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Tchamwa Bamini G, Charpentier E, Guemas E, Chauvin P, Fillaux J, Valentin A, Cassaing S, Ménard S, Berry A, Iriart X. No evidence of pathogenicity of Dientamoeba fragilis following detection in stools: A case-control study. Parasite 2024; 31:40. [PMID: 39052010 PMCID: PMC11271704 DOI: 10.1051/parasite/2024041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/28/2024] [Indexed: 07/27/2024] Open
Abstract
Dientamoeba fragilis is a ubiquitous intestinal parasite with detection in the stools that has become increasingly frequent following the advent of PCR as a routine screening tool. However, the pathogenicity of this parasite is still much debated. In order to assess the potentially pathogenic nature of this protozoan, a retrospective case-control study was carried out between January and December 2020 on patients from Toulouse University Hospital, with the aim of evaluating the potential clinical effects and changes in laboratory parameters linked to the presence and load of D. fragilis in stools. After matching age, sex and mode of care (consultation or hospitalisation), no significant difference was observed in the frequency of clinical signs between the 36 patients who tested positive for Dientamoeba fragilis PCR in their stools and the 72 control patients who were PCR negative for this protozoan. The presence of D. fragilis in the faeces was not associated with changes in laboratory parameters. Furthermore, a high digestive load of D. fragilis had no identifiable impact on clinical and laboratory parameters. Only the concomitant presence of Blastocystis sp. in stools was significantly more frequent in the D. fragilis group (uni- and multivariate analysis). Finally, this study showed no significant difference in clinical or laboratory signs between patients carrying Dientamoeba fragilis and the control group, regardless of the intestinal parasite load, suggesting that D. fragilis could be considered a commensal of the digestive tract.
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Affiliation(s)
| | - Eléna Charpentier
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Parasitology-Mycology Department, Toulouse University Hospital 31059 Toulouse France
| | - Emilie Guemas
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Parasitology-Mycology Department, Toulouse University Hospital 31059 Toulouse France
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Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, INSERM UMR1291, Paul Sabatier University 31024 Toulouse France
| | - Pamela Chauvin
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Parasitology-Mycology Department, Toulouse University Hospital 31059 Toulouse France
| | - Judith Fillaux
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Parasitology-Mycology Department, Toulouse University Hospital 31059 Toulouse France
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RESTORE Institute, UMR 1301-Inserm 5070-CNRS EFS Paul Sabatier University 31100 Toulouse France
| | - Alexis Valentin
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Parasitology-Mycology Department, Toulouse University Hospital 31059 Toulouse France
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UMR 152 PHARMA-DEV, IRD, UPS, Toulouse University 31062 Toulouse France
| | - Sophie Cassaing
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Parasitology-Mycology Department, Toulouse University Hospital 31059 Toulouse France
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RESTORE Institute, UMR 1301-Inserm 5070-CNRS EFS Paul Sabatier University 31100 Toulouse France
| | - Sandie Ménard
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Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, INSERM UMR1291, Paul Sabatier University 31024 Toulouse France
| | - Antoine Berry
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Parasitology-Mycology Department, Toulouse University Hospital 31059 Toulouse France
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Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, INSERM UMR1291, Paul Sabatier University 31024 Toulouse France
| | - Xavier Iriart
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Parasitology-Mycology Department, Toulouse University Hospital 31059 Toulouse France
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Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, INSERM UMR1291, Paul Sabatier University 31024 Toulouse France
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Rudzińska M, Sikorska K. Epidemiology of Blastocystis Infection: A Review of Data from Poland in Relation to Other Reports. Pathogens 2023; 12:1050. [PMID: 37624010 PMCID: PMC10458783 DOI: 10.3390/pathogens12081050] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 08/26/2023] Open
Abstract
Blastocystis is a common gut protist of humans and various animals worldwide, with a high level of genetic diversity. Neither its zoonotic potential and transmission routes nor its pathogenicity are fully known. This fact, and the fact that Blastocystis is the most abundant eukaryote in human faeces, raises the question of its relevance to public health. Here, we summarise (in relation to other reports) the results of studies on the prevalence and genotypic variation of Blastocystis, which were carried out in animals, humans, and in water environments in Poland. In humans, the prevalence ranged between 0.14 and 23.6%, in some animals reached 58.97%, and in water environments was 5.1%. Seven subtypes were identified in humans (ST1-ST4, ST6, ST7, and ST9), of which ST3 was the most common. Among animals (wild, livestock, and pet animals), eleven STs were identified, with differential host specificity. Humans and animals shared ST1, ST2, ST3, ST6, and ST7, while ST1 and ST3 were present in humans, animals, and water sources. These observations indicate the possibility of Blastocystis transmission between animals and humans. Further studies should be continued in search of the sources and transmission routes of Blastocystis in order to prevent the spread of infections among humans and animals.
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Affiliation(s)
- Monika Rudzińska
- Department of Tropical Medicine and Epidemiology, Faculty of Health Sciences, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
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van Berkel L, Heuvelmans M, Monkelbaan JF. Symptoms and PCR testing interval for bacterial pathogens in patients with diarrhoea. J Med Microbiol 2022; 71. [PMID: 35476821 DOI: 10.1099/jmm.0.001541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction . Acute diarrhoea can be caused by Salmonella species, Shigella species, Yersinia enterocolitica, Campylobacter species and Plesiomonas shigelloides (SSYCP). In clinical practice, however, polymerase chain reaction (PCR) for SSYCP is frequently performed as part of the diagnostic work-up for patients with chronic diarrhoea and gastrointestinal complaints.Hypothesis. This study postulates that PCR for SSYCP is of limited clinical use in patients with chronic diarrhoea and gastrointestinal complaints.Aim. The primary aim of this study is to evaluate whether testing for SSYCP remains sensible in patients with chronic diarrhoea and gastrointestinal symptoms and if earlier testing leads to more positive PCR results.Methodology. Between January 2017 and December 2018, data on PCR results, culture results, symptoms, symptom to testing interval (STI) and immune status were retrospectively collected from the medical records of patients with gastrointestinal symptoms for whom PCR results for SSYCP were available. The STIs of PCR-positive patients and PCR-negative patients were compared.Results. In total, 146 PCR-positive and 149 PCR-negative patients were included. STIs of <7 days occurred in 55 % of all PCR-positive patients compared to 38 % in PCR-negative patients. PCR-positive patients were more often tested within 7 days after onset of gastrointestinal symptoms or diarrhoea. A third of PCR-positive patients had an STI of >7 days. Immunocompromised patients had a shorter STI. Admitted patients had a shorter STI. Eighty-six PCR-positive patients had a positive culture (58 %). Antibiotic use 3 months prior to PCR testing was correlated with negative PCR results.Conclusions . This study shows that early testing correlates with more positive PCR results and underlines that PCR for SSYCP is of lesser importance in the diagnostic workup of chronic diarrhoea and/or gastrointestinal symptoms. The shorter STI found in immunocompromised patients is possibly due to a lower threshold for testing in this population. It is also important to take recent antibiotic use into consideration when interpreting PCR results, given the correlation between negative PCR results and antibiotic use. Careful and precise documentation of symptoms in medical records is essential for clinical practice and research.
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Affiliation(s)
- Lisanne van Berkel
- Department of Hepatology and Gastroenterology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, Netherlands
- Present address: Gelre Ziekenhuizen, Albert Schweitzerlaan 31, Apeldoorn, Netherlands
| | - Maarten Heuvelmans
- Department of Medical Microbiology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, Netherlands
| | - Jan F Monkelbaan
- Department of Hepatology and Gastroenterology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, Netherlands
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van Kalleveen MW, Budding AE, Benninga MA, Savelkoul PHM, van Gool T, van Maldeghem I, Dorigo-Zetsma JW, Bart A, Plötz FB, de Meij TGJ. Intestinal Microbiota in Children With Symptomatic Dientamoeba fragilis Infection: A Case-control Study. Pediatr Infect Dis J 2021; 40:279-283. [PMID: 33181781 DOI: 10.1097/inf.0000000000002975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Dientamoeba fragilis in children has been associated with gastrointestinal symptoms, like abdominal pain and diarrhea. The mechanism underlying these symptoms in children with D. fragilis remains unclear. We hypothesized that concomitant microbial alterations, which have been described in other parasitic infections, may be associated with gastrointestinal symptoms in D. fragilis. METHODS In this case-control study performed in 2 centers, 19 children referred to a pediatrician because of gastrointestinal symptoms and with a positive fecal PCR for D. fragilis were included as cases. We included 19 healthy children as controls and matched for age and gender, selected from an existing cohort of 63 children. A PCR for D. fragilis was performed on fecal samples of the 19 controls to assess D. fragilis carriership in this asymptomatic group. Microbiota was analyzed with the IS-pro technique, and the intestinal microbiota composition and diversity were compared between the 2 groups. RESULTS Microbiota of children with D. fragilis and gastrointestinal symptoms did not significantly differ in terms of composition and diversity compared with controls, both on phylum and species level. In the asymptomatic controls, a positive fecal PCR for D. fragilis was found in 16 of 19 (84.2%). CONCLUSION Intestinal microbiota does not seem to play a key role in the presence of clinical symptoms in children with D. fragilis. The pathogenicity of D. fragilis and pathophysiologic pathways underlying the development of gastrointestinal symptoms remains yet to be clarified.
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Affiliation(s)
- Michael W van Kalleveen
- From the Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands
- Department of Gastroenterology, Noordwest Hospital, Alkmaar, The Netherlands
| | | | - Marc A Benninga
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands
| | - Paul H M Savelkoul
- Department of Medical Microbiology & Infection Control
- Department of Medical Microbiology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tom van Gool
- Department of Medical Microbiology, Section Clinical Parasitology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Iris van Maldeghem
- From the Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands
| | - J W Dorigo-Zetsma
- Department of Medical Microbiology, Tergooi Hospital, Blaricum, The Netherlands
| | - Aldert Bart
- Department of Medical Microbiology, Tergooi Hospital, Blaricum, The Netherlands
| | - Frans B Plötz
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Tim G J de Meij
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands
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Integrative Transkingdom Analysis of the Gut Microbiome in Antibiotic Perturbation and Critical Illness. mSystems 2021; 6:6/2/e01148-20. [PMID: 33727397 PMCID: PMC8546997 DOI: 10.1128/msystems.01148-20] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Bacterial microbiota play a critical role in mediating local and systemic immunity, and shifts in these microbial communities have been linked to impaired outcomes in critical illness. Emerging data indicate that other intestinal organisms, including bacteriophages, viruses of eukaryotes, fungi, and protozoa, are closely interlinked with the bacterial microbiota and their host, yet their collective role during antibiotic perturbation and critical illness remains to be elucidated. We employed multi-omics factor analysis (MOFA) to systematically integrate the bacterial (16S rRNA), fungal (intergenic transcribed spacer 1 rRNA), and viral (virus discovery next-generation sequencing) components of the intestinal microbiota of 33 critically ill patients with and without sepsis and 13 healthy volunteers. In addition, we quantified the absolute abundances of bacteria and fungi using 16S and 18S rRNA PCRs and characterized the short-chain fatty acids (SCFAs) butyrate, acetate, and propionate using nuclear magnetic resonance spectroscopy. We observe that a loss of the anaerobic intestinal environment is directly correlated with an overgrowth of aerobic pathobionts and their corresponding bacteriophages as well as an absolute enrichment of opportunistic yeasts capable of causing invasive disease. We also observed a strong depletion of SCFAs in both disease states, which was associated with an increased absolute abundance of fungi with respect to bacteria. Therefore, these findings illustrate the complexity of transkingdom changes following disruption of the intestinal bacterial microbiome. IMPORTANCE While numerous studies have characterized antibiotic-induced disruptions of the bacterial microbiome, few studies describe how these disruptions impact the composition of other kingdoms such as viruses, fungi, and protozoa. To address this knowledge gap, we employed MOFA to systematically integrate viral, fungal, and bacterial sequence data from critically ill patients (with and without sepsis) and healthy volunteers, both prior to and following exposure to broad-spectrum antibiotics. In doing so, we show that modulation of the bacterial component of the microbiome has implications extending beyond this kingdom alone, enabling the overgrowth of potentially invasive fungi and viruses. While numerous preclinical studies have described similar findings in vitro, we confirm these observations in humans using an integrative analytic approach. These findings underscore the potential value of multi-omics data integration tools in interrogating how different components of the microbiota contribute to disease states. In addition, our findings suggest that there is value in further studying potential adjunctive therapies using anaerobic bacteria or SCFAs to reduce fungal expansion after antibiotic exposure, which could ultimately lead to improved outcomes in the intensive care unit (ICU).
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Bacterial, viral and parasitic pathogens analysed by qPCR: Findings from a prospective study of travellers' diarrhoea. Travel Med Infect Dis 2020; 40:101957. [PMID: 33359433 DOI: 10.1016/j.tmaid.2020.101957] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The diagnostics of travellers' diarrhoea (TD) has been revolutionised by multiplex qPCR assays. While mostly of bacterial aetiology, viruses and parasites account for the disease among 10-20% of travellers. Despite this, prospective studies applying qPCR assays remain scarce that cover not only bacteria, such as the various diarrhoeagenic Escherichia coli (DEC), but also viral and parasitic pathogens. METHOD We analysed by qPCR pre- and post-travel stool samples of 146 Finnish travellers for bacterial, viral and parasitic pathogens: enteropathogenic (EPEC), enteroaggregative (EAEC), enterotoxigenic (ETEC), enterohaemorrhagic (EHEC), and enteroinvasive (EIEC) E. coli; Shigella, Campylobacter, Salmonella, Yersinia and Vibrio cholerae; norovirus G1 and G2, rotavirus, enteroviruses, and sapovirus; and Giardia lamblia, Entamoeba histolytica, and Cryptosporidium. Symptoms and medication data during travel were collected by questionnaires. RESULTS We detected bacterial pathogens in 102/146 samples (69.9%; EAEC, EPEC, ETEC most common), viral ones in 13 (8.9%; norovirus most common), and parasitic ones in one (0.7%; Giardia). Noroviruses were associated with severe symptoms (23.5% versus non-severe 4.9%). In the TD group, 41.7% (5/12) of those with viral pathogens (vs. 13.3%; 11/83 without) took antibiotics. CONCLUSION Viral pathogens, particularly noroviruses, prevail in severe TD. The symptoms of viral disease are often severe and lead to unwarranted use of antibiotics.
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Wiemer D, Schwarz NG, Burchard GD, Frickmann H, Loderstaedt U, Hagen RM. Surveillance of enteropathogenic bacteria, protozoa and helminths in travellers returning from the tropics. Eur J Microbiol Immunol (Bp) 2020; 10:147-155. [PMID: 32910786 PMCID: PMC7592519 DOI: 10.1556/1886.2020.00015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/11/2020] [Indexed: 11/19/2022] Open
Abstract
Diarrhoea is a frequent symptom associated with travelling to tropical regions, but the cause is often not found. Epidemiology was assessed including up-to-date real-time PCR approaches.We analysed datasets of 528 patients who presented at the Bernhard Nocht Institute for Tropical Medicine in Hamburg, Germany, between 2006 and 2010 for screening purposes or because of diarrhoea. Stool samples were obtained and investigated by microscopy, bacterial culture, two PCR assays targeting Entamoeba histolytica, Entamoeba dispar, Giardia duodenalis, and Cryptosporidium parvum, or Salmonella spp., Shigella/EIEC spp., Campylobacter jejuni, and Yersinia spp.Among patients with gastrointestinal symptoms, 51% tested positive for bacteria or parasites, of which 66% had a known enteropathogenic potential. In patients without diarrhoea, 53% (n = 80) were positive, and 33% of these cases harboured agents of pathogenic potential. Association with clinical symptoms was primarily found for bacterial infections. Blastocystis hominis, however, was more frequent in asymptomatic than in symptomatic travellers.In conclusion, the study stresses the etiological relevance of bacterial gastroenteritis in travellers returning from the tropics, the need for molecular approaches to increase diagnostic sensitivity and demonstrates that asymptomatic carriage of enteropathogens after prolonged stays in the tropics is similarly frequent compared with symptomatic infections in travellers.
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Affiliation(s)
- Dorothea Wiemer
- 1Department of Tropical Medicine at the Bernhard Nocht Institute, Bundeswehr Hospital Hamburg, Hamburg, Germany
| | | | | | - Hagen Frickmann
- 1Department of Tropical Medicine at the Bernhard Nocht Institute, Bundeswehr Hospital Hamburg, Hamburg, Germany.,3Institute for Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
| | | | - Ralf-Matthias Hagen
- 4Department for Microbiology and Hospital Hygiene, Bundeswehr Central Hospital Koblenz, Koblenz, Germany
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Schaumburg F, Correa-Martinez CL, Niemann S, Köck R, Becker K. Aetiology of traveller's diarrhea: A nested case-control study. Travel Med Infect Dis 2020; 37:101696. [DOI: 10.1016/j.tmaid.2020.101696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/27/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
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Furuya-Kanamori L, Stone J, Yakob L, Kirk M, Collignon P, Mills DJ, Lau CL. Risk factors for acquisition of multidrug-resistant Enterobacterales among international travellers: a synthesis of cumulative evidence. J Travel Med 2020; 27:5613537. [PMID: 31691808 DOI: 10.1093/jtm/taz083] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/13/2019] [Accepted: 10/21/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Recent studies have shown that over 50% of people travelling to Southeast Asia return colonized with multidrug-resistant Enterobacterales (MRE) including carbapenemase-producing Enterobacterales. Importation of MRE by travellers and subsequent spread to family members, communities and healthcare facilities poses real risks that have not yet been adequately assessed. This systematic review and meta-analysis aims to quantify the risk factors and interventions for reducing the risk of MRE acquisition among international travellers. METHODS A systematic search was conducted in PubMed, Web of Science and Scopus for analytical epidemiological studies containing data post-2000 that assessed the risk factors to acquire and/or interventions to reduce the risk of MRE acquisition in travellers. Two researchers independently screened all the studies and extracted the information, and disagreements were resolved through consensus. The proportions of MRE acquisition by the region of destination and the odds ratio (OR) for the different risk factors and/or interventions were pooled using the inverse variance heterogeneity model. RESULTS A total of 20 studies (5253 travellers from high-income countries) were included in the meta-analysis. South Asia [58.7%; 95% confidence interval (CI), 44.5-72.5%] and Northern Africa (43.9%; 95% CI 37.6-50.3%) were the travel destinations with the highest proportion of MRE acquisition. Inflammatory bowel disease (OR 2.1; 95% CI 1.2-3.8), use of antibiotics (OR 2.4; 95% CI 1.9-3.0), traveller's diarrhoea (OR 1.7; 95% CI 1.3-2.3) and contact with the healthcare system overseas (OR 1.5; 95% CI 1.1-2.2) were associated with MRE colonization. Vegetarians (OR 1.4; 95% CI 1.0-2.0) and backpackers (OR 1.5; 95% CI 1.2-1.8) were also at increased odds of MRE colonization. Few studies (n = 6) investigated preventive measures and found that consuming only bottled water/beverages, meticulous hand hygiene and probiotics had no protective effect on MRE colonization. CONCLUSIONS International travel is an important driver for MRE spread worldwide. Future research needs to identify effective interventions to reduce the risk of MRE acquisition as well as design strategies to reduce local transmission on return.
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Affiliation(s)
- Luis Furuya-Kanamori
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Jennifer Stone
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Laith Yakob
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Martyn Kirk
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | - Peter Collignon
- ACT Pathology, Canberra Hospital, Canberra, Australia.,ANU Medical School, ANU College of Health and Medicine, Australian National University, Canberra, Australia
| | | | - Colleen L Lau
- Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia.,Travel Medicine Alliance Clinics, Brisbane, Australia
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Devaux CA, Mediannikov O, Medkour H, Raoult D. Infectious Disease Risk Across the Growing Human-Non Human Primate Interface: A Review of the Evidence. Front Public Health 2019; 7:305. [PMID: 31828053 PMCID: PMC6849485 DOI: 10.3389/fpubh.2019.00305] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 10/07/2019] [Indexed: 12/22/2022] Open
Abstract
Most of the human pandemics reported to date can be classified as zoonoses. Among these, there is a long history of infectious diseases that have spread from non-human primates (NHP) to humans. For millennia, indigenous groups that depend on wildlife for their survival were exposed to the risk of NHP pathogens' transmission through animal hunting and wild meat consumption. Usually, exposure is of no consequence or is limited to mild infections. In rare situations, it can be more severe or even become a real public health concern. Since the emergence of acquired immune deficiency syndrome (AIDS), nobody can ignore that an emerging infectious diseases (EID) might spread from NHP into the human population. In large parts of Central Africa and Asia, wildlife remains the primary source of meat and income for millions of people living in rural areas. However, in the past few decades the risk of exposure to an NHP pathogen has taken on a new dimension. Unprecedented breaking down of natural barriers between NHP and humans has increased exposure to health risks for a much larger population, including people living in urban areas. There are several reasons for this: (i) due to road development and massive destruction of ecosystems for agricultural needs, wildlife and humans come into contact more frequently; (ii) due to ecological awareness, many long distance travelers are in search of wildlife discovery, with a particular fascination for African great apes; (iii) due to the attraction for ancient temples and mystical practices, others travelers visit Asian places colonized by NHP. In each case, there is a risk of pathogen transmission through a bite or another route of infection. Beside the individual risk of contracting a pathogen, there is also the possibility of starting a new pandemic. This article reviews the known cases of NHP pathogens' transmission to humans whether they are hunters, travelers, ecotourists, veterinarians, or scientists working on NHP. Although pathogen transmission is supposed to be a rare outcome, Rabies virus, Herpes B virus, Monkeypox virus, Ebola virus, or Yellow fever virus infections are of greater concern and require quick countermeasures from public health professionals.
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Affiliation(s)
- Christian A. Devaux
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
- CNRS, Marseille, France
| | - Oleg Mediannikov
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Hacene Medkour
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Didier Raoult
- Aix-Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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Ögren J, Dienus O, Matussek A. Optimization of routine microscopic and molecular detection of parasitic protozoa in SAF-fixed faecal samples in Sweden. Infect Dis (Lond) 2019; 52:87-96. [DOI: 10.1080/23744235.2019.1682188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Jessica Ögren
- Clinical Microbiology, Region Jönköping County, Jönköping, Sweden
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Olaf Dienus
- Clinical Microbiology, Region Jönköping County, Jönköping, Sweden
| | - Andreas Matussek
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Laboratory Medicine, Region Jönköping County, Jönköping, Sweden
- Karolinska University Laboratory, Stockholm, Sweden
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12
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Dao TL, Sevestre J, Hoang VT, Ly TDA, Ranqu S, Parola P, Gautret P. Refractory giardiasis in medical students returning from humanitarian work abroad. Travel Med Infect Dis 2019; 36:101469. [PMID: 31470111 DOI: 10.1016/j.tmaid.2019.101469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/21/2019] [Accepted: 08/26/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Thi Loi Dao
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Jacques Sevestre
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Van Thuan Hoang
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Tran Duc Anh Ly
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Stéphane Ranqu
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Philippe Gautret
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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van Hattem JM, Arcilla MS, Schultsz C, Bootsma MC, Verhaar N, Rebers SP, Goorhuis A, Grobusch MP, Penders J, de Jong MD, van Gool T, Bart A. Carriage of Blastocystis spp. in travellers - A prospective longitudinal study. Travel Med Infect Dis 2018; 27:87-91. [PMID: 29929001 DOI: 10.1016/j.tmaid.2018.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/31/2018] [Accepted: 06/07/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION A lack of prospective and longitudinal data on pre- and post-travel carriage of Blastocystis spp. complicates interpretation of a positive test post-travel. Therefore we studied dynamics of Blastocystis carriage in a cohort of Dutch travellers. METHODS From the prospective, multicentre COMBAT study among 2001 Dutch travellers, a subset of 491 travellers was selected based on travel destination to 7 subregions (70 or 71 travellers each). Faecal samples taken directly before and after travel were screened for Blastocystis with qPCR, followed, when positive, by sequence analysis to determine subtypes. RESULTS After exclusion of 12 samples with missing samples or inhibited qPCR-reactions, stool samples of 479 travellers were analysed. Before travel, 174 of them (36.3%) carried Blastocystis and in most of these, the same subtype was persistently carried. However, in 48/174 of those travellers (27.6%; CI95 20.8-36.6%) no Blastocystis or a different subtype was detected in the post-travel sample, indicating loss of Blastocystis during travel. Only 26 (5.4%; CI95 3.7%-8.0%) of all travellers acquired Blastocystis, including two individuals that were already positive for Blastocystis before travel but acquired a different subtype during travel. DISCUSSION This study shows that Blastocystis carriage in travellers is highly dynamic. The observed acquisition and loss of Blastocystis could either be travel-related or reflect the natural course of Blastocystis carriage. We demonstrate that the majority of Blastocystis detected in post-travel samples were already carried before travel.
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Affiliation(s)
- Jarne M van Hattem
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands.
| | - Maris S Arcilla
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Constance Schultsz
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands; Department of Global Health - Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, the Netherlands
| | - Martin C Bootsma
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Mathematics, Faculty of Science, Utrecht University, Utrecht, the Netherlands
| | - Nienke Verhaar
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Sjoerd P Rebers
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Abraham Goorhuis
- Centre of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Martin P Grobusch
- Centre of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - John Penders
- School for Public Health and Primary Care (Caphri), Department of Medical Microbiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Menno D de Jong
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Tom van Gool
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Aldert Bart
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands
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Lääveri T, Pakkanen SH, Kirveskari J, Kantele A. Travellers' diarrhoea: Impact of TD definition and control group design on study results. Travel Med Infect Dis 2018; 24:37-43. [PMID: 29409749 DOI: 10.1016/j.tmaid.2018.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Travellers' diarrhoea (TD) is a common health problem among visitors to the (sub)tropics. Much research deals with aetiology, prevention, and post-infection sequalae, yet the data may not allow comparisons due to incompatible definitions of TD and No TD control groups. METHOD The impact of defining TD and No TD control groups was explored by revisiting our recent data. We set up two TD groups: classical TD i.e. ≥3 loose or liquid stools/day and WHO TD (diarrhoea as defined by the WHO) i.e. any diarrhoea, and four No TD groups by TD definition and timing (no classical/WHO TD during travel, no ongoing classical/WHO TD). RESULTS TD was recorded for 37% versus 65% of subjects when using classical versus WHO definitions, respectively; the proportions of the various pathogens proved similar. The strictest criterion for the No TD control group (no WHO TD during travel) yielded pathogens among 61% and the least strict (no ongoing classical TD) among 73% of the travellers; the differences were greatest for enteroaggregative Escherichia coli and Campylobacter. CONCLUSIONS Definition of TD and control group design substantially impact on TD study results. The WHO definition yields more cases, but the pathogen selection is similar by both definitions. Design of the No TD control group was found critical: only those remaining asymptomatic throughout the journey should be included.
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Affiliation(s)
- Tinja Lääveri
- Inflammation Center, Division of Infectious Diseases, University of Helsinki and Helsinki University Hospital, POB 348, FIN-00029 HUS, Helsinki, Finland
| | - Sari H Pakkanen
- Department of Bacteriology and Immunology, University of Helsinki, P.O. Box 21, FIN-00014 Helsinki, Finland
| | - Juha Kirveskari
- Helsinki University Hospital Laboratory (HUSLAB), Department of Bacteriology, POB 720, FIN-00029 HUS, Helsinki, Finland; Mobidiag Ltd, Keilaranta 16 A, FIN-02150 Espoo, Finland
| | - Anu Kantele
- Inflammation Center, Division of Infectious Diseases, University of Helsinki and Helsinki University Hospital, POB 348, FIN-00029 HUS, Helsinki, Finland; Clinicum, University of Helsinki, PO Box 63, FIN-00014, Helsinki, Finland; Aava Travel Clinic, Medical Centre Aava, Annankatu 32, FIN-00100 Helsinki, Finland; Unit of Infectious Diseases, Department of Medicine/Solna, Karolinska Institutet, SE-17176 Stockholm, Sweden.
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