedraogo B, Piarroux M, Rebaudet S, Piarroux R, Landier J, Sokhna C, Gaudart J. Spatio-temporal variation of malaria hotspots in Central Senegal, 2008-2012. BMC Infect Dis 2020; 20:424. [PMID: 32552759 PMCID: PMC7301493 DOI: 10.1186/s12879-020-05145-w] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 06/10/2020] [Indexed: 12/01/2022] Open
Abstract
Background In malaria endemic areas, identifying spatio-temporal hotspots is becoming an important element of innovative control strategies targeting transmission bottlenecks. The aim of this work was to describe the spatio-temporal variation of malaria hotspots in central Senegal and to identify the meteorological, environmental, and preventive factors that influence this variation. Methods This study analysed the weekly incidence of malaria cases recorded from 2008 to 2012 in 575 villages of central Senegal (total population approximately 500,000) as part of a trial of seasonal malaria chemoprevention (SMC). Data on weekly rainfall and annual vegetation types were obtained for each village through remote sensing. The time series of weekly malaria incidence for the entire study area was divided into periods of high and low transmission using change-point analysis. Malaria hotspots were detected during each transmission period with the SaTScan method. The effects of rainfall, vegetation type, and SMC intervention on the spatio-temporal variation of malaria hotspots were assessed using a General Additive Mixed Model. Results The malaria incidence for the entire area varied between 0 and 115.34 cases/100,000 person weeks during the study period. During high transmission periods, the cumulative malaria incidence rate varied between 7.53 and 38.1 cases/100,000 person-weeks, and the number of hotspot villages varied between 62 and 147. During low transmission periods, the cumulative malaria incidence rate varied between 0.83 and 2.73 cases/100,000 person-weeks, and the number of hotspot villages varied between 10 and 43. Villages with SMC were less likely to be hotspots (OR = 0.48, IC95%: 0.33–0.68). The association between rainfall and hotspot status was non-linear and depended on both vegetation type and amount of rainfall. The association between village location in the study area and hotspot status was also shown. Conclusion In our study, malaria hotspots varied over space and time according to a combination of meteorological, environmental, and preventive factors. By taking into consideration the environmental and meteorological characteristics common to all hotspots, monitoring of these factors could lead targeted public health interventions at the local level. Moreover, spatial hotspots and foci of malaria persisting during LTPs need to be further addressed. Trial registration The data used in this work were obtained from a clinical trial registered on July 10, 2008 at www.clinicaltrials.gov under NCT00712374.
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Affiliation(s)
- Sokhna Dieng
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France. .,Ecole des Hautes Etudes en Santé Publique, Rennes, France.
| | - El Hadj Ba
- UMR VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Sénégal
| | - Badara Cissé
- Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation (IRESSEF) Diamniadio, Dakar, Sénégal
| | - Kankoe Sallah
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France.,AP-HP, Hôpital Bichat, Unité de Recherche Clinique PNVS, Paris, France
| | - Abdoulaye Guindo
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France.,Research and Training Center - Ogobara K Doumbo, FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Boukary Ouedraogo
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France.,Direction des Systèmes d'Information en santé, Ministère de la santé, Ouagadougou, Burkina Faso
| | - Martine Piarroux
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Stanislas Rebaudet
- APHM, Assistance Publique - Hôpitaux de Marseille, Marseille, France.,Hôpital Européen, Marseille, France
| | - Renaud Piarroux
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jordi Landier
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France
| | - Cheikh Sokhna
- UMR VITROME, Campus International IRD-UCAD de l'IRD, Dakar, Sénégal
| | - Jean Gaudart
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic & ICT, Marseille, France
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Michel E, Gaudart J, Beaulieu S, Bulit G, Piarroux M, Boncy J, Dely P, Piarroux R, Rebaudet S. Estimating effectiveness of case-area targeted response interventions against cholera in Haiti. eLife 2019; 8:50243. [PMID: 31886768 PMCID: PMC7041943 DOI: 10.7554/elife.50243] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/20/2019] [Indexed: 01/24/2023] Open
Abstract
Case-area targeted interventions (CATIs) against cholera are conducted by rapid response teams, and may include various activities like water, sanitation, hygiene measures. However, their real-world effectiveness has never been established. We conducted a retrospective observational study in 2015-2017 in the Centre department of Haiti. Using cholera cases, stool cultures and CATI records, we identified 238 outbreaks that were responded to. After adjusting for potential confounders, we found that a prompt response could reduce the number of accumulated cases by 76% (95% confidence interval, 59 to 86) and the outbreak duration by 61% (41 to 75) when compared to a delayed response. An intense response could reduce the number of accumulated cases by 59% (11 to 81) and the outbreak duration by 73% (49 to 86) when compared to a weaker response. These results suggest that prompt and repeated CATIs were significantly effective at mitigating and shortening cholera outbreaks in Haiti.
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Affiliation(s)
- Edwige Michel
- Ministry of Public Health and Population, Directorate of Epidemiology Laboratory and Research, Port-au-Prince, Haiti
| | - Jean Gaudart
- Aix-Marseille Université, APHM, INSERM, IRD, SESSTIM, Hop Timone, BiSTIC, Biostatistics and ICT, Marseille, France
| | | | - Gregory Bulit
- United Nations Children's Fund, Port-au-Prince, Haiti
| | - Martine Piarroux
- Centre d'Épidémiologie et de Santé Publique des Armées, Service de Santé des Armées, Marseille, France
| | - Jacques Boncy
- Ministry of Public Health and Population, National Laboratory of Public Health, Delmas, Haiti
| | - Patrick Dely
- Ministry of Public Health and Population, Directorate of Epidemiology Laboratory and Research, Port-au-Prince, Haiti
| | - Renaud Piarroux
- Sorbonne Université, Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique (IPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stanislas Rebaudet
- APHM, Hôpital Européen, Aix Marseille Université, INSERM, IRD, SESSTIM, IPLESP, Marseille, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, Paris, France
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42
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Piarroux R, Rebaudet S. [The surprising disappearance of cholera in Haiti]. Rev Prat 2019; 69:763-765. [PMID: 32233320] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Renaud Piarroux
- Sorbonne Université, INSERM, institut Pierre-Louis d'épidémiologie et de santé publique, Paris, France. Laboratoire de parasitologie et mycologie, groupe hospitalier La Pitié-Salpêtrière, AP-HP, Paris, France
| | - Stanislas Rebaudet
- Sorbonne Université, INSERM, institut Pierre-Louis d'épidémiologie et de santé publique, Paris, France. Hôpital européen, AP-HM, Marseille, France
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Mouri O, Ezzine N, Haddad E, Achouri L, Parizot C, Thellier M, Piarroux R. New promising method to assess microfilarial Loa loa load on the peripheral blood. Diagn Microbiol Infect Dis 2019; 95:114887. [PMID: 31630909 DOI: 10.1016/j.diagmicrobio.2019.114887] [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: 04/03/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 10/26/2022]
Abstract
Loiasis is a vector-borne parasitic disease caused by the filarial Loa loa (L. loa). Definitive diagnosis can be done by identifying and counting microfilariae in the peripheral blood by microscopy and with L.loa-specific PCR. An additional diagnostic method is the detection of L.loa-specific antibodies. Accurate methods are needed to automate quantification of microfilaria (mf) in peripheral blood. Indeed, the treatment procedure depends on the microfilarial L. loa load in blood. We report the first documented use of flow cytometry as a new method to count microfilaraemia in peripheral blood from a patient with L. loa infection. The diagnosis of loiasis was strongly suspected based on clinical presentation and rapidly confirmed by identifying typical features of L. loa in the peripheral blood. This diagnosis was achieved by flow cytometry using a specific fluorescence pattern for microfilaraemia count. The current report highlights the potential of flow cytometry to assess microfilarial L. loa load from a patient with loiasis infection.
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Affiliation(s)
- Oussama Mouri
- Department of Parasitology and Mycology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
| | - Naouel Ezzine
- Department of Immunology, AP-HP, George Pompidou Hospital, Paris, France
| | - Elie Haddad
- Department of Infectious Diseases, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Lhaouari Achouri
- Department of Parasitology and Mycology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Marc Thellier
- Department of Parasitology and Mycology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Université, INSERM, France; Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France
| | - Renaud Piarroux
- Department of Parasitology and Mycology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Université, INSERM, France; Institut Pierre-Louis d'Epidémiologie et de Santé Publique, France
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Bernheim D, Dupont D, Aptel F, Dard C, Chiquet C, Normand AC, Piarroux R, Cornet M, Maubon D. Pythiosis: Case report leading to new features in clinical and diagnostic management of this fungal-like infection. Int J Infect Dis 2019; 86:40-43. [PMID: 31212104 DOI: 10.1016/j.ijid.2019.06.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 05/14/2019] [Accepted: 06/12/2019] [Indexed: 02/05/2023] Open
Abstract
A 21-year-old man developed infectious keratitis after swimming in Spain whilst wearing contact lenses. Mycelial growth from a corneal sample suggested keratomycosis, but a drastic worsening of the patient's condition was observed on antifungal drugs. On day 38, panfungal PCR identified Pythium insidiosum, which is an aquatic organism belonging to the oomycete family. Based on the recent literature, this patient was promptly prescribed a systemic and local antibiotic regimen and cure was ultimately achieved. In order to facilitate P. insidiosum identification in future cases, we have generated the first matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) reference spectrum for P. insidiosum. It is planned to deposit this MALDI-TOF MS reference spectrum on an open-access platform and this should allow immediate identification of the pathogen. Finally, this case report also demonstrates that P. insidiosum is emerging outside tropical and subtropical areas. Clinicians and microbiologists should have better knowledge to accurately manage and diagnose this sight-threatening infection.
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Affiliation(s)
- Diane Bernheim
- Department of Ophthalmology, Grenoble-Alpes University Hospital, Grenoble, France
| | - Damien Dupont
- Hospices Civils de Lyon, Institut des Agents Infectieux, Parasitologie Mycologie, Lyon, 69000, France; Integrative Physiology of the Brain Arousal Systems, Centre de Recherche en Neurosciences de Lyon, INSERM U1028-CNRS UMR 5292, Université Claude Bernard Lyon 1, Lyon, 69000, France
| | - Florent Aptel
- Department of Ophthalmology, Grenoble-Alpes University Hospital, Grenoble, France; University Grenoble Alpes, CNRS, Grenoble INP, HP2 Laboratory, INSERM U1042, 38000 Grenoble, France
| | - Celine Dard
- Department of Infectious Agents, Parasitology, Mycology Laboratory, Grenoble-Alpes University Hospital, Grenoble, France
| | - Christophe Chiquet
- Department of Ophthalmology, Grenoble-Alpes University Hospital, Grenoble, France; University Grenoble Alpes, CNRS, Grenoble INP, HP2 Laboratory, INSERM U1042, 38000 Grenoble, France
| | - Anne Cécile Normand
- Laboratoire de Parasitologie, Mycologie Hôpital Pitié Salpétrière et Paris, Sorbonne Université, Paris, France
| | - Renaud Piarroux
- Laboratoire de Parasitologie, Mycologie Hôpital Pitié Salpétrière et Paris, Sorbonne Université, Paris, France
| | - Muriel Cornet
- Department of Infectious Agents, Parasitology, Mycology Laboratory, Grenoble-Alpes University Hospital, Grenoble, France; Grenoble-Alpes University, CNRS, Grenoble INP, TIMC-IMAG, 38000 Grenoble, France
| | - Danièle Maubon
- Department of Infectious Agents, Parasitology, Mycology Laboratory, Grenoble-Alpes University Hospital, Grenoble, France; Grenoble-Alpes University, CNRS, Grenoble INP, TIMC-IMAG, 38000 Grenoble, France.
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Michel E, Gaudart J, Beaulieu S, Bulit G, Piarroux M, Boncy J, Dely P, Piarroux R, Rebaudet S. Première démonstration de l’efficacité d’interventions de réponse rapides contre les flambées de choléra : une étude quasi-expérimentale en Haïti. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.272] [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: 11/29/2022]
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46
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Bénard AHM, Guenou E, Fookes M, Ateudjieu J, Kasambara W, Siever M, Rebaudet S, Boncy J, Adrien P, Piarroux R, Sack DA, Thomson N, Debes AK. Whole genome sequence of Vibrio cholerae directly from dried spotted filter paper. PLoS Negl Trop Dis 2019; 13:e0007330. [PMID: 31145741 PMCID: PMC6559667 DOI: 10.1371/journal.pntd.0007330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 09/21/2018] [Revised: 06/11/2019] [Accepted: 03/25/2019] [Indexed: 01/29/2023] Open
Abstract
Background Global estimates for cholera annually approximate 4 million cases worldwide with 95,000 deaths. Recent outbreaks, including Haiti and Yemen, are reminders that cholera is still a global health concern. Cholera outbreaks can rapidly induce high death tolls by overwhelming the capacity of health facilities, especially in remote areas or areas of civil unrest. Recent studies demonstrated that stool specimens preserved on filter paper facilitate molecular analysis of Vibrio cholerae in resource limited settings. Specimens preserved in a rapid, low-cost, safe and sustainable manner for sequencing provides previously unavailable data about circulating cholera strains. This may ultimately contribute new information to shape public policy response on cholera control and elimination. Methodology/Principal findings Whole genome sequencing (WGS) recovered close to a complete sequence of the V. cholerae O1 genome with satisfactory genome coverage from stool specimens enriched in alkaline peptone water (APW) and V. cholerae culture isolates, both spotted on filter paper. The minimum concentration of V. cholerae DNA sufficient to produce quality genomic information was 0.02 ng/μL. The genomic data confirmed the presence or absence of genes of epidemiological interest, including cholera toxin and pilus loci. WGS identified a variety of diarrheal pathogens from APW-enriched specimen spotted filter paper, highlighting the potential for this technique to explore the gut microbiome, potentially identifying co-infections, which may impact the severity of disease. WGS demonstrated that these specimens fit within the current global cholera phylogenetic tree, identifying the strains as the 7th pandemic El Tor. Conclusions WGS results allowed for mapping of short reads from APW-enriched specimen and culture isolate spotted filter papers. This provided valuable molecular epidemiological sequence information on V. cholerae strains from remote, low-resource settings. These results identified the presence of co-infecting pathogens while providing rare insight into the specific V. cholerae strains causing outbreaks in cholera-endemic areas. Cholera affects more than 4 million people globally every year; people predominantly living in poverty or in resource-constrained conditions including political crises or natural disasters. Cholera’s typical presentation is characterized by rapid onset of acute watery diarrhea and vomiting which can progress from watery stool to shock in as little as four hours. Laboratory conditions needed for culture confirmation and strain preservation are rarely to never present in these affected areas. In fact, many cholera endemic areas in Sub-Saharan African are so remote that even treatment response alone is often challenging. Here we present the genomic analysis of DNA extracted from dried filter paper, which is a low-cost, low-tech and sustainable method. Previously this method has facilitated cholera confirmation by PCR, but we demonstrate that this method is also suitable for whole genome sequencing and subsequent strain characterization by presenting the analysis of samples from an outbreak in a remote area of Cameroon. This method will facilitate the understanding of the molecular epidemiology in cholera-prone areas, which were previously too challenging to attempt. It also introduces a method that can be used on a broader scale for diarrheal disease surveillance, including providing a window into co-infection and microbiome analyses.
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Affiliation(s)
| | - Etienne Guenou
- M.A. SANTE (Meilleur Accès aux Soins de Santé), Yaoundé, Cameroon
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Maria Fookes
- Wellcome Trust Sanger Institute, Genome campus, Hinxton United Kingdom
| | - Jerome Ateudjieu
- M.A. SANTE (Meilleur Accès aux Soins de Santé), Yaoundé, Cameroon
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Cameroon Dschang Cameroon
- Clinical Research Unit, Division of Health Operations Research, Ministry of Public Health, N°8, quartier du Lac (Yaoundé III), Cameroon
| | | | - Matthew Siever
- John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Stanislas Rebaudet
- Assistance Publique–Hôpitaux de Marseille (APHM), Marseille, France
- Hôpital Européen, Marseille, France
| | - Jacques Boncy
- National Laboratory of Public Health in Haiti (LNSP), Ministry of Public Health and Population, Haiti
| | - Paul Adrien
- Directorate for Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Haiti
| | - Renaud Piarroux
- Sorbonne Université, INSERM, Institut Pierre-Louis d’Epidémiologie et de Santé Publique, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - David A. Sack
- John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Nicholas Thomson
- Wellcome Trust Sanger Institute, Genome campus, Hinxton United Kingdom
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, United Kingdom
| | - Amanda K. Debes
- John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
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Abstract
Hospital-acquired aspergillosis is usually associated with environmental contamination. In 2015, continuous monitoring of airborne fungi and multilocus variable-number tandem-repeat analysis identified the source of Aspergillus fumigatus as the airway of a patient. Therefore, patients colonized with Aspergillus spp. should be treated in airborne infection isolation rooms.
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Kendjo E, Houzé S, Mouri O, Taieb A, Gay F, Jauréguiberry S, Tantaoui I, Ndour PA, Buffet P, Piarroux M, Thellier M, Piarroux R. Epidemiologic Trends in Malaria Incidence Among Travelers Returning to Metropolitan France, 1996-2016. JAMA Netw Open 2019; 2:e191691. [PMID: 30951158 PMCID: PMC6523451 DOI: 10.1001/jamanetworkopen.2019.1691] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IMPORTANCE Despite annually adapted recommendations to prevent malaria in travelers to endemic areas, France is still the industrialized country reporting the highest number of imported cases of malaria. Better understanding of the epidemiologic context and evolution during the past 2 decades may help to define a better preventive strategy. OBJECTIVE To study epidemiologic trends of imported cases of malaria in travelers in geographic territories of France on the European continent (metropolitan France) from 1996 through 2016 to potentially explain the persistence of high imported malaria incidence despite national preventive measures. DESIGN, SETTING, AND PARTICIPANTS In a cross-sectional study, between January 1 and May 31, 2018, data were extracted from the French National Reference Center of Malaria Surveillance. Trends in patients with imported malaria in association with age, sex, ethnicity, purpose of travel, malaria species, severity of illness, case mortality rate, and endemic countries visited were analyzed in 43 333 malaria cases among civilian travelers living in metropolitan France. MAIN OUTCOMES AND MEASURES Evolution of the main epidemiologic characteristics of patients with imported malaria. RESULTS Among the 43 333 patients with imported malaria in civilian travelers included in the study, 24 949 were male (62.4%), and 8549 were younger than 18 years (19.9%). A total of 28 658 malaria cases (71.5%) were among African individuals, and 10 618 cases (26.5%) among European individuals. From 1996 through 2016, the number of confirmed malaria cases peaked at 3400 cases in 2000, then declined to 1824 cases in 2005 and stabilized thereafter to approximately 1720 malaria cases per year. A total of 37 065 cases (85.5%) were due to Plasmodium falciparum. The proportion of malaria cases among African individuals rose from 53.5% in 1996 to 83.4% in 2016, and the most frequent motivation for traveling was visiting friends and relatives (25 329 [77.1%]; P < .001). Despite an increase in the proportion of severe cases, which rose from 131 cases (8.9%) in 1996 to 279 cases (16.7%) in 2016 (P < .001), mortality remained stable, being approximately 0.4% during the study period. CONCLUSIONS AND RELEVANCE Beyond the apparent stability of the number of imported malaria cases in France, significant changes appear to have occurred among the population who developed malaria infection following travel in endemic areas. These changes may imply that adaptation of the preventive strategy is needed to reduce the burden of the disease among travelers.
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Affiliation(s)
- Eric Kendjo
- Sorbonne Université, Institut National de
la Santé et de la Recherche Médicale (INSERM), Institut Pierre–Louis
d’Epidémiologie et de Santé Publique, Assistance Publique
Hôpitaux de Paris (AP-HP), Centre National de Référence du Paludisme,
Hôpital Pitié–Salpêtrière, France
| | - Sandrine Houzé
- Sorbonne Université, Institut de Recherche
pour le Développement, AP-HP, Centre National de Référence du
Paludisme, Hôpital Bichât Claude–Bernard, Paris, France
| | - Oussama Mouri
- AP-HP, Centre National de Référence du
Paludisme, Hôpital Pitié–Salpêtrière, Paris, France
| | - Aida Taieb
- Sorbonne Université, INSERM, Laboratory of
Excellence GR–Ex The Red Blood Cell, Paris, France
| | - Frédérick Gay
- Sorbonne Université, Institut National de
la Santé et de la Recherche Médicale (INSERM), Institut Pierre–Louis
d’Epidémiologie et de Santé Publique, Assistance Publique
Hôpitaux de Paris (AP-HP), Centre National de Référence du Paludisme,
Hôpital Pitié–Salpêtrière, France
| | - Stéphane Jauréguiberry
- Sorbonne Université, Institut National de
la Santé et de la Recherche Médicale (INSERM), Institut Pierre–Louis
d’Epidémiologie et de Santé Publique, Assistance Publique
Hôpitaux de Paris (AP-HP), Centre National de Référence du Paludisme,
Hôpital Pitié–Salpêtrière, France
| | - Ilhame Tantaoui
- Sorbonne Université, Institut National de
la Santé et de la Recherche Médicale (INSERM), Institut Pierre–Louis
d’Epidémiologie et de Santé Publique, Assistance Publique
Hôpitaux de Paris (AP-HP), Centre National de Référence du Paludisme,
Hôpital Pitié–Salpêtrière, France
| | - Papa A. Ndour
- Sorbonne Université, INSERM, Laboratory of
Excellence GR–Ex The Red Blood Cell, Institut National de la Transfusion
Sanguine, AP-HP, Hôpital Necker–Enfants Malades, Paris, France
| | - Pierre Buffet
- Sorbonne Université, INSERM, Laboratory of
Excellence GR–Ex The Red Blood Cell, Institut National de la Transfusion
Sanguine, AP-HP, Hôpital Necker–Enfants Malades, Paris, France
| | - Martine Piarroux
- Sorbonne Université, INSERM, Institut
Pierre–Louis d’Epidémiologie et de Santé Publique, AP-HP,
Hôpital Saint–Antoine, Paris, France
| | - Marc Thellier
- Sorbonne Université, Institut National de
la Santé et de la Recherche Médicale (INSERM), Institut Pierre–Louis
d’Epidémiologie et de Santé Publique, Assistance Publique
Hôpitaux de Paris (AP-HP), Centre National de Référence du Paludisme,
Hôpital Pitié–Salpêtrière, France
| | - Renaud Piarroux
- Sorbonne Université, Institut National de
la Santé et de la Recherche Médicale (INSERM), Institut Pierre–Louis
d’Epidémiologie et de Santé Publique, Assistance Publique
Hôpitaux de Paris (AP-HP), Centre National de Référence du Paludisme,
Hôpital Pitié–Salpêtrière, France
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Becker P, Normand AC, Vanantwerpen G, Vanrobaeys M, Haesendonck R, Vercammen F, Stubbe D, Piarroux R, Hendrickx M. Identification of fungal isolates by MALDI-TOF mass spectrometry in veterinary practice: validation of a web application. J Vet Diagn Invest 2019; 31:471-474. [PMID: 30943879 DOI: 10.1177/1040638719835577] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has emerged as a reliable method to identify fungal isolates. The success of this approach relies on the availability of exhaustive databases, but the latter were built with a focus on human pathogens. We assessed a large in-house database of reference spectra and a dedicated web application for their suitability for use in veterinary laboratories. A panel of 290 mold and yeast isolates representing 69 different fungal species was isolated from various animals (including pets, cattle, and zoo animals) and identified using both MALDI-TOF MS and conventional techniques. The performance of the 2 methods was compared, and identifications were confirmed by DNA sequencing. MALDI-TOF MS allowed distinction between some closely related species and achieved 89% correct identification at the species level. In comparison, only 60% of the isolates were correctly identified with conventional approaches. Using this online application, MALDI-TOF MS thus appears to be a relevant alternative for the identification of fungal isolates encountered by animal health professionals.
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Affiliation(s)
- Pierre Becker
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Anne-Cécile Normand
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Gerty Vanantwerpen
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Mia Vanrobaeys
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Roel Haesendonck
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Francis Vercammen
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Dirk Stubbe
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Renaud Piarroux
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
| | - Marijke Hendrickx
- Belgian Coordinated Collections of Microorganisms (BCCM/IHEM) Fungal Collection, Mycology and Aerobiology, Sciensano, Brussels, Belgium (Becker, Stubbe, Hendrickx).,Animal Health Care Flanders, Torhout, Belgium (Vanantwerpen, Vanrobaeys).,Zoolyx, Aalst, Belgium (Haesendonck).,Centre for Research and Conservation, Royal Zoological Society of Antwerp, Antwerp, Belgium (Vercammen).,Sorbonne University, National Institute for Health and Medical Research, Pierre-Louis Institute of Epidemiology and Public Health (Piarroux).,Public Assistance-Hospitals of Paris, University Hospital Pitie-Salpetriere (Normand, Piarroux), Paris, France
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Rebaudet S, Bulit G, Gaudart J, Michel E, Gazin P, Evers C, Beaulieu S, Abedi AA, Osei L, Barrais R, Pierre K, Moore S, Boncy J, Adrien P, Duperval Guillaume F, Beigbeder E, Piarroux R. The case-area targeted rapid response strategy to control cholera in Haiti: a four-year implementation study. PLoS Negl Trop Dis 2019; 13:e0007263. [PMID: 30990822 PMCID: PMC6485755 DOI: 10.1371/journal.pntd.0007263] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 05/23/2018] [Revised: 04/26/2019] [Accepted: 02/25/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In October 2010, Haiti was struck by a large-scale cholera epidemic. The Haitian government, UNICEF and other international partners launched an unprecedented nationwide alert-response strategy in July 2013. Coordinated NGOs recruited local rapid response mobile teams to conduct case-area targeted interventions (CATIs), including education sessions, household decontamination by chlorine spraying, and distribution of chlorine tablets. An innovative red-orange-green alert system was also established to monitor the epidemic at the communal scale on a weekly basis. Our study aimed to describe and evaluate the exhaustiveness, intensity and quality of the CATIs in response to cholera alerts in Haiti between July 2013 and June 2017. METHODOLOGY/PRINCIPAL FINDINGS We analyzed the response to 7,856 weekly cholera alerts using routine surveillance data and severity criteria, which was based on the details of 31,306 notified CATIs. The odds of CATI response during the same week (exhaustiveness) and the number of complete CATIs in responded alerts (intensity and quality) were estimated using multivariate generalized linear mixed models and several covariates. CATIs were carried out significantly more often in response to red alerts (adjusted odds ratio (aOR) [95%-confidence interval, 95%-CI], 2.52 [2.22-2.87]) compared with orange alerts. Significantly more complete CATIs were carried out in response to red alerts compared with orange alerts (adjusted incidence ratio (aIR), 1.85 [1.73-1.99]). Over the course of the eight-semester study, we observed a significant improvement in the exhaustiveness (aOR, 1.43 [1.38-1.48] per semester) as well as the intensity and quality (aIR, 1.23 [1.2-1.25] per semester) of CATI responses, independently of funds available for the strategy. The odds of launching a CATI response significantly decreased with increased rainfall (aOR, 0.99 [0.97-1] per each accumulated cm). Response interventions were significantly heterogeneous between NGOs, communes and departments. CONCLUSIONS/SIGNIFICANCE The implementation of a nationwide case-area targeted rapid response strategy to control cholera in Haiti was feasible albeit with certain obstacles. Such feedback from the field and ongoing impact studies will be very informative for actors and international donors involved in cholera control and elimination in Haiti and in other affected countries.
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Affiliation(s)
- Stanislas Rebaudet
- Assistance Publique–Hôpitaux de Marseille (AP-HM), Marseille, France
- Hôpital Européen Marseille, Marseille, France
- Institut Pierre-Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, Paris, France
| | | | - Jean Gaudart
- Assistance Publique–Hôpitaux de Marseille (AP-HM), Marseille, France
- Aix Marseille Univ, IRD, INSERM, SESSTIM, Marseille, France
| | - Edwige Michel
- Direction d’Epidémiologie de Laboratoire et de Recherche, Ministère de la Santé Publique et de la Population, Haiti
| | - Pierre Gazin
- Institut de Recherche pour le Développement (IRD), Marseille, France
| | | | | | - Aaron Aruna Abedi
- United Nations Children's Fund, Haiti
- Direction de la Lutte contre la Maladie, Ministère de la Santé Publique, Kinshasa, Democratic Republic of the Congo
| | - Lindsay Osei
- Assistance Publique–Hôpitaux de Marseille (AP-HM), Marseille, France
- United Nations Children's Fund, Haiti
| | - Robert Barrais
- Direction d’Epidémiologie de Laboratoire et de Recherche, Ministère de la Santé Publique et de la Population, Haiti
| | - Katilla Pierre
- Direction d’Epidémiologie de Laboratoire et de Recherche, Ministère de la Santé Publique et de la Population, Haiti
| | | | - Jacques Boncy
- Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, Haiti
| | - Paul Adrien
- Direction d’Epidémiologie de Laboratoire et de Recherche, Ministère de la Santé Publique et de la Population, Haiti
| | | | | | - Renaud Piarroux
- Sorbonne Université, INSERM, Institut Pierre-Louis d’Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
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