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Paccoud O, Desnos-Ollivier M, Persat F, Demar M, Boukris-Sitbon K, Bellanger AP, Bonhomme J, Bonnal C, Botterel F, Bougnoux ME, Brun S, Cassaing S, Cateau E, Chouaki T, Cornet M, Dannaoui E, Desbois-Nogard N, Durieux MF, Favennec L, Fekkar A, Gabriel F, Gangneux JP, Guitard J, Hasseine L, Huguenin A, Le Gal S, Letscher-Bru V, Mahinc C, Morio F, Nicolas M, Poirier P, Ranque S, Roosen G, Rouges C, Roux AL, Sasso M, Alanio A, Lortholary O, Lanternier F. Features of cryptococcosis among 652 HIV-seronegative individuals in France: a cross-sectional observational study (2005-2020). Clin Microbiol Infect 2024:S1198-743X(24)00162-9. [PMID: 38556212 DOI: 10.1016/j.cmi.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/20/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES We aimed to describe features and outcomes of cryptococcosis among HIV-seronegative individuals in a large surveillance network for cryptococcosis in France. METHODS We included incident cases of cryptococcosis in HIV-seronegative individuals from 2005 to 2020. We compared patient characteristics, disease presentations, cryptococcal antigen results, and induction antifungal treatments according to underlying disease. We examined factors associated with 90-day mortality. Among patients with disseminated infections, we investigated whether receipt of flucytosine and polyene combination was associated with lower mortality. RESULTS Among 652 individuals, 209 (32.1%) had malignancy, 130 (19.9%) were solid-organ transplant recipients, 204 (31.3%) had other immunocompromising conditions, and 109 (16.7%) had no reported underlying factor. The commonest presentations were disseminated infections (63.3%, 413/652) and isolated pulmonary infections (25.3%, 165/652). Solid-organ transplant patients were most likely to have disseminated infections and a positive serum cryptococcal antigen result. Patients with malignancy were older and less likely to receive a flucytosine-containing regimen for disseminated infections than others (58.7%, 78/133 vs. 73.2%, 194/265; p 0.029). The crude 90-day case-fatality ratio was 27.2% (95% CI, 23.5%-31.1%). Age ≥60 years (aOR: 2.75 [1.78-4.26]; p < 0.001), meningitis/fungaemia (aOR: 4.79 [1.80-12.7]; p 0.002), and malignancy (aOR: 2.4 [1.14-5.07]; p 0.02) were associated with higher 90-day mortality. Receipt of flucytosine and polyene combination was associated with lower 90-day mortality (aOR: 0.40 [0.23-0.71]; p 0.002) in multivariable analysis and inverse probability of treatment weighted analysis (aOR: 0.45 [0.25-0.80]; p 0.006). DISCUSSION HIV-seronegative individuals with cryptococcosis comprise a wide range of underlying conditions with different presentations and outcomes, requiring a tailored approach to diagnosis and management.
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Affiliation(s)
- Olivier Paccoud
- Université Paris Cité, Department of Infectious Diseases and Tropical Medicine, Necker - Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), IHU Imagine, 75014 Paris, France.
| | - Marie Desnos-Ollivier
- Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France
| | - Florence Persat
- UR3738 Centre pour l'lnnovation en Cancérologie de Lyon, Team Inflammation and Immunity of the Respiratory Epithelium, Claude Bernard University-Lyon 1, 69495 Pierre Bénite, France; Department of Medical Mycology and Parasitology, Institute of Infectious Agents, Croix-Rousse Hospital, Hospices Civils de Lyon, 69004 Lyon, France
| | - Magalie Demar
- Laboratoire Hospitalo-Universitaire de Parasito-Mycologie, Centre hospitalier de Cayenne Guyane, Cayenne, France
| | - Karine Boukris-Sitbon
- Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France
| | - Anne-Pauline Bellanger
- CHU de Besançon, Laboratoire de Parasitologie-Mycologie, UMR Chrono-Environnement/CNRS 6249, F-25000, Besançon, France
| | - Julie Bonhomme
- Laboratoire de Parasitologie-Mycologie, CHU de Caen, ToxEMAC-ABTE, Unicaen Université Normandie, Caen, France
| | - Christine Bonnal
- Laboratory of Parasitology-Mycology, Bichat-Claude Bernard University Hospital, AP-HP, 75018 Paris, France
| | - Françoise Botterel
- Unité de Parasitologie - Mycologie, Département des agents infectieux, AP-HP, Dynamyc research Unit, UPEC, France
| | - Marie-Elisabeth Bougnoux
- Unité de Parasitologie-Mycologie, Service de Microbiologie Clinique, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, INRAE USC2019, Unité Biologie et Pathogénicité Fongiques, Paris, France
| | - Sophie Brun
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Bobigny, France
| | - Sophie Cassaing
- Department of Parasitology and Mycology, Toulouse University Hospital, Restore-FLAMES, Toulouse III University, France
| | - Estelle Cateau
- Laboratoire de Parasitologie-Mycologie - CHU de Poitiers, Ecologie et Biologie des Interactions UMR CNRS 7267, France
| | - Taieb Chouaki
- Service de Parasitologie Mycologie Médicales, CHU Amiens Picardie 80054, Amiens, France; Inserm U1285, Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000 Lille, France
| | - Muriel Cornet
- Université Grenoble Alpes, CNRS, UMR 5525, CHU Grenoble Alpes, VetAgro Sup, Grenoble INP, TIMC, 38000 Grenoble, France
| | - Eric Dannaoui
- Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France; Unité de Parasitologie-Mycologie, Service de Microbiologie Clinique, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France
| | - Nicole Desbois-Nogard
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique, France
| | | | - Loïc Favennec
- French National Cryptosporidiosis Reference Center, CHU de Rouen, Rouen, Normandie, France; EA 7510, UFR Santé, University of Rouen Normandy, Rouen, France
| | - Arnaud Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013, Paris, France; Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, F-75013, Paris, France
| | - Frederic Gabriel
- Laboratoire de Parasitologie-Mycologie, CHU de Bordeaux, F-33000 Bordeaux, France
| | - Jean-Pierre Gangneux
- Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Laboratory of Parasitology and Medical Mycology, European Confederation of Medical Mycology (ECMM) Excellence Center, Centre National de Référence Aspergilloses Chroniques, Rennes Teaching Hospital, F-35000 Rennes, France
| | - Juliette Guitard
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Paris, France
| | - Lilia Hasseine
- Parasitologie - Mycologie, Hôpital de l'Archet, CHU Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | - Antoine Huguenin
- Université de Reims Champagne Ardenne, ESCAPE EA7510, Laboratoire de Parasitologie-Mycologie, Pôle de Biologie Pathologie, CHU de Reims, Rue du Général Koening, Reims, France
| | - Solène Le Gal
- CHU de Brest, Laboratoire de Parasitologie-Mycologie, Univ Brest, Univ Angers, Infections Respiratoires Fongiques, F-29200, Brest, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et Mycologie Médicale, Les Hôpitaux Universitaires de Strasbourg, Institut de Parasitologie et Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France
| | - Caroline Mahinc
- Centre Hospitalier Universitaire de Saint Etienne, Service de Parasitologie Mycologie, Saint Etienne, France
| | - Florent Morio
- Nantes Université, CHU Nantes, Cibles et Médicaments des Infections et de l'Immunité, UR1155, Nantes, France
| | - Muriel Nicolas
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
| | - Philippe Poirier
- Université Clermont Auvergne, Inserm, 3IHP, Centre Hospitalier Universitaire Clermont-Ferrand, Service de Parasitologie-Mycologie, Clermont-Ferrand, France
| | - Stéphane Ranque
- Aix-Marseille Université, IHU Méditerranée Infection, AP-HM, IRD, SSA, VITROME, 13005 Marseille, France
| | | | - Célia Rouges
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne-Laure Roux
- Université Paris-Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-Le-Bretonneux, France; AP-HP, GHU Paris Saclay, Hôpital Ambroise Paré, Microbiology Department, Boulogne-Billancourt, France
| | - Milène Sasso
- Laboratoire de Parasitologie-Mycologie, CHU Nîmes & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France
| | - Alexandre Alanio
- Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France; Laboratoire de Parasitologie-Mycologie, AP-HP, Hôpital Saint-Louis, F-75010 Paris, France
| | - Olivier Lortholary
- Université Paris Cité, Department of Infectious Diseases and Tropical Medicine, Necker - Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), IHU Imagine, 75014 Paris, France; Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France
| | - Fanny Lanternier
- Université Paris Cité, Department of Infectious Diseases and Tropical Medicine, Necker - Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), IHU Imagine, 75014 Paris, France; Mycology Department, Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Mycology Translational Research Group, France
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Nevez G, Guillerm G, Talarmin JP, Quinio D, Iriart X, Lissillour PL, Rezig S, Fangous MS, Ranty M, Bodenes L, Aubron C, Couturier MA, Le Gal S. Hormographiella aspergillata pulmonary infections: Detection and identification of the fungus using pan-fungal PCR assays and DNA sequencing. J Mycol Med 2024; 34:101463. [PMID: 38342037 DOI: 10.1016/j.mycmed.2024.101463] [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: 10/23/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/13/2024]
Abstract
Hormographiella aspergillata is a basidiomycete exceptionally involved in invasive fungal infections (IFI). We report a case of H. aspergillata pulmonary infection in a 30-year-old female in a context of pancytopenia and relapsed of acute myeloid leukemia (AML). She presented with fever, thoracic pain, left pleural effusion and pneumonia, diagnosed on chest X-ray and CT-scan. Direct examination of a bronchoalveolar lavage (BAL) specimen performed on day (d) 10 was negative, while the culture was positive on d30. H. aspergillata was suspected, considering macroscopic and microscopic examination. Its identification was confirmed using Microflex® Bruker mass spectrometry and pan-fungal (PF)-PCR assay followed by DNA sequencing. After this initial diagnosis, the patient was monitored for 2.8 years. She was treated with liposomal amphotericin B and/or voriconazole until switching to isavuconazole on d298 due to side-effects. This antifungal treatment was maintained until d717 and then discontinued, the patient being considered as cured. Over this follow-up period, the patient was submitted to recurrent pulmonary sampling. Each time, cultures were negative, while PF - PCR assays and DNA sequencing confirmed the presence of H. aspergillata. The present case-report is the 32nd observation of H. aspergillata invasive infection showing that this IFI is still infrequent. Fifteen have occurred in patients with AML, which appears as the most frequent underlying disease favoring this IFI. Six recent case-reports in addition to ours highlight PF-PCR assays and DNA sequencing as relevant diagnostic tools that must be included in routine diagnosis and monitoring of IFI, specifically those due to rare basidiomycetes.
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Affiliation(s)
- Gilles Nevez
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France.
| | - Gaelle Guillerm
- Hematology, Brest University Hospital, F-29609 Brest, France
| | - Jean-Philippe Talarmin
- Infectious Diseases and Tropical Medicine, Cornouaille Hospital, Quimper, France, F-29000 Quimper, France
| | - Dorothée Quinio
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France
| | - Xavier Iriart
- Parasitology and Mycology Unit, Toulouse University Hospital, F-31059 Toulouse, France; Toulouse Institute for Infectious and Inflammatory Diseases (UMR "Infinity" Inserm/ CNRS/ Toulouse III University), F-31024 Toulouse, France
| | | | - Schéhérazade Rezig
- Infectious Diseases and Tropical Medicine, Brest University Hospital, F-29609 Brest, France
| | | | - Marion Ranty
- Pneumology, Brest University Hospital, F-29609 Brest, France
| | - Laetitia Bodenes
- Intensive care unit, Brest University Hospital, F-29609 Brest, France
| | - Cécile Aubron
- Intensive care unit, Brest University Hospital, F-29609 Brest, France
| | | | - Solène Le Gal
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France
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Nevez G, Hoffmann C, Le Gal S. Comment on " Pneumocystis jirovecii Pneumonia in a HIV-Infected Patient with a CD4 Count Greater Than 400 Cells/ μL and Atovaquone Prophylaxis". Case Rep Infect Dis 2023; 2023:9793264. [PMID: 37908307 PMCID: PMC10615577 DOI: 10.1155/2023/9793264] [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] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/29/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
- Gilles Nevez
- Université de Brest, Université d'Angers, IRF, Brest, France
- Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France
| | - Claire Hoffmann
- Université de Brest, Université d'Angers, IRF, Brest, France
- Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France
| | - Solène Le Gal
- Université de Brest, Université d'Angers, IRF, Brest, France
- Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France
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Bonnet PL, Hoffmann CV, Le Nan N, Bellamy L, Hoarau G, Flori P, Demar M, Argy N, Morio F, Le Gal S, Nevez G. Atovaquone exposure and Pneumocystis jirovecii cytochrome b mutations: French data and review of the literature. Med Mycol 2023; 61:myad095. [PMID: 37656874 DOI: 10.1093/mmy/myad095] [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: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023] Open
Abstract
Pneumocystis jirovecii is a transmissible fungus responsible for severe pneumonia (Pneumocystis pneumonia [PCP]) in immunocompromised patients. Missense mutations due to atovaquone selective pressure have been identified on cytochrome b (CYB) gene of P. jirovecii. It was recently shown that atovaquone prophylaxis can lead to the selection of specific P. jirovecii CYB mutants potentially resistant to atovaquone among organ transplant recipients. In this context, our objectives were to provide data on P. jirovecii CYB mutants and the putative selective pressure exerted by atovaquone on P. jirovecii organisms in France. A total of 123 patients (124 P. jirovecii specimens) from four metropolitan hospitals and two overseas hospitals were retrospectively enrolled. Fourteen patients had prior exposure to atovaquone, whereas 109 patients did not at the time of P. jirovecii detection. A 638 base-pair fragment of the CYB gene of P. jirovecii was amplified and sequenced. A total of 10 single nucleotide polymorphisms (SNPs) were identified. Both missense mutations C431T (Ala144Val) and C823T (Leu275Phe), located at the Qo active site of the enzyme, were significantly associated with prior atovaquone exposure, these mutations being conversely incidental in the absence of prior atovaquone exposure (P < 0.001). Considering that the aforementioned hospitals may be representative of the national territory, these findings suggest that the overall presence of P. jirovecii CYB mutants remains low in France.
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Affiliation(s)
- Pierre L Bonnet
- Laboratory of Parasitology and Mycology, Brest University Hospital, 29609 Brest, France
- Fungal Respiratory Infections Research Unit (FRI), University of Angers, University of Western Brittany, 29238 Brest, France
| | - Claire V Hoffmann
- Fungal Respiratory Infections Research Unit (FRI), University of Angers, University of Western Brittany, 29238 Brest, France
| | - Nathan Le Nan
- Fungal Respiratory Infections Research Unit (FRI), University of Angers, University of Western Brittany, 29238 Brest, France
| | - Lorenn Bellamy
- Clinical Data Center, Brest University Hospital, 29609 Brest, France
| | - Gautier Hoarau
- Ophthalmology Department, OPHTARA Network, Bicêtre Paris Saclay University Hospital, AP-HP, 94276 Le Kremlin-Bicêtre, France
| | - Pierre Flori
- Laboratory of Infectious Agents, Parasitology Section, GIMAP, Faculty of Medicine, 42055 Saint-Etienne, France
| | - Magalie Demar
- University Hospital Laboratory of Parasitology-Mycology, Cayenne Hospital Center, 97306 Cayenne, French Guiana
| | - Nicolas Argy
- IRD, MERIT, University of Paris Cité, 75006 Paris, France
| | - Florent Morio
- Laboratory of Parasitology and Medical Mycology, Nantes University Hospital, 44000 Nantes, France
| | - Solène Le Gal
- Laboratory of Parasitology and Mycology, Brest University Hospital, 29609 Brest, France
- Fungal Respiratory Infections Research Unit (FRI), University of Angers, University of Western Brittany, 29238 Brest, France
| | - Gilles Nevez
- Laboratory of Parasitology and Mycology, Brest University Hospital, 29609 Brest, France
- Fungal Respiratory Infections Research Unit (FRI), University of Angers, University of Western Brittany, 29238 Brest, France
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Guegan H, Roojee M, Gal SL, Artus M, Nevez G, Gangneux JP, Robert-Gangneux F. Evaluation of the PneumoGenius® PCR assay for the diagnosis of Pneumocystis pneumonia and the detection of Pneumocystis dihydropteroate synthase mutations in respiratory samples. Med Mycol 2023; 61:7110982. [PMID: 37028929 DOI: 10.1093/mmy/myad032] [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: 01/12/2023] [Revised: 03/08/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023] Open
Abstract
Pneumocystis pneumonia (PCP) is the most frequent fungal opportunistic infection defining AIDS in HIV-infected patients, and is of growing importance in HIV-negative patients. In this latter category of patients, the diagnosis mainly relies on real-time PCR (qPCR) detection of Pneumocystis jirovecii (Pj) on respiratory samples. The PneumoGenius®kit (PathoNostics) allows the simultaneous detection of Pj mtLSU and dihydropteroate synthase (DHPS) polymorphisms, which could be of interest to anticipate therapeutic failure. This study aimed at evaluating its clinical performance on 251 respiratory specimens (239 patients), (i) for P. jirovecii detection in clinical samples, and (ii) for DHPS polymorphisms detection in circulating strains. Patients were classified according to modified EORTC-MSG criteria, as having proven PCP (n = 62), probable PCP (n = 87), Pneumocystis colonization (n = 37), and no PCP (n = 53). Compared to in-house qPCR, the sensitivity of PneumoGenius® assay for P. jirovecii detection' reached 91.9% (182/198), the specificity was excellent (100%, 53/53) and the global concordance was 93.6% (235/253). Four diagnoses of proven/probable PCP were missed by the PneumoGenius® assay, reaching a 97.5% sensitivity (157/161) in this sub-group. The 12 other 'false- negative' results were obtained in patients diagnosed as colonized using the in-house PCR. DHPS genotyping was successful for 147/182 samples with PneumoGenius® and revealed dhps mutation in 8 samples, which were all confirmed by sequencing. In conclusion, PneumoGenius® assay missed the detection of low-burden PCP. This lower sensitivity for PCP diagnosis can be balanced by a higher specificity (P.jirovecii colonization less frequently detected) and the efficient detection of DHPS hot spot mutations.
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Affiliation(s)
- Hélène Guegan
- Université de Rennes, CHU de Rennes, EHESP, Institut de Recherche en Santé, Environnement et travail, Inserm UMR_S 1085, Rennes, France
| | - Maël Roojee
- Laboratoire de Parasitologie-Mycologie, CHU de Rennes, Rennes, France
| | - Solène Le Gal
- Centre Hospitalier Universitaire Brest, Brest, France; Infections Respiratoires Fongiques, Université Brest, Université Angers, Brest/Angers, France
| | - Mathilde Artus
- Centre Hospitalier Universitaire Brest, Brest, France; Infections Respiratoires Fongiques, Université Brest, Université Angers, Brest/Angers, France
| | - Gilles Nevez
- Centre Hospitalier Universitaire Brest, Brest, France; Infections Respiratoires Fongiques, Université Brest, Université Angers, Brest/Angers, France
| | - Jean-Pierre Gangneux
- Université de Rennes, CHU de Rennes, EHESP, Institut de Recherche en Santé, Environnement et travail, Inserm UMR_S 1085, Rennes, France
| | - Florence Robert-Gangneux
- Université de Rennes, CHU de Rennes, EHESP, Institut de Recherche en Santé, Environnement et travail, Inserm UMR_S 1085, Rennes, France
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Mercier V, Letscher-Bru V, Bougnoux ME, Delhaes L, Botterel F, Maubon D, Dalle F, Alanio A, Houzé S, Dannaoui E, Cassagne C, Cassaing S, Durieux MF, Fekkar A, Bouchara JP, Gangneux JP, Bonhomme J, Dupont D, Costa D, Sendid B, Chouaki T, Bourgeois N, Huguenin A, Brun S, Mahinc C, Hasseine L, Le Gal S, Bellanger AP, Bailly E, Morio F, Nourrisson C, Desbois-Nogard N, Perraud-Cateau E, Debourgogne A, Yéra H, Lachaud L, Sasso M. Gradient concentration strip-specific epidemiological cut-off values of antifungal drugs in various yeast species and five prevalent Aspergillus species complexes. Clin Microbiol Infect 2022; 29:652.e9-652.e15. [PMID: 36509375 DOI: 10.1016/j.cmi.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 10/16/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine the epidemiological cut-off values (ECVs) of ten antifungal agents in a wide range of yeasts and Aspergillus spp. using gradient concentration strips. METHODS The minimum inhibitory concentrations for amphotericin B, anidulafungin, caspofungin, micafungin, flucytosine, fluconazole, itraconazole, isavuconazole, posaconazole, and voriconazole, determined with gradient concentration strips at 35 French microbiology laboratories between 2002 and 2020, were retrospectively collected. Then, the ECVs were calculated using the iterative method and a cut-off value of 97.5%. RESULTS Minimum inhibitory concentrations were available for 17 653 clinical isolates. In total, 48 ECVs (including 32 new ECVs) were determined: 29 ECVs for frequent yeast species (e.g. Candida albicans and itraconazole/flucytosine, and Candida glabrata species complex [SC] and flucytosine) and rare yeast species (e.g. Candida dubliniensis, Candida inconspicua, Saccharomyces cerevisiae, and Cryptococcus neoformans) and 19 ECVs for Aspergillusflavus SC, Aspergillusfumigatus SC, Aspergillusnidulans SC, Aspergillusniger SC, and Aspergillusterreus SC. CONCLUSIONS These ECVs can be added to the already available gradient concentration strip-specific ECVs to facilitate minimum inhibitory concentration interpretation and streamline the identification of nonwild type isolates.
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Affiliation(s)
- Victor Mercier
- Laboratoire de Parasitologie-Mycologie, CHU Nîmes & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et Mycologie Médicale, Les Hôpitaux Universitaires de Strasbourg, Institut de Parasitologie et Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France
| | - Marie-Elisabeth Bougnoux
- Laboratoire de Parasitologie-Mycologie, Hôpital Necker Enfants Malades, AP-HP, Unité Biologie et Pathogénicité Fongiques, Institut Pasteur, Université de Paris, INRAE, USC2019, Paris, France
| | - Laurence Delhaes
- Laboratoire de Parasitologie-Mycologie, CHU de Bordeaux, Inserm U1045, Université de Bordeaux, Bordeaux, France
| | - Francoise Botterel
- Laboratoire de Parasitologie-Mycologie, CHU Henri Mondor, AP-HP, Paris, France
| | - Danièle Maubon
- Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - Frédéric Dalle
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire Gérard Mack, UMR PAM Univ Bourgogne Franche-Comté - AgroSup Dijon - Equipe Vin, Aliment, Microbiologie, Stress, Dijon, France
| | - Alexandre Alanio
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, Institut Pasteur, Université Paris Cité, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, UMR2000, Paris, France
| | - Sandrine Houzé
- Université Paris Cité, IRD, MERIT, F 75006 Paris et Service de Parasitologie, AP-HP, Hôpital Bichat, Paris, France
| | - Eric Dannaoui
- Laboratoire de Parasitologie-Mycologie, département de Microbiologie, Hôpital Européen Georges Pompidou, AP-HP, Université de Paris Cité, Faculté de Médecine, Paris, France
| | - Carole Cassagne
- Laboratoire de Parasitologie-Mycologie, AP-MH, IHU Méditerranée Infection, Aix Marseille Univ., Marseille, France
| | - Sophie Cassaing
- Service de Parasitologie-Mycologie, CHU Toulouse, Université Paul Sabatier, Toulouse, France
| | | | - Arnaud Fekkar
- Laboratoire de Parasitologie-Mycologie, AP-HP La Pitié-Salpêtrière, France. Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, F-75013, Paris, France
| | | | - Jean-Pierre Gangneux
- Laboratoire de Parasitologie-Mycologie, CHU de Rennes, Institut de Recherche en Santé Environnement et Travail, UMR U1085 Inserm-Université Rennes 1, Rennes, France
| | - Julie Bonhomme
- Laboratoire de Microbiologie, CHU Caen, Université de Normandie Unicaen, ToxEMAC-ABTE, Caen, France
| | - Damien Dupont
- Laboratoire de Parasitologie-Mycologie Médicale, Hospices Civils de Lyon, Institut des Agents Infectieux, Université Lyon 1, Lyon, France
| | - Damien Costa
- Département de Parasitologie-Mycologie, CHU de Rouen, France
| | - Boualem Sendid
- Service de Parasitologie-Mycologie, CHU Lille, Inserm U1285, CNRS UMR 8576, Université de Lille, Lille, France
| | - Taieb Chouaki
- Laboratoire de Mycologie-Parasitologie, CHU d'Amiens-Picardie, Amiens, France
| | - Nathalie Bourgeois
- Service de Parasitologie-Mycologie, CHU de Montpellier, & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France
| | - Antoine Huguenin
- Laboratoire de Parasitologie-Mycologie, CHU de Rennes, Université de Reims Champagne Ardenne, ESCAPE EA7510, Reims, France
| | - Sophie Brun
- Service de Parasitologie-Mycologie, Hôpital Universitaire Avicenne, AP-HP, Bobigny, France
| | - Caroline Mahinc
- Unité de Parasitologie-Mycologie, Laboratoire des Agents Infectieux et d'Hygiène CHU de St-Etienne, Saint Priest en Jarez, France
| | | | - Solène Le Gal
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, France
| | | | - Eric Bailly
- Service de Parasitologie-Mycologie, CHU de Tours, France
| | - Florent Morio
- Laboratoire de Parasitologie et Mycologie, Nantes Université, CHU de Nantes, Cibles et médicaments des infections et de l'immunité, IICiMed, UR1155, Nantes, France
| | - Céline Nourrisson
- Service de Parasitologie-Mycologie, 3IHP, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nicole Desbois-Nogard
- Laboratoire de Parasitologie-Mycologie, CHU de la Martinique, Fort de France, Martinique, France
| | - Estelle Perraud-Cateau
- Laboratoire de Parasitologie-Mycologie, CHU de Poitiers, Écologie et Biologie des Interactions UMR CNRS 7267 - equipe Microbiologie de l'Eau, Poitiers, France
| | - Anne Debourgogne
- Laboratoire de Microbiologie, CHRU de Nancy, UR 7300 Stress Immunité Pathogène, Université de Lorraine, Vandoeuvre les Nancy, France
| | - Hélène Yéra
- Laboratoire de Parasitologie-Mycologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre Université Paris Cité, Institut Cochin (U1016 Inserm/UMR8104 CNRS/UMR-S8104), Paris, France
| | - Laurence Lachaud
- Service de Parasitologie-Mycologie, CHU de Montpellier, & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France
| | - Milène Sasso
- Laboratoire de Parasitologie-Mycologie, CHU Nîmes & Université de Montpellier, CNRS, IRD, MiVEGEC, Montpellier, France.
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Papon N, Govic YL, Havlíček V, Capilla J, Luptáková D, Dumas D, Gal SL, Nevez G, Vandeputte P, Bouchara JP. S10.5c Insight into the role of secondary metabolism in the pathogenesis of Scedosporium apiospermum. Med Mycol 2022. [PMCID: PMC9554670 DOI: 10.1093/mmy/myac072.s10.5c] [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: 11/22/2022] Open
Abstract
S10.5 Fungal respiratory infections in Cystic Fibrosis, September 24, 2022, 10:30 AM - 12:00 PM Secondary metabolism is a general term defining biosynthetic pathways that occur in plants, bacteria, and fungi and lead to the production of highly diversified molecular structures. Among the diverse functions that were attributed to these molecules, it is now obvious that they are predominantly involved in chemical warfare with competitors in their environments. In fungi, the two main classes of fungal secondary metabolites are polyketides (PKs) and nonribosomal peptides (NRPs). The biosynthesis of such bioactive molecules is performed by large multifunctional enzymes (NRP synthases, NRPS, and polyketide synthases, PKS) encoded by genes usually located within clusters. Conversely to Aspergillus fumigatus, only a few data are currently available for other pathogenic fungi. In this context, our research group is interested in delineating the role of secondary metabolism in Scedosporium apiospermum, a multi-resistant mold known to colonize chronically the airways of patients with cystic fibrosis (CF). Taking advantage of the availability of the S. apiospermum genome sequence, we first conducted an in silico analysis aiming at exploring the PKs and NRPs battery of the fungus. A total of 9 genes encoding PKs, 9 encoding NRPs, and 5 encoding hybrid NRPs/PKs enzymes were identified. All 3 of the PKs gene clusters presented homologies with those involved in the biosynthesis of pseurotin A. transbergamotene, and ovalicin, or the tremorgenic toxin b-aflatrem while a fourth one is involved in the biosynthesis of melanin. Among the NRPs encoding genes, 6 exhibited sufficient similarity scores with other fungal NRPs to predict the class of the generated peptide: siderophores (2), epidithiodioxopiperazines (2), and cyclopeptides (2). Nevertheless, substrate prediction methods for NRPs domains failed, thus questioning about the nature of the produced peptides. We thus focused our attention on the characterization of some NRP and PK biosynthetic pathways. Since iron acquisition is known to be crucial for the survival of microorganisms as for the virulence of numerous pathogens, we first investigated clusters predicted to be responsible for the biosynthesis of siderophores in S. apiospermum. For instance, we disrupted the SAPIO_CDS2806 gene, an ortholog of sidD which drives the production of the extracellular hydroxamate-type siderophore fusarinin C in Aspergillus fumigatus. A comparison of culture supernatants from sidD mutants and their parent strain revealed that S. apiospermum secretes a unique extracellular siderophore, namely Nα‐methylcoprogen B and that sidD gene was essential for the biosynthesis of this siderophore. sidD mutation resulted in the lack of growth under iron limiting conditions. Interestingly, pyoverdine supported the growth of the parent strain only, suggesting that Nα‐methylcoprogen B is required for iron acquisition from this Pseudomonas aeruginosa siderophore. Finally, the deletion of sidD resulted in the loss of virulence in a murine model of scedosporiosis. Altogether, our results demonstrate that S. apiospermum sidD gene drives the synthesis of a unique extracellular siderophore, namely Nα‐methylcoprogen B, which is essential for fungal growth and virulence. Above all, we also provide unprecedented data suggesting that this fungal siderophore scavenges iron from pyoverdine, which might explain the antagonism between S. apiospermum and P. aeruginosa in CF.
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Affiliation(s)
- Nicolas Papon
- ‘Fungal Respiratory Infections’ Research Unit , University of Angers, Angers , France
| | - Yohann Le Govic
- ‘Infectious Agents , Resistance and Chemotherapy’, UR 4294, University of Picardy Jules Verne, Amiens , France
- Parasitology-Mycology Department , Center for Human Biology, University Hospital of Amiens, Amiens , France
| | - Vladimir Havlíček
- Institute of Microbiology of the Czech Academy of Sciences , Prague , Czech Republic
| | - Javier Capilla
- Unitat de Microbiologia , Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona , Spain
| | - Dominika Luptáková
- Institute of Microbiology of the Czech Academy of Sciences , Prague , Czech Republic
| | - Dayana Dumas
- Unitat de Microbiologia , Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili, Reus, Tarragona , Spain
| | - Solène Le Gal
- ‘Fungal Respiratory Infections’ Research Unit , University of Angers, Angers , France
- Parasitology-Mycology Department , University Hospital of Brest, Brest , France
| | - Gilles Nevez
- ‘Fungal Respiratory Infections’ Research Unit , University of Angers, Angers , France
- Parasitology-Mycology Department , University Hospital of Brest, Brest , France
| | - Patrick Vandeputte
- ‘Fungal Respiratory Infections’ Research Unit , University of Angers, Angers , France
| | - J-P Bouchara
- ‘Fungal Respiratory Infections’ Research Unit , University of Angers, Angers , France
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Gangneux JP, Dannaoui E, Fekkar A, Luyt CE, Botterel F, De Prost N, Tadié JM, Reizine F, Houzé S, Timsit JF, Iriart X, Riu-Poulenc B, Sendid B, Nseir S, Persat F, Wallet F, Le Pape P, Canet E, Novara A, Manai M, Cateau E, Thille AW, Brun S, Cohen Y, Alanio A, Mégarbane B, Cornet M, Terzi N, Lamhaut L, Sabourin E, Desoubeaux G, Ehrmann S, Hennequin C, Voiriot G, Nevez G, Aubron C, Letscher-Bru V, Meziani F, Blaize M, Mayaux J, Monsel A, Boquel F, Robert-Gangneux F, Le Tulzo Y, Seguin P, Guegan H, Autier B, Lesouhaitier M, Pelletier R, Belaz S, Bonnal C, Berry A, Leroy J, François N, Richard JC, Paulus S, Argaud L, Dupont D, Menotti J, Morio F, Soulié M, Schwebel C, Garnaud C, Guitard J, Le Gal S, Quinio D, Morcet J, Laviolle B, Zahar JR, Bougnoux ME. Fungal infections in mechanically ventilated patients with COVID-19 during the first wave: the French multicentre MYCOVID study. The Lancet Respiratory Medicine 2022; 10:180-190. [PMID: 34843666 PMCID: PMC8626095 DOI: 10.1016/s2213-2600(21)00442-2] [Citation(s) in RCA: 135] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 12/24/2022]
Abstract
Background Patients with severe COVID-19 have emerged as a population at high risk of invasive fungal infections (IFIs). However, to our knowledge, the prevalence of IFIs has not yet been assessed in large populations of mechanically ventilated patients. We aimed to identify the prevalence, risk factors, and mortality associated with IFIs in mechanically ventilated patients with COVID-19 under intensive care. Methods We performed a national, multicentre, observational cohort study in 18 French intensive care units (ICUs). We retrospectively and prospectively enrolled adult patients (aged ≥18 years) with RT-PCR-confirmed SARS-CoV-2 infection and requiring mechanical ventilation for acute respiratory distress syndrome, with all demographic and clinical and biological follow-up data anonymised and collected from electronic case report forms. Patients were systematically screened for respiratory fungal microorganisms once or twice a week during the period of mechanical ventilation up to ICU discharge. The primary outcome was the prevalence of IFIs in all eligible participants with a minimum of three microbiological samples screened during ICU admission, with proven or probable (pr/pb) COVID-19-associated pulmonary aspergillosis (CAPA) classified according to the recent ECMM/ISHAM definitions. Secondary outcomes were risk factors of pr/pb CAPA, ICU mortality between the pr/pb CAPA and non-pr/pb CAPA groups, and associations of pr/pb CAPA and related variables with ICU mortality, identified by regression models. The MYCOVID study is registered with ClinicalTrials.gov, NCT04368221. Findings Between Feb 29 and July 9, 2020, we enrolled 565 mechanically ventilated patients with COVID-19. 509 patients with at least three screening samples were analysed (mean age 59·4 years [SD 12·5], 400 [79%] men). 128 (25%) patients had 138 episodes of pr/pb or possible IFIs. 76 (15%) patients fulfilled the criteria for pr/pb CAPA. According to multivariate analysis, age older than 62 years (odds ratio [OR] 2·34 [95% CI 1·39–3·92], p=0·0013), treatment with dexamethasone and anti-IL-6 (OR 2·71 [1·12–6·56], p=0·027), and long duration of mechanical ventilation (>14 days; OR 2·16 [1·14–4·09], p=0·019) were independently associated with pr/pb CAPA. 38 (7%) patients had one or more other pr/pb IFIs: 32 (6%) had candidaemia, six (1%) had invasive mucormycosis, and one (<1%) had invasive fusariosis. Multivariate analysis of associations with death, adjusted for candidaemia, for the 509 patients identified three significant factors: age older than 62 years (hazard ratio [HR] 1·71 [95% CI 1·26–2·32], p=0·0005), solid organ transplantation (HR 2·46 [1·53–3·95], p=0·0002), and pr/pb CAPA (HR 1·45 [95% CI 1·03–2·03], p=0·033). At time of ICU discharge, survival curves showed that overall ICU mortality was significantly higher in patients with pr/pb CAPA than in those without, at 61·8% (95% CI 50·0–72·8) versus 32·1% (27·7–36·7; p<0·0001). Interpretation This study shows the high prevalence of invasive pulmonary aspergillosis and candidaemia and high mortality associated with pr/pb CAPA in mechanically ventilated patients with COVID-19. These findings highlight the need for active surveillance of fungal pathogens in patients with severe COVID-19. Funding Pfizer.
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Bretagne S, Sitbon K, Botterel F, Dellière S, Letscher-Bru V, Chouaki T, Bellanger AP, Bonnal C, Fekkar A, Persat F, Costa D, Bourgeois N, Dalle F, Lussac-Sorton F, Paugam A, Cassaing S, Hasseine L, Huguenin A, Guennouni N, Mazars E, Le Gal S, Sasso M, Brun S, Cadot L, Cassagne C, Cateau E, Gangneux JP, Moniot M, Roux AL, Tournus C, Desbois-Nogard N, Le Coustumier A, Moquet O, Alanio A, Dromer F. COVID-19-Associated Pulmonary Aspergillosis, Fungemia, and Pneumocystosis in the Intensive Care Unit: a Retrospective Multicenter Observational Cohort during the First French Pandemic Wave. Microbiol Spectr 2021; 9:e0113821. [PMID: 34668768 PMCID: PMC8528108 DOI: 10.1128/spectrum.01138-21] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/17/2021] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to evaluate diagnostic means, host factors, delay of occurrence, and outcome of patients with COVID-19 pneumonia and fungal coinfections in the intensive care unit (ICU). From 1 February to 31 May 2020, we anonymously recorded COVID-19-associated pulmonary aspergillosis (CAPA), fungemia (CA-fungemia), and pneumocystosis (CA-PCP) from 36 centers, including results on fungal biomarkers in respiratory specimens and serum. We collected data from 154 episodes of CAPA, 81 of CA-fungemia, 17 of CA-PCP, and 5 of other mold infections from 244 patients (male/female [M/F] ratio = 3.5; mean age, 64.7 ± 10.8 years). CA-PCP occurred first after ICU admission (median, 1 day; interquartile range [IQR], 0 to 3 days), followed by CAPA (9 days; IQR, 5 to 13 days), and then CA-fungemia (16 days; IQR, 12 to 23 days) (P < 10-4). For CAPA, the presence of several mycological criteria was associated with death (P < 10-4). Serum galactomannan was rarely positive (<20%). The mortality rates were 76.7% (23/30) in patients with host factors for invasive fungal disease, 45.2% (14/31) in those with a preexisting pulmonary condition, and 36.6% (34/93) in the remaining patients (P = 0.001). Antimold treatment did not alter prognosis (P = 0.370). Candida albicans was responsible for 59.3% of CA-fungemias, with a global mortality of 45.7%. For CA-PCP, 58.8% of the episodes occurred in patients with known host factors of PCP, and the mortality rate was 29.5%. CAPA may be in part hospital acquired and could benefit from antifungal prescription at the first positive biomarker result. CA-fungemia appeared linked to ICU stay without COVID-19 specificity, while CA-PCP may not really be a concern in the ICU. Improved diagnostic strategy for fungal markers in ICU patients with COVID-19 should support these hypotheses. IMPORTANCE To diagnose fungal coinfections in patients with COVID-19 in the intensive care unit, it is necessary to implement the correct treatment and to prevent them if possible. For COVID-19-associated pulmonary aspergillosis (CAPA), respiratory specimens remain the best approach since serum biomarkers are rarely positive. Timing of occurrence suggests that CAPA could be hospital acquired. The associated mortality varies from 36.6% to 76.7% when no host factors or host factors of invasive fungal diseases are present, respectively. Fungemias occurred after 2 weeks in ICUs and are associated with a mortality rate of 45.7%. Candida albicans is the first yeast species recovered, with no specificity linked to COVID-19. Pneumocystosis was mainly found in patients with known immunodepression. The diagnosis occurred at the entry in ICUs and not afterwards, suggesting that if Pneumocystis jirovecii plays a role, it is upstream of the hospitalization in the ICU.
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Affiliation(s)
- Stéphane Bretagne
- Institut Pasteur, Université de Paris, CNRS UMR2000, unité de Mycologie Moléculaire, Centre national de Référence Mycoses Invasives et Antifongiques, Paris, France
- Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux De Paris (AP-HP), Paris, France
- Université de Paris, Paris, France
| | - Karine Sitbon
- Institut Pasteur, Université de Paris, CNRS UMR2000, unité de Mycologie Moléculaire, Centre national de Référence Mycoses Invasives et Antifongiques, Paris, France
| | - Françoise Botterel
- Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Henri Mondor, Université Paris-Est Créteil Val-de-Marne, Créteil, France
| | - Sarah Dellière
- Institut Pasteur, Université de Paris, CNRS UMR2000, unité de Mycologie Moléculaire, Centre national de Référence Mycoses Invasives et Antifongiques, Paris, France
- Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux De Paris (AP-HP), Paris, France
- Université de Paris, Paris, France
| | - Valérie Letscher-Bru
- Service de Parasitologie et de Mycologie Médicale, CHU de Strasbourg, Strasbourg, France
| | - Taieb Chouaki
- Laboratoire de Parasitologie-Mycologie, CHU Amiens-Picardie, Amiens, France
| | | | - Christine Bonnal
- Assistance Publique-Hôpitaux De Paris (AP-HP), Laboratoire de Parasitologie-Mycologie, Hôpital Universitaire Bichat, Paris, France
| | - Arnault Fekkar
- Assistance Publique-Hôpitaux De Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Sorbonne Université, Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses (CIMI), Paris, France
| | - Florence Persat
- Hospices Civils de Lyon, Service de Parasitologie et Mycologie Médicale, Hôpital de la Croix-Rousse, Lyon–Université Claude Bernard Lyon 1, Lyon, France
| | - Damien Costa
- Laboratoire de Parasitologie-Mycologie, CHU Charles-Nicolle, Rouen, France
| | - Nathalie Bourgeois
- Laboratoire de Parasitologie-Mycologie, CHU de Montpellier, Montpellier, France
| | - Frédéric Dalle
- Laboratoire de Parasitologie Mycologie, Centre Hospitalier Universitaire de Dijon—Hôpital François Mitterrand, Dijon, France
| | | | - André Paugam
- Université de Paris, Paris, France
- Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Cochin, Paris, France
| | - Sophie Cassaing
- Service de Parasitologie-Mycologie, Hôpital Purpan Toulouse, CHU Toulouse, Toulouse, France
| | - Lilia Hasseine
- Laboratoire de Parasitologie Mycologie CHU de Nice, Nice, France
| | - Antoine Huguenin
- Parasitologie Mycologie-Laboratoire de Parasitologie-Mycologie, Pôle de Biopathologie, CHU de Reims, Université de Reims Champagne Ardenne, Reims, France
| | - Nadia Guennouni
- Assistance Publique-Hôpitaux De Paris (AP-HP), Service de Bactériologie, Virologie, Parasitologie et Hygiène, Hôpital Necker-Enfants Malades, IHU Imagine, Paris, France
| | - Edith Mazars
- CH de Valenciennes, Laboratoire de Microbiologie, Valenciennes, France
| | - Solène Le Gal
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France
| | - Milène Sasso
- Laboratoire de Parasitologie Mycologie CHU Nîmes, Nîmes, France
| | - Sophie Brun
- Assistance Publique-Hôpitaux De Paris (AP-HP), Laboratoire de Parasitologie Mycologie Hôpital Avicenne, Bobigny, France
| | - Lucile Cadot
- Département d'Hygiène Hospitalière, CHU Montpellier, Montpellier, France
| | - Carole Cassagne
- IHU Marseille—Institut Hospitalier Universitaire Méditerranée Infection, Marseille, France
| | - Estelle Cateau
- Laboratoire de Parasitologie-Mycologie, CHU de Poitiers, Poitiers, France
| | - Jean-Pierre Gangneux
- CHU de Rennes, Université de Rennes, Institut de Recherche en Santé, Environnement et Travail (IRSET), Rennes, France
| | - Maxime Moniot
- Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Anne-Laure Roux
- Assistance Publique-Hôpitaux De Paris (AP-HP), Hôpital Raymond Poincaré Garches, Hôpital Ambroise Paré, Boulogne Billancourt, France
| | - Céline Tournus
- Laboratoire de Microbiologie, Centre Hospitalier de Saint-Denis, Saint-Denis, France
| | - Nicole Desbois-Nogard
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, La Martinique, France
| | | | - Olivier Moquet
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Beauvais, Beauvais, France
| | - Alexandre Alanio
- Institut Pasteur, Université de Paris, CNRS UMR2000, unité de Mycologie Moléculaire, Centre national de Référence Mycoses Invasives et Antifongiques, Paris, France
- Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux De Paris (AP-HP), Paris, France
- Université de Paris, Paris, France
| | - Françoise Dromer
- Institut Pasteur, Université de Paris, CNRS UMR2000, unité de Mycologie Moléculaire, Centre national de Référence Mycoses Invasives et Antifongiques, Paris, France
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Hoffmann CV, Nevez G, Moal MC, Quinio D, Le Nan N, Papon N, Bouchara JP, Le Meur Y, Le Gal S. Selection of Pneumocystis jirovecii Inosine 5'-Monophosphate Dehydrogenase Mutants in Solid Organ Transplant Recipients: Implication of Mycophenolic Acid. J Fungi (Basel) 2021; 7:jof7100849. [PMID: 34682270 PMCID: PMC8537117 DOI: 10.3390/jof7100849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022] Open
Abstract
Mycophenolic acid (MPA) targets the inosine 5'-monophosphate dehydrogenase (IMPDH) of human lymphocytes. It is widely used as an immunosuppressant to prevent rejection in solid organ transplant (SOT) recipients who, incidentally, are at risk for Pneumocystis pneumonia (PCP). We hypothesized that MPA exerts selective pressure on P. jirovecii microorganisms considering its in vitro antifungal activity on other fungi. Thus, we analysed impdh gene in P. jirovecii isolates from SOT recipients. P. jirovecii specimens from 26 patients diagnosed with PCP from 2010 to 2020 were retrospectively examined: 10 SOT recipients treated with MPA and 16 non-SOT patients without prior exposure to MPA. The P. jirovecii impdh gene was amplified and sequenced. Nucleotide sequences were aligned with the reference sequences retrieved from available P. jirovecii whole genomes. The deduced IMPDH protein sequences were aligned with available IMPDH proteins from Pneumocystis spp. and other fungal species known to be in vitro sensitive or resistant to MPA. A total of nine SNPs was identified. One SNP (G1020A) that results in an Ala261Thr substitution was identified in all SOT recipients and in none of the non-SOT patients. Considering that IMPDHs of other fungi, resistant to MPA, harbour Thr (or Ser) at the analogous position, the Ala261Thr mutation observed in MPA-treated patients was considered to represent the signature of P. jirovecii exposure to MPA. These results suggest that MPA may be involved in the selection of specific P. jirovecii strains that circulate in the SOT recipient population.
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Affiliation(s)
- Claire V. Hoffmann
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, 29609 Brest, France; (C.V.H.); (D.Q.)
- Groupe d’Etude des Interactions Hôte-Pathogène (GEIHP), Université d’Angers, Université de Brest, 29238 Brest, France;
| | - Gilles Nevez
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, 29609 Brest, France; (C.V.H.); (D.Q.)
- Groupe d’Etude des Interactions Hôte-Pathogène (GEIHP), Université d’Angers, Université de Brest, 29238 Brest, France;
- Correspondence: (G.N.); (S.L.G.); Tel.: +33-(0)-2-98-14-51-02 (G.N. & S.L.G.); Fax: +33-(0)-2-98-14-51-49 (G.N. & S.L.G.)
| | - Marie-Christine Moal
- Département de Néphrologie, CHU de Brest, 29609 Brest, France; (M.-C.M.); (Y.L.M.)
| | - Dorothée Quinio
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, 29609 Brest, France; (C.V.H.); (D.Q.)
- Groupe d’Etude des Interactions Hôte-Pathogène (GEIHP), Université d’Angers, Université de Brest, 29238 Brest, France;
| | - Nathan Le Nan
- Groupe d’Etude des Interactions Hôte-Pathogène (GEIHP), Université d’Angers, Université de Brest, 29238 Brest, France;
| | - Nicolas Papon
- Groupe d’Etude des Interactions Hôte-Pathogène (GEIHP), Université de Brest, Université d’Angers, 49035 Angers, France; (N.P.); (J.-P.B.)
| | - Jean-Philippe Bouchara
- Groupe d’Etude des Interactions Hôte-Pathogène (GEIHP), Université de Brest, Université d’Angers, 49035 Angers, France; (N.P.); (J.-P.B.)
| | - Yannick Le Meur
- Département de Néphrologie, CHU de Brest, 29609 Brest, France; (M.-C.M.); (Y.L.M.)
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, Labex IGO, 20609 Brest, France
| | - Solène Le Gal
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, 29609 Brest, France; (C.V.H.); (D.Q.)
- Groupe d’Etude des Interactions Hôte-Pathogène (GEIHP), Université d’Angers, Université de Brest, 29238 Brest, France;
- Correspondence: (G.N.); (S.L.G.); Tel.: +33-(0)-2-98-14-51-02 (G.N. & S.L.G.); Fax: +33-(0)-2-98-14-51-49 (G.N. & S.L.G.)
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11
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Nevez G, Totet A, Matos O, Calderon EJ, Miller RF, Le Gal S. It is still PCP that can stand for Pneumocystis pneumonia: Appeal for generalized use of only one acronym. Med Mycol 2021; 59:842-844. [PMID: 34003930 DOI: 10.1093/mmy/myab024] [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: 02/09/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 11/14/2022] Open
Abstract
Twenty-years ago, considering the host specificity of Pneumocystis species, the human-derived Pneumocystis, Pneumocystis carinii formae specialis hominis, was renamed Pneumocystis jirovecii. Pneumocystis carinii formae specialis carinii was finally renamed Pneumocystis carinii and kept for the species derived from Rattus norvegicus. P. jirovecii is now widely used by most authors. The PCP acronym that initially referred to "Pneumocystis cariniipneumonia" was contemporaneously redefined to stand for Pneumocystispneumonia in order to avoid changing the acronym of the name of the disease that clinicians have used for several decades. Using analysis of multidata bases on PubMed, we have noted a recent acceleration in the use of PJP for Pneumocystis jiroveciipneumonia, which may be grammatically correct but not in accordance with retaining PCP, which was proposed in the early 2000s. Through this reminder, in order to standardize the literature on P. jirovecii, we plead for the use of only one acronym, PCP. LAY SUMMARY Through this reminder on Pneumocystis nomenclature, we plead for the use of only one acronym, PCP, the retention of which was proposed in the early 2000s, and which currently stands for Pneumocystispneumonia.
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Affiliation(s)
- Gilles Nevez
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France.,Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP), Université d'Angers, Université de Brest, France
| | - Anne Totet
- Parasitologie et Mycologie, CHU Amiens-Picardie, Amiens, France.,Agents Infectieux, Résistance et chimiothérapie (Laboratoire AGIR, UR 4294), Université de Picardie Jules Verne, Amiens, France
| | - Olga Matos
- Medical Parasitology Unit, Group of Opportunistic Protozoa/HIV and other Protozoa, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisboa, Portugal.,Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Enrique J Calderon
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Robert F Miller
- Institute for Global Health, University College London, London, UK.,Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Solène Le Gal
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France.,Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP), Université d'Angers, Université de Brest, France
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12
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Affiliation(s)
- Céline Nourrisson
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, 3IHP, Clermont-Ferrand, France.,Université Clermont Auvergne, CNRS UMR 6023, Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Solène Le Gal
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Brest, Brest, France.,Groupe d'Etude des Interactions Hôte-Pathogène EA 3142, Université Brest, Université Angers, Brest/Angers, France
| | - Maxime Moniot
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, 3IHP, Clermont-Ferrand, France
| | - Frédéric Delbac
- Université Clermont Auvergne, CNRS UMR 6023, Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Jean-Pierre Bail
- Service de Chirurgie Viscérale, Centre Hospitalier Universitaire Brest, Brest, France
| | - Gilles Nevez
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Brest, Brest, France.,Groupe d'Etude des Interactions Hôte-Pathogène EA 3142, Université Brest, Université Angers, Brest/Angers, France
| | - Philippe Poirier
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, 3IHP, Clermont-Ferrand, France.,Université Clermont Auvergne, CNRS UMR 6023, Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
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13
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Papon N, Nevez G, Le Gal S, Vigneau C, Robert-Gangneux F, Bouchara JP, Cornely OA, Denning DW, Gangneux JP. Fungal infections in transplant recipients: pros and cons of immunosuppressive and antimicrobial treatment. The Lancet Microbe 2021; 2:e6-e8. [DOI: 10.1016/s2666-5247(20)30199-3] [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: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 11/17/2022] Open
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14
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Le Gal S, Bonnet P, Huguenin A, Chapelle C, Boulic P, Tonnelier JM, Moal MC, Gut-Gobert C, Barnier A, Nevez G. The shift from pulmonary colonization to Pneumocystis pneumonia. Med Mycol 2020; 59:510-513. [PMID: 33369642 DOI: 10.1093/mmy/myaa107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/08/2020] [Revised: 11/24/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022] Open
Abstract
Pulmonary specimen pairs from five patients who presented with pulmonary colonization and later developed Pneumocystis Pneumonia (PcP) were retrospectively examined for P. jirovecii genotyping. A match of genotypes in pulmonary specimen pairs of three patients was observed, whereas a partial match and a mismatch were observed in the fourth and fifth patients, respectively. The genotyping results suggest that the colonization state can differ from PcP but can also represent the incubation period of PcP. Clinicians should not systematically rule out the treatment of putative colonized patients and should at least discuss the initiation of prophylaxis on a case-by-case basis.
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Affiliation(s)
- Solène Le Gal
- Université de Brest, Université d'Angers, GEIHP, Brest, France.,Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France
| | - Pierre Bonnet
- Université de Brest, Université d'Angers, GEIHP, Brest, France.,Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France
| | - Antoine Huguenin
- EA 7510, ESCAPE, Laboratory of Parasitology and Mycology, Université de Reims Champagne-Ardenne, 51 rue Cognacq Jay, 51092 Reims CEDEX, France
| | - Célia Chapelle
- Université de Brest, Université d'Angers, GEIHP, Brest, France
| | - Pierrick Boulic
- Université de Brest, Université d'Angers, GEIHP, Brest, France
| | | | | | | | - Aude Barnier
- Pneumology and Internal Medicine, Brest University Hospital, Brest, France
| | - Gilles Nevez
- Université de Brest, Université d'Angers, GEIHP, Brest, France.,Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France
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15
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16
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Le Govic Y, Havlíček V, Capilla J, Luptáková D, Dumas D, Papon N, Le Gal S, Bouchara JP, Vandeputte P. Synthesis of the Hydroxamate Siderophore N α-Methylcoprogen B in Scedosporium apiospermum Is Mediated by sidD Ortholog and Is Required for Virulence. Front Cell Infect Microbiol 2020; 10:587909. [PMID: 33194829 PMCID: PMC7655970 DOI: 10.3389/fcimb.2020.587909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/27/2020] [Accepted: 10/08/2020] [Indexed: 02/04/2023] Open
Abstract
Scedosporium species rank second among the filamentous fungi capable to colonize chronically the respiratory tract of patients with cystic fibrosis (CF). Nevertheless, there is little information on the mechanisms underpinning their virulence. Iron acquisition is critical for the growth and pathogenesis of many bacterial and fungal genera that chronically inhabit the CF lungs. In a previous study, we showed the presence in the genome of Scedosporium apiospermum of several genes relevant for iron uptake, notably SAPIO_CDS2806, an ortholog of sidD, which drives the synthesis of the extracellular hydroxamate-type siderophore fusarinine C (FsC) and its derivative triacetylfusarinine C (TAFC) in Aspergillus fumigatus. Here, we demonstrate that Scedosporium apiospermum sidD gene is required for production of an excreted siderophore, namely, Nα-methylcoprogen B, which also belongs to the hydroxamate family. Blockage of the synthesis of Nα-methylcoprogen B by disruption of the sidD gene resulted in the lack of fungal growth under iron limiting conditions. Still, growth of ΔsidD mutants could be restored by supplementation of the culture medium with a culture filtrate from the parent strain, but not from the mutants. Furthermore, the use of xenosiderophores as the sole source of iron revealed that S. apiospermum can acquire the iron using the hydroxamate siderophores ferrichrome or ferrioxamine, i.e., independently of Nα-methylcoprogen B production. Conversely, Nα-methylcoprogen B is mandatory for iron acquisition from pyoverdine, a mixed catecholate-hydroxamate siderophore. Finally, the deletion of sidD resulted in the loss of virulence in a murine model of scedosporiosis. Our findings demonstrate that S. apiospermum sidD gene drives the synthesis of a unique extracellular, hydroxamate-type iron chelator, which is essential for fungal growth and virulence. This compound scavenges iron from pyoverdine, which might explain why S. apiospermum and Pseudomonas aeruginosa are rarely found simultaneously in the CF lungs.
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Affiliation(s)
- Yohann Le Govic
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université Angers, Université Brest, Angers, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France
| | - Vladimir Havlíček
- Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Javier Capilla
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Dominika Luptáková
- Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Dayana Dumas
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Nicolas Papon
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université Angers, Université Brest, Angers, France
| | - Solène Le Gal
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université Angers, Université Brest, Angers, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Brest, France
| | - Jean-Philippe Bouchara
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université Angers, Université Brest, Angers, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France
| | - Patrick Vandeputte
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université Angers, Université Brest, Angers, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France
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17
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Bonnet P, Le Gal S, Calderon E, Delhaes L, Quinio D, Robert-Gangneux F, Ramel S, Nevez G. Pneumocystis jirovecii in Patients With Cystic Fibrosis: A Review. Front Cell Infect Microbiol 2020; 10:571253. [PMID: 33117730 PMCID: PMC7553083 DOI: 10.3389/fcimb.2020.571253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022] Open
Abstract
Pneumocystis pneumonia (PCP) remains the most frequent AIDS-defining illness in developed countries. This infection also occurs in non-AIDS immunosuppressed patients, e.g., those who have undergone an organ transplantation. Moreover, mild Pneumocystis jirovecii infections related to low pulmonary fungal burden, frequently designated as pulmonary colonization, occurs in patients with chronic pulmonary diseases, e.g., cystic fibrosis (CF). Indeed, this autosomal recessive disorder alters mucociliary clearance leading to bacterial and fungal colonization of the airways. This mini-review compiles and discusses available information on P. jirovecii and CF. It highlights significant differences in the prevalence of P. jirovecii pulmonary colonization in European and Brazilian CF patients. It also describes the microbiota associated with P. jirovecii in CF patients colonized by P. jirovecii. Furthermore, we have described P. jirovecii genomic diversity in colonized CF patients. In addition of pulmonary colonization, it appears that PCP can occur in CF patients specifically after lung transplantation, thus requiring preventive strategies. In other respects, Pneumocystis primary infection is a worldwide phenomenon occurring in non-immunosuppressed infants within their first months. The primary infection is mostly asymptomatic but it can also present as a benign self-limiting infection. It probably occurs in the same manner in CF infants. Nonetheless, two cases of severe Pneumocystis primary infection mimicking PCP in CF infants have been reported, the genetic disease appearing in these circumstances as a risk factor of PCP while the host-pathogen interaction in older children and adults with pulmonary colonization remains to be clarified.
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Affiliation(s)
- Pierre Bonnet
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France
| | - Solène Le Gal
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France.,Groupe d'Etude des Interactions Hôte-Pathogène (ER, GEIHP), Université d'Angers, Université de Brest, Brest, France
| | - Enrique Calderon
- CIBER de Epidemiologia y Salud Publica and Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Seville, Spain
| | - Laurence Delhaes
- Laboratory of Parasitology and Mycology, Bordeaux University Hospital, Bordeaux, France Inserm U1045 - University of Bordeaux, Bordeaux, France
| | - Dorothée Quinio
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France
| | - Florence Robert-Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085, Rennes, France
| | - Sophie Ramel
- Centre de Ressources et de Compétences de la Mucoviscidose, Fondation Ildys, Roscoff, France
| | - Gilles Nevez
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France.,Groupe d'Etude des Interactions Hôte-Pathogène (ER, GEIHP), Université d'Angers, Université de Brest, Brest, France
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18
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Nevez G, Guillaud-Saumur T, Cros P, Papon N, Vallet S, Quinio D, Minoui-Tran A, Pilorgé L, de Parscau L, Sizun J, Ochoa TJ, Bustamante B, Ponce C, Vargas SL, Le Gal S. Pneumocystis primary infection in infancy: Additional French data and review of the literature. Med Mycol 2020; 58:163-171. [PMID: 31127850 PMCID: PMC7107579 DOI: 10.1093/mmy/myz040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/08/2019] [Revised: 04/03/2019] [Accepted: 04/05/2019] [Indexed: 11/12/2022] Open
Abstract
Data on features of Pneumocystis primary infection in infancy are still fragmented. To study Pneumocystis primary infection, 192 infants who were monitored for acute pulmonary disease or fever over a 40-month period were retrospectively investigated. P. jirovecii detection on archival nasopharyngeal aspirates was performed using a qPCR assay. Factors associated with P. jirovecii were assessed using univariate and multivariate analyses. P. jirovecii genotypes in infants and a control group of adults contemporaneously diagnosed with Pneumocystis pneumonia were identified using unilocus, bilocus, and multilocus sequence typing (MLST). P. jirovecii was detected in 35 infants (18.2%). The univariate analysis pointed out four factors: viral infection (P = .035, OR [IC 95], 2.2 [1.1–4.7]), lower respiratory tract infection (P = .032, OR [IC 95], 2.5 [1.1–5.9]), absence of hospital discharge after birth (P = .003, OR (IC 95), 0.1 (0.02–0.5]), and the 63–189-day group (P < .001, OR [IC 95], 42.2 [5.4–332]). The multivariate analysis confirmed these two latter factors (P = .02, OR [IC 95], 0.1 [0.02–0.72]; P = .005, OR [IC 95], 11.5 [2.1–63.5]). Thus, P. jirovecii acquisition mostly takes place in the community. A comparison of these data with those of previously published studies showed that median and interquartile range of positive-infant ages were close to those observed in Chile, Denmark, and Peru, highlighting similar characteristics. Common unilocus or bilocus genotypes were identified in infants and adults, whereas no MLST genotypes were shared. Therefore, a common reservoir made up of infected infants and adults is still hypothetical. Finally, primary infection is a worldwide phenomenon occurring at the same time in childhood regardless of geographical location, rather than an incidental event.
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Affiliation(s)
- Gilles Nevez
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | - Thibaud Guillaud-Saumur
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | - Pierrick Cros
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | - Nicolas Papon
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France
| | - Sophie Vallet
- Laboratoire de Virologie, CHRU de Brest, Brest, France.,UMR INSERM U 1078, Université de Bretagne-Loire, Brest, France
| | - Dorothée Quinio
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | | | - Léa Pilorgé
- Laboratoire de Virologie, CHRU de Brest, Brest, France
| | | | - Jacques Sizun
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | - Theresa J Ochoa
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Beatriz Bustamante
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carolina Ponce
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago
| | - Sergio L Vargas
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago
| | - Solène Le Gal
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
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19
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Hoffmann C, Guillerm G, Le Pape P, Carausu L, Lavergne RA, Nevez G, Le Gal S. Mucorales DNA detection in serum specimens for early diagnosis of mucormycosis. Diagn Microbiol Infect Dis 2020; 97:115004. [PMID: 32156450 DOI: 10.1016/j.diagmicrobio.2020.115004] [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: 10/23/2019] [Revised: 01/13/2020] [Accepted: 01/26/2020] [Indexed: 10/25/2022]
Abstract
We report a case of pulmonary mucormycosis in a patient with T-cell acute lymphoblastic leukemia. The diagnosis of mucormycosis was initially based on mycological examination of a pulmonary specimen. However, we describe how it could have been made 2 months earlier using polymerase chain reaction assays targeting Mucorales species on serum specimens.
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Affiliation(s)
- Claire Hoffmann
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France; Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP; EA 3142), Université de Bretagne Occidentale-Université d'Angers, Brest, France
| | - Gaëlle Guillerm
- Service d'Hématologie Clinique, Hôpital Morvan, CHU de Brest, Brest, France
| | - Patrice Le Pape
- Laboratoire de Parasitologie-Mycologie, Institut de Biologie, CHU de Nantes, France; Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155-IICiMed, Faculté de Pharmacie, Nantes, France
| | - Liana Carausu
- Service d'Hématologie Clinique, Hôpital Morvan, CHU de Brest, Brest, France
| | - Rose-Anne Lavergne
- Laboratoire de Parasitologie-Mycologie, Institut de Biologie, CHU de Nantes, France; Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155-IICiMed, Faculté de Pharmacie, Nantes, France
| | - Gilles Nevez
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France; Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP; EA 3142), Université de Bretagne Occidentale-Université d'Angers, Brest, France
| | - Solène Le Gal
- Laboratoire de Parasitologie et Mycologie, Hôpital de La Cavale Blanche, CHU de Brest, Brest, France; Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP; EA 3142), Université de Bretagne Occidentale-Université d'Angers, Brest, France.
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Le Gal S, Hoarau G, Bertolotti A, Negri S, Le Nan N, Bouchara JP, Papon N, Blanchet D, Demar M, Nevez G. Pneumocystis jirovecii Diversity in Réunion, an Overseas French Island in Indian Ocean. Front Microbiol 2020; 11:127. [PMID: 32117149 PMCID: PMC7019000 DOI: 10.3389/fmicb.2020.00127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/20/2020] [Indexed: 12/17/2022] Open
Abstract
Data on Pneumocystis jirovecii characteristics from the overseas French territories are still scarce whereas numerous data on P. jirovecii genotypes are available for metropolitan France. The main objective of the present study was to identify P. jirovecii multilocus genotypes in patients living in Réunion and to compare them with those identified using the same method in metropolitan France and in French Guiana. Archival P. jirovecii specimens from immunosuppressed patients, 16 living in Réunion (a French island of the Indian ocean), six living in French Guiana (a South-American French territory), and 24 living in Brest (Brittany, metropolitan France) were examined at the large subunit rRNA (mtLSUrRNA) genes, cytochrome b (CYB), and superoxide dismutase (SOD) genes using PCR assays and direct sequencing. A total of 23 multi-locus genotypes (MLG) were identified combining mtLSUrRNA, CYB, and SOD alleles, i.e., six in Reunionese patients, three in Guianese patients, and 15 in Brest patients. Only one MLG (mtLSU1-CYB1-SOD2) was shared by Reunionese and Guianese patients (one patient from each region) whereas none of the 22 remaining MLG were shared by the 3 patient groups. A total of eight MLG were newly identified, three in Réunion and five in Brest. These results that were obtained through a retrospective investigation of a relatively low number of P. jirovecii specimens, provides original and first data on genetic diversity of P. jirovecii in Réunion island. The results suggest that P. jirovecii organisms from Réunion present specific characteristics compared to other P. jirovecii organisms from metropolitan France and French Guiana.
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Affiliation(s)
- Solène Le Gal
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Université d'Angers-Université de Brest, Angers, France.,Laboratory of Mycology and Parasitology, CHRU de Brest, Brest, France
| | - Gautier Hoarau
- Department of Microbiology, CHU La Réunion, Saint Pierre, France
| | | | - Steven Negri
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Université d'Angers-Université de Brest, Angers, France
| | - Nathan Le Nan
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Université d'Angers-Université de Brest, Angers, France
| | - Jean-Philippe Bouchara
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Université d'Angers-Université de Brest, Angers, France
| | - Nicolas Papon
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Université d'Angers-Université de Brest, Angers, France
| | - Denis Blanchet
- Laboratory of Mycology and Parasitology, Andrée Rosemon Hospital, Cayenne, French Guiana.,Equipe EA3593 - Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, French Guiana
| | - Magalie Demar
- Laboratory of Mycology and Parasitology, Andrée Rosemon Hospital, Cayenne, French Guiana.,Equipe EA3593 - Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, French Guiana
| | - Gilles Nevez
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Université d'Angers-Université de Brest, Angers, France.,Laboratory of Mycology and Parasitology, CHRU de Brest, Brest, France
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21
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Le Gal S, Toubas D, Totet A, Dalle F, Abou Bacar A, Le Meur Y, Nevez G, Accoceberry I, Bailly E, Bellanger AP, Bonhomme J, Cateau E, Candolfi E, Damiani C, Dannaoui E, Dardé ML, Debourgogne A, Delhaes L, Desoubeaux G, Favennec L, Flori P, Gabriel F, Iriart X, Lachaud L, Leterrier M, Le Pape P, Machouard M, Marty P, Maubon D, Millon L, Pomares C, Pons D, Rodier MH. Pneumocystis Infection Outbreaks in Organ Transplantation Units in France: A Nation-Wide Survey. Clin Infect Dis 2019; 70:2216-2220. [DOI: 10.1093/cid/ciz901] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/09/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
The burden of nosocomial Pneumocystis infections in transplantation units in France was evaluated through a retrospective survey. Over 12 years, 16 outbreaks occurred, including 13 among renal transplant recipients (RTRs). We performed Pneumocystis jirovecii genotyping in 5 outbreaks, which suggested that specific strains may have been selected by RTRs.
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Affiliation(s)
- Solène Le Gal
- Groupe d’études des Interactions Hôte-Pathogène (EA 3142), Université de Brest, Université d’Angers, France
- Laboratory of Parasitology and Mycology, Brest University Hospital Brest, France Brest, France
| | - Dominique Toubas
- Laboratory of Parasitology and Mycology, Reims University Hospital Brest, France Reims, France
| | - Anne Totet
- Laboratory of Parasitology and Mycology, Amiens University Hospital Brest, France Amiens, France
| | - Frederic Dalle
- Laboratory of Parasitology and Mycology, Dijon University Hospital Brest, France Dijon, France
| | - Ahmed Abou Bacar
- Institut de Parasitologie et de Pathologie Tropicale de Strasbourg, Université de Strasbourg, Hôpitaux Universitaires de Strasbourg Strasbourg, France
| | - Yann Le Meur
- Department of Nephrology and Renal Transplantation Unit, Brest University Hospital, Brest, France
| | - Gilles Nevez
- Groupe d’études des Interactions Hôte-Pathogène (EA 3142), Université de Brest, Université d’Angers, France
- Laboratory of Parasitology and Mycology, Brest University Hospital Brest, France Brest, France
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22
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Nevez G, Le Gal S. Pulmonary co-infection with Pneumocystis jirovecii and Histoplasma capsulatum in AIDS patients is not a rare event. Int J Infect Dis 2019; 87:126-127. [DOI: 10.1016/j.ijid.2019.08.012] [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: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 10/26/2022] Open
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23
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Nevez G, Guillaud-Saumur T, Cros P, Roué JM, Le Ny F, Tierrie T, Sizun J, de Parscau L, Le Gal S. Pneumocystis Is Still Involved in Nonimmunosuppressed Preterm Infants in Europe. Clin Infect Dis 2019; 67:645-646. [PMID: 29462273 DOI: 10.1093/cid/ciy132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gilles Nevez
- Groupe d'Étude des Interactions Hôtes-Pathogènes-EA, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, France
| | - Thibaud Guillaud-Saumur
- Groupe d'Étude des Interactions Hôtes-Pathogènes-EA, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, France
| | - Pierrick Cros
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | | | - Fabien Le Ny
- Laboratoire de Mycologie et Parasitologie, CHRU de Brest, France
| | - Tess Tierrie
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | - Jacques Sizun
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | | | - Solène Le Gal
- Groupe d'Étude des Interactions Hôtes-Pathogènes-EA, Angers-Brest, Université de Bretagne-Loire, France
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24
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Le Govic Y, Papon N, Le Gal S, Bouchara JP, Vandeputte P. Non-ribosomal Peptide Synthetase Gene Clusters in the Human Pathogenic Fungus Scedosporium apiospermum. Front Microbiol 2019; 10:2062. [PMID: 31551992 PMCID: PMC6737921 DOI: 10.3389/fmicb.2019.02062] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/21/2019] [Indexed: 11/13/2022] Open
Abstract
Scedosporium species are opportunistic fungi which preferentially affect patients with underlying conditions such as immunosuppression or cystic fibrosis (CF). While being the second most common molds capable to chronically colonize the CF lungs, the natural history of infection remains unclear. In filamentous fungi, a broad range of important secondary metabolites that are recognized as virulence factors are produced by multidomain non-ribosomal peptide synthetases (NRPSs). The aim of this study was to provide a global in silico analysis of NRPS-encoding genes based on the recently sequenced Scedosporium apiospermum genome. We uncovered a total of nine NRPS genes, of which six exhibited sufficient similarity scores with other fungal NRPSs to predict the class of the generated peptide: siderophores (n = 2), epidithiodioxopiperazines (n = 2), and cyclopeptides (n = 2). Phylogenetic trees based on the multiple alignments of adenylation (A) domain sequences corroborated these findings. Nevertheless, substrate prediction methods for NRPS A-domains tended to fail, thus questioning about the exact nature of the peptide produced. Further studies should be undertaken since NRPSs, which are not synthesized by human cells, could represent attractive therapeutic targets.
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Affiliation(s)
- Yohann Le Govic
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université d'Angers, Angers, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Université d'Angers, Angers, France
| | - Nicolas Papon
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université d'Angers, Angers, France
| | - Solène Le Gal
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université de Bretagne Occidentale, Brest, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Université de Bretagne Occidentale, Brest, France
| | - Jean-Philippe Bouchara
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université d'Angers, Angers, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Université d'Angers, Angers, France
| | - Patrick Vandeputte
- Groupe d'Etude des Interactions Hôte-Pathogène (GEIHP, EA 3142), SFR ICAT 4208, Université d'Angers, Angers, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Université d'Angers, Angers, France
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25
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Pougnet R, Pougnet L, Le Gal S, Loddé B, Nevez G. "Champimer" project: investigation of fungal diversity at the air-water interface of maritime environment. Int Marit Health 2019; 70:140-141. [PMID: 31237675 DOI: 10.5603/imh.2019.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 05/27/2019] [Indexed: 11/25/2022] Open
Affiliation(s)
- Richard Pougnet
- French Society of Maritime Medicine (Société Française de Médecine Maritime [SFMM]), Brest, France. .,Environmental Diseases Unit, University Hospital, CHRU, Brest, France. .,Universitive Preventive Medicine Unit (Service Universitaire de Médecine Préventive et de Promotion de la Santé [SUMPPS]), Université de Bretagne Occidentale, Brest, France.
| | - Laurence Pougnet
- French Society of Maritime Medicine (Société Française de Médecine Maritime [SFMM]), Brest, France.,Military Hospital, Clermont-Tonnerre, Brest, France.,Groupe d'Etudes des Interactions Hôte-Pathogène (GEIHP), Université de Bretagne Occidentale, Brest, France
| | - Solène Le Gal
- Groupe d'Etudes des Interactions Hôte-Pathogène (GEIHP), Université de Bretagne Occidentale, Brest, France.,Laboratoire de parasitologie et mycologie médicales (UF 8872), CHRU, Brest, France
| | - Brice Loddé
- French Society of Maritime Medicine (Société Française de Médecine Maritime [SFMM]), Brest, France.,Environmental Diseases Unit, University Hospital, CHRU, Brest, France.,Optimisation des Régulations Physiologiques (ORPHY), Université de Bretagne Occidentale, Brest, France
| | - Gilles Nevez
- Groupe d'Etudes des Interactions Hôte-Pathogène (GEIHP), Université de Bretagne Occidentale, Brest, France.,Laboratoire de parasitologie et mycologie médicales (UF 8872), CHRU, Brest, France
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26
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Schwarz C, Vandeputte P, Rougeron A, Giraud S, Dugé de Bernonville T, Duvaux L, Gastebois A, Alastruey-Izquierdo A, Martín-Gomez MT, Mazuelos EM, Sole A, Cano J, Pemán J, Quindos G, Botterel F, Bougnoux ME, Chen S, Delhaès L, Favennec L, Ranque S, Sedlacek L, Steinmann J, Vazquez J, Williams C, Meyer W, Le Gal S, Nevez G, Fleury M, Papon N, Symoens F, Bouchara JP. Developing collaborative works for faster progress on fungal respiratory infections in cystic fibrosis. Med Mycol 2018. [PMID: 29538733 DOI: 10.1093/mmy/myx106] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cystic fibrosis (CF) is the major genetic inherited disease in Caucasian populations. The respiratory tract of CF patients displays a sticky viscous mucus, which allows for the entrapment of airborne bacteria and fungal spores and provides a suitable environment for growth of microorganisms, including numerous yeast and filamentous fungal species. As a consequence, respiratory infections are the major cause of morbidity and mortality in this clinical context. Although bacteria remain the most common agents of these infections, fungal respiratory infections have emerged as an important cause of disease. Therefore, the International Society for Human and Animal Mycology (ISHAM) has launched a working group on Fungal respiratory infections in Cystic Fibrosis (Fri-CF) in October 2006, which was subsequently approved by the European Confederation of Medical Mycology (ECMM). Meetings of this working group, comprising both clinicians and mycologists involved in the follow-up of CF patients, as well as basic scientists interested in the fungal species involved, provided the opportunity to initiate collaborative works aimed to improve our knowledge on these infections to assist clinicians in patient management. The current review highlights the outcomes of some of these collaborative works in clinical surveillance, pathogenesis and treatment, giving special emphasis to standardization of culture procedures, improvement of species identification methods including the development of nonculture-based diagnostic methods, microbiome studies and identification of new biological markers, and the description of genotyping studies aiming to differentiate transient carriage and chronic colonization of the airways. The review also reports on the breakthrough in sequencing the genomes of the main Scedosporium species as basis for a better understanding of the pathogenic mechanisms of these fungi, and discusses treatment options of infections caused by multidrug resistant microorganisms, such as Scedosporium and Lomentospora species and members of the Rasamsonia argillacea species complex.
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Affiliation(s)
- Carsten Schwarz
- Department of Pediatric Pneumology and Immunology, Cystic Fibrosis Center Berlin/Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Patrick Vandeputte
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France.,Laboratoire de Parasitologie-Mycologie, CHU, Angers, France
| | - Amandine Rougeron
- Université de Bordeaux, Microbiologie Fondamentale et Pathogénicité UMR 5234, Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France; Laboratoire de Parasitologie-Mycologie, CHU, Bordeaux, France
| | - Sandrine Giraud
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Thomas Dugé de Bernonville
- Biomolécules et Biotechnologies Végétales (EA 2106), Département de Biologie et Physiologie Végétales, UFR Sciences et Techniques, Université François Rabelais, Tours
| | - Ludovic Duvaux
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France.,Institut de Recherche en Horticulture et Semences (IRHS), UMR INRA 1345, Beaucouzé, France
| | - Amandine Gastebois
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Maria Teresa Martín-Gomez
- Respiratory Bacteriology Unit & Clinical Mycology Unit, Department of Microbiology, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Amparo Sole
- Unidad de Trasplante Pulmonar y Fibrosis Quística, Hospital Universitari la Fe, Valencia, Spain
| | - Josep Cano
- Mycology Unit, Medical School/Oenology School, Universitat Rovira i Virgili, Reus, Spain
| | - Javier Pemán
- Unidad de Micología, Servicio de Microbiología, Universitari la Fe, Valencia, Spain
| | - Guillermo Quindos
- Laboratorio de Micología Médica, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco, Bilbao, Spain
| | - Françoise Botterel
- Laboratoire de Parasitologie-Mycologie, CHU Henri Mondor, Créteil, France
| | | | - Sharon Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - Pathology West, Westmead Hospital, Westmead, New South Wales, Australia
| | - Laurence Delhaès
- Center for Cardiothoracic Research of Bordeaux, Inserm U1045, Bordeaux, France
| | - Loïc Favennec
- Laboratoire de Parasitologie-Mycologie, EA 3800, CHU Charles Nicolle and Université de Rouen, Rouen, France
| | - Stéphane Ranque
- Laboratoire de Parasitologie-Mycologie, AP-HM Timone, Marseille, France
| | - Ludwig Sedlacek
- Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jose Vazquez
- Division of Infectious Diseases, Department of Medicine, Georgia Regents University, Augusta, GA, USA
| | - Craig Williams
- University of the West of Scotland, Institute of Healthcare Associated Infection, University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Sydney Medical School, Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead Hospital, Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Solène Le Gal
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Brest, France.,Laboratoire de Parasitologie-Mycologie, CHU, Brest, France
| | - Gilles Nevez
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Brest, France.,Laboratoire de Parasitologie-Mycologie, CHU, Brest, France
| | - Maxime Fleury
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Nicolas Papon
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Françoise Symoens
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Jean-Philippe Bouchara
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France.,Laboratoire de Parasitologie-Mycologie, CHU, Angers, France
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27
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Delhaes L, Touati K, Faure-Cognet O, Cornet M, Botterel F, Dannaoui E, Morio F, Le Pape P, Grenouillet F, Favennec L, Le Gal S, Nevez G, Duhamel A, Borman A, Saegeman V, Lagrou K, Gomez E, Carro ML, Canton R, Campana S, Buzina W, Chen S, Meyer W, Roilides E, Simitsopoulou M, Manso E, Cariani L, Biffi A, Fiscarelli E, Ricciotti G, Pihet M, Bouchara JP. Prevalence, geographic risk factor, and development of a standardized protocol for fungal isolation in cystic fibrosis: Results from the international prospective study "MFIP". J Cyst Fibros 2018; 18:212-220. [PMID: 30348610 DOI: 10.1016/j.jcf.2018.10.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 08/07/2018] [Accepted: 10/01/2018] [Indexed: 01/18/2023]
Affiliation(s)
| | - Kada Touati
- University & CHU of Lille, F-59000 Lille, France
| | - Odile Faure-Cognet
- Univ. Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France
| | - Muriel Cornet
- Univ. Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France
| | | | | | | | | | | | | | | | | | | | | | - Veroniek Saegeman
- University of Leuven, National Reference center for Mycosis, Belgium
| | - Katrien Lagrou
- University of Leuven, National Reference center for Mycosis, Belgium
| | - Elia Gomez
- Hosital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Madrid, Spain
| | - Maiz-Luis Carro
- Hosital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Madrid, Spain
| | - Rafael Canton
- Hosital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Madrid, Spain
| | | | | | - Sharon Chen
- Molecular Mycology Research Laboratory, Marie Bashir Institute for Biosecurity and Emerging Infections, University of Sydney, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Marie Bashir Institute for Biosecurity and Emerging Infections, University of Sydney, Australia
| | | | | | | | - Lisa Cariani
- Microbiology and Cystic Fibrosis Microbiology Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Italy
| | - Arianna Biffi
- Microbiology and Cystic Fibrosis Microbiology Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Italy
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28
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Fréalle E, Valade S, Guigue N, Hamane S, Chabé M, Le Gal S, Damiani C, Totet A, Aliouat EM, Nevez G, Menotti J. Diffusion of Pneumocystis jirovecii in the surrounding air of patients with Pneumocystis colonization: frequency and putative risk factors. Med Mycol 2018; 55:568-572. [PMID: 27811179 DOI: 10.1093/mmy/myw113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/19/2016] [Indexed: 11/14/2022] Open
Abstract
In a prospective bicentric study, Pneumocystis jirovecii excretion and diffusion was explored in air samples collected in the rooms occupied by 17 Pneumocystis-colonized patients. P. jirovecii DNA was detected by real-time PCR in the air collected from 3 patients' rooms (17.6%), with identical genotypes in corresponding clinical and air samples. Pneumocystis DNA was detected for 2/3 patients with autoimmune disease treated with corticosteroids versus 1/6 patients with hematologic disease and 0/5 kidney transplant recipients. These data confirm the possible excretion of the fungus by Pneumocystis-colonized patients and thus bring additional arguments for the prevention of airborne transmission in hospital wards.
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Affiliation(s)
- Emilie Fréalle
- CHU Lille, Laboratory of Parasitology-Mycology, F-59000, Lille.,Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille
| | - Sandrine Valade
- Intensive Care Unit, Saint-Louis University Hospital, AP-HP and Paris-Diderot University, Sorbonne Paris Cité, Paris
| | - Nicolas Guigue
- Laboratory of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP and Paris-Diderot University, Sorbonne Paris Cité, Paris
| | - Samia Hamane
- Laboratory of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP and Paris-Diderot University, Sorbonne Paris Cité, Paris
| | - Magali Chabé
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille
| | - Solène Le Gal
- Laboratory of Parasitology-Mycology, GEIHP EA 3142, Brest University Hospital, Brest
| | - Céline Damiani
- Laboratory of Parasitology-Mycology, Amiens University Hospital and University of Picardie-Jules Verne, Amiens
| | - Anne Totet
- Laboratory of Parasitology-Mycology, Amiens University Hospital and University of Picardie-Jules Verne, Amiens
| | - El Moukhtar Aliouat
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille
| | - Gilles Nevez
- Laboratory of Parasitology-Mycology, GEIHP EA 3142, Brest University Hospital, Brest
| | - Jean Menotti
- Laboratory of Parasitology-Mycology, Saint-Louis University Hospital, AP-HP and Paris-Diderot University, Sorbonne Paris Cité, Paris.,Environmental epidemiology unit, EA 4064, Paris-Descartes University, Sorbonne Paris Cité, Paris, France
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29
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Le Govic Y, Papon N, Le Gal S, Lelièvre B, Bouchara JP, Vandeputte P. Genomic Organization and Expression of Iron Metabolism Genes in the Emerging Pathogenic Mold Scedosporium apiospermum. Front Microbiol 2018; 9:827. [PMID: 29755443 PMCID: PMC5932178 DOI: 10.3389/fmicb.2018.00827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 01/22/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022] Open
Abstract
The ubiquitous mold Scedosporium apiospermum is increasingly recognized as an emerging pathogen, especially among patients with underlying disorders such as immunodeficiency or cystic fibrosis (CF). Indeed, it ranks the second among the filamentous fungi colonizing the respiratory tract of CF patients. However, our knowledge about virulence factors of this fungus is still limited. The role of iron-uptake systems may be critical for establishment of Scedosporium infections, notably in the iron-rich environment of the CF lung. Two main strategies are employed by fungi to efficiently acquire iron from their host or from their ecological niche: siderophore production and reductive iron assimilation (RIA) systems. The aim of this study was to assess the existence of orthologous genes involved in iron metabolism in the recently sequenced genome of S. apiospermum. At first, a tBLASTn analysis using A. fumigatus iron-related proteins as query revealed orthologs of almost all relevant loci in the S. apiospermum genome. Whereas the genes putatively involved in RIA were randomly distributed, siderophore biosynthesis and transport genes were organized in two clusters, each containing a non-ribosomal peptide synthetase (NRPS) whose orthologs in A. fumigatus have been described to catalyze hydroxamate siderophore synthesis. Nevertheless, comparative genomic analysis of siderophore-related clusters showed greater similarity between S. apiospermum and phylogenetically close molds than with Aspergillus species. The expression level of these genes was then evaluated by exposing conidia to iron starvation and iron excess. The expression of several orthologs of A. fumigatus genes involved in siderophore-based iron uptake or RIA was significantly induced during iron starvation, and conversely repressed in iron excess conditions. Altogether, these results indicate that S. apiospermum possesses the genetic information required for efficient and competitive iron uptake. They also suggest an important role of the siderophore production system in iron uptake by S. apiospermum.
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Affiliation(s)
- Yohann Le Govic
- Groupe d'Etude des Interactions Hôte-Pathogène (EA 3142), SFR ICAT 4208, UNIV Angers, UNIV Brest, Angers, France
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France
| | - Nicolas Papon
- Groupe d'Etude des Interactions Hôte-Pathogène (EA 3142), SFR ICAT 4208, UNIV Angers, UNIV Brest, Angers, France
| | - Solène Le Gal
- Groupe d'Etude des Interactions Hôte-Pathogène (EA 3142), SFR ICAT 4208, UNIV Angers, UNIV Brest, Brest, France
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Brest, France
| | - Bénédicte Lelièvre
- Groupe d'Etude des Interactions Hôte-Pathogène (EA 3142), SFR ICAT 4208, UNIV Angers, UNIV Brest, Angers, France
- Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Universitaire, Angers, France
| | - Jean-Philippe Bouchara
- Groupe d'Etude des Interactions Hôte-Pathogène (EA 3142), SFR ICAT 4208, UNIV Angers, UNIV Brest, Angers, France
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France
| | - Patrick Vandeputte
- Groupe d'Etude des Interactions Hôte-Pathogène (EA 3142), SFR ICAT 4208, UNIV Angers, UNIV Brest, Angers, France
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France
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Argy N, Le Gal S, Coppée R, Song Z, Vindrios W, Massias L, Kao WC, Hunte C, Yazdanpanah Y, Lucet JC, Houzé S, Clain J, Nevez G. Pneumocystis Cytochrome b Mutants Associated With Atovaquone Prophylaxis Failure as the Cause of Pneumocystis Infection Outbreak Among Heart Transplant Recipients. Clin Infect Dis 2018. [DOI: 10.1093/cid/ciy154] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Nicolas Argy
- Laboratoire de Parasitologie, Hôpital Bichat–Claude Bernard, APHP, France
- Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, France
- MERIT UMR 216 Institut de Recherche pour le Développement, France
| | - Solène Le Gal
- Laboratoire de Parasitologie, Centre Hospitalo-Universitaire de Brest, France
- GEIHP EA 3142, Université de Bretagne Occidentale, Brest, France
| | - Romain Coppée
- Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, France
- MERIT UMR 216 Institut de Recherche pour le Développement, France
| | - Zehua Song
- Institute for Integrative Biology of the Cell, CEA, CNRS, Université Paris-Sud, Gif-sur-Yvette, France
- Translational Research Institute, Henan Provincial People’s Hospital, School of Medicine, Henan University, Zhengzhou, China
| | | | - Laurent Massias
- Laboratoire de Pharmacologie-Toxicologie, Hôpital Bichat–Claude Bernard, APHP, France
- IAME, UMR 1137, INSERM, Université Paris Diderot, COMUE Sorbonne Paris Cité, France
| | - Wei-Chun Kao
- Institute for Biochemistry and Molecular Biology, ZBMZ, Faculty of Medicine, BIOSS Centre for Biological Signalling Studies, University of Freiburg, Germany
| | - Carola Hunte
- Institute for Biochemistry and Molecular Biology, ZBMZ, Faculty of Medicine, BIOSS Centre for Biological Signalling Studies, University of Freiburg, Germany
| | - Yazdan Yazdanpanah
- Service des Maladies Infectieuses et Tropicales, France
- IAME, UMR 1137, INSERM, Université Paris Diderot, COMUE Sorbonne Paris Cité, France
| | - Jean-Christophe Lucet
- IAME, UMR 1137, INSERM, Université Paris Diderot, COMUE Sorbonne Paris Cité, France
- Unité d’Hygiène et de Lutte Contre l’Infection Nosocomiale, Hôpital Bichat–Claude Bernard, APHP, Paris, France
| | - Sandrine Houzé
- Laboratoire de Parasitologie, Hôpital Bichat–Claude Bernard, APHP, France
- Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, France
- MERIT UMR 216 Institut de Recherche pour le Développement, France
| | - Jérôme Clain
- Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, France
- MERIT UMR 216 Institut de Recherche pour le Développement, France
| | - Gilles Nevez
- Laboratoire de Parasitologie, Centre Hospitalo-Universitaire de Brest, France
- GEIHP EA 3142, Université de Bretagne Occidentale, Brest, France
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Navarro-Arias MJ, Dementhon K, Defosse TA, Foureau E, Courdavault V, Clastre M, Le Gal S, Nevez G, Le Govic Y, Bouchara JP, Giglioli-Guivarc'h N, Noël T, Mora-Montes HM, Papon N. Group X hybrid histidine kinase Chk1 is dispensable for stress adaptation, host–pathogen interactions and virulence in the opportunistic yeast Candida guilliermondii. Res Microbiol 2017; 168:644-654. [DOI: 10.1016/j.resmic.2017.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/03/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022]
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Hoarau G, Le Gal S, Zunic P, Poubeau P, Antok E, Jaubert J, Nevez G, Picot S. Evaluation of quantitative FTD-Pneumocystis jirovecii kit for Pneumocystis infection diagnosis. Diagn Microbiol Infect Dis 2017; 89:212-217. [PMID: 28851493 DOI: 10.1016/j.diagmicrobio.2017.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 11/28/2022]
Abstract
We evaluated the Fast track Diagnostics (FTD) Pneumocystis PCR kit, targeting the mitochondrial large subunit ribosomal RNA gene (mtLSU rRNA) of Pneumocystis jirovecii (P. jirovecii). A hundred and thirty-three patients were prospectively enrolled. Respiratory specimens were examined using both microscopy and the PCR assay. Twenty-six patients led to P. jirovecii detection. Fourteen patients presented with Pneumocystis pneumonia (PCP) whereas 12 patients were considered to be colonized. The median copy numbers in bronchoalveolar lavage fluid were significantly different in the PCP and colonization groups (1.35×108/ml vs. 1.45×105/ml, P < 0.0001). Lower and upper cut-off values of 3.9×105 copies/ml and 3.2×106 copies/ml allowed differentiating PCP and colonization. The FTD P. jirovecii assay was secondarily compared to an in-house reference PCR assay targeting the mtLSUrRNA gene. A concordance rate of 97.5% was observed (Cohen's kappa coefficient κ=0.935). The FTD Pneumocystis PCR kit showed good performance and represents an alternative method to diagnose P. jirovecii infections.
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Affiliation(s)
- Gautier Hoarau
- Department of Microbiology, CHU La Reunion, St Pierre, France; UMR PIMIT « processus infectieux en milieu insulaire tropical », Inserm 1187, CNRS 9192, IRD 249, université de La Réunion, CYROI, 97490 Sainte-Clotilde, Reunion.
| | | | - Patricia Zunic
- Department of Hematology and Medical Oncology, CHU La Reunion, St Pierre, France
| | - Patrice Poubeau
- Department of Infectious Diseases, CHU La Reunion, St Pierre, France
| | | | - Julien Jaubert
- Department of Microbiology, CHU La Reunion, St Pierre, France
| | - Gilles Nevez
- University of Brest, GEIHP EA, 3142, Brest, France
| | - Sandrine Picot
- Department of Microbiology, CHU La Reunion, St Pierre, France
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33
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Nevez G, Robert-Gangneux F, Pougnet L, Virmaux M, Belleguic C, Deneuville E, Rault G, Chevrier S, Ramel S, Le Bihan J, Guillaud-Saumur T, Calderon E, Le Govic Y, Gangneux JP, Le Gal S. Pneumocystis jirovecii and Cystic Fibrosis in Brittany, France. Mycopathologia 2017; 183:81-87. [DOI: 10.1007/s11046-017-0172-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/27/2017] [Indexed: 11/30/2022]
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Vindrios W, Argy N, Le Gal S, Lescure FX, Massias L, Le MP, Wolff M, Yazdanpanah Y, Nevez G, Houze S, Dorent R, Lucet JC. Outbreak of Pneumocystis jirovecii Infection Among Heart Transplant Recipients: Molecular Investigation and Management of an Interhuman Transmission. Clin Infect Dis 2017; 65:1120-1126. [DOI: 10.1093/cid/cix495] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/24/2017] [Indexed: 11/14/2022] Open
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35
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Le Gal S, Robert-Gangneux F, Pépino Y, Belaz S, Damiani C, Guéguen P, Pitous M, Virmaux M, Lissillour E, Pougnet L, Guillaud-Saumur T, Toubas D, Valot S, Hennequin C, Morio F, Hasseine L, Bouchara JP, Totet A, Nevez G. A misleading false-negative result of Pneumocystis real-time PCR assay due to a rare punctual mutation: A French multicenter study. Med Mycol 2016; 55:180-184. [PMID: 27489302 DOI: 10.1093/mmy/myw051] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 06/15/2016] [Revised: 02/05/2016] [Accepted: 06/18/2016] [Indexed: 11/13/2022] Open
Abstract
This article describes a previously unreported mutation at position 210 (C210T) of the mitochondrial large subunit ribosomal RNA (mtLSUrRNA) gene of Pneumocystis jirovecii, which led to a false-negative result of a real-time polymerase chain reaction (PCR) assay. Since the aforementioned real-time PCR assay is widely used in France, a French multicenter study was conducted to estimate the mutation frequency and its potential impact on the routine diagnosis of Pneumocystis pneumonia (PCP). Through analysis of data obtained from eight centers, the mutation frequency was estimated at 0.28%. This low frequency should not call into question the routine use of this PCR assay. Nonetheless, the occurrence of the false-negative PCR result provides arguments for maintaining microscopic techniques combined to PCR assays to achieve PCP diagnosis.
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Affiliation(s)
- Solène Le Gal
- University of Brest, GEIHP EA 3142, Brest, France .,Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France
| | - Florence Robert-Gangneux
- University of Rennes 1, INSERM U1085, Rennes, France.,Laboratory of Parasitology and Mycology, Rennes University Hospital, Rennes, France
| | - Yann Pépino
- University of Brest, GEIHP EA 3142, Brest, France
| | - Sorya Belaz
- University of Rennes 1, INSERM U1085, Rennes, France.,Laboratory of Parasitology and Mycology, Rennes University Hospital, Rennes, France
| | - Céline Damiani
- University of Picardy-Jules Verne, EA 4285 UMR-I 01 INERIS, Amiens, France.,Department of Parasitology and Mycology, Amiens University Hospital, Amiens, France
| | - Paul Guéguen
- Laboratory of Molecular Genetics and Histocompatibility, Brest University Hospital, Brest, France.,University of Brest, INSERM 1078, Molecular Genetics and Epidemiological Genetics, SFR 148, Brest, France
| | | | | | | | | | | | - Dominique Toubas
- Parasitology and Mycology laboratory, Reims University Hospital, Reims, France
| | - Stéphane Valot
- Parasitology and Mycology laboratory, Dijon University Hospital, Dijon, France
| | - Christophe Hennequin
- Parasitology and Mycology laboratory, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Florent Morio
- Parasitology and Mycology laboratory, Nantes University Hospital, Nantes, France
| | - Lilia Hasseine
- Parasitology and Mycology laboratory, Nice University Hospital, Nice, France
| | | | - Anne Totet
- University of Picardy-Jules Verne, EA 4285 UMR-I 01 INERIS, Amiens, France.,Department of Parasitology and Mycology, Amiens University Hospital, Amiens, France
| | - Gilles Nevez
- University of Brest, GEIHP EA 3142, Brest, France .,Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France
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Nevez G, Le Gal S, Quinio D, Ianotto JC, Berthou C, Hamane S, Sarfati C, Menotti J. Encephalitozoon hellem in a patient with CD4+ T-cell prolymphocytic leukemia: case report and genomic identification. Diagn Microbiol Infect Dis 2015; 83:245-7. [DOI: 10.1016/j.diagmicrobio.2015.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 07/20/2015] [Indexed: 11/26/2022]
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Damiani C, Le Gal S, Deffontaine M, Gyde E, Taillaint S, Ramon C, Benabes B, Davigny O, Lepilliez A, Monsigny M, Pautard JC, Popin E, Quequet C, Tardieux P, Tuloup E, Totet A. Les moisissures dans l’habitat des patients allergiques en Picardie : caractérisation de la contamination. J Mycol Med 2015. [DOI: 10.1016/j.mycmed.2015.06.041] [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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38
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Le Gal S, Robert-Gangneux F, Damiani C, Virmaux M, Belleguic C, Deneuville E, Rault G, Ramel S, Totet A, Gangneux JP, Nevez G. Prévalence de Pneumocystis jirovecii chez les patients atteints de mucoviscidose en Bretagne. J Mycol Med 2015. [DOI: 10.1016/j.mycmed.2015.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Pougnet L, Le Gal S, Damiani C, Frealle E, Gueguen P, Virmaux M, Ansart S, Jaffuel S, Couturaud F, Delluc A, Tonnelier JM, Castellant P, Le Meur Y, Le Floch G, Totet A, Menotti J, Nevez G. Détection, quantification et caractérisation de Pneumocystis jirovecii dans l’air environnant les patients colonisés par Pneumocystis. J Mycol Med 2015. [DOI: 10.1016/j.mycmed.2015.06.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Le Gal S, Pougnet L, Damiani C, Fréalle E, Guéguen P, Virmaux M, Ansart S, Jaffuel S, Couturaud F, Delluc A, Tonnelier JM, Castellant P, Le Meur Y, Le Floch G, Totet A, Menotti J, Nevez G. Pneumocystis jirovecii in the air surrounding patients with Pneumocystis pulmonary colonization. Diagn Microbiol Infect Dis 2015; 82:137-42. [PMID: 25801779 DOI: 10.1016/j.diagmicrobio.2015.01.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 01/09/2015] [Accepted: 01/11/2015] [Indexed: 12/23/2022]
Abstract
In this study, Pneumocystis jirovecii was detected and characterized in the air surrounding patients with Pneumocystis pulmonary colonization. Air samples were collected in the rooms of 10 colonized patients using Coriolis® μ air sampler at 1m and 5m from the patient's head. P. jirovecii DNA was amplified and genotyped in pulmonary and air samples at the mitochondrial large subunit ribosomal RNA gene. P. jirovecii DNA was detected in 5 of the 10 air samples collected at 1m and in 5 of the 10 other air samples collected at 5m. P. jirovecii genotyping was successful in 4 pairs or triplets of air and pulmonary samples. Full genotype matches were observed in 3 of the 4 pairs or triplets of air and pulmonary samples. These results provide original data supporting P. jirovecii exhalation from colonized patients and emphasize the risk of P. jirovecii nosocomial transmission from this patient population.
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Affiliation(s)
- Solène Le Gal
- University of Brest, LUBEM EA 3882, SFR 148, Brest, France; Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France.
| | - Laurence Pougnet
- Laboratory, Military Teaching Hospital Clermont Tonnerre, Brest, France
| | - Céline Damiani
- University of Picardy-Jules Verne, UMR-I 01, SFR Cap Santé, Amiens, France; Laboratory of Parasitology and Mycology, Amiens University Hospital, Amiens, France
| | - Emilie Fréalle
- Laboratory of Parasitology and Mycology, Lille University Hospital, Lille, France
| | - Paul Guéguen
- Laboratory of Molecular Genetics and Histocompatibility, Brest University Hospital, Brest, France; University of Brest, INSERM U1078, Molecular Genetics and Epidemiological Genetics, SFR 148, Brest, France
| | | | - Séverine Ansart
- Department of Infectious Diseases, Brest University Hospital, Brest, France; University of Brest, INSERM UMR 1101, Laboratory of Medical Information Processing, SFR 148, Brest, France
| | - Sylvain Jaffuel
- Department of Infectious Diseases, Brest University Hospital, Brest, France
| | - Francis Couturaud
- Department of Internal Medicine and Pneumology, Brest University Hospital, Brest, France; University of Brest, EA3878 (GETBO), CIC INSERM 0502, SFR 148, Brest, France
| | - Aurélien Delluc
- Department of Internal Medicine and Pneumology, Brest University Hospital, Brest, France; University of Brest, EA3878 (GETBO), CIC INSERM 0502, SFR 148, Brest, France
| | | | | | - Yann Le Meur
- Department of Nephrology and Renal Transplantation Unit, Brest University Hospital, Brest, France; University of Brest, EA 2216, SFR 148, Brest, France
| | | | - Anne Totet
- University of Picardy-Jules Verne, UMR-I 01, SFR Cap Santé, Amiens, France; Laboratory of Parasitology and Mycology, Amiens University Hospital, Amiens, France
| | - Jean Menotti
- Laboratory of Parasitology and Mycology, Saint Louis Hospital APHP, Paris, France; Paris-Diderot University, Paris, France
| | - Gilles Nevez
- University of Brest, LUBEM EA 3882, SFR 148, Brest, France; Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France.
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Le Gal S, Blanchet D, Damiani C, Guéguen P, Virmaux M, Abboud P, Guillot G, Kérangart S, Merle C, Calderon E, Totet A, Carme B, Nevez G. AIDS-related Pneumocystis jirovecii genotypes in French Guiana. Infect Genet Evol 2014; 29:60-7. [PMID: 25445659 DOI: 10.1016/j.meegid.2014.10.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 09/19/2014] [Accepted: 10/13/2014] [Indexed: 10/24/2022]
Abstract
The study described Pneumocystis jirovecii (P. jirovecii) multilocus typing in seven AIDS patients living in French Guiana (Cayenne Hospital) and seven immunosuppressed patients living in Brest, metropolitan France (Brest Hospital). Archival P. jirovecii specimens were examined at the dihydropteroate synthase (DHPS) locus using a PCR-RFLP technique, the internal transcribed spacer (ITS) 1 and ITS 2 and the mitochondrial large subunit rRNA (mtLSUrRNA) gene using PCR and sequencing. Analysis of typing results were combined with an analysis of the literature on P. jirovecii mtLSUrRNA types and ITS haplotypes. A wild DHPS type was identified in six Guianese patients and in seven patients from metropolitan France whereas a DHPS mutant was infected in the remaining Guianese patient. Typing of the two other loci pointed out a high diversity of ITS haplotypes and an average diversity of mtLSUrRNA types in French Guiana with a partial commonality of these haplotypes and types described in metropolitan France and around the world. Combining DHPS, ITS and mtLSU types, 12 different multilocus genotypes (MLGs) were identified, 4 MLGs in Guianese patients and 8 MLGs in Brest patients. MLG analysis allows to discriminate patients in 2 groups according to their geographical origin. Indeed, none of the MLGs identified in the Guianese patients were found in the Brest patients and none of the MLGs identified in the Brest patients were found in the Guianese patients. These results show that in French Guiana (i) PCP involving DHPS mutants occur, (ii) there is a diversity of ITS and mtLSUrRNA types and (iii) although partial type commonality in this territory and metropolitan France can be observed, MLG analysis suggests that P. jirovecii organisms from French Guiana may present specific characteristics.
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Affiliation(s)
- Solène Le Gal
- University of Brest, LUBEM EA 3882, SFR 148, Brest, France; Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France.
| | | | - Céline Damiani
- Laboratory of Parasitology and Mycology, Amiens University Hospital, Amiens, France; University of Picardy-Jules Verne, UMR-I 01, Amiens, France
| | - Paul Guéguen
- Laboratory of Molecular Genetics and Histocompatibility, Brest University Hospital, Brest, France; University of Brest, INSERM U1078, Molecular Genetics and Epidemiological Genetics, SFR 148, Brest, France
| | | | | | | | | | - Cédric Merle
- University of Brest, LUBEM EA 3882, SFR 148, Brest, France
| | - Enrique Calderon
- Instituto de Biomedecina de Sevilla and CIBER de Epidemiologia y Salud Publica, Hospital Universitario Virgen del Rocio, Seville, Spain
| | - Anne Totet
- Laboratory of Parasitology and Mycology, Amiens University Hospital, Amiens, France; University of Picardy-Jules Verne, UMR-I 01, Amiens, France
| | - Bernard Carme
- Andrée Rosemon Hospital, Cayenne, French Guiana; University of Antilles-Guyane, EA 3593 EPaT, Cayenne, French Guiana
| | - Gilles Nevez
- University of Brest, LUBEM EA 3882, SFR 148, Brest, France; Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France.
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Mounier J, Gouëllo A, Keravec M, Le Gal S, Pacini G, Debaets S, Nevez G, Rault G, Barbier G, Héry-Arnaud G. Use of denaturing high-performance liquid chromatography (DHPLC) to characterize the bacterial and fungal airway microbiota of cystic fibrosis patients. J Microbiol 2014; 52:307-14. [PMID: 24535743 DOI: 10.1007/s12275-014-3425-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 10/15/2013] [Accepted: 10/21/2013] [Indexed: 11/28/2022]
Abstract
The aim of this study was to evaluate the use of denaturing high-performance liquid chromatography (DHPLC) to characterize cystic fibrosis (CF) airway microbiota including both bacteria and fungi. DHPLC conditions were first optimized using a mixture of V6, V7 and V8 region 16S rRNA gene PCR amplicons from 18 bacterial species commonly found in CF patients. Then, the microbial diversity of 4 sputum samples from 4 CF patients was analyzed using cultural methods, cloning/sequencing (for bacteria only) and DHPLC peak fraction collection/sequencing. DHPLC analysis allowed identifying more bacterial and fungal species than the classical culture methods, including well-recognized pathogens such as Pseudomonas aeruginosa. Even if a lower number of bacterial Operational Taxonomic Units (OTUs) was identified by DHPLC, it allowed to find OTUs unidentified by cloning/sequencing. The combination of both techniques permitted to correlate the majority of DHPLC peaks to defined OTUs. Finally, although Aspergillus fumigatus detection using DHPLC can still be improved, this technique clearly allowed to identify a higher number of fungal species versus classical culture-based methods. To conclude, DHPLC provided meaningful additional data concerning pathogenic bacteria and fungi as well as fastidious microorganisms present within the CF respiratory tract. DHPLC can be considered as a complementary technique to culture-dependent analyses in routine microbiological laboratories.
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Affiliation(s)
- Jérôme Mounier
- EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne, SFR148 ScInBioS, Université de Brest, Brest, F-29200, France
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Abstract
Opportunistic infections cause a significant morbidity and mortality in immunocompromised patients. We describe the case of a patient with skin fusariosis and a probable cerebral toxoplasmosis after UCB stem cell transplantation for B-cell acute lymphoblastic leukaemia. Fusarium species (spp) infections are difficult to treat. To date, there has been no consensus on the treatment of fusariosis and the management of its side effects. Given the negative pretransplant Toxoplasma serology in this case, identifying the origin of the Toxoplasma infection was challenging. All usual transmission routes were screened for and ruled out. The patient's positive outcome was not consistent with that of the literature reporting 60% mortality due to each infection.
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Le Gal S, Robert-Gangneux F, Perrot M, Rouillé A, Virmaux M, Damiani C, Totet A, Gangneux JP, Nevez G. Absence of Pneumocystis dihydropteroate synthase mutants in Brittany, France. Diagn Microbiol Infect Dis 2013; 76:113-5. [PMID: 23433532 DOI: 10.1016/j.diagmicrobio.2013.01.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 01/16/2013] [Accepted: 01/16/2013] [Indexed: 11/15/2022]
Abstract
Archival Pneumocystis jirovecii specimens from 84 patients monitored at Rennes University Hospital (Rennes, France) were assayed at the dihydropteroate synthase (DHPS) locus. No patient was infected with mutants. The results provide additional data showing that P. jirovecii infections involving DHPS mutants do not represent a public health issue in Brittany, western France.
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Affiliation(s)
- Solène Le Gal
- University of Brest, LUBEM EA 3882, SFR 148, Brest, France; Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France.
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Damiani C, Choukri F, Le Gal S, Menotti J, Sarfati C, Nevez G, Derouin F, Totet A. Possible nosocomial transmission of Pneumocystis jirovecii. Emerg Infect Dis 2013; 18:877-8. [PMID: 22516237 PMCID: PMC3358058 DOI: 10.3201/eid1805.111432] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Le Gal S, Damiani C, Virmaux M, Carme B, Nacher M, Aznar C, Totet A, Nevez G. Molecular typing of Pneumocystis jirovecii in a patient from French Guiana. Mycoses 2010; 54:e621-2. [DOI: 10.1111/j.1439-0507.2010.01931.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gal SL, Héry-Arnaud G, Ramel S, Virmaux M, Damiani C, Totet A, Nevez G. Pneumocystis jirovecii and cystic fibrosis in France. ACTA ACUST UNITED AC 2010; 42:225-7. [DOI: 10.3109/00365540903447000] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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