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Heydari H, Iranikhah A, Ghasemi A, Mohammadbeigi A, Sadat-Mirei SA, Shams S, Kermani S. Evaluation of the prevalence of Aeromonas spp., Campylobacter spp., and Clostridioides difficile in immunocompromised children with diarrhea. BMC Infect Dis 2024; 24:512. [PMID: 38778271 PMCID: PMC11110422 DOI: 10.1186/s12879-024-09372-3] [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] [Received: 11/07/2023] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
AIM Diarrhea is a common disease in immunocompromised patients and can be associated with greater morbidity and even mortality. Therefore, the present study was designed to determine the prevalence of Aeromonas spp., Campylobacter spp., and C. difficile among immunocompromised children. METHODS This study was conducted on 130 stool samples from patients with diarrhea who had defects in the immune system and were referred to Hazrat Masoumeh Children's Hospital in Qom. Demographic information, clinical symptoms, immune status, and duration of chemotherapy were also recorded for each child. DNAs were extracted from the stool, and then direct PCR assays were done by specific primers for the detection of Aeromonas spp., Campylobacter spp., and toxigenic C. difficile, including tcdA/B and cdtA/B genes. Co-infection in patients was also evaluated. RESULTS 60.8% and 39.2% were male and female, respectively, with a m ± SD age of 56.72 ± 40.49 months. Most cases of immunocompromised states were related to Acute Lymphocytic Leukemia (77.7%) and Non-Hodgkin Lymphoma (14.6%). 93.1% of patients were undergoing chemotherapy during the study. Among patients, most clinical symptoms were related to bloody diarrhea (98.5%) and fever (92.3%). Based on PCR, 14.6, 9.2, and 1.5% were positive for Aeromonas spp., C. difficile, and C. jejuni, respectively. Among the C. difficile-positive cases, the tcdA gene was only detected in one patient. In total, three co-infections were identified, which included Aeromonas spp./C. difficile (tcdA+), C. jejuni/C. difficile, and C. jejuni/Aeromonas spp. CONCLUSIONS This is the first study in Iran to investigate the simultaneous prevalence of some pathogens in immunocompromised children with diarrhea. Because Aeromonas spp., Campylobacter spp., and C. difficile are not routinely detected in some laboratories, infections caused by them are underappreciated in the clinic. Our results showed that these pathogens are present in our region and can cause gastroenteritis in children, especially those with underlying diseases. Therefore, increasing the level of hygiene in some areas and controlling bacterial diarrheal diseases should be given more attention by health officials.
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Affiliation(s)
- Hosein Heydari
- Pediatric Medicine Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Abolfazl Iranikhah
- Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Ahmad Ghasemi
- Department of Microbiology, Research Center of Reference Health Laboratories, Ministry of Health and Medical Education, Tehran, Iran
| | - Abolfazl Mohammadbeigi
- Department of Epidemiology and Biostatistics, School of Health, Qom University of Medical Sciences, Qom, Iran
| | | | - Saeed Shams
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran.
| | - Somayeh Kermani
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran.
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Hannachi N, Arregle F, Lepidi H, Baudoin JP, Gouriet F, Martel H, Hubert S, Desnues B, Riberi A, Casalta JP, Habib G, Camoin-Jau L. A Massive Number of Extracellular Tropheryma whipplei in Infective Endocarditis: A Case Report and Literature Review. Front Immunol 2022; 13:900589. [PMID: 35844524 PMCID: PMC9278803 DOI: 10.3389/fimmu.2022.900589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/25/2022] [Indexed: 11/25/2022] Open
Abstract
Whipple’s disease (WD) is a chronic multisystemic infection caused by Tropheryma whipplei. If this bacterium presents an intracellular localization, associated with rare diseases and without pathognomonic signs, it is often subject to a misunderstanding of its physiopathology, often a misdiagnosis or simply an oversight. Here, we report the case of a patient treated for presumed rheumatoid arthritis. Recently, this patient presented to the hospital with infectious endocarditis. After surgery and histological analysis, we discovered the presence of T. whipplei. Electron microscopy allowed us to discover an atypical bacterial organization with a very large number of bacteria present in the extracellular medium in vegetation and valvular tissue. This atypical presentation we report here might be explained by the anti-inflammatory treatment administrated for our patient’s initial diagnosis of rheumatoid arthritis.
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Affiliation(s)
- Nadji Hannachi
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée infection, Marseille, France
- Département de Pharmacie, Faculté de Médecine, Université Ferhat Abbas Sétif I, Sétif, Algeria
| | - Florent Arregle
- IHU Méditerranée Infection, département d'infectiologie, Marseille, France
- Département de cardiologie, la Timone Hospital, AP-HM, Marseille, France
| | - Hubert Lepidi
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée infection, Marseille, France
- Laboratoire d’anatomie et de cytologie pathologique, la Timone Hospital, AP-HM, Marseille, France
| | - Jean-Pierre Baudoin
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée infection, Marseille, France
| | - Frédérique Gouriet
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée infection, Marseille, France
| | - Hélène Martel
- IHU Méditerranée Infection, département d'infectiologie, Marseille, France
- Département de cardiologie, la Timone Hospital, AP-HM, Marseille, France
| | - Sandrine Hubert
- Département de cardiologie, la Timone Hospital, AP-HM, Marseille, France
| | - Benoit Desnues
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée infection, Marseille, France
| | - Alberto Riberi
- Department of Cardiac Surgery, La Timone Hospital, Marseille, France
| | - Jean-Paul Casalta
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée infection, Marseille, France
| | - Gilbert Habib
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée infection, Marseille, France
- Département de cardiologie, la Timone Hospital, AP-HM, Marseille, France
| | - Laurence Camoin-Jau
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée infection, Marseille, France
- Laboratoire d’Hématologie, La Timone Hospital, APHM, Marseille, France
- *Correspondence: Laurence Camoin-Jau,
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Sayyahfar S, Latifian M, Esmaeili P, Baseri N, Bagheri Amiri F, Bakhshi B, Esteghamati A, Esmaeili S. Tropheryma whipplei in the stool samples of children with acute diarrhea: a study from Tehran, Iran. BMC Infect Dis 2022; 22:193. [PMID: 35220952 PMCID: PMC8883655 DOI: 10.1186/s12879-022-07198-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/23/2022] [Indexed: 12/18/2022] Open
Abstract
Abstract
Background
Recently, Tropheryma whipplei has been suggested as one of the causative agents of diarrhea among children worldwide. Limited data is available on the prevalence of T. whipplei among children with diarrhea in most countries such as Iran. This study was conducted to evaluate the prevalence of T. whipplei in children with acute diarrhea in Iran.
Methods
In this study, the stool samples were collected from 130 children under 10 years old with acute diarrhea from children's hospitals in Tehran city. Genomic DNA was extracted from stool samples and was tested for the presence of DNA of T. whipplei using the SYBR Green Real-time PCR method. Positive T. whipplei samples were finally confirmed by PCR Product sequencing.
Results
The mean age of participants was 32.5 months, and 54.6% of children were female. Using the SYBR Green Real-time PCR, 9.23% (12/130) of samples were positive for T. whipplei, which were confirmed by sequencing. 66.67% of positive cases were males. The duration of diarrhea in infected children with T. whipplei (83.3%) was significantly longer (OR: 5.93, 95% CI 1.24–28.22) compared to children with negative results (45.8%). Other demographic factors and clinical signs had not a statistically significant relationship with T. whipplei infection.
Conclusions
In this study, T. whipplei was detected in stool samples of children with acute diarrhea. The results indicated that T. whipplei could be associated with childhood diarrhea in Iran. The health care system and physicians should be aware of the presence of T. whipplei infection in Iran, especially in childhood diarrhea.
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