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Imbert S, Normand AC, Costa D, Gabriel F, Lachaud L, Schuttler C, Cassaing S, Mahinc C, Hasseine L, Demar M, Brun S, Bonnal C, Moreno-Sabater A, Becker P, Piarroux R, Fekkar A. Multicentric Analysis of the Species Distribution and Antifungal Susceptibility of Clinical Isolates from Aspergillus Section Circumdati. Antimicrob Agents Chemother 2023; 67:e0146222. [PMID: 36892306 PMCID: PMC10112188 DOI: 10.1128/aac.01462-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/05/2023] [Indexed: 03/10/2023] Open
Abstract
The clinical involvement and antifungal susceptibility of Aspergillus section Circumdati are poorly known. We analyzed 52 isolates, including 48 clinical isolates, belonging to 9 species inside the section Circumdati. The whole section exhibited, by the EUCAST reference method, a poor susceptibility to amphotericin B, but species/series-specific patterns were observed for azole drugs. This underlines the interest in getting an accurate identification inside the section Circumdati to guide the choice of antifungal treatment in clinical practice.
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Affiliation(s)
- S. Imbert
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
- Sorbonne Université, Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Paris, France
| | - A. C. Normand
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
| | - D. Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie Mycologie, Rouen, France
| | - F. Gabriel
- Centre Hospitalier Universitaire de Bordeaux, Service de Parasitologie Mycologie, Bordeaux, France
| | - L. Lachaud
- Centre Hospitalier Universitaire de Montpellier, Service de Parasitologie Mycologie, Montpellier, France
| | | | - S. Cassaing
- Centre Hospitalier Universitaire de Toulouse, Service de Parasitologie Mycologie, Toulouse, France
| | - C. Mahinc
- Centre Hospitalier Universitaire de Saint Etienne, Service de Parasitologie Mycologie, Saint Etienne, France
| | - L. Hasseine
- Centre Hospitalier Universitaire de Nice, Service de Parasitologie Mycologie, Nice, France
| | - M. Demar
- Centre Hospitalier de Cayenne, Département de Parasitologie Mycologie, Cayenne, French Guiana
| | - S. Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie Mycologie, Bobigny, France
| | - C. Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie Mycologie, Paris, France
| | - A. Moreno-Sabater
- AP-HP, Hôpital Saint-Antoine, Service de Parasitologie Mycologie, Paris, France
| | - P. Becker
- Service of Mycology and Aerobiology, BCCM/IHEM Fungal Collection, Brussels, Belgium
| | - R. Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
| | - A. Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, Paris, France
- Sorbonne Université, Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Paris, France
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Imbert S, Cassaing S, Bonnal C, Normand AC, Gabriel F, Costa D, Blaize M, Lachaud L, Hasseine L, Kristensen L, Guitard J, Schuttler C, Raberin H, Brun S, Hendrickx M, Piarroux R, Fekkar A. Invasive aspergillosis due to Aspergillus cryptic species: A prospective multicentre study. Mycoses 2021; 64:1346-1353. [PMID: 34181773 DOI: 10.1111/myc.13348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Aspergillus cryptic species are increasingly recognised causes of Aspergillus diseases, including life-threatening invasive aspergillosis (IA). However, as their accurate identification remains challenging in a routine practice, few is known from a clinical and epidemiological perspective. Recently, the MSI application has emerged as a powerful tool for the detection and identification of Aspergillus cryptic species. We aimed to use to the network of users of the MSI application to conduct a multicentre prospective screening of Aspergillus cryptic species-related IA and analyse their epidemiological, clinical and mycological characteristics. METHODS Over a 27-month period, the clinical involvement of 369 Aspergillus cryptic isolates, from 13 French and Danish MSI application users, was prospectively analysed. Species identification was confirmed by DNA-sequencing and antifungal susceptibility testing was performed using EUCAST reference method. Fifty-one A fumigatus sensu stricto invasive cases were also analysed. RESULTS Fifteen cryptic isolates were responsible of IA. Eight species were involved, including 5 cases related to the species A sublatus. These species showed high rate of in vitro low susceptibility to antifungal drugs. In comparison with A fumigatus sensu stricto invasive cases, pre-exposure to azole drugs was significantly associated with cryptic IA (P = .02). DISCUSSION This study brings new insights in cryptic species related IA and underlines the importance to identify accurately at the species level these Aspergillus isolates. The increasing use of antifungal drugs might lead in the future to an epidemiologic shift with an emergence of resistant isolates involved in IA.
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Affiliation(s)
- Sebastien Imbert
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Université, INSERM, CNRS, Paris, France
| | - Sophie Cassaing
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Christine Bonnal
- Service de Parasitologie Mycologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Anne-Cecile Normand
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France
| | - Frederic Gabriel
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Damien Costa
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Marion Blaize
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Université, INSERM, CNRS, Paris, France
| | - Laurence Lachaud
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Lilia Hasseine
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Lise Kristensen
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Juliette Guitard
- Service de Parasitologie Mycologie, AP-HP, Hôpital Saint-Antoine, Paris, France
| | | | - Helene Raberin
- Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | - Sophie Brun
- Service de Parasitologie Mycologie, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Marijke Hendrickx
- Service of Mycology and Aerobiology, BCCM/IHEM Fungal Collection, Scientific Institute of Public Health, Brussels, Belgium
| | - Renaud Piarroux
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, Institut Pierre Louis d'Epidemiologie et de Santé Publique, Paris, France
| | - Arnaud Fekkar
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Université, INSERM, CNRS, Paris, France
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Normand AC, Imbert S, Brun S, Al-Hatmi AMS, Chryssanthou E, Cassaing S, Schuttler C, Hasseine L, Mahinc C, Costa D, Bonnal C, Ranque S, Sautour M, Rubio E, Delhaes L, Riat A, Sendid B, Kristensen L, Brandenberger M, Guitard J, Packeu A, Piarroux R, Fekkar A. Clinical Origin and Species Distribution of Fusarium spp. Isolates Identified by Molecular Sequencing and Mass Spectrometry: A European Multicenter Hospital Prospective Study. J Fungi (Basel) 2021; 7:jof7040246. [PMID: 33806102 PMCID: PMC8064482 DOI: 10.3390/jof7040246] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 01/30/2023] Open
Abstract
Fusarium spp. are widespread environmental fungi as well as pathogens that can affect plants, animals and humans. Yet the epidemiology of human fusariosis is still cloudy due to the rapidly evolving taxonomy. The Mass Spectrometry Identification database (MSI) has been developed since 2017 in order to allow a fast, accurate and free-access identification of fungi by matrix-assisted laser desorption ionization—time of flight (MALDI-TOF) mass spectrometry. Taking advantage of the MSI database user network, we aim to study the species distribution of Fusarium spp. isolates in an international multicenter prospective study. This study also allowed the assessment of the abilities of miscellaneous techniques to identify Fusarium isolates at the species level. The identification was performed by PCR-sequencing and phylogenic-tree approach. Both methods are used as gold standard for the evaluation of mass spectrometry. Identification at the species complex was satisfactory for all the tested methods. However, identification at the species level was more challenging and only 32% of the isolates were correctly identified with the National Center for Biotechnology Information (NCBI) DNA database, 20% with the Bruker MS database and 43% with the two MSI databases. Improvement of the mass spectrometry database is still needed to enable precise identification at the species level of any Fusarium isolates encountered either in human pathology or in the environment.
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Affiliation(s)
- Anne-Cécile Normand
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Correspondence: ; Tel.: +33-142160113
| | - Sébastien Imbert
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6525 Nijmegen, The Netherlands;
| | - Sophie Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
| | - Abdullah M. S. Al-Hatmi
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6525 Nijmegen, The Netherlands;
- Natural & Medical Sciences Research Center, Department of Microbiology, University of Nizwa, Nizwa 616, Oman
| | - Erja Chryssanthou
- Division of Clinical Microbiology, Karolinska Institutet, Department of Laboratory Medicine, 171 77 Stockholm, Sweden;
| | - Sophie Cassaing
- CHU Toulouse, Service de Parasitologie-Mycologie, 31000 Toulouse, France;
| | | | - Lilia Hasseine
- CHU de Nice, Service de Parasitologie Mycologie, 06200 Nice, France;
| | - Caroline Mahinc
- CHU de Saint Etienne, Service de Parasitologie Mycologie, 42000 Saint Etienne, France;
| | - Damien Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie Mycologie, 76000 Rouen, France;
| | - Christine Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie Mycologie, 75018 Paris, France;
| | - Stéphane Ranque
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, 13005 Marseille, France;
| | - Marc Sautour
- CHU de Dijon, Service de Parasitologie Mycologie, 21079 Dijon, France;
| | - Elisa Rubio
- Department of Microbiology, ISGlobal Barcelona Institute for Global Health, Barcelona, Spain CDB, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
| | - Laurence Delhaes
- CHU de Bordeaux, Groupe Hospitalier Pellegrin, Service de Mycologie, 33404 Bordeaux, France;
| | - Arnaud Riat
- Laboratory of bacteriology, Division of Laboratory Medicine, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland;
| | - Boualem Sendid
- Department Parasitology-Mycology, CHU de Lille, 59000 Lille, France;
| | - Lise Kristensen
- Department of Clinical Microbiology, Aarhus University Hospital, 8200 Aarhus, Denmark;
| | | | - Juliette Guitard
- Centre de Recherche Saint-Antoine, Inserm, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Sorbonne Université, 75012 Paris, France;
| | - Ann Packeu
- Sciensano, BCCM/IHEM collection, Mycology and Aerobiology Unit, 1000 Brussels, Belgium;
| | - Renaud Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Inserm, Institut Pierre Louis d’Epidemiologie et de Santé Publique, Sorbonne Université, 75571 Paris, France
| | - Arnaud Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Cimi-Paris, Sorbonne Université, 75005 Paris, France
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Imbert S, Normand AC, Gabriel F, Cassaing S, Bonnal C, Costa D, Lachaud L, Hasseine L, Kristensen L, Schuttler C, Raberin H, Brun S, Hendrickx M, Stubbe D, Piarroux R, Fekkar A. Multi-centric evaluation of the online MSI platform for the identification of cryptic and rare species of Aspergillus by MALDI-TOF. Med Mycol 2019; 57:962-968. [DOI: 10.1093/mmy/myz004] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 11/12/2022] Open
Abstract
Abstract
The taxonomy of Aspergillus species has recently been revolutionized with the introduction of cryptic species and section concepts. However, their species-level identification in routine laboratories remains a challenge. The aim of this study was to prospectively assess the identification accuracy of cryptic species of Aspergillus in various laboratories using the mass spectrometry identification (MSI) platform, an independent and freely accessible online mass spectrometry database. Over a 12-month period, when a select set of MSI users identified cryptic species, they were contacted and requested to send the isolates to our laboratory for sequence-based identification. Sequence and MSI identification results were then compared. During the study period, 5108 Aspergillus isolates were identified using MSI including 1477 (28.9%) cryptic species. A total of 245 isolates that corresponded to 56 cryptic species and 13 sections were randomly selected for DNA sequencing confirmation. Agreement between the two methods was 99.6% at the section level and 66.1% at the species level. However, almost all discrepancies (72/83, 86.7%) were misidentifications between closely related cryptic species belonging to the same section. Fifty-one isolates from noncryptic species were also identified, thus yielding 100% and 92.2% agreement at the section and species level, respectively. Although the MSI fungus database is a reliable tool to identify Aspergillus at the section level, the database still requires adjustment to correctly identify rare or cryptic species at the species level. Nevertheless, the application properly differentiated between cryptic and sensu stricto species in the same section, thus alerting on possible specific isolate characteristics.
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Affiliation(s)
- Sébastien Imbert
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013 Paris, France
- Centre d’Immunologie et des Maladies Infectieuses, CIMI-Paris, F-75013 Paris, France
- Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
| | - Anne Cécile Normand
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013 Paris, France
| | - Frédéric Gabriel
- Centre Hospitalier Universitaire de Bordeaux, Service de Parasitologie Mycologie, F-33000, Bordeaux, France
| | - Sophie Cassaing
- Centre Hospitalier Universitaire de Toulouse, Service de Parasitologie Mycologie, F-31059, Toulouse, France
| | - Christine Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie Mycologie, F-75018 Paris, France
| | - Damien Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie Mycologie, F-76000, Rouen, France
| | - Laurence Lachaud
- Centre Hospitalier Universitaire de Montpellier, Service de Parasitologie Mycologie, F-34000, Montpellier, France
| | - Lilia Hasseine
- Centre Hospitalier Universitaire de Nice, Service de Parasitologie Mycologie, F-06000, Nice, France
| | - Lise Kristensen
- Aarhus University Hospital, Department of Clinical Microbiology, DK-8200, Aarhus N, Denmark
| | | | - Hélène Raberin
- Centre Hospitalier Universitaire de Saint Etienne, Service de Parasitologie Mycologie, F-42100, Saint Etienne, France
| | - Sophie Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie Mycologie, F-93000 Bobigny, France
| | - Marijke Hendrickx
- Service of Mycology and Aerobiology, BCCM/IHEM Fungal collection, Scientific Institute of Public Health, B-1050, Brussels, Belgium
| | - Dirk Stubbe
- Service of Mycology and Aerobiology, BCCM/IHEM Fungal collection, Scientific Institute of Public Health, B-1050, Brussels, Belgium
| | - Renaud Piarroux
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013 Paris, France
- Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, F-75013 Paris, France
| | - Arnaud Fekkar
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013 Paris, France
- Centre d’Immunologie et des Maladies Infectieuses, CIMI-Paris, F-75013 Paris, France
- Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
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Abstract
The aim of the study was to measure HIV prevalence and risk behaviour in 185 Irish Intravenous Drug Misusers. Information was obtained by application of a standardised WHO questionnaire covering HIV risk behaviour in the preceding 6 months. HIV serostatus was obtained by saliva/blood sample testing. One hundred and 3 (55.7 per cent) shared and 114 (61.6 per cent) lent used injecting equipment in the previous 6 months. 97 (94.2 per cent) of those who shared always cleaned the needles before use but only 48 (49.5 per cent) of these always cleaned in an efficient manner. One hundred and 14 (79.2 per cent) males and 28 (68.3 per cent) females reported heterosexual activity in the preceding 6 months. On examination sexual risk behaviour was found to be high. 50.5 per cent of males and 63 per cent of females never used condoms with regular partners. 32.6 per cent of males never used condoms with casual partners. The large majority of partners of male I.D.U'.s (both regular and casual) were non injectors. Therefore there is potential for sexual spread of HIV into the non-injecting heterosexual population. Conversely the vast majority of partners of female IDU's were injectors. This suggests that female IDU's are at higher risk of HIV infection than their male counterparts. HIV prevalence in the study group was 8.4 per cent. Implications of results for future intervention are discussed.
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Affiliation(s)
- A Dorman
- Drug Treatment Centre Board, Dublin
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Donnio P, Le Deaut P, Schuttler C, Avril J. Caracterisation et signification clinique des souches de Bacillus isolees par hemocultures. Med Mal Infect 1987. [DOI: 10.1016/s0399-077x(87)80339-6] [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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