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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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Bellanger AP, Gbaguidi-Haore H, Berceanu A, Gouzien L, El Machhour C, Bichard D, Lanternier F, Scherer E, Millon L. Use of the Mucorales qPCR on blood to screen high-risk hematology patients is associated with better survival. Med Mycol 2024; 62:myae030. [PMID: 38533663 DOI: 10.1093/mmy/myae030] [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: 02/01/2024] [Revised: 03/10/2024] [Accepted: 03/25/2024] [Indexed: 03/28/2024] Open
Abstract
Our objective was to determine whether the twice-weekly screening of high-risk hematology patients by Mucorales qPCR on serum affects the prognosis of mucormycosis. Results from all serum Mucorales qPCR tests performed on patients from the hematology unit from January 2017 to December 2022 were analyzed. Patients with positive results were classified as having proven, probable or 'PCR-only' mucormycosis. One-month mortality for the local cohort was compared with that of a national cohort of cases of mucormycosis collected by the French surveillance network for invasive fungal disease ('Réseau de surveillances des infections fongiques invasives en France' (RESSIF)) from 2012 to 2018. From 2017 to 2022, 7825 serum Mucorales qPCR tests were performed for patients from the hematology unit; 107 patients with at least one positive Mucorales qPCR (164 positive samples) were identified. Sixty patients (70 positive samples, median Cq = 40) had no radiological criteria for mucormycosis and were considered not to have invasive fungal disease (70/7825, 0.9% false positives). It was not possible to classify disease status for six patients (12 positive samples, median Cq = 38). Forty-one patients (82 positive samples, median Cq = 35) had a final diagnosis of mucormycosis. In comparison with the RESSIF cohort, the local cohort was independently associated with a 48% lower one-month all-cause mortality rate (age-, sex-, and primary disease-adjusted hazard ratio = 0.52; 95% confidence interval: 0.29-0.94; P 0.03). Proactive screening for invasive mold diseases in high-risk hematology patients, including twice-weekly Mucorales qPCR on serum, was associated with mucormycosis higher survival.
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Affiliation(s)
- Anne-Pauline Bellanger
- Parasitology-Mycology, University Hospital of Besançon, Besançon, France
- Chrono-Environment UMR CNRS- 6249, University of Franche-Comté, Besançon, France
| | - Houssein Gbaguidi-Haore
- Chrono-Environment UMR CNRS- 6249, University of Franche-Comté, Besançon, France
- Infection Control Department, University Hospital of Besançon, Besançon, France
| | - Ana Berceanu
- Hematological Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Laura Gouzien
- Intensive Care Unit, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Chaima El Machhour
- Parasitology-Mycology, University Hospital of Besançon, Besançon, France
| | - Damien Bichard
- Pharmacy Department, University Hospital of Besançon, Besançon, France
| | - Fanny Lanternier
- Infectious Diseases Unit, Necker-Enfants Malades University Hospital, AP-HP, Paris, France
| | - Emeline Scherer
- Parasitology-Mycology, University Hospital of Besançon, Besançon, France
- Chrono-Environment UMR CNRS- 6249, University of Franche-Comté, Besançon, France
| | - Laurence Millon
- Parasitology-Mycology, University Hospital of Besançon, Besançon, France
- Chrono-Environment UMR CNRS- 6249, University of Franche-Comté, Besançon, France
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3
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Galmiche S, Thoreau B, Bretagne S, Alanio A, Paugam A, Letscher-Bru V, Cassaing S, Gangneux JP, Guegan H, Favennec L, Minoza A, Morio F, Bonhomme J, Desoubeaux G, Eloy O, Hasseine L, Sasso M, Millon L, Bellanger AP, Poirier P, Moniot M, Chouaki T, Huguenin A, Dalle F, Bouteille B, Nicolas M, Desbois-Nogard N, Bougnoux ME, Danion F, Poindron V, Néel A, Boukris-Sitbon K, Lanternier F, Terrier B. Invasive fungal diseases in patients with autoimmune diseases: a case series from the French RESSIF network. RMD Open 2023; 9:e003281. [PMID: 37558492 PMCID: PMC10414070 DOI: 10.1136/rmdopen-2023-003281] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES We aimed to describe patients with autoimmune diseases (AID) developing invasive fungal disease (IFD) and identify factors associated with short-term mortality. METHODS We analysed cases of IFD associated with AID from the surveillance network of invasive fungal diseases (Réseau de surveillance des infections fongiques invasives, RESSIF) registry of the French national reference centre for invasive mycoses. We studied association of AID-specific treatments with 30-day mortality. We analysed total lymphocyte and CD4-T cell counts in patients with Pneumocystis jirovecii pneumonia (PCP). RESULTS From 2012 to 2018, 549 individuals with IFD and AID were included, mainly with PCP (n=227, 41.3%), fungemia (n=167, 30.4%) and invasive aspergillosis (n=84, 15.5%). Rheumatoid arthritis (RA) and anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) were the most frequent AID in PCP (n=55 and 25, respectively) and invasive aspergillosis (n=15 and 10, respectively), inflammatory bowel diseases (IBDs) were predominant in fungemia (n=36). At IFD diagnosis, 365 (66.5%) patients received glucocorticoids (GCs), 285 (51.9%) immunosuppressants, 42 (7.7%) tumor necrosis factor (TNF)-α blockers, 75 (13.7%) other biologics. Mortality at 30 days was 28.1% (143/508). Fungemia and high-dose GCs were independently associated with higher 30-day mortality. In PCP patients, lymphopenia <1500/mm3 was frequent (132/179, 73.7%) even if CD4+T cell count exceeded 200/mm3 in 56/78 patients (71.8%) (median 472.5/mm3, IQR 160-858). CONCLUSION IFD associated with AID occurs primarily in RA, AAV and IBD, especially when treated with GCs and immunosuppressants. Mortality is high, especially for patients on high-dose GCs. Lymphopenia may help identify risk of PCP, but normal CD4+T cell count does not rule out the risk. Further studies are needed to assess the individual risk factors for IFD.
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Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, Île-de-France, France
- Ecole doctorale Pierre Louis de santé publique, Sorbonne Université, Paris, France
| | - Benjamin Thoreau
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Cochin Hospital, AP-HP, Université Paris Cité, Paris, Île-de-France, France
- INSERM U1016, Cochin Institute, Paris, Université Paris Cité, CNRS UMR 8104, Paris, Île-de-France, France
| | - Stéphane Bretagne
- Parasitologie - Mycologie, Hôpital St Louis, APHP, Paris, Île-de-France, France
- Institut Pasteur, Université Paris Cité, CNRS, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, Île-de-France, France
| | - Alexandre Alanio
- Parasitologie - Mycologie, Hôpital St Louis, APHP, Paris, Île-de-France, France
- Institut Pasteur, Université Paris Cité, CNRS, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, Île-de-France, France
| | - André Paugam
- Parasitologie - Mycologie, Université Paris Cité, Cochin Hospital, APHP, Paris, Île-de-France, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et Mycologie Médicale, Les Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Parasitologie et Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France
| | - Sophie Cassaing
- Parasitologie - Mycologie, Université de Toulouse, CHU Toulouse, Toulouse, Occitanie, France
- PharmaDev, Faculté de Pharmacie, Université de Toulouse, UPS, IRD, Toulouse, Occitanie, France
| | - Jean-Pierre Gangneux
- Université de Rennes, CHU, INSERM, Irset: Institut de Recherche en Santé, Environnement et Travail, UMR_S 1085, Rennes, France
| | - Hélène Guegan
- Université de Rennes, CHU, INSERM, Irset: Institut de Recherche en Santé, Environnement et Travail, UMR_S 1085, Rennes, France
| | - Loïc Favennec
- French National Cryptosporidiosis Reference Center, CHU de Rouen, Rouen, Normandie, France
- EA 7510, UFR Santé, University of Rouen Normandy, Normandy University, Rouen, France
| | - Alida Minoza
- Faculté de Médecine et Pharmacie, Université de Poitiers, Poitiers, Nouvelle-Aquitaine, France
- Département des agents anti-infectieux, Service de Mycologie-Parasitologie, CHU Poitiers, Poitiers, France
| | - Florent Morio
- Parasitologie - Mycologie, CHU Nantes, Nantes, Pays de la Loire, France
- UR 1155 IICiMed, Institut de Recherche en Santé 2, Université de Nantes, Nantes, Pays de la Loire, France
| | - Julie Bonhomme
- Microbiologie, CHU de Caen, ToxEMAC-ABTE Unicaen, Caen, Normandie, France
| | - Guillaume Desoubeaux
- Centre d'Étude des Pathologies Respiratoires - Inserm UMR1100, Université de Tours, Tours, France
- Parasitologie - Mycologie - Médecine tropicale, CHU de Tours, Tours, Centre-Val de Loire, France
| | - Odile Eloy
- Microbiologie, CH Versailles, Le Chesnay, Île-de-France, France
| | - Lilia Hasseine
- Parasitologie - Mycologie, hôpital de l'Archet, CHU Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | - Milène Sasso
- Laboratoire de Parasitologie - Mycologie, CHU Nîmes, Université de Montpellier, CNRS, IRD, MiVEGEC, Nimes, Occitanie, France
| | - Laurence Millon
- Laboratoire de Parasitologie - Mycologie, CHU de Besançon, Besançon, Bourgogne-Franche-Comté, France
- UMR 6249 CNRS Chrono-Environnement, Université Bourgogne Franche-Comté, Besançon, Bourgogne - Franche-Comté, France
| | - Anne-Pauline Bellanger
- Laboratoire de Parasitologie - Mycologie, CHU de Besançon, Besançon, Bourgogne-Franche-Comté, France
| | - Philippe Poirier
- Parasitologie - Mycologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), UMR Inserm/Université Clermont Auvergne U1071, USC INRA 2018, Clermont-Ferrand, Auvergne-Rhône-Alpes, France
| | - Maxime Moniot
- Parasitologie - Mycologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Taieb Chouaki
- Mycologie - parasitologie, CHU Amiens-Picardie, Amiens, Hauts-de-France, France
| | - Antoine Huguenin
- Parasitologie - Mycologie, hôpital Maison-Blanche, CHU de Reims, Reims, France
| | - Frédéric Dalle
- Parasitologie - Mycologie, Plateforme de Biologie Hospitalo-Universitaire Gérard Mack, Dijon, Bourgogne-Franche-Comté, France
- UMR PAM Univ Bourgogne Franche-Comté - AgroSup Dijon - Equipe Vin, Aliment, Microbiologie, Stress, Université Bourgogne Franche-Comté, Dijon, Bourgogne-Franche-Comté, France
| | - Bernard Bouteille
- Parasitologie - Mycologie, Centre de Biologie et de Recherche en Santé, CHU Limoges, Limoges, Nouvelle-Aquitaine, France
| | - Muriel Nicolas
- Mycologie - Parasitologie, Centre Hospitalier Universitaire Pointe-à-Pitre Abymes, Pointe-à-Pitre, Guadeloupe
| | | | - Marie-Elisabeth Bougnoux
- Laboratoire de Parasitologie - Mycologie, Service de Microbiologie, Necker-Enfants Malades University Hospital, APHP, Paris, Île-de-France, France
- Institut Pasteur, Université Paris Cité, Unité Biologie et Pathogénicité Fongiques, Département Mycologie, Paris, Île-de-France, France
| | - François Danion
- Maladies infectieuses et tropicales, Les Hôpitaux Universitaires de Strasbourg, Strasbourg, Grand Est, France
- Laboratoire d'Immuno-rhumatologie moléculaire UMR_S 1109, INSERM, Strasbourg, Grand Est, France
| | - Vincent Poindron
- Service d'Immunologie clinique, Hopitaux universitaires de Strasbourg, Strasbourg, France
| | - Antoine Néel
- CRTI UMR 1064, INSERM, Université de Nantes, Nantes, France
- Service de Médecine interne, CHU Nantes, Nantes, Pays de la Loire, France
| | - Karine Boukris-Sitbon
- Institut Pasteur, Université Paris Cité, CNRS, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, Île-de-France, France
| | - Fanny Lanternier
- Institut Pasteur, Université Paris Cité, CNRS, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, Île-de-France, France
- Infectious Diseases Unit, Necker-Enfants Malades University Hospital, AP-HP, Paris, France
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Cochin Hospital, AP-HP, Université Paris Cité, Paris, Île-de-France, France
- Université Paris Cité, U970, PARCC, INSERM, Paris, Île-de-France, France
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Bohard L, Lallemand S, Borne R, Courquet S, Bresson-Hadni S, Richou C, Millon L, Bellanger AP, Knapp J. Complete mitochondrial exploration of Echinococcus multilocularis from French alveolar echinococcosis patients. Int J Parasitol 2023:S0020-7519(23)00076-0. [PMID: 37148987 DOI: 10.1016/j.ijpara.2023.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 05/08/2023]
Abstract
Alveolar echinococcosis (AE) is a parasitosis that is expanding worldwide, including in Europe. The development of genotypic markers is essential to follow its spatiotemporal evolution. Sequencing of the commonly used mitochondrial genes cob, cox1, and nad2 shows low discriminatory power, and analysis of the microsatellite marker EmsB does not allow nucleotide sequence analysis. We aimed to develop a new method for the genotyping of Echinococcus multilocularis based on whole mitochondrial genome (mitogenome) sequencing, to determine the genetic diversity among 30 human visceral samples from French patients, and compare this method with those currently in use. Sequencing of the whole mitochondrial genome was carried out after amplification by PCR, using one uniplex and two multiplex reactions to cover the 13,738 bp of the mitogenome, combined with Illumina technology. Thirty complete mitogenome sequences were obtained from AE lesions. One showed strong identity with Asian genotypes (99.98% identity) in a patient who had travelled to China. The other 29 mitogenomes could be differentiated into 13 haplotypes, showing higher haplotype and nucleotide diversity than when using the cob, cox1, and nad2 gene sequences alone. The mitochondrial genotyping data and EmsB profiles did not overlap, probably because one method uses the mitochondrial genome and the other the nuclear genome. The pairwise fixation index (Fst) value between individuals living inside and those living outside the endemic area was high (Fst = 0.222, P = 0.002). This is consistent with the hypothesis of an expansion from historical endemic areas to peripheral regions.
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Affiliation(s)
- Louis Bohard
- Department of Infectious Disease, University Hospital of Besançon, 3 boulevard A. Fleming, 25030 Besançon, France
| | - Séverine Lallemand
- UMR CNRS 6249 Chrono-environnement Laboratory, University of Franche-Comté, 16 Route de Gray, 25030 Besançon, France
| | - Romain Borne
- UMR CNRS 6249 Chrono-environnement Laboratory, University of Franche-Comté, 16 Route de Gray, 25030 Besançon, France
| | - Sandra Courquet
- UMR CNRS 6249 Chrono-environnement Laboratory, University of Franche-Comté, 16 Route de Gray, 25030 Besançon, France; Department of Parasitology-Mycology, Reference National Center for Echinococcosis, University Hospital of Besançon, 3 boulevard A. Fleming, 25030 Besançon, France
| | - Solange Bresson-Hadni
- UMR CNRS 6249 Chrono-environnement Laboratory, University of Franche-Comté, 16 Route de Gray, 25030 Besançon, France; Department of Parasitology-Mycology, Reference National Center for Echinococcosis, University Hospital of Besançon, 3 boulevard A. Fleming, 25030 Besançon, France
| | - Carine Richou
- Department of Hepatology, University Hospital of Besançon, 3 boulevard A. Fleming, Besançon France
| | - Laurence Millon
- UMR CNRS 6249 Chrono-environnement Laboratory, University of Franche-Comté, 16 Route de Gray, 25030 Besançon, France; Department of Parasitology-Mycology, Reference National Center for Echinococcosis, University Hospital of Besançon, 3 boulevard A. Fleming, 25030 Besançon, France
| | - Anne-Pauline Bellanger
- UMR CNRS 6249 Chrono-environnement Laboratory, University of Franche-Comté, 16 Route de Gray, 25030 Besançon, France; Department of Parasitology-Mycology, Reference National Center for Echinococcosis, University Hospital of Besançon, 3 boulevard A. Fleming, 25030 Besançon, France
| | - Jenny Knapp
- UMR CNRS 6249 Chrono-environnement Laboratory, University of Franche-Comté, 16 Route de Gray, 25030 Besançon, France; Department of Parasitology-Mycology, Reference National Center for Echinococcosis, University Hospital of Besançon, 3 boulevard A. Fleming, 25030 Besançon, France.
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Caillet A, Bellanger AP, Navellou JC, Daguindau E, Rocchi S, Scherer E, Berceanu A, Millon L. Refractory invasive pulmonary aspergillosis due to Aspergillus flavus detected with the combination of two in-house Aspergillus qPCR. J Mycol Med 2023; 33:101350. [PMID: 36375310 DOI: 10.1016/j.mycmed.2022.101350] [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: 09/09/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
We present a case of probable invasive pulmonary aspergillosis due to Aspergillus flavus, in a female patient treated for an acute myeloid leukemia. Two weeks after an allogenic stem cell transplantation a probable invasive pulmonary aspergillosis was diagnosed based on thoracic imaging combined with positive galactomannan antigen and positive in-house mitochondrial Aspergillus qPCR in serum. Although an antifungal treatment was initiated, Aspergillus qPCR and galactomannan antigen remained positive in serum and worsening of the thoracic lesions was observed. The discordance between the negativity of the in-house ribosomal Aspergillus qPCR (specific to A. fumigatus) and the positivity of the in-house mitochondrial Aspergillus qPCR (targeting A. fumigatus and some other Aspergillus) allowed the suspicion of a thermophilic Aspergillus species that was not A. fumigatus. No strain was obtained in culture but the involvement of A. flavus was confirmed using a specific A. flavus qPCR. This case illustrated the usefulness of our original strategy combining two different in-house Aspergillus qPCRs, in addition to galactomannan assay, to diagnose invasive aspergillosis in hematology patients.
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Affiliation(s)
- Adrien Caillet
- Hematology Department, Besançon University Hospital, Besançon 25000, France
| | - Anne-Pauline Bellanger
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon 25000, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon 25000, France.
| | | | - Etienne Daguindau
- Hematology Department, Besançon University Hospital, Besançon 25000, France
| | - Steffi Rocchi
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon 25000, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon 25000, France
| | - Emeline Scherer
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon 25000, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon 25000, France
| | - Ana Berceanu
- Hematology Department, Besançon University Hospital, Besançon 25000, France
| | - Laurence Millon
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon 25000, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon 25000, France
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6
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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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7
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Rouzet A, Scherer E, Barrera C, Gondouin A, Reboux G, Humbert K, Millon L, Bellanger AP. Bird fancier's lung serodiagnosis by automated r-IgLL1 ELISA. J Immunol Methods 2022; 505:113267. [PMID: 35421363 DOI: 10.1016/j.jim.2022.113267] [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: 12/03/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 11/27/2022]
Abstract
CONTEXT Bird fancier's lung (BFL) is the most prevalent form of hypersensitivity pneumonitis (HP) worldwide. The current techniques used for the serological diagnosis of BFL all use crude extracts from feathers, droppings, and blooms as test antigens, which is associated with a lack of standardization and variability of the results. An antigenic protein, immunoglobulin lambda-like polypeptide-1 (IgLL1), isolated from pigeon droppings, was recently identified to be associated with BFL. We used genetic engineering to produce IgLL1 as a recombinant antigen. AIM We aimed to prospectively validate the use of an automated ELISA based on recombinant IgLL1 protein (r-IgLL1) as the test antigen for the serological diagnosis of BFL. METHODS Immunoprecipitation (IP) techniques (immunodiffusion (ID), immunoelectrophoresis (IEP)) and ELISA using r-IgLL1 were performed concomitantly over 10 months on 634 sera from patients with a BFL serodiagnosis request. Questionnaires were sent to obtain details on the avian exposure, clinical data, and final diagnosis. Concordance, sensitivity (Se), and specificity (Sp) of the two techniques were compared. RESULTS In total, 72 completed questionnaires were returned with 18 cases of BFL diagnosed and 54 of non-BFL. The concordance between the ELISA and ID+IEP precipitation techniques was 71%. The combination of immunoprecipitation techniques showed a Se of 78% and a Sp of 67%. The ELISA using r-IgLL1 showed a Se of 89% and a Sp of 91%. The automated r-IgLL1 ELISA test is sufficiently efficient to be used alone for the diagnosis of patients exposed solely to Columbidae. In cases of other avian exposure, the Se and Sp of the r-IgLL1 ELISA used for screening combined with the immunodiffusion test for confirmation were 89% and 93%, respectively. CONCLUSIONS The automated ELISA using r-IgLL1 is a promising tool for BFL serodiagnosis. Replacing immunodiffusion by the automated ELISA using r-IgLL1 as a screening technique will be the basis of our future strategy for BFL serodiagnosis.
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Affiliation(s)
- Adeline Rouzet
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France.
| | - Emeline Scherer
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Coralie Barrera
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Anne Gondouin
- Department of Pneumology, University Hospital of Besancon, Besancon, France
| | - Gabriel Reboux
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Karine Humbert
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Laurence Millon
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
| | - Anne-Pauline Bellanger
- Department of Parasitology-Mycology, University Hospital of Besancon, Besancon, France; Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besancon, France; Referent Biology Medical Laboratory for the serological diagnosis of hypersensitivity pneumonitis, LBMR-PHS, University Hospital of Besancon, France
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8
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Danion F, Letscher-Bru V, Guitard J, Sitbon K, Dellière S, Angoulvant A, Desoubeaux G, Botterel F, Bellanger AP, Gargala G, Uhel F, Bougnoux ME, Gerber V, Michel J, Cornu M, Bretagne S, Lanternier F. Coronavirus Disease 2019-Associated Mucormycosis in France: A Rare but Deadly Complication. Open Forum Infect Dis 2022; 9:ofab566. [PMID: 35071681 PMCID: PMC8773954 DOI: 10.1093/ofid/ofab566] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 09/03/2021] [Accepted: 11/04/2021] [Indexed: 11/14/2022] Open
Abstract
We studied COVID-19 associated mucormycosis based on 17 cases reported nationwide and assessed the differences with India. They differed by frequencies of diabetes mellitus (47% in France versus up to 95% in India), hematological malignancies (35% versus 1%), anatomical sites (12% versus >80% rhino-orbito-cerebral) and prognosis (88% mortality versus <50%).
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Affiliation(s)
- François Danion
- Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Service de Maladies Infectieuses et Tropicales, Strasbourg, France.,Laboratoire d'ImmunoRhumatologie Moléculaire, INSERM Unité Mixte de Recherche_S 1109, Strasbourg, France
| | - Valérie Letscher-Bru
- Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Laboratoire de Mycologie-Parasitologie, Strasbourg, France
| | - Juliette Guitard
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Paris, France
| | - Karine Sitbon
- Institut Pasteur, CNRS, Université de Paris, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et des Antifongiques, Paris, France
| | - Sarah Dellière
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Laboratoire de Mycologie-Parasitologie, Paris, France
| | - Adela Angoulvant
- Université Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service des Maladies Infectieuses et Tropicales, Le Kremlin-Bicêtre, France.,Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre National de Recherche Scientifique, AgroParisTech, GQE-Le Moulon, Gif-sur-Yvette, France
| | - Guillaume Desoubeaux
- Centre Hospitalier Universitaire de Tours, Laboratoire de Mycologie-Parasitologie, Tours, France
| | - Francoise Botterel
- Assistance Publique-Hôpitaux de Paris, CHU Henri-Mondor, Laboratoire de Mycologie-Parasitologie, Créteil, France
| | | | - Gilles Gargala
- CHU de Rouen, Laboratoire de Mycologie-Parasitologie, Rouen, France
| | - Fabrice Uhel
- Assistance Publique-Hôpitaux de Paris, Hôpital Louis-Mourier, Service de Médecine Intensive et Réanimation, Département Médical Universitaire ESPRIT, Colombes, France
| | - Marie-Elisabeth Bougnoux
- Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Laboratoire de Mycologie-Parasitologie, Paris, France
| | - Victor Gerber
- Hôpitaux Civils de Colmar, Service de Réanimation Médicale, Colmar, France
| | - Justin Michel
- Université Aix Marseille, AP-HM, Hôpital de La Conception, Service Oto-Rhino-Laryngologie et Chirurgie Cervico-faciale, Marseille, France
| | - Marjorie Cornu
- Université de Lille, Inserm U1285, CHU Lille, Laboratoire Parasitologie-Mycologie.,CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France
| | - Stéphane Bretagne
- Institut Pasteur, CNRS, Université de Paris, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et des Antifongiques, Paris, France.,Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Laboratoire de Mycologie-Parasitologie, Paris, France
| | - Fanny Lanternier
- Institut Pasteur, CNRS, Université de Paris, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et des Antifongiques, Paris, France.,Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Paris, France
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9
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Millon L, Caillot D, Berceanu A, Bretagne S, Lanternier F, Morio F, Letscher-Bru V, Dalle F, Denis B, Alanio A, Boutoille D, Bougnoux ME, Botterel F, Chouaki T, Charbonnier A, Ader F, Dupont D, Bellanger AP, Rocchi S, Scherer E, Gbaguidi-Haore H, Herbrecht R. Evaluation of serum Mucorales PCR for the diagnosis of Mucormycoses: The MODIMUCOR prospective trial. Clin Infect Dis 2022; 75:777-785. [PMID: 34986227 DOI: 10.1093/cid/ciab1066] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [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: 08/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early diagnosis and prompt initiation of specific antifungal treatment is essential for improving the prognosis of mucormycosis. We aimed to assess the performance of serum Mucorales quantitative PCR (qPCR) for the early diagnosis and follow-up of mucormycosis. METHODS We prospectively enrolled 232 patients with suspicion of invasive mold disease, evaluated using standard imaging and mycological procedures. Thirteen additional patients with proven or probable mucormycosis were included to analyze DNA load kinetics. Serum samples were collected twice-a-week for Mucorales qPCR tests targeting the Mucorales species Lichtheimia, Rhizomucor and Mucor/Rhizopus. RESULTS The sensitivity was 85·2%, specificity 89·8%, and positive and negative likelihood ratios 8·3 and 0·17, respectively in this prospective study. The first Mucorales qPCR-positive serum was observed a median of four days (IQR, 0-9) before sampling of the first mycological or histological positive specimen and a median of one day (IQR, (-2)-6) before the first imaging was performed. Negativity of Mucorales qPCR within seven days after liposomal-amphotericin B initiation was associated with an 85% lower 30-day mortality rate (adjusted hazard Ratio = 0·15, 95%CI [0·03-0·73], p = 0·02). CONCLUSION Our study argues for the inclusion of qPCR for the detection of circulating Mucorales DNA for mucormycosis diagnosis and follow-up after treatment initiation. Positive results should be added to the criteria for the consensual definitions from the European Organization for the Research and Treatment of Cancer/ Mycoses Study Group Education and Research Consortium (EORTC/MSGERC), as already done for Aspergillus PCR.
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Affiliation(s)
- Laurence Millon
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Denis Caillot
- Department of Clinical Hematology, CHU Dijon, Dijon, France
| | - Ana Berceanu
- Service d'Hematologie, CHU Besançon, Besançon, France
| | - Stéphane Bretagne
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - Fanny Lanternier
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Université de Paris, Paris, France.,Necker Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants malades, AP-HP, IHU Imagine, Paris, France
| | - Florent Morio
- Laboratoire de Parasitologie-Mycologie, CHU Nantes, Nantes, France.,Département de Parasitologie et Mycologie Médicale, EA1155 - IICiMed, Nantes Université, Nantes, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg Strasbourg, France
| | - Frédéric Dalle
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire Gérard Mack, Dijon France.,UMR PAM Univ Bourgogne Franche-Comté - AgroSup Dijon - Equipe Vin, Aliment, Microbiologie, Stress, Dijon, France
| | - Blandine Denis
- Infectious Diseases Department, APHP, Saint-Louis Hospital, Paris, France
| | - Alexandre Alanio
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - David Boutoille
- Unité Maladies Infectieuses et Tropicales, CHU Nantes, Nantes, France
| | - Marie-Elisabeth Bougnoux
- Parasitology-Mycology Unit, Necker Enfants Malades Hospital, APHP, Paris, France.,Fungal Biology and Pathogenicity Unit - INRA USC 2019. Institut Pasteur, Paris, France
| | - Françoise Botterel
- EA Dynamyc 7380 UPEC, ENVA, Faculté de Médecine, Créteil, France.,Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène, Mycologie-Parasitologie, DHU VIC, CHU Henri Mondor, Créteil, France
| | - Taieb Chouaki
- Laboratoire de Parasitologie et Mycologie Médicales, Centre de Biologie Humaine, CHU Amiens Picardie, Amiens, France.,Equipe AGIR : Agents Infectieux, Résistance et Chimiothérapie UR4294, Université de Picardie Jules Verne, Amiens, France
| | - Amandine Charbonnier
- Department of Clinical Hematology and Cellular Therapy, Amiens University Medical Center, Amiens, France
| | - Florence Ader
- Hospices Civils de Lyon, Département des Maladies Infectieuses et Tropicales, F-69004, Lyon, France
| | - Damien Dupont
- Institut des Agents Infectieux, Parasitologie Mycologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Anne-Pauline Bellanger
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Steffi Rocchi
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Emeline Scherer
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Houssein Gbaguidi-Haore
- UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France.,Infection Control Department, CHU Besançon, Besançon, France
| | - Raoul Herbrecht
- Université de Strasbourg, INSERM, IRFAC UMR-S1113, Strasbourg, France.,Service d'Hématologie, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
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10
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Bellanger AP, Lallemand S, Tumasyan Horikian A, Navellou JC, Barrera C, Rouzet A, Scherer E, Reboux G, Piton G, Millon L. OUP accepted manuscript. Med Mycol 2022; 60:6590791. [PMID: 35604675 PMCID: PMC9213863 DOI: 10.1093/mmy/myac031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 12/12/2022] Open
Abstract
Although a high prevalence of COVID-19-associated pulmonary aspergillosis has been reported, it is still difficult to distinguish between colonization with Aspergillus fumigatus and infection. Concomitantly, similarities between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and hypersensitivity pneumonitis were suggested. The objective of this study was to investigate retrospectively if precipitin assays targeting A. fumigatus could have been useful in the management of SARS-CoV-2 patients hospitalized in an Intensive Care Unit (ICU) in 2020. SARS-CoV-2 ICU patients were screened for Aspergillus co-infection using biomarkers (galactomannan antigen, qPCR) and culture of respiratory samples (tracheal aspirates and bronchoalveolar lavage). For all these patients, clinical data, ICU characteristics and microbial results were collected. Electrosyneresis assays were performed using commercial A. fumigatus somatic and metabolic antigens. ELISA were performed using in-house A. fumigatus purified antigen and recombinant antigens. Our study population consisted of 65 predominantly male patients, with a median ICU stay of 22 days, and a global survival rate of 62%. Thirty-five patients had at least one positive marker for Aspergillus species detection. The number of arcs obtained by electrosyneresis using the somatic A. fumigatus antigen was significantly higher for these 35 SARS-CoV-2 ICU patients (P 0.01, Welch's t-test). Our study showed that SARS-CoV-2 ICU patients with a positive marker for Aspergillus species detection more often presented precipitins towards A. fumigatus. Serology assays could be an additional tool to assess the clinical relevance of the Aspergillus species in respiratory samples of SARS-CoV-2 ICU patients.
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Affiliation(s)
- A P Bellanger
- To whom correspondence should be addressed. Anne-Pauline Bellanger, Pharm-D PhD, Department of Parasitology-Mycology, Jean Minjoz University Hospital, 25030 Besançon, France. Tel: +33 (0)3 70 63 23 51; Fax: +33 (0)3 70 63 23 24; E-mail:
| | - S Lallemand
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
| | - A Tumasyan Horikian
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
| | - J C Navellou
- Intensive Medical Care Unit, Regional Hospital of Besancon, Besancon, France
| | - C Barrera
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
- CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France
| | - A Rouzet
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
- CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France
| | - E Scherer
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
- CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France
| | - G Reboux
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
| | - G Piton
- Intensive Medical Care Unit, Regional Hospital of Besancon, Besancon, France
| | - L Millon
- Department of Parasitology-Mycology, University Hospital of Besançon, Besancon, France
- Referent Laboratory of Medical Biology for the serological diagnosis of hypersensitivity pneumonitis (LBMR PHS), University Hospital of Besançon, Besancon, France
- CNRS-University of Franche-Comte/ UMR 6249 Chrono-environment, Besançon, Besancon, France
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11
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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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12
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Vuillemey L, Febvay C, Puzenat E, Bellanger AP, Chague C, Puyraveau M, Delbosc B, Gauthier AS, Aubin F. Analysis of cytokines in tear fluid from atopic dermatitis patients with dupilumab-associated ocular adverse events. J Eur Acad Dermatol Venereol 2021; 36:e195-e197. [PMID: 34626023 DOI: 10.1111/jdv.17729] [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: 08/13/2021] [Revised: 09/09/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022]
Affiliation(s)
- L Vuillemey
- Department of Ophthalmology, CHU Besançon, Besançon, France
| | - C Febvay
- Department of Ophthalmology, CHU Besançon, Besançon, France
| | - E Puzenat
- Department of Dermatology, CHU Besançon, Besançon, France
| | - A P Bellanger
- Department of Parasitology, CHU Besançon, Besançon, France
| | - C Chague
- University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France
| | - M Puyraveau
- Department of Clinical Research, CHU Besançon, Besançon, France
| | - B Delbosc
- Department of Ophthalmology, CHU Besançon, Besançon, France.,University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France
| | - A-S Gauthier
- Department of Ophthalmology, CHU Besançon, Besançon, France.,University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France
| | - F Aubin
- Department of Dermatology, CHU Besançon, Besançon, France.,University Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France
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13
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Dollat M, Bellanger AP, Millon L, Chirouze C, Lepiller Q, Marguet P. Knowledge and vaccination practices among family physicians in northeastern France regarding tick-borne encephalitis virus. Ticks Tick Borne Dis 2021; 12:101774. [PMID: 34175735 DOI: 10.1016/j.ttbdis.2021.101774] [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: 01/06/2021] [Revised: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 10/21/2022]
Abstract
Tick-borne encephalitis (TBE) cases have been emerging in Europe. The Franche-Comte area, in northeastern France, borders Switzerland, but the two countries differ in their approach to TBE surveillance and prevention. Because family physicians (FPs) are in direct contact with the local population, at-risk of infected tick bites, they need to be well aware of TBE epidemiology and management. An observational survey was performed in 2019 in order to investigate Franche-Comte physicians' knowledge and vaccination practices with regard to TBE. Standardized online questionnaires were sent to a list of FPs practicing in Franche-Comte. The questionnaires included socio-demographic details, questions about TBE knowledge, symptomatology and vaccination. The response rate was 14.7%. FPs practicing in rural areas reported a significantly higher frequency of consultations for tick bites. While 81% of FPs indicated that they had some knowledge about TBE, only 20% were at ease with its clinical symptomatology. Thirty-one % of the FP participants performed TBE vaccinations. A general lack of knowledge about TBE and its clinical symptoms was observed in this survey. FPs play an essential role in screening and preventing TBE, especially those practicing in rural areas and in areas bordering Switzerland.
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Affiliation(s)
- Marie Dollat
- Emergency Department, Pontarlier Regional Hospital, 25300 Pontarlier, France
| | - Anne-Pauline Bellanger
- Department of Parasitology-Mycology, Besançon University Hospital, 25000 Besancon, France.
| | - Laurence Millon
- Department of Parasitology-Mycology, Besançon University Hospital, 25000 Besancon, France
| | - Catherine Chirouze
- Department of Infectious and Tropical Diseases, Besançon University Hospital, 25000 Besancon, France
| | - Quentin Lepiller
- Department of Virology, Besançon University Hospital, 25000 Besancon, France
| | - Philippe Marguet
- Emergency Department, Pontarlier Regional Hospital, 25300 Pontarlier, France
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14
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Dumortier J, Radenne S, Kamar N, Conti F, Abergel A, Coilly A, Francoz C, Houssel-Debry P, Vanlemmens C, Laverdure N, Duvoux C, Iriart X, Thellier M, Angoulvant A, Argy N, Autier B, Bellanger AP, Botterel F, Garrouste C, Rabodonirina M, Poirier P. Microsporidiosis after liver transplantation: A French nationwide retrospective study. Transpl Infect Dis 2021; 23:e13665. [PMID: 34101311 DOI: 10.1111/tid.13665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/07/2021] [Accepted: 05/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Microsporidiosis has been largely reported in patients with acquired immunodeficiency syndrome, but emerged as a cause of persistent diarrhea in solid organ transplant patients. METHODS Through the French Microsporidiosis Network and the Groupe français de recherche en greffe de foie, we collected all microsporidiosis cases identified in liver transplant patients between 1995 and 2020 in France. RESULTS We identified 24 liver transplant recipients with microsporidiosis. Sex ratio was balanced and median age was 58.8 (3.5-83.5) years (there were 4 children). Microsporidiosis occurred at a median time of 3.9 (0.1-18.9) years post-transplant. Median duration of diarrhea before diagnosis was 22 days (12-45). Therapeutic care included immunosuppressive therapy changes in 20 patients, as follows: stop cyclosporine or tacrolimus (n = 2), dose reduction of cyclosporine or tacrolimus (n = 12), stop MMF (n = 5), and dose reduction of corticosteroids (n = 1). In addition, 15 patients received specific therapy against microsporidiosis: fumagillin (n = 11) or albendazole (n = 4). Median duration of treatment was 14 days (8-45 days). Finally, 7 patients had immunosuppressive treatment tapering only. Microsporidiosis was complicated by renal failure in 15 patients, requiring dialysis in one case. Two patients had infection relapse. No patient presented proven rejection within the 3 months after microsporidiosis. None of the patients died within the 3 months after microsporidiosis. CONCLUSIONS Microsporidiosis is a very rare infection after liver transplantation but can induce severe dehydration and renal failure. Therefore, it must be systematically sought in any case of persistent diarrhea after first line screening of frequent infectious causes.
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Affiliation(s)
- Jérôme Dumortier
- Hospices civils de Lyon, Hôpital Edouard Herriot, Unité de transplantation hépatique, et Université Claude Bernard Lyon 1, Lyon, France
| | - Sylvie Radenne
- Service d'Hépato-Gastroentérologie, Hospices civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France
| | - Nassim Kamar
- Département de Néphrologie et Transplantation d'Organes, CHU Toulouse Rangueil, INSERM U1043, Université Paul Sabatier, Toulouse, France
| | - Filomena Conti
- Service d'hépatologie et transplantation hépatique, APHP - Hôpital de la Pitié Salpêtrière, Paris, France
| | - Armand Abergel
- CHU Clermont-Ferrand, Médecine digestive, Institut Pascal., UMR 6602 UCA CNRS SIGMA, Clermont-Ferrand, France
| | - Audrey Coilly
- AP-HP, Hôpital Paul Brousse, Centre Hépato-Biliaire, et INSERM, Unité 1193, Villejuif, France
| | - Claire Francoz
- APHP, Hôpital Beaujon, Service d'Hépatologie et Transplantation Hépatique, Université Paris Diderot - INSERM U1149, Clichy, France
| | - Pauline Houssel-Debry
- Service des Maladies du foie, CHU de Rennes, Hôpital de Pontchaillou, Rennes, France
| | - Claire Vanlemmens
- Service d'Hépatologie et Soins Intensifs Digestifs, CHU de Besançon, Hôpital Jean Minjoz, Besançon, France
| | - Noémie Laverdure
- Service d'Hépato-Gastroentérologie et Nutrition pédiatriques, Hospices civils de Lyon, Hôpital Femme-Mère-Enfant, Bron, France
| | | | - Xavier Iriart
- Service de Parasitologie-Mycologie, CHU Toulouse, Hôpital Purpan, et Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
| | - Marc Thellier
- Service de Parasitologie-Mycologie, APHP - Hôpital de la Pitié Salpêtrière, Paris, France
| | - Adela Angoulvant
- Service de Maladies infectieuses et Tropicale, APHP -Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Nicolas Argy
- Service de Parasitologie-Mycologie, APHP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Brice Autier
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085, Rennes, France
| | | | - Françoise Botterel
- Service de Maladies infectieuses et Tropicale, APHP -Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Cyril Garrouste
- Service de Néphrologie et transplantation rénale, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Meja Rabodonirina
- Service de Parasitologie, Hospices civils de Lyon, Hôpital de la Croix-Rousse, et Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Poirier
- Service de Parasitologie-Mycologie, CHU Clermont-Ferrand, 3iHP, INSERM, Université Clermont Auvergne, Clermont-Ferrand, France
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15
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Johannson KA, Bellanger AP. Birds of a Feather Precipitate Together. Arch Bronconeumol 2021; 58:S0300-2896(21)00167-8. [PMID: 34154840 DOI: 10.1016/j.arbres.2021.05.012] [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: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Kerri A Johannson
- Departments of Medicine & Community Health Sciences, University of Calgary, Calgary, Canada; Calvin, Phoebe and Joan Snyder Institute for Chronic Disease, University of Calgary, Calgary, Canada.
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16
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Jebbawi F, Bellanger AP, Lunström-Stadelmann B, Rufener R, Dosch M, Goepfert C, Gottstein B, Millon L, Grandgirard D, Leib SL, Beldi G, Wang J. Innate and adaptive immune responses following PD-L1 blockade in treating chronic murine alveolar echinococcosis. Parasite Immunol 2021; 43:e12834. [PMID: 33754355 DOI: 10.1111/pim.12834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/10/2021] [Accepted: 03/17/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) immune checkpoint blockade are efficacious in certain cancer therapies. OBJECTIVES The present study aimed to provide a picture about the development of innate and adaptive immune responses upon PD-L1 blockade in treating chronic murine AE. METHODS Immune treatment started at 6 weeks post-E. multilocularis infection, and was maintained for 8 weeks with twice per week anti-PD-L1 administration (intraperitoneal). The study included an outgroup-control with mice perorally medicated with albendazole 5 d/wk, and another one with both treatments combined. Assessment of treatment efficacy was based on determining parasite weight, innate and adaptive immune cell profiles, histopathology and liver tissue cytokine levels. RESULTS/CONCLUSIONS Findings showed that the parasite load was significantly reduced in response to PD-L1 blockade, and this blockade (a) contributed to T-cell activity by increasing CD4+ /CD8+ effector T cells, and decreasing Tregs; (b) had the capacity to restore DCs and Kupffer cells/Macrophages; (c) suppressed NKT and NK cells; and thus (d) lead to an improved control of E. multilocularis infection in mice. This study suggests that the PD-L1 pathway plays an important role by regulating adaptive and innate immune cells against E. multilocularis infection, with significant modulation of tissue inflammation.
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Affiliation(s)
- Fadi Jebbawi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Anne-Pauline Bellanger
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Britta Lunström-Stadelmann
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Reto Rufener
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Michel Dosch
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Christine Goepfert
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Animal Pathology, COMPATH, University of Bern, Switzerland
| | - Bruno Gottstein
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Laurence Millon
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Denis Grandgirard
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Stephen L Leib
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Junhua Wang
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland.,Institute for Infectious Diseases, University of Bern, Bern, Switzerland
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Bellanger AP, Wang J, Gbaguidi-Haore H, Barrera C, Bresson-Hadni S, Zlobec I, Lachenmayer A, Richou C, Turco C, Gottstein B, Millon L, Beldi G. Investigating new serological and tissue markers for the follow-up of patients operated for alveolar echinococcosis. Parasite Immunol 2021; 43:e12827. [PMID: 33655559 DOI: 10.1111/pim.12827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/11/2021] [Accepted: 02/26/2021] [Indexed: 01/17/2023]
Abstract
AIMS Alveolar echinococcosis (AE) is characterized by a chronically progressing hepatic injury caused by Echinococcus multilocularis. Surgery presently remains the best curative option. Currently, biological predictive features derived from the resected specimens are not suitable to assess surgery efficacy. The present study was designed to investigate whether a selection of markers measured on the resected specimens exhibits predictive features related to parasite viability, or to a total elimination of the parasite, in addition to serological markers. METHODS AND RESULTS In a collaboration between two centres, one in France (Besançon), and one in Switzerland (Bern), samples from 40 AE patients were analysed by microarray and serology techniques, individually. Paired serum samples before and after surgery were obtained for 26 patients. In the sera, a significant decrease in PD-L1 levels was observed after surgery, in addition to anti-Em18 levels. In the liver tissue, low levels of Cluster of Differentiation (CD)-3 were correlated with the absence of serum anti-Em18 after surgery. CONCLUSION This study showed PD-L1 is promising as a potential serological marker and further confirmed the performance of anti-Em18 serology. Further studies on a larger cohort are needed to confirm the utility of performing systematically microarray on resected liver tissue.
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Affiliation(s)
- Anne-Pauline Bellanger
- Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France
| | - Junhua Wang
- Faculty of Medicine, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | | | - Coralie Barrera
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France
| | - Solange Bresson-Hadni
- Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France.,National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France
| | - Inti Zlobec
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Anja Lachenmayer
- Visceral Surgery Department, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Carine Richou
- National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France.,Hepatology Department, University Hospital Jean Minjoz, Besancon, France
| | - Celia Turco
- Digestive Surgical Oncology Department, Liver transplantation Unit, University Hospital Jean Minjoz, Besancon, France
| | - Bruno Gottstein
- Faculty of Medicine, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Laurence Millon
- Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,National Reference Center for Echinococcosis, University Hospital of Besancon, Besançon, France
| | - Guido Beldi
- Visceral Surgery Department, Inselspital, University Hospital of Bern, Bern, Switzerland
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18
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Bellanger AP, Tatoyan N, Monnot T, Deconinck E, Scherer E, Montange D, Bichard D, Millon L, Gbaguidi-Haore H, Berceanu A. Investigating the impact of posaconazole prophylaxis on systematic fungal screening using galactomannan antigen, Aspergillus fumigatus qPCR, and Mucorales qPCR. J Mycol Med 2021; 31:101117. [PMID: 33610794 DOI: 10.1016/j.mycmed.2021.101117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/14/2021] [Accepted: 01/22/2021] [Indexed: 11/17/2022]
Affiliation(s)
| | - Natacha Tatoyan
- Parasitology Mycology Department, University Hospital, Besançon, France
| | - Tess Monnot
- Pharmacy Department, University Hospital, Besançon, France
| | - Eric Deconinck
- Hematology Department, University Hospital, Besançon, France
| | - Emeline Scherer
- Parasitology Mycology Department, University Hospital, Besançon, France
| | - Damien Montange
- Pharmacology Department, University Hospital, Besançon, France
| | - Damien Bichard
- Pharmacy Department, University Hospital, Besançon, France
| | - Laurence Millon
- Parasitology Mycology Department, University Hospital, Besançon, France
| | | | - Ana Berceanu
- Hematology Department, University Hospital, Besançon, France
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19
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Bellanger AP, Reboux G. Studying smoking benefit in farmer's lung to understand Covid-19. Occup Med (Lond) 2020; 70:620-621. [PMID: 32779722 PMCID: PMC7454784 DOI: 10.1093/occmed/kqaa147] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Gabriel Reboux
- Chrono-Environment Research Team UMR/CNRS-6249, University of Bourgogne Franche-Comté, Besançon, France
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20
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Ben Salah E, Sakly W, Barrera C, Mosbahi S, Bellanger AP, Farhani R, Ksia A, Gottstein B, Nouri A, Babba H, Millon L. Soluble programmed death-1 (sPD-1) as predictor of early surgical outcomes of paediatric cystic echinococcosis. Parasite Immunol 2020; 43:e12809. [PMID: 33207012 DOI: 10.1111/pim.12809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
AIMS Following treatment, cystic echinococcosis (CE) exhibits a relatively high relapse rate. Here, we evaluated the value of soluble programmed death-1 (sPD-1), sPD-1 ligand (sPD-L1) and anti-recP29 antibody concentrations, as predictors of early surgical treatment outcomes in young CE-affected patients. METHODS AND RESULTS This prospective study included 59 Tunisian children (177 plasmas), where CE was surgically treated and monitored for 3 post-operative years. Based on CE post-surgical development, patients were clustered into a 'No relapsed' CE (NRCE; n = 39) and a 'Relapsed' CE (RCE; n = 20) group. Plasma levels of sPD-1, sPD-L1 and anti-recP29 IgG were measured using ELISA. In the NRCE group, sPD-1, sPD-L1 and anti-recP29 IgG concentrations were significantly lower at D365 than at D30. By contrast, in the RCE group, no significant difference was observed between D0, D30 and D365. When considering individual variations, the probability to be 'relapse-free' was 67% and 73% when anti-recP29 IgG and sPD-L1 level, respectively, decreased between D30 and D365. The probability to be 'relapse-free' was 86% when the sPD-1 level decreased between D30 and D365 (P = .003; chi-square test). CONCLUSION sPD-1 may be a useful biomaker for the early evaluation of surgical procedure efficacy in paediatric CE cases.
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Affiliation(s)
- Eya Ben Salah
- Departement de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, LR12ES08, Université de Monastir, Monastir, Tunisia
| | - Wahiba Sakly
- Departement de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, LR12ES08, Université de Monastir, Monastir, Tunisia
| | - Coralie Barrera
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France
| | - Sana Mosbahi
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Anne-Pauline Bellanger
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France
| | - Rabeb Farhani
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Amine Ksia
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Abdellatif Nouri
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Hamouda Babba
- Departement de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, LR12ES08, Université de Monastir, Monastir, Tunisia
| | - Laurence Millon
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France
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21
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Johannson KA, Barnes H, Bellanger AP, Dalphin JC, Fernández Pérez ER, Flaherty KR, Huang YCT, Jones KD, Kawano-Dourado L, Kennedy K, Millerick-May M, Miyazaki Y, Morisset J, Morell F, Raghu GR, Robbins C, Sack CS, Salisbury ML, Selman M, Vasakova M, Walsh SLF, Rose CS. Exposure Assessment Tools for Hypersensitivity Pneumonitis. An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2020; 17:1501-1509. [PMID: 33258669 PMCID: PMC7706597 DOI: 10.1513/annalsats.202008-942st] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
This report is based on proceedings from the Exposure Assessment Tools for Hypersensitivity Pneumonitis (HP) Workshop, sponsored by the American Thoracic Society, that took place on May 18, 2019, in Dallas, Texas. The workshop was initiated by members from the Environmental, Occupational, and Population Health and Clinical Problems Assemblies of the American Thoracic Society. Participants included international experts from pulmonary medicine, occupational medicine, radiology, pathology, and exposure science. The meeting objectives were to 1) define currently available tools for exposure assessment in evaluation of HP, 2) describe the evidence base supporting the role for these exposure assessment tools in HP evaluation, 3) identify limitations and barriers to each tool's implementation in clinical practice, 4) determine which exposure assessment tools demonstrate the best performance characteristics and applicability, and 5) identify research needs for improving exposure assessment tools for HP. Specific discussion topics included history-taking and exposure questionnaires, antigen avoidance, environmental assessment, specific inhalational challenge, serum-specific IgG testing, skin testing, lymphocyte proliferation testing, and a multidisciplinary team approach. Priorities for research in this area were identified.
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22
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Bellanger AP, Courquet S, Pallandre JR, Godet Y, Millon L. Echinococcus multilocularis vesicular fluid induces the expression of immune checkpoint proteins in vitro. Parasite Immunol 2020; 42:e12711. [PMID: 32171024 DOI: 10.1111/pim.12711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 02/21/2020] [Accepted: 03/10/2020] [Indexed: 11/29/2022]
Abstract
AIMS Alveolar echinococcosis is a severe chronic helminthic infection that mimics a tumour-like disease. This study aimed at investigating in vitro interactions between Echinococcus multilocularis vesicular fluid (VF) and different immune checkpoints (PD-1/PD-L1, CTLA-4, LAG-3 and TIM-3). METHODS AND RESULTS Peripheral blood mononuclear cells (PBMC) from healthy blood donors were isolated by Ficoll. Natural killer (NK) cells were selected. Each type of cell was stimulated individually with E. multilocularis-VF. Expression of the different immune checkpoints was measured by flow cytometry on day 3 and day 6; all supernatants were used for immunoassays. Cells and supernatants from 22 healthy donors were analysed. A significant increase of PD-1, PD-L1, LAG-3 and TIM-3 was observed upon E. multilocularis-VF exposure for NK cells on day 3 (P < .05, Wilcoxon signed-rank test). A significant increase of PD-L1 and CTLA-4 was observed upon E. multilocularis-VF exposure for T cells on day 6 (P < .05, Wilcoxon signed-rank test), which was associated with increased levels of Th1 and Th2 cytokines P < .05, Wilcoxon signed-rank test). CONCLUSION These preliminary data suggest that immune checkpoints could be a way for E. multilocularis to modulate the host immune response during alveolar echinococcosis.
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Affiliation(s)
- Anne-Pauline Bellanger
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besancon, France.,Echinococcosis National Reference Center, Besancon, France.,Chrono-Environnement UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France
| | - Sandra Courquet
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besancon, France.,Echinococcosis National Reference Center, Besancon, France.,Chrono-Environnement UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France
| | | | - Yann Godet
- INSERM Unit 1098, University of Franche-Comté, Besançon, France
| | - Laurence Millon
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besancon, France.,Echinococcosis National Reference Center, Besancon, France.,Chrono-Environnement UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France
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23
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Bellanger AP, Berceanu A, Scherer E, Desbrosses Y, Daguindau E, Rocchi S, Millon L. Invasive Fungal Disease, Isavuconazole Treatment Failure, and Death in Acute Myeloid Leukemia Patients. Emerg Infect Dis 2020; 25:1778-1779. [PMID: 31441760 PMCID: PMC6711214 DOI: 10.3201/eid2509.190598] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We present 2 fatal cases of invasive fungal disease with isavuconazole treatment failure in immunocompromised patients: one with a TR34-L98H azole–resistant Aspergillus fumigatus isolate and the other a Rhizomucor–A. fumigatus co-infection. Such patients probably require surveillance by galactomannan antigen detection and quantitative PCRs for A. fumigatus and Mucorales fungi.
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24
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Bellanger AP, Morisse-Pradier H, Reboux G, Scherer E, Pramil S, Dominique S, Millon L. Hypersensitivity pneumonitis in a cystic fibrosis patient. Occup Med (Lond) 2019; 69:632-634. [PMID: 31504833 DOI: 10.1093/occmed/kqz115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hypersensitivity pneumonitis (HP) is a chronic inflammatory lung disease caused by repeated inhalation of antigenic substances. We present a case of metalworking fluids (MWFs)-HP sensitized to Pseudomonas oleovorans in a cystic fibrosis patient. This case illustrates that HP diagnosis remains challenging, especially in patients with another pulmonary disease, and that serodiagnosis contributes to identifying the precise microorganism involved. It also demonstrates that P. oleovorans is an important secondary aetiological agent in MWF-HP, less known than Mycobacterium immunogenum.
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Affiliation(s)
- A P Bellanger
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besançon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France
| | | | - G Reboux
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besançon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France
| | - E Scherer
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besançon, France
| | - S Pramil
- Pneumology Department, Rouen University Hospital, Rouen, France
| | - S Dominique
- Pneumology Department, Rouen University Hospital, Rouen, France
| | - L Millon
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besançon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France
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25
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Gauthier P, Bellanger AP, Bozon F, Lepiller Q, Chirouze C, Marguet P. A survey investigating the current practice of French health professionals regarding infection risk after monkey bites. Zoonoses Public Health 2019; 67:193-197. [PMID: 31828958 DOI: 10.1111/zph.12665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/10/2019] [Revised: 10/16/2019] [Accepted: 11/06/2019] [Indexed: 12/01/2022]
Abstract
International tourism is steadily increasing, with 15% of travellers reporting health problems when they come back. Animal bites represent 2% of consulting causes, of which 20% are due to monkey bites. The Monkey B virus (Macacine alphaherpesvirus 1) is an alphaherpesvirus (Herpesviridae, genus Simplexvirus) enzootic in macaques (Genus Macaca). Zoonotic infections with the Monkey B virus following exposure to macaques are exceptionally rare, but can cause fatal encephalomyelitis in humans. An observational survey was undertaken in 2018 to assess the practice of French health professionals regarding infection risk after monkey bites. French health professionals practicing in vaccination and rabies centres were specifically targeted for this study. Standardized questionnaires were sent by email to a sample of French health professionals. They were asked to participate on a voluntary and anonymous basis. The questionnaires requested epidemiological details and included multiple-choice questions about the infection management of monkey bites. The response rate was 33.5%. The frequency of monkey bites in 2017 was variable with a minority of centres managing more than 6 per year (12%), 46% managing 1-5 monkey bites and 42% none. Most of the monkey bites were described as occurring in South Asia at tourist sites, on naked upper limbs, shortly after the travellers arrived at their destination. Tetanus status verification, rabies post-exposure prophylaxis and antibiotic therapy were said to be prescribed in most cases. Knowledge about the Monkey B virus was reported as scarce for 38% of the participants. The number of monkey bites managed per year per centre varied greatly but practices regarding infectious risk after monkey bites were generally homogeneous. The risk of Monkey B virus transmission did not readily come to mind in the differential diagnosis of infection risk for many French health professionals.
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Affiliation(s)
- Pauline Gauthier
- Emergency Department, Regional Hospital of Pontarlier, Pontarlier, France
| | | | - Fabienne Bozon
- Infectious and Tropical Disease Department, University Hospital of Besançon, Besancon, France
| | - Quentin Lepiller
- Virology Department, University Hospital of Besançon, Besancon, France.,EA3181, University Bourgogne Franche-Comté, Besancon, France
| | - Catherine Chirouze
- Infectious and Tropical Disease Department, University Hospital of Besançon, Besancon, France
| | - Philippe Marguet
- Emergency Department, Regional Hospital of Pontarlier, Pontarlier, France
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26
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Barrera C, Rocchi S, Degano B, Soumagne T, Laurent L, Bellanger AP, Laplante JJ, Millon L, Dalphin JC, Reboux G. Microbial exposure to dairy farmers' dwellings and COPD occurrence. Int J Environ Health Res 2019; 29:387-399. [PMID: 30461300 DOI: 10.1080/09603123.2018.1545900] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
Dairy farming is a risk factor for chronic obstructive pulmonary disease (COPD). The aim was to determine predictive markers either in blood samples or in dwelling dust samples by comparing COPD and healthy controls with or without farming activity. Dust was collected and analyzed by real-time quantitative PCR. ELISA and DELFIA® were performed to assay the level of specific IgG and IgE of 10 targeted microorganisms. The dwelling exposure of farmers was higher than in the non-farmers (Especially Eurotium amstelodami and Lichtheimia corymbifera). The IgG response against Wallemia sebi and Saccharopolyspora rectivirgula was more often higher in the farmers than the non-farmers. However, exposure and sensitization to the microorganisms tested cannot explain the occurrence of COPD in the dairy farmers' population. COPD development is probably caused by multiple factors associated with exposure over a period of several years.
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Affiliation(s)
- Coralie Barrera
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Steffi Rocchi
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Bruno Degano
- c Department of Functional Explorations , University Hospital , Besançon , France
| | - Thibaud Soumagne
- d Department of Pneumology , University Hospital , Besançon , France
| | - Lucie Laurent
- c Department of Functional Explorations , University Hospital , Besançon , France
| | - Anne-Pauline Bellanger
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Jean-Jacques Laplante
- e Department of Occupational Diseases , Social and Agricultural Mutual (MSA) of Franche-Comté , Besançon , France
| | - Laurence Millon
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Jean-Charles Dalphin
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- d Department of Pneumology , University Hospital , Besançon , France
| | - Gabriel Reboux
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
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Carlet C, Tachikart A, Bellanger AP, Aubin F, Chirouze C, Klopfenstein T. Lasiodiplodia theobromae deep mycosis in a kidney transplant patient. Med Mal Infect 2019; 49:545-547. [PMID: 31351804 DOI: 10.1016/j.medmal.2019.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/27/2019] [Accepted: 07/03/2019] [Indexed: 11/17/2022]
Affiliation(s)
- C Carlet
- Dermatology department, Jean-Minjoz university hospital, 25000 Besançon, France.
| | - A Tachikart
- Nephrology department, Jean-Minjoz university hospital, 25000 Besançon, France
| | - A P Bellanger
- Parasitology-mycology department, Jean-Minjoz university hospital, 25000 Besançon, France
| | - F Aubin
- Dermatology department, Jean-Minjoz university hospital, 25000 Besançon, France
| | - C Chirouze
- Infectious and tropical diseases department, Jean-Minjoz university hospital, 25000 Besançon, France
| | - T Klopfenstein
- Infectious and tropical diseases department, Jean-Minjoz university hospital, 25000 Besançon, France
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Bellanger AP, Gbaguidi-Haore H, Liapis E, Scherer E, Millon L. Rapid identification of Candida sp. by MALDI-TOF mass spectrometry subsequent to short-term incubation on a solid medium. APMIS 2019; 127:217-221. [PMID: 30803048 DOI: 10.1111/apm.12936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/07/2019] [Indexed: 11/27/2022]
Abstract
Rapid identification of Candida species is important for appropriate antifungal therapy of fungemia. The matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) system is a useful tool to identify bacteria and yeasts. In this study, we evaluated the feasibility of identifying yeasts after a short-term incubation on a solid medium. We tested 24 strains of eight Candida species. Blood culture bottles were spiked with a calibrated suspension of each Candida strain. Three different culture media, two types of blood culture bottles and three different incubation time points were tested. A multivariable random-effects logistic regression analysis was performed for determining factors independently associated with a successful MALDI-TOF MS identification. One-hundred and thirty-one out of 432 MALDI-TOF MS analyses (30%) exhibited a score ≥ 1.7. The performance of the technique varied across Candida species. Factors associated with a successful identification were the use of a chromogenic Candida medium and the time points 4 and 5 h. Using the factors 'chromogenic Candida medium' and time point 5 h the global performance of identification reached 60% and a mean MALDI-TOF score of 1.78. Identifying yeasts after a short-term incubation on a solid medium seems possible, especially when using a chromogenic Candida medium and respecting at least 5 h of incubation. This assay was a first step and needs to be completed using more strains, various chromogenic Candida medium and maybe also testing a longer culture time such as 6 h.
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Affiliation(s)
- Anne-Pauline Bellanger
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besancon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France
| | | | - Eleni Liapis
- Bacteriology Department, Jean Minjoz University Hospital, Besançon, France
| | - Emeline Scherer
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besancon, France
| | - Laurence Millon
- Parasitology Mycology Department, Jean Minjoz University Hospital, Besancon, France.,Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France
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Millon L, Scherer E, Rocchi S, Bellanger AP. Molecular Strategies to Diagnose Mucormycosis. J Fungi (Basel) 2019; 5:jof5010024. [PMID: 30897709 PMCID: PMC6463105 DOI: 10.3390/jof5010024] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [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: 02/02/2019] [Revised: 03/14/2019] [Accepted: 03/18/2019] [Indexed: 12/14/2022] Open
Abstract
Molecular techniques have provided a new understanding of the epidemiology of mucormycosis and improved the diagnosis and therapeutic management of this life-threatening disease. PCR amplification and sequencing were first applied to better identify isolates that were grown from cultures of biopsies or bronchalveolar lavage samples that were collected in patients with Mucorales infection. Subsequently, molecular techniques were used to identify the fungus directly from the infected tissues or from bronchalveolar lavage, and they helped to accurately identify Mucorales fungi in tissue samples when the cultures were negative. However, these tools require invasive sampling (biospsy, bronchalveolar lavage), which is not feasible in patients in poor condition in Hematology or Intensive Care units. Very recently, PCR-based procedures to detect Mucorales DNA in non-invasive samples, such as plasma or serum, have proved successful in diagnosing mucormycosis early in all patients, whatever the clinical status, and these procedures are becoming essential to improving patient outcome.
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Affiliation(s)
- Laurence Millon
- Parasitology Mycology Department, University Hospital, 25000 Besancon, France.
- Chrono-Environnement UMR/CNRS 6249, University of Bourgogne Franche-Comté, 25000 Besançon, France.
| | - Emeline Scherer
- Parasitology Mycology Department, University Hospital, 25000 Besancon, France.
- Chrono-Environnement UMR/CNRS 6249, University of Bourgogne Franche-Comté, 25000 Besançon, France.
| | - Steffi Rocchi
- Parasitology Mycology Department, University Hospital, 25000 Besancon, France.
- Chrono-Environnement UMR/CNRS 6249, University of Bourgogne Franche-Comté, 25000 Besançon, France.
| | - Anne-Pauline Bellanger
- Parasitology Mycology Department, University Hospital, 25000 Besancon, France.
- Chrono-Environnement UMR/CNRS 6249, University of Bourgogne Franche-Comté, 25000 Besançon, France.
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Bellanger AP, Reboux G, Rouzet A, Barrera C, Rocchi S, Scherer E, Millon L. Hypersensitivity pneumonitis: A new strategy for serodiagnosis and environmental surveys. Respir Med 2019; 150:101-106. [PMID: 30961934 DOI: 10.1016/j.rmed.2019.02.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 01/08/2023]
Abstract
We propose a strategy for serodiagnosis of hypersensitivity pneumonitis (HP): 1) question patients about their private or occupational activity, or visit him on site; 2) select panels of six somatic specific antigens appropriate for each type of exposure; 3) and use ELISA to test concomitantly two recombinant antigens highly specific to Farmer's lung, Metalworking-fluid HP, and for Bird fancier's lung. The serodiagnosis provides an immunological argument that may complete radiological, functional lung exploration and clinical features; 4) If the serodiagnosis is negative but the suspicion of HP is strong, a microbial analysis of the patient's specific exposure is conducted; 5) "A la carte" antigens are produced from the microorganisms isolated in the patient's environment sample and tested; 6) Finally, the patient may be asked to undergo a specific inhalation challenge with the offending antigens in a safety cabin, or to avoid his usual environment for a few days.
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Affiliation(s)
- Anne-Pauline Bellanger
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Gabriel Reboux
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France.
| | - Adeline Rouzet
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Coralie Barrera
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Steffi Rocchi
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Emeline Scherer
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
| | - Laurence Millon
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne- Franche-Comté, France
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Wang J, Jebbawi F, Bellanger AP, Beldi G, Millon L, Gottstein B. Cover Image. Parasite Immunol 2018. [DOI: 10.1111/pim.12486] [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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Wang J, Jebbawi F, Bellanger AP, Beldi G, Millon L, Gottstein B. Immunotherapy of alveolar echinococcosis via PD-1/PD-L1 immune checkpoint blockade in mice. Parasite Immunol 2018; 40:e12596. [PMID: 30315719 PMCID: PMC6587932 DOI: 10.1111/pim.12596] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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: 05/25/2018] [Revised: 09/04/2018] [Accepted: 10/08/2018] [Indexed: 01/01/2023]
Abstract
The growth potential of the tumour‐like Echinococcus multilocularis metacestode (causing alveolar echinococcosis, AE) is directly dependent upon the nature/function of the periparasitic adaptive host immune‐mediated processes. PD‐1/PD‐L1 pathway (programmed cell death 1), which inhibits lymphocytic proliferation in tumour development, is over‐expressed at the chronic stage of AE. We tested the impact of a PD‐1/PD‐L1 pathway blockade on the outcome of both chronic AE (intraperitoneal metacestode inoculation, secondary AE and SAE) and acute AE (peroral egg infection, primary AE and PAE). To assess the parasite proliferation potential, we measured parasite mass weight for SAE and liver lesion number for PAE. In both models, the parasite load was significantly decreased in response to anti‐PD‐L1 antibody treatment. In SAE, anti‐PDL1 administration was associated with increased Th1 response parameters and decreased Treg responses, while in PAE anti‐PDL1 administration was associated with fewer lesions in the liver and decreased Treg/Th2 responses. Our findings highly suggested that a PD‐1/PD‐L1 pathway blockade triggered the host immune responses in favour of an immune‐mediated control of E. multilocularis proliferation. Based on this, future studies that combine PD‐1/PD‐L1 blockade with a parasitostatic albendazole medication may yield in a putatively curative therapeutic approach to control alveolar echinococcosis.
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Affiliation(s)
- Junhua Wang
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Fadi Jebbawi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Anne-Pauline Bellanger
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
| | - Laurence Millon
- Chrono-Environment UMR/CNRS 6249, University of Bourgogne Franche-Comté, Besançon, France.,Parasitology Mycology Department, University Hospital Jean Minjoz, Besancon, France
| | - Bruno Gottstein
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
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Bellanger AP, Gbaguidi Haore H, Berceanu A, Scherer E, Millon L. Analyse rétrospective des seuils de positivé du galactomannane dans les lavages broncho-alvéolaires. J Mycol Med 2017. [DOI: 10.1016/j.mycmed.2017.04.044] [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: 11/25/2022]
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Jeanvoine A, Berceanu A, Emery A, Damassie M, Scherer E, Millon L, Bellanger AP. Comparaison des CMI vis-à-vis du posaconazole et de l’isavuconazole pour des souches de Mucorales isolées au CHRU de Besançon. J Mycol Med 2017. [DOI: 10.1016/j.mycmed.2017.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bellanger AP, Maire C, Vacheyrou M, Vieille I, Reboux G, Millon L. Contribution du MALDI-TOF pour l’identification des filamenteux en routine au CHRU de Besançon. J Mycol Med 2017. [DOI: 10.1016/j.mycmed.2017.04.094] [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: 11/30/2022]
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Bellanger AP, Mougey V, Pallandre JR, Gbaguidi-Haore H, Godet Y, Millon L. Echinococcus multilocularis vesicular fluid inhibits activation and proliferation of natural killer cells. Folia Parasitol (Praha) 2017; 64. [PMID: 28906255 DOI: 10.14411/fp.2017.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/05/2017] [Indexed: 12/18/2022]
Abstract
Alveolar echinococcosis is a severe chronic helminthic disease that mimics slow-growing liver cancer. The immune evasion strategy of Echinococcus multilocularis Leuckart, 1863 remains poorly understood. The aim of this study was to investigate in vitro the impact of E. multilocularis vesicular fluid (Em-VF) on peripheral blood mononuclear cells (PBMC) and on natural killer (NK) cells. PBMC and NK cells were exposed to Em-VF (1 µg/ml) during six days. The effect of Em-VF was assessed on CD69, viability and proliferation, and on and transforming growth factor β (TGF-β), interferon γ (IFN-γ), interleukin 17 (IL-17) and interleukin 10, using flow cytometry and ELISA, respectively. Exposure to Em-VF had no bearing on PBMC's viability, proliferation and expression of CD69. In contrast, higher levels of IL-17 at day three and of TGF-β at day six were observed in PBMC supernatant after exposure to Em-VF (p < 0.05, Wilcoxon signed-rank test). Exposure to Em-VF induced a significant decrease of CD69 expression of NK cells at day three and a significant decrease of proliferation of NK cells at day six (p < 0.05, Wilcoxon signed-rank test). In contrast, NK cells viability and levels of cytokines did not vary significantly over Em-VF stimulation. Exposure to Em-VF had a significant bearing on activation and proliferation of NK cells. NK cells may play an important role in the immune response of the host against E. multilocularis.
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Affiliation(s)
- Anne-Pauline Bellanger
- Parasitology-Mycology Department, University Hospital, Besancon, France.,Chrono-Environnement CNRS 6249 Research Team, Franche-Comte University, Besancon, France
| | - Valentine Mougey
- Parasitology-Mycology Department, University Hospital, Besancon, France
| | | | | | - Yann Godet
- INSERM Unit 1098, University of Franche-Comte, Besancon, France
| | - Laurence Millon
- Parasitology-Mycology Department, University Hospital, Besancon, France.,Chrono-Environnement CNRS 6249 Research Team, Franche-Comte University, Besancon, France
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Bellanger AP, Lignon T, Godet Y, Rognon B, Reboux G, Gbaguidi-Haore H, Borg C, Millon L. Fungal peptides from pneumonitis hypersensitivity etiologic agents are able to induce specific cellular immune response. J Immunol Methods 2016; 440:67-73. [PMID: 27876506 DOI: 10.1016/j.jim.2016.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/18/2016] [Accepted: 11/18/2016] [Indexed: 12/28/2022]
Abstract
PURPOSE Hypersensitivity pneumonitis (HP) is an immunoallergic disease due to chronic exposure to high quantities of different microorganisms such as Mycobacterium immunogenum (Mi), a mycobacterium, and Lichtheimia corymbifera (Lc), a filamentous fungus. It has recently been demonstrated that the protein DLDH (dihydrolipoyl dehydrogenase), is common to these microorganisms. This study aimed to investigate the immune potential of overlapping peptide pools covering the MiDLDH and LcDLDH. EXPERIMENTAL DESIGN A selection of 34 peptides, from the MiDLDH and LcDLDH, able to interact with Major Histocompatibility Complex (MHC) 1 and MHC 2, was obtained using three different epitope prediction websites. By means of ELISPOT assays, we compared the frequency of Interferon gamma (IFNγ) secreting peripheral blood mononuclear cells (PBMC) after stimulation with overlapping peptide pools. Tests were performed using cells from 35 healthy blood donors. RESULTS One peptide pool containing five peptides from MiDLDH and able to interact with MHC 2 induced a marked IFNγ specific immune response (Pool F, p<0.001, Wilcoxon signed-rank test). CONCLUSION This study demonstrated that peptides from microorganisms involved in HP were able to induce a high IFNγ specific immune response after stimulation of PBMCs from healthy blood donors which could be useful to develop an effective prevention strategy.
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Affiliation(s)
- Anne-Pauline Bellanger
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon, France.
| | - Thibaud Lignon
- Parasitology-Mycology Department, Besançon University Hospital, Besançon, France
| | - Yann Godet
- INSERM Unit 1098, University of Franche-Comté, Besançon, France
| | - Bénédicte Rognon
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon, France
| | - Gabriel Reboux
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon, France
| | | | - Christophe Borg
- INSERM Unit 1098, University of Franche-Comté, Besançon, France
| | - Laurence Millon
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon, France
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El Safadi D, Cian A, Nourrisson C, Pereira B, Morelle C, Bastien P, Bellanger AP, Botterel F, Candolfi E, Desoubeaux G, Lachaud L, Morio F, Pomares C, Rabodonirina M, Wawrzyniak I, Delbac F, Gantois N, Certad G, Delhaes L, Poirier P, Viscogliosi E. Prevalence, risk factors for infection and subtype distribution of the intestinal parasite Blastocystis sp. from a large-scale multi-center study in France. BMC Infect Dis 2016; 16:451. [PMID: 27566417 PMCID: PMC5002209 DOI: 10.1186/s12879-016-1776-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/11/2016] [Indexed: 12/21/2022] Open
Abstract
Background Blastocystis sp. is the most common intestinal parasite of humans. Despite its potential public health impact, epidemiological data regarding the prevalence and molecular subtype distribution of Blastocystis sp. in Europe are rarely reported. Therefore, the first multi-center epidemiological survey performed in Europe was conducted in France to diagnose and subtype Blastocystis sp. and to identify risk factors for infection. Methods Stool samples from 788 patients were collected either in summer or winter in 11 hospitals throughout France together with patient data. All stool samples were tested for the presence of Blastocystis sp. by quantitative PCR targeting the SSU rDNA gene. Positive samples were sequenced to determine the distribution of the subtypes in our cohort. Statistical analyses were performed to identify potential risk factors for infection. Results Using quantitative PCR, the overall prevalence of Blastocystis sp. was shown to reach 18.1 %. The prevalence was significantly higher in summer (23.2 %) than in winter (13.7 %). Travellers or subjects infected with other enteric parasites were significantly more infected by Blastocystis sp. than non-travellers or subjects free of other enteric parasites, respectively. Different age-related epidemiological patterns were also highlighted from our data. The prevalence of Blastocystis sp. was not significantly higher in patients with digestive symptoms or diagnosed with chronic bowel diseases. Among symptomatic patients, Blastocystis sp. infection was significantly associated with abdominal pain. Gender, socioeconomic status, and immune status were not identified as potential risk factors associated with infection. Among a total of 141 subtyped isolates, subtype 3 was predominant (43.3 %), followed by subtype 1 and subtype 4 (20 %), subtype 2 (12.8 %), subtype 6 and subtype 7 (2.1 %). No association between ST and clinical symptoms was statistically evidenced. Conclusions A high prevalence of Blastocystis sp. infection was found in our French patient population. Seasonal impact on the prevalence of Blastocystis sp. was highlighted and recent travels and age were identified as main risk factors for infection. Most cases were caused by subtypes 1 to 4, with a predominance of subtype 3. Large variations in both prevalence and ST distribution between hospitals were also observed, suggesting distinct reservoirs and transmission sources of the parasite. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1776-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dima El Safadi
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France
| | - Amandine Cian
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France
| | - Céline Nourrisson
- Laboratoire de Parasitologie-Mycologie, CHU Gabriel-Montpied, Clermont-Ferrand, France.,Clermont Université, Université Blaise Pascal-Université d'Auvergne - CNRS UMR 6023 Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Unité de Biostatistiques, Direction de la Recherche Clinique (DRCI), Clermont-Ferrand, France
| | - Christelle Morelle
- Laboratoire de Parasitologie-Mycologie, CHU de Montpellier, CNRS UMR 5290/IRD 224/UM1, Université de Montpellier 1, Montpellier, France
| | - Patrick Bastien
- Laboratoire de Parasitologie-Mycologie, CHU de Montpellier, CNRS UMR 5290/IRD 224/UM1, Université de Montpellier 1, Montpellier, France
| | | | - Françoise Botterel
- Laboratoire de Parasitologie-Mycologie, AP-HP Hôpital Henri Mondor, Créteil, France
| | - Ermanno Candolfi
- Institut de Parasitologie et de Pathologie Tropicale de Strasbourg, Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Guillaume Desoubeaux
- Service de Parasitologie-Mycologie-Médecine Tropicale, CHU de Tours/CEPR Inserm U1100 Equipe 3, Université François-Rabelais de Tours, Tours, France
| | - Laurence Lachaud
- Département de Parasitologie-Mycologie, Faculté de Médecine de Montpellier-Nîmes, Université de Montpellier I, CHU de Montpellier, Montpellier, France
| | - Florent Morio
- Département de Parasitologie et Mycologie Médicale, Laboratoire de Parasitologie-Mycologie, Institut de Biologie, CHU de Nantes, EA1155-IICiMed, Université de Nantes, Nantes, France
| | - Christelle Pomares
- Laboratoire de Parasitologie-Mycologie CHU de Nice, C3M INSERM U1065, Université de Nice Sophia Antipolis, Nice, France
| | | | - Ivan Wawrzyniak
- Clermont Université, Université Blaise Pascal-Université d'Auvergne - CNRS UMR 6023 Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Frédéric Delbac
- Clermont Université, Université Blaise Pascal-Université d'Auvergne - CNRS UMR 6023 Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France
| | - Nausicaa Gantois
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France
| | - Gabriela Certad
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France
| | - Laurence Delhaes
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France.,Département de Parasitologie-Mycologie, CHU de Lille, Faculté de Médecine, Lille, France
| | - Philippe Poirier
- Laboratoire de Parasitologie-Mycologie, CHU Gabriel-Montpied, Clermont-Ferrand, France. .,Clermont Université, Université Blaise Pascal-Université d'Auvergne - CNRS UMR 6023 Laboratoire Microorganismes: Génome et Environnement, Clermont-Ferrand, France.
| | - Eric Viscogliosi
- Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Centre d'Infection et d'Immunité de Lille, 1 rue du Professeur Calmette, BP 245, 59019, Lille cedex, France.
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Bellanger AP, Minetos YD, Albert N, Shirazi F, Walsh TJ, Kontoyiannis DP. Glucocorticosteroids do not impact directly growth rate and biomass of Rhizopus arrhizus (syn. R. oryzae) in vitro. Virulence 2016; 6:441-3. [PMID: 25942104 DOI: 10.1080/21505594.2015.1039762] [Citation(s) in RCA: 2] [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] [Indexed: 10/23/2022] Open
Abstract
Glucocorticoid (GC) use is a common risk factor for invasive fungal infections. This is attributed to the complex dysregulation of immunity caused by GCs. However, studies have demonstrated increased growth with GC exposure for some molds, such as Aspergillus fumigatus and Exserohilum rostratum. No such data exist for Mucorales. Therefore, we investigated the influence of GC exposure on the growth of Rhizopus arrhizus (syn. R. oryzae) in different culture media and in different atmospheres. We measured continuous spore growth using spectrophotometry and biomass variations using XTT assay. We did not observe enhanced growth or biomass variation with any of the GCs regardless of the medium or conditions. These results support the existence of fungus-specific differences in the effect of GCs on fungal biology.
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Affiliation(s)
- A P Bellanger
- a Infectious Disease Department; MD Anderson Cancer Center , Houston , Texas
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Bellanger AP, Gbaguidi-Haore H, Gondoin A, Pallandre JR, Vacheyrou M, Valot B, Soumagne T, Reboux G, Dalphin JC, Millon L. Positive fungal quantitative PCR and Th17 cytokine detection in bronchoalveolar lavage fluids: Complementary biomarkers of hypersensitivity pneumonitis? J Immunol Methods 2016; 434:61-5. [PMID: 27098083 DOI: 10.1016/j.jim.2016.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 02/09/2016] [Revised: 04/15/2016] [Accepted: 04/15/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Interstitial lung disease (ILD) is a large group of diseases, including hypersensitivity pneumonitis (HP), idiopathic pulmonary fibrosis (IPF) and sarcoidosis. OBJECTIVE In this study, we aimed to identify bronchoalveolar lavage fluid (BALF) biomarkers which could be contributive for HP diagnosis. METHODS We analyzed 39 BALF samples from 12 ILD patients with sarcoidosis, 11 with IPF and 16 with HP. We determined the levels of 10 cytokines and carried out quantitative PCR for 10 microorganisms involved in farm-associated or domestic forms of HP. RESULTS IL-8, IL-6, TNFα, IL-17 and IL-23 levels were significantly higher in BALF samples from HP patients (p<0.05, one-way Kruskal-Wallis analysis). QPCR tests for Eurotium amstelodami and Wallemia sebi were positively significantly more frequently for HP patients (p<0.05, one-way Kruskal-Wallis). CONCLUSION The biomarkers identified here can be detected in BALF, which could be routinely obtained as complementary analysis in ILD diagnosis.
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Affiliation(s)
- Anne-Pauline Bellanger
- Chrono-Environnement UMR 6249 Research Team, Franche-Comté University, Besançon, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon, France.
| | | | - Anne Gondoin
- Pneumology Department, Besançon University Hospital, Besançon, France
| | - Jean-Rene Pallandre
- Immunology Department, French Blood Institute of Bourgogne Franche Comte, France
| | - Mallory Vacheyrou
- Chrono-Environnement UMR 6249 Research Team, Franche-Comté University, Besançon, France
| | - Benoit Valot
- Chrono-Environnement UMR 6249 Research Team, Franche-Comté University, Besançon, France
| | - Thibaud Soumagne
- Pneumology Department, Besançon University Hospital, Besançon, France
| | - Gabriel Reboux
- Chrono-Environnement UMR 6249 Research Team, Franche-Comté University, Besançon, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon, France
| | | | - Laurence Millon
- Chrono-Environnement UMR 6249 Research Team, Franche-Comté University, Besançon, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon, France
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Miltgen G, Paillot J, Vanlemmens C, Di Martino V, Heyd B, Millon L, Bellanger AP. Fatal acute respiratory distress by Toxoplasma gondii in a toxoplasma seronegative liver transplant recipient. New Microbiol 2016; 39:160-162. [PMID: 27196559] [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] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 03/02/2016] [Indexed: 06/05/2023]
Abstract
The risk of Toxoplasma gondii infection in solid organ transplant recipients is well known but mainly after heart transplantation. We discuss a case of acute respiratory distress caused by Toxoplasma gondii on Day 32 after liver transplantation. The reported case, which is extremely rare, emphasizes how direct examination and Quantitative Polymerase Chain Reaction (QPCR) in broncholaveolar lavage help to diagnose the infection. Given Trimethoprim/Sulfamethoxazole toxicity, systematic prescription of Toxoplasma gondii chemoprophylaxis is not commonly approved in liver transplantation.
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Affiliation(s)
- Guillaume Miltgen
- Department of Mycology-Parasitology, Jean Minjoz University Hospital, Besançon, France
| | - Jonathan Paillot
- Department of Anaesthesiology and Intensive Care, Jean Minjoz University Hospital, Besançon, France
| | - Claire Vanlemmens
- Department of Gastroenterology and Hepatology, Jean Minjoz University Hospital, Besançon, France
| | - Vincent Di Martino
- Department of Gastroenterology and Hepatology, Jean Minjoz University Hospital, Besançon, France
| | - Bruno Heyd
- Department of Liver Transplantation and Digestive Surgery, Jean Minjoz University Hospital, Besançon, France
| | - Laurence Millon
- Department of Mycology-Parasitology, Jean Minjoz University Hospital, Besançon, France
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Bellanger AP, Tatara AM, Shirazi F, Gebremariam T, Albert ND, Lewis RE, Ibrahim AS, Kontoyiannis DP. Statin Concentrations Below the Minimum Inhibitory Concentration Attenuate the Virulence of Rhizopus oryzae. J Infect Dis 2016; 214:114-21. [PMID: 26984141 PMCID: PMC5007635 DOI: 10.1093/infdis/jiw090] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 01/28/2016] [Accepted: 02/29/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mucormycosis is a destructive invasive mold infection afflicting patients with diabetes and hematologic malignancies. Patients with diabetes are often treated with statins, which have been shown to have antifungal properties. We sought to examine the effects of statins on Rhizopus oryzae, a common cause of mucormycosis. METHODS Clinical strains of R. oryzae were exposed to lovastatin, atorvastatin, and simvastatin and the minimum inhibitory concentrations (MICs) were determined. R. oryzae germination, DNA fragmentation, susceptibility to oxidative stress, and ability to damage endothelial cells were assessed. We further investigated the impact of exposure to lovastatin on the virulence of R. oryzae RESULTS All statins had MICs of >64 µg/mL against R. oryzae Exposure of R. oryzae to statins decreased germling formation, induced DNA fragmentation, and attenuated damage to endothelial cells independently of the expression of GRP78 and CotH. Additionally, R. oryzae exposed to lovastatin showed macroscopic loss of melanin, yielded increased susceptibility to the oxidative agent peroxide, and had attenuated virulence in both fly and mouse models of mucormycosis. CONCLUSIONS Exposure of R. oryzae to statins at concentrations below their MICs decreased virulence both in vitro and in vivo. Further investigation is warranted into the use of statins as adjunctive therapy in mucormycosis.
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Affiliation(s)
- Anne-Pauline Bellanger
- Department of Infectious Disease, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston
| | - Alexander M Tatara
- Department of Infectious Disease, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston
| | - Fazal Shirazi
- Department of Infectious Disease, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston
| | - Teclegiorgis Gebremariam
- Division of Infectious Disease, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
| | - Nathaniel D Albert
- Department of Infectious Disease, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston
| | - Russell E Lewis
- Department of Medical Science and Surgery, University Orsola-Malpighi, Bologna, Italy
| | - Ashraf S Ibrahim
- Division of Infectious Disease, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
| | - Dimitrios P Kontoyiannis
- Department of Infectious Disease, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston
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Bourgeois B, Marguet P, Gbaguidi-Haore H, Knapp J, Said-Ali Z, Demonmerot F, Bresson-Hadni S, Millon L, Bellanger AP. Alveolar echinococcosis: how knowledgeable are primary care physicians and pharmacists in the Franche-Comté region of France? Acta Parasitol 2015; 60:682-90. [PMID: 26408591 DOI: 10.1515/ap-2015-0097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/25/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alveolar echinococcosis (AE) is a parasitic disease resulting from the intrahepatic growth of Echinococcus multilocularis larva. This zoonotic helminthic disease is rare but, if left untreated or treated too late, can be severe or even fatal. In France, endemic areas containing infected foxes have become larger, spreading towards western regions of the country and leading to an increased risk of environmental contamination. An observational survey was undertaken in 2014 to assess the level of knowledge of AE among primary care physicians (PCPs) and pharmacists in the Franche-Comté region. METHODS Standardized questionnaires were sent to a random sample of 183 PCPs and 236 pharmacists practicing in the Franche-Comté region (eastern France), requesting their voluntary and anonymous participation. The questionnaires collected socio-demographic details, self-evaluation and asked multiple choice questions (MCQs) about epidemiology, prevention, diagnosis and management of AE. RESULTS The crude response rate was 37.5% of the PCPs and pharmacists questioned. Responses to MCQs showed that most of the participating PCPs and pharmacists had acceptable basic knowledge of AE, especially concerning epidemiology and prevention of the disease. However, a serious lack of knowledge was observed concerning the management of AE. CONCLUSION PCPs are often the first health professionals to suspect latent AE, which is still a rural disease in France. Both PCPs and pharmacists play an important role in informing and referring patients potentially exposed to AE. This study shows that although AE is rare, PCPs and pharmacists of the Franche-Comté region have a satisfactory level of knowledge of AE.
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Alanio A, Olivi M, Cabaret O, Foulet F, Bellanger AP, Millon L, Berceanu A, Cordonnier C, Costa JM, Bretagne S. Correlation Between Pneumocystis jirovecii Mitochondrial Genotypes and High and Low Fungal Loads Assessed by Single Nucleotide Primer Extension Assay and Quantitative Real-Time PCR. J Eukaryot Microbiol 2015; 62:650-6. [PMID: 25940946 DOI: 10.1111/jeu.12222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 12/12/2022]
Abstract
We designed a single nucleotide primer extension (SNaPshot) assay for Pneumocystis jirovecii genotyping, targeting mt85 SNP of the mitochondrial large subunit ribosomal RNA locus, to improve minority allele detection. We then analyzed 133 consecutive bronchoalveolar lavage (BAL) fluids tested positive for P. jirovecii DNA by quantitative real-time PCR, obtained from two hospitals in different locations (Hospital 1 [n = 95] and Hospital 2 [n = 38]). We detected three different alleles, either singly (mt85C: 39.1%; mt85T: 24.1%; mt85A: 9.8%) or together (27%), and an association between P. jirovecii mt85 genotype and the patient's place of hospitalization (p = 0.011). The lowest fungal loads (median = 0.82 × 10(3) copies/μl; range: 15-11 × 10(3) ) were associated with mt85A and the highest (median = 1.4 × 10(6) copies/μl; range: 17 × 10(3) -1.3 × 10(7) ) with mt85CTA (p = 0.010). The ratios of the various alleles differed between the 36 mixed-genotype samples. In tests of serial BALs (median: 20 d; range 4-525) from six patients with mixed genotypes, allele ratio changes were observed five times and genotype replacement once. Therefore, allele ratio changes seem more frequent than genotype replacement when using a SNaPshot assay more sensitive for detecting minority alleles than Sanger sequencing. Moreover, because microscopy detects only high fungal loads, the selection of microscopy-positive samples may miss genotypes associated with low loads.
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Affiliation(s)
- Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France.,Université Paris-Diderot, Sorbonne Cité, Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France.,CNRS URA3012, Paris, France
| | - Martine Olivi
- Laboratoire Cerba, Cergy-Pontoise, Saint-Ouen-l'Aumône, France
| | - Odile Cabaret
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe hospitalier Chenevier-Mondor, Créteil, France.,Université Paris-Est-Créteil, Créteil, France
| | - Françoise Foulet
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe hospitalier Chenevier-Mondor, Créteil, France.,Université Paris-Est-Créteil, Créteil, France
| | - Anne-Pauline Bellanger
- Laboratoire de Parasitologie-Mycologie, Centre hospitalier universitaire, Besançon, France.,Laboratoire Chrono-Environnement, Université Franche-Comté, UMR CNRS 6249, Besançon, France
| | - Laurence Millon
- Laboratoire de Parasitologie-Mycologie, Centre hospitalier universitaire, Besançon, France.,Laboratoire Chrono-Environnement, Université Franche-Comté, UMR CNRS 6249, Besançon, France
| | - Ana Berceanu
- Service d'Hématologie, Centre Hospitalier Universitaire, Besançon, France
| | - Catherine Cordonnier
- Université Paris-Est-Créteil, Créteil, France.,Département d'Hématologie, APHP, Groupe Hospitalier Albert Chenevier-Henri Mondor, Creteil, France
| | - Jean-Marc Costa
- Laboratoire Cerba, Cergy-Pontoise, Saint-Ouen-l'Aumône, France.,Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe hospitalier Chenevier-Mondor, Créteil, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France.,Université Paris-Diderot, Sorbonne Cité, Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France.,CNRS URA3012, Paris, France
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Bellanger AP, Pallandre JR, Gbaguidi-Haore H, Knapp J, Malézieux N, Lignon T, Borg C, Millon L. Investigating the impact of Echinococcus multilocularis vesicular fluid on human cells from healthy blood donors. J Immunol Methods 2015; 417:52-59. [PMID: 25510487 DOI: 10.1016/j.jim.2014.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 12/03/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
Abstract
CONTEXT AND OBJECTIVES Alveolar echinococcosis (AE) is a severe chronic helminthic disease that mimics slow-growing liver cancer. Previous studies using murine models suggest that Echinococcus multilocularis (Em) metacestodes have developed mechanisms which impair the natural inflammatory host response. The aim of this study was to investigate in vitro the impact of Em vesicular fluid (VF) on monocytes, monocytes derived dendritic cells and lymphocytes from healthy blood donors. METHODS First, assays were performed to investigate whether or not Em-VF influences monocyte-derived dendritic cell (MoDC) differentiation and maturation. Monocytes during differentiation and immature MoDCs were exposed to Em-VF. The effect of Em-VF was assessed using flow cytometry (CD86, CD83, CD80) and immune assays (IL-10 and TGFβ). Second, assays were performed to investigate the interaction between Em-VF, peripheral blood monocyte cells (PBMC) and Toll-like Receptor (TLR) agonists (LPS, PolyIC, R848 and CpG). PBMC were stimulated by each of the TLR agonists with and without Em-VF. The subsequent TGFβ production was assessed. RESULTS Exposure to Em-VF had bearing on both differentiation and maturation of MoDC, but only partially. A decrease in the expression of co-stimulatory molecules was observed; however, levels of immune-regulatory cytokines were stable. PBMC exposed simultaneously to Em-VF and LPS induced a significant increase of TGFβ (p<0.05, Wilcoxon signed-rank test). Further experiments showed that TGFβ production was lymphocyte-dependent. CONCLUSION The assays performed confirmed that Em-VF influences the host immune response. However, only minor changes were observed when investigating the Em-VF impact on cells from healthy blood donors. Assays with TLR agonists suggested that co-stimulation with LPS reinforces the response of healthy blood donors exposed to Em-VF.
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Affiliation(s)
- Anne-Pauline Bellanger
- Parasitology-Mycology Department, Besançon University Hospital, F-25000 Besançon, France; Franche-Comté University, F-25000 Besançon, France; CNRS 6249 /UMR "Chrono-environnement", F-25000 Besançon, France.
| | - Jean-René Pallandre
- Inserm U1098, EFS Bourgogne Franche-Comté, University of Franche-Comté, IFR133 Besançon, France
| | | | - Jenny Knapp
- Parasitology-Mycology Department, Besançon University Hospital, F-25000 Besançon, France; CNRS 6249 /UMR "Chrono-environnement", F-25000 Besançon, France
| | - Noémie Malézieux
- Parasitology-Mycology Department, Besançon University Hospital, F-25000 Besançon, France
| | - Thibaud Lignon
- Parasitology-Mycology Department, Besançon University Hospital, F-25000 Besançon, France
| | - Christophe Borg
- Inserm U1098, EFS Bourgogne Franche-Comté, University of Franche-Comté, IFR133 Besançon, France
| | - Laurence Millon
- Parasitology-Mycology Department, Besançon University Hospital, F-25000 Besançon, France; Franche-Comté University, F-25000 Besançon, France; CNRS 6249 /UMR "Chrono-environnement", F-25000 Besançon, France
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Bellanger AP, Runge M, Wendling D, Humbert P. Lumbar myositis associated with Toxocara spp. infection. ACTA ACUST UNITED AC 2013; 10:54-5. [PMID: 24239450 DOI: 10.1016/j.reuma.2013.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 04/17/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Anne-Pauline Bellanger
- Department of Parasitology-Mycology, University Hospital, Besançon, France; CNRS-University of Franche-Comte/UMR 6249 Chrono-environnement, Besançon, France.
| | - Michel Runge
- Department of Radiology, University Hospital, Besançon, France
| | - Daniel Wendling
- Department of Rheumatology, University Hospital, Besançon, France
| | - Philippe Humbert
- Department of Dermatology, University Hospital, Besançon, France; SFR FED 4234 IBCT Cell and Tissue Engineering and Biology, INSERM U 1098_University of Franche-Comte, Besançon, France
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Bellanger AP, Grenouillet F, François N, Skana F, Millon L. Inhibitory effect of chromogenic culture media on the growth of Rhodotorula: relevance to the diagnosis of Rhodotorulaspp. infections. APMIS 2013; 121:1109-17. [DOI: 10.1111/apm.12090] [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: 09/10/2012] [Revised: 12/27/2012] [Accepted: 01/09/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Anne-Pauline Bellanger
- CNRS 6249/UMR Chrono-environnement; Univ Franche Comte; Besançon France
- Parasitology-Mycology Department; University Hospital of Besançon; Besançon France
- Clinical Investigation Center (Inserm CIT 808); University Hospital of Besançon; Besançon France
| | - Frédéric Grenouillet
- CNRS 6249/UMR Chrono-environnement; Univ Franche Comte; Besançon France
- Parasitology-Mycology Department; University Hospital of Besançon; Besançon France
| | - Nadine François
- Parasitology-Mycology Department; University Hospital of Lille; Lille France
| | - Florence Skana
- Parasitology-Mycology Department; University Hospital of Besançon; Besançon France
| | - Laurence Millon
- CNRS 6249/UMR Chrono-environnement; Univ Franche Comte; Besançon France
- Parasitology-Mycology Department; University Hospital of Besançon; Besançon France
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Piotte E, Bellanger AP, Piton G, Millon L, Marguet P. Pre-travel consultation: evaluation of primary care physician practice in the Franche-Comté region. J Travel Med 2013; 20:221-7. [PMID: 23809071 DOI: 10.1111/jtm.12030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 11/05/2012] [Accepted: 11/09/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Primary care physicians (PCP) are first in line to provide adequate pre-travel medical advice. Little data are available on the content of pre-travel PCP consultations in France. We undertook an observational survey to assess the level of specific knowledge among PCPs on health advice, vaccinations, and malaria prophylaxis. METHODS Standardized questionnaires were sent to a random sample of 400 PCPs practicing in the Franche-Comté regions (eastern France) who were asked to complete and return it on a voluntary and anonymous basis. The questionnaire requested sociodemographic details, practice-related characteristics, and proposed three clinical situations with multiple choice questions (MCQ). To identify factors associated with a higher level of specific knowledge in travel medicine, results were studied by uni- and multivariate analyses. An overall score was calculated based on the MCQ answers and a motivation score was calculated based on parameters such as frequency and developments in pre-travel consulting at the practice, PCPs' personal experience as travelers, and the formal agreement of PCPs to administer yellow fever vaccination. RESULTS The response rate was 37.5%, with 150 questionnaires returned completed and suitable for analysis. After multivariate logistic regression, the three variables associated with a higher score were: proximity of a vaccination center (p = 0.001), motivation score (p = 0.004), and absence of request for expert advice on malaria prophylaxis (p = 0.007). CONCLUSIONS PCPs play an important role in travel medicine. This study showed that their high level of knowledge in travel medicine was mostly linked to their motivation to practice in this specialized discipline.
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Affiliation(s)
- Emeline Piotte
- Emergency Department, Regional Hospital of Pontarlier, Pontarlier, France
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Bellanger AP, Scherer E, Cazorla A, Grenouillet F. Dysenteric syndrome due to Balantidium coli: a case report. New Microbiol 2013; 36:203-205. [PMID: 23686128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 01/13/2013] [Indexed: 06/02/2023]
Abstract
A 28-year-old man was hospitalized for a dysenteric syndrome that had developed during the previous days. Physical examination revealed abdominal pains, fever, vomiting and more than ten liquid stools per day. Fresh stool examination showed numerous mobile ciliated trophozoites of Balantidium coli. The patient reported having been on a hike the previous weekend during which he had drunk water through a hydration pouch bladder. Complete resolution was observed after intravenous rehydration and ten days of oral treatment with metronidazole (Flagyl®). Balantidium coli is the largest ciliate protozoan able to infect humans. This parasite is common in pigs and has a worldwide distribution. Human infections, a rare event in industrialised countries, are usually acquired by ingestion of food or water contaminated by mammal faeces. Human B. coli infections are easily treated but may be severe and even fatal if neglected.
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Faucher JF, Bellanger AP, Chirouze C, Hustache-Mathieu L, Genton S, Hoen B. Primaquine for radical cure of Plasmodium vivax and Plasmodium ovale malaria: an observational survey (2008-2010). J Travel Med 2013; 20:134-6. [PMID: 23464724 DOI: 10.1111/jtm.12009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 12/06/2012] [Accepted: 12/07/2012] [Indexed: 11/29/2022]
Abstract
Since 2008, the French guidelines have promoted the systematic use of 30 mg/day of primaquine for the radical cure of Plasmodium vivax and Plamodium ovale infections. We observed three relapses in 10 patients with P vivax acquired in French Guiana. No relapses were seen in West African P ovale patients.
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Affiliation(s)
- Jean-François Faucher
- Infectious and Tropical Diseases Department, Besançon University Hospital, Besançon, France.
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