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Badoz M, Serzian G, Favoulet B, Sellal JM, De Chillou C, Hammache N, Laurent G, Mebazaa A, Ecarnot F, Bardonnet K, Seronde MF, Schiele F, Meneveau N. Impact of Midregional N-Terminal Pro-Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrillation: The Biorhythm Study. J Am Heart Assoc 2021; 10:e020917. [PMID: 34187182 PMCID: PMC8403329 DOI: 10.1161/jaha.121.020917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background We assessed the impact of preprocedural plasma levels of MRproANP (midregional N‐terminal pro–atrial natriuretic peptide) and sST2 (soluble suppression of tumorigenicity 2) on recurrence of atrial fibrillation (AF) at 1 year after catheter ablation of AF. Methods and Results This was a prospective, multicenter, observational study including patients undergoing catheter ablation of AF. MRproANP and sST2 were measured in a peripheral venous blood preprocedure, and MRproANP was assessed in the right and left atrial blood during ablation. The primary end point was recurrent AF between 3 and 12 months postablation, defined as a documented (>30 seconds) episode of AF, flutter, or atrial tachycardia. We included 106 patients from December 2017 to March 2019; 105 had complete follow‐up, and the mean age was 63 years with 74.2% males. Overall, 34 patients (32.1%) had recurrent AF. In peripheral venous blood, MRproANP was significantly higher in patients with recurrent AF (median, 192.2; [quartile 1–quartile 3, 155.9–263.9] versus 97.1 [60.9–150.7] pmol/L; P<0.0001), as was sST2 (median, 30.3 [quartile 1–quartile 3, 23.3–39.3] versus 23.4 [95% CI, 17.4–33.0] ng/mL; P=0.0033). In the atria, MRproANP was significantly higher than in peripheral blood and was higher during AF than during sinus rhythm. Receiver operating characteristic curve analysis identified a threshold of MRproANP>107.9 pmol/L to predict AF recurrence at 1 year and a threshold of >26.7 ng/mL for sST2. By multivariate analysis, MRproANP>107.9 pmol/L was the only independent predictor of recurrent AF (OR, 24.27; 95% CI, 4.23–139.18). MRproANP<107.9 pmol/L identified subjects at very low risk of recurrence (negative predictive value >95%). Conclusions Elevated MRproANP level independently predicts recurrent AF, whereas sST2 levels do not appear to have any prognostic value in assessing the risk of recurrence of AF up to 1 year after catheter ablation. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03351816.
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Affiliation(s)
- Marc Badoz
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Guillaume Serzian
- Department of CardiologyUniversity Hospital Besançon Besançon France
| | - Baptiste Favoulet
- Department of CardiologyUniversity Hospital Besançon Besançon France
| | - Jean-Marc Sellal
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France.,IADIINSERM U1254Université de Lorraine Nancy France
| | - Christian De Chillou
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France
| | - Néfissa Hammache
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France.,IADIINSERM U1254Université de Lorraine Nancy France
| | - Gabriel Laurent
- Department of Cardiology University Hospital François Mitterand Dijon France
| | - Alexandre Mebazaa
- INSERM UMR-S 942 Paris France.,Department of Anesthesiology and Critical Care Medicine Assistance Publique - Hôpitaux de ParisSaint Louis Lariboisière University Hospitals Paris France
| | - Fiona Ecarnot
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Karine Bardonnet
- Department of BiochemistryUniversity Hospital Besançon Besançon France
| | - Marie-France Seronde
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - François Schiele
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Nicolas Meneveau
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
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2
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Weil D, Heurgue-Berlot A, Monnet E, Chassagne S, Cervoni JP, Feron T, Grandvallet C, Muel E, Bronowicki JP, Thiefin G, Di Martino V, Bardonnet K, Thévenot T. Accuracy of calprotectin using the Quantum Blue Reader for the diagnosis of spontaneous bacterial peritonitis in liver cirrhosis. Hepatol Res 2019; 49:72-81. [PMID: 30084186 DOI: 10.1111/hepr.13239] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/12/2018] [Accepted: 07/29/2018] [Indexed: 02/08/2023]
Abstract
AIM We aimed to evaluate the accuracy of the dosage of calprotectin in ascitic fluid (AF) using the Quantum Blue assay, for the prompt diagnosis of spontaneous bacterial peritonitis (SBP). METHODS We prospectively collected 236 AF samples from 119 cirrhotic patients hospitalized in two French centers between May 2016 and May 2017. Bloody and chylous/cloudy AF, and secondary peritonitis were excluded. SBP was diagnosed if neutrophils in AF were >250/mm3 using standard cytology. The Quantum Blue Reader selectively measured the calprotectin antigen (MRP8/14) in 12 min within the measurable range from 0.18 to 1.80 μg/mL; values outside this range were registered as 0.17 and 1.81 μg/mL. RESULTS A total of 36 AF were considered as SBP (15.2%). SBP had higher median levels of calprotectin than non-SBP (1.81 vs. 0.25 μg/mL, P < 0.001). Calprotectin levels were positively correlated with neutrophils in AF (r = 0.57, P < 0.001) and C-reactive protein (r = 0.43, P < 0.001), but not with the Child-Pugh and Model for End-Stage Liver Disease scores. The optimal threshold of calprotectin to diagnose SBP was set at 1.51 μg/mL (80th percentile of calprotectin), yielding sensitivity, specificity, and positive and negative predictive values of 86.1%, 92.0%, 65.9%, and 97.3%, respectively. Only one asymptomatic patient with SBP had a low calprotectin level, but a high serum C-reactive protein level that strongly suggested an ongoing infection. We also showed that intraclass correlation coefficients for inter- and intra-observer agreement were excellent, with 0.95 and 0.89, respectively. CONCLUSIONS The dosage of calprotectin in AF using the Quantum Blue assay is a rapid and reliable method of ruling out SBP in hospitalized cirrhotic patients.
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Affiliation(s)
- Delphine Weil
- Department of Hepatology, University Hospital of Besançon, Besançon, France
| | | | - Elisabeth Monnet
- Department of Hepatology, University Hospital of Besançon, Besançon, France.,Unit of Public Health and Epidemiology, CIC INSERM1431, Besançon, France
| | - Sophie Chassagne
- Biology Laboratory, University Hospital Besançon, Besançon, France
| | - Jean-Paul Cervoni
- Department of Hepatology, University Hospital of Besançon, Besançon, France
| | - Thomas Feron
- Department of Hepato-Gastroenterology, University Hospital of Reims, Reims, France
| | | | - Emilie Muel
- Department of Hepatology, University Hospital of Besançon, Besançon, France
| | | | - Gérard Thiefin
- Department of Hepato-Gastroenterology, University Hospital of Reims, Reims, France
| | - Vincent Di Martino
- Department of Hepatology, University Hospital of Besançon, Besançon, France
| | - Karine Bardonnet
- Biology Laboratory, University Hospital Besançon, Besançon, France
| | - Thierry Thévenot
- Department of Hepatology, University Hospital of Besançon, Besançon, France
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Perrotti A, Chenevier-Gobeaux C, Ecarnot F, Bardonnet K, Barrucand B, Flicoteaux G, Lassalle P, Chocron S. Is Endocan a Diagnostic Marker for Pneumonia After Cardiac Surgery? The ENDOLUNG Study. Ann Thorac Surg 2017; 105:535-541. [PMID: 29132699 DOI: 10.1016/j.athoracsur.2017.07.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 02/13/2017] [Revised: 06/21/2017] [Accepted: 07/17/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Postoperative pneumonia is frequent after cardiac surgery and is associated with increased morbidity and mortality. We tested the hypothesis that endocan is an early biomarker for the detection of pneumonia after cardiac surgery. METHODS Between January and May 2016, 155 patients scheduled to undergo elective cardiac surgery with cardiopulmonary bypass were prospectively included in the study. Serum level of endocan was measured at five timepoints (preoperative, and at 6, 24, 48, and 72 hours after the end of surgery). Procalcitonin and C-reactive protein were measured at 24 and 72 hours. The preoperative and postoperative characteristics of the patients were recorded. Independent predictors of postoperative pneumonia were identified by logistic regression. Threshold values of endocan predictive of postoperative pneumonia were determined using receiver-operating characteristics curve analysis. RESULTS Seventeen patients (11%) had pneumonia after surgery. Endocan greater than 3.7 ng/mL before induction of anesthesia, or greater than 12.1 ng/mL at 6 hours after surgery, as well body mass index higher than 27 kg/m2 and duration of surgery were independent predictors of postoperative pneumonia. At induction of anesthesia, an endocan cutoff value of 3.7 ng/mL had 65% sensitivity and 72% specificity for the prediction of postoperative pneumonia; whereas at 6 hours, with a cutoff value of 12.1 ng/mL, these values were 71% and 75%, respectively. The time saved by endocan dosage compared with clinical diagnosis of postoperative pneumonia was 96 hours. CONCLUSIONS This study shows that endocan is an early marker of postoperative pneumonia in patients after cardiac surgery.
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Affiliation(s)
- Andréa Perrotti
- Department of Cardiac Surgery, University Hospital Jean Minjoz, and EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Camille Chenevier-Gobeaux
- Department of Automated Biological Diagnosis, Hôpitaux Universitaires Paris Centre, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Jean Minjoz, and EA3920, University of Burgundy Franche-Comté, Besançon, France.
| | - Karine Bardonnet
- Biology Laboratory, University Hospital Jean Minjoz, Besançon, France
| | - Benoit Barrucand
- Department of Anesthesiology, University Hospital Jean Minjoz, Besançon, France
| | | | - Philippe Lassalle
- Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - Sidney Chocron
- Department of Cardiac Surgery, University Hospital Jean Minjoz, and EA3920, University of Burgundy Franche-Comté, Besançon, France
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Piarroux M, Gaudart J, Bresson-Hadni S, Bardonnet K, Faucher B, Grenouillet F, Knapp J, Dumortier J, Watelet J, Gerard A, Beytout J, Abergel A, Wallon M, Vuitton DA, Piarroux R, the FrancEchino network C. Landscape and climatic characteristics associated with human alveolar echinococcosis in France, 1982 to 2007. Euro Surveill 2015; 20. [DOI: 10.2807/1560-7917.es2015.20.18.21118] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- M Piarroux
- Aix-Marseille University, INSERM-IRD-AMU UMR 912, Marseille, France
| | - J Gaudart
- Aix-Marseille University, INSERM-IRD-AMU UMR 912, Marseille, France
| | - S Bresson-Hadni
- Franche-Comté University, CNRS UMR 6249, Besançon, France
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University Hospital Jean Minjoz, Department of digestive surgery, Besançon, France
| | - K Bardonnet
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University Hospital Jean Minjoz, Department of digestive surgery, Besançon, France
- University Hospital Jean Minjoz, Department of biochemistry, Besançon, France
| | - B Faucher
- Aix-Marseille University, UMR MD 3, Marseille, France
| | - F Grenouillet
- Centre National de Référence Echinococcose alvéolaire, Department of parasitology, CHRU Jean Minjoz Besançon, France
| | - J Knapp
- Centre National de Référence Echinococcose alvéolaire, Department of parasitology, CHRU Jean Minjoz Besançon, France
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University Hospital Jean Minjoz, Department of digestive surgery, Besançon, France
| | - J Dumortier
- University Hospital Edouard Herriot, Department of hepatogastroenterology, Hospices civils de Lyon, Lyon, France
| | - J Watelet
- University Hospital Brabois, Department of hepatogastroenterology, Nancy, France
| | - A Gerard
- University Hospital Brabois, Department of intensive care, Nancy, France
| | - J Beytout
- University Hospital G Montpied, Department of tropical medicine and infectious diseases, Clermont-Ferrand, France
| | - A Abergel
- University Hospital Estaing, Department of hepatogastroenterology, Clermont-Ferrand, France
| | - M Wallon
- University Hospital de la Croix Rousse, Institute of parasitology and medical mycology, Hospices civils de Lyon, Lyon, France
| | - D A Vuitton
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University Hospital Jean Minjoz, Department of digestive surgery, Besançon, France
- Franche-Comté University, CNRS UMR 6249, Besançon, France
| | - R Piarroux
- Aix-Marseille University, UMR MD 3, Marseille, France
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Courivaud C, Bardonnet K, Crepin T, Bresson-Vautrin C, Rebibou JM, Ducloux D. Serum immunoglobulin G levels and peritonitis in peritoneal dialysis patients. J Nephrol 2015; 28:511-5. [PMID: 25757532 DOI: 10.1007/s40620-015-0176-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/28/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Peritonitis is a frequent and serious complication of peritoneal dialysis (PD). Whether low immunoglobulin level is associated with PD-related peritonitis is unknown. METHODS We conducted a prospective study to assess whether immunoglobulin levels at PD onset could predict the occurrence of peritonitis. All patients starting peritoneal dialysis between 01/2005 and 12/2010 at the University hospital of Besançon, France, were included in the study. RESULTS Of 240 consecutive PD patients enrolled (mean follow-up 25 ± 12 months), 76 (32%) had at least one episode of peritonitis. Mean immunoglobulin (Ig)G level at PD start was lower in patients who subsequently experienced peritonitis (7.9 + 3.4 vs. 9.7 + 3.4 g/l, p = 0.005). An increased IgG level at PD onset was associated with a reduced risk of peritonitis [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.80-0.97 for each increase of 1 g/l in IgG, p = 0.008]. IgG level ≤6.4 g/l ("low IgG") was the best predictive value for the occurrence of subsequent peritonitis: 52 patients (24%) had low IgG levels. At multivariate analysis, both low IgG level (HR 2.49, 95% CI 1.32-4.69, p = 0.005) and diabetes (HR 2.78, 95% CI 1.49-5.20, p = 0.001) were predictive of the occurrence of peritonitis. CONCLUSION Low IgG levels predict the occurrence of PD-related peritonitis. Randomized studies should determine whether such patients could benefit from intravenous immunoglobulin administration.
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Affiliation(s)
- Cécile Courivaud
- INSERM UMR1098, Fédération Hospitalo-Universitaire INCREASE, 25020, Besançon, France
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Perrotti A, Miltgen G, Chevet-Noel A, Durst C, Vernerey D, Bardonnet K, Davani S, Chocron S. Neutrophil gelatinase-associated lipocalin as early predictor of acute kidney injury after cardiac surgery in adults with chronic kidney failure. Ann Thorac Surg 2015; 99:864-9. [PMID: 25595830 DOI: 10.1016/j.athoracsur.2014.10.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 06/25/2014] [Revised: 09/24/2014] [Accepted: 10/03/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND To assess the utility of neutrophil gelatinase-associated lipocalin (NGAL) as an early marker of acute kidney injury (AKI) occurring after cardiac surgery in patients with prior chronic kidney failure. METHODS Patients with preoperative creatinine clearance 60 mL • min(-1) • 1.73 m(-2) or less according to the Cockcroft-Gault formula and scheduled to undergo cardiac surgery were eligible for inclusion. The AKI was defined as an increase in plasma creatinine greater than 50% over preoperative values. Threshold values of NGAL predictive of AKI were determined using receiver operating characteristic curve analysis, and predictive value of NGAL for AKI was evaluated by logistic regression. RESULTS Over a 1-year inclusion period, 166 patients were included. At 6 hours post-surgery, hypertension, occurrence of at least 1 postoperative complication, and NGAL greater than 155 ng/mL were shown to be independent predictors of AKI. NGAL greater than 155 ng/mL at 6 hours was associated with an odds ratio for risk of postoperative AKI of 7.1 [2.7 to 18]. On average, diagnosis of postoperative AKI was made 20 hours earlier using NGAL at 6 hours post-surgery as compared with a diagnosis based on a 50% increase in creatinine over baseline. The threshold for NGAL of 155 ng/mL at 6 hours had a sensitivity of 79% and specificity of 58% for the diagnosis of AKI. CONCLUSIONS Earlier diagnosis of AKI post-surgery based on NGAL assessment makes it possible to initiate appropriate therapy at an earlier stage in this high-risk patient population.
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Affiliation(s)
- Andrea Perrotti
- Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France
| | - Guillaume Miltgen
- Department of Biochemistry, University Hospital Jean Minjoz, Besançon, France
| | - Albin Chevet-Noel
- Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France
| | - Camille Durst
- Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France
| | - Dewi Vernerey
- Department of Methodology and Quality of Life in Oncology Unit, University Hospital Jean Minjoz, Besançon, France
| | - Karine Bardonnet
- Department of Biochemistry, University Hospital Jean Minjoz, Besançon, France
| | - Siamak Davani
- Department of Pharmacology, University Hospital Jean Minjoz, Besançon, France
| | - Sidney Chocron
- Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France.
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Piarroux M, Piarroux R, Knapp J, Bardonnet K, Dumortier J, Watelet J, Gerard A, Beytout J, Abergel A, Bresson-Hadni S, Gaudart J. Populations at risk for alveolar echinococcosis, France. Emerg Infect Dis 2013; 19:721-8. [PMID: 23647623 PMCID: PMC3647496 DOI: 10.3201/eid1905.120867] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
During 1982–2007, alveolar echinococcosis (AE) was diagnosed in 407 patients in France, a country previously known to register half of all European patients. To better define high-risk groups in France, we conducted a national registry-based study to identify areas where persons were at risk and spatial clusters of cases. We interviewed 180 AE patients about their way of life and compared responses to those of 517 controls. We found that almost all AE patients lived in 22 départements in eastern and central France (relative risk 78.63, 95% CI 52.84–117.02). Classification and regression tree analysis showed that the main risk factor was living in AE-endemic areas. There, most at-risk populations lived in rural settings (odds ratio [OR] 66.67, 95% CI 6.21–464.51 for farmers and OR 6.98, 95% CI 2.88–18.25 for other persons) or gardened in nonrural settings (OR 4.30, 95% CI 1.82–10.91). These findings can help sensitization campaigns focus on specific groups.
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Bardonnet K, Vuitton DA, Grenouillet F, Mantion GA, Delabrousse E, Blagosklonov O, Miguet JP, Bresson-Hadni S. 30-yr course and favorable outcome of alveolar echinococcosis despite multiple metastatic organ involvement in a non-immune suppressed patient. Ann Clin Microbiol Antimicrob 2013; 12:1. [PMID: 23281596 PMCID: PMC3564901 DOI: 10.1186/1476-0711-12-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 12/21/2012] [Indexed: 01/08/2023] Open
Abstract
We report the 30-yr history of a well-documented human case of alveolar echinococcosis, with a lung lesion at presentation followed by the discovery of a liver lesion, both removed by surgery. Subsequently, within the 13 years following diagnosis, metastases were disclosed in eye, brain and skull, as well as additional lung lesions. This patient had no immune suppression, and did not have the genetic background known to predispose to severe alveolar echinococcosis; it may thus be hypothesized that iterative multi-organ involvement was mostly due to the poor adherence to benzimidazole treatment for the first decade after diagnosis. Conversely, after a new alveolar echinococcosis recurrence was found in the right lung in 1994, the patient accepted to take albendazole continuously at the right dosage. After serology became negative and a fluoro-deoxy-glucose-Positron Emission Tomography performed in 2005 showed a total regression of the lesions in all organs, albendazole treatment could be definitively withdrawn. In 2011, the fluoro-deoxy-glucose-Positron Emission Tomography showed a total absence of parasitic metabolic activity and the patient had no clinical symptoms related to alveolar echinococcosis. The history of this patient suggests that multi-organ involvement and alveolar echinococcosis recurrence over time may occur in non-immune suppressed patients despite an apparently “radical” surgery. Metastatic dissemination might be favored by a poor adherence to chemotherapy. Combined surgery and continuous administration of albendazole at high dosage may allow alveolar echinococcosis patients to survive more than 30 years after diagnosis despite multi-organ involvement.
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Affiliation(s)
- Karine Bardonnet
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University Hospital, University of Franche-Comté, Besançon 25030, France.
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Piarroux M, Piarroux R, Giorgi R, Knapp J, Bardonnet K, Sudre B, Watelet J, Dumortier J, Gérard A, Beytout J, Abergel A, Mantion G, Vuitton DA, Bresson-Hadni S. Clinical features and evolution of alveolar echinococcosis in France from 1982 to 2007: results of a survey in 387 patients. J Hepatol 2011; 55:1025-33. [PMID: 21354448 DOI: 10.1016/j.jhep.2011.02.018] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [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: 09/11/2010] [Revised: 02/04/2011] [Accepted: 02/10/2011] [Indexed: 01/02/2023]
Abstract
BACKGROUND & AIMS Alveolar echinococcosis (AE) is a rare disease in humans, caused by the larval stage of the fox tapeworm Echinococcus multilocularis. METHODS We present here 387 detailed AE cases diagnosed in France from 1982 to 2007 actively identified by a retrospective survey performed in 1997-1998 and prospectively thereafter. RESULTS Male:female ratio was 1.03 and mean age 57.8 years at time of diagnosis. Among the 362 complete files (including 347 non dead-out and 15 dead-out lesions), 73% of the patients were symptomatic at first admittance. Among them, 83% presented with clinical patterns evocative either of a digestive or a hepatic disorder. Other symptomatic patients presented with erratic clinical pictures, generally due to metastasis or extra-hepatic location of the parasite. Except for a few patients with particularly severe AE who died shortly after the diagnosis, most patients were treated using benzimidazoles. Their mortality tends to merge with that of the general French population, matched by sex, age, and calendar year. This study also highlights an unexpectedly high frequency of blood-tied family cases (13% of patients submitted to a specific questionnaire). CONCLUSIONS Even though the broad set of clinical features provoked by E. multilocularis makes AE a potential diagnostic trap for many physicians, our study revealed an improvement of its prognosis. However, as shown by our findings about the frequency of family cases, there is still a need for studies aimed at better describing this uncommon parasitic disease.
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Affiliation(s)
- Martine Piarroux
- TheMA, UMR CNRS 6049, Université de Franche-Comté, 25030 Besançon, France
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10
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Reboux G, Piarroux R, Roussel S, Millon L, Bardonnet K, Dalphin JC. Assessment of four serological techniques in the immunological diagnosis of farmers' lung disease. J Med Microbiol 2007; 56:1317-1321. [PMID: 17893167 DOI: 10.1099/jmm.0.46953-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Farmers' lung disease (FLD) is a pulmonary disease that results from repeated inhalation of antigens from mouldy hay or straw. The objective of this prospective study was to assess the reliability of four serological techniques in FLD diagnosis. Sera from 15 consecutive patients with FLD, 15 healthy control farmers and 30 urban controls were analysed using four serological techniques [electrosyneresis (ES), Ouchterlony double diffusion (DD), ELISA and Western blot (WB)] with four antigens (Absidia corymbifera, Eurotium amstelodami, Wallemia sebi and Saccharopolyspora rectivirgula). In the authors' region, ES on cellulose acetate with A. corymbifera antigen was the most relevant diagnostic tool for discriminating FLD patients from healthy exposed farmers (sensitivity 87 %, specificity 100 %). DD tests were in accordance with ES, but their discriminatory power was lower. No threshold indicating both good sensitivity and specificity could be established with ELISA. WB analysis failed to identify specific bands for FLD. This study demonstrates the efficacy of determining precipitin levels with an appropriate technique, using a panel of antigens consistent with the specific exposure of a given area.
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Affiliation(s)
- Gabriel Reboux
- Department of Mycology, University Hospital, Besançon, France
| | - Renaud Piarroux
- Department of Mycology, University Hospital, Besançon, France
| | | | - Laurence Millon
- Department of Mycology, University Hospital, Besançon, France
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Bertrand X, Leconte des Floris MF, Bardonnet K, Morel P, Talon D. Staphylococcus aureus-contaminated apheresis platelets traced to donors' nasal carriage. Transfusion 2006; 46:310-1. [PMID: 16441612 DOI: 10.1111/j.1537-2995.2006.00719.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Bart JM, Bardonnet K, Elfegoun MCB, Dumon H, Dia L, Vuitton DA, Piarroux R. Echinococcus granulosus strain typing in North Africa: comparison of eight nuclear and mitochondrial DNA fragments. Parasitology 2004; 128:229-34. [PMID: 15030010 DOI: 10.1017/s0031182003004359] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Recent studies of Echinococcus granulosus molecular strain typing have enabled a better understanding of the transmission cycle of cystic echinococcosis. There have been many publications in this area but there is a need for the evaluation of these tools. We have attempted to respond to this need in our study, which assessed 8 DNA fragments of 40 E. granulosus cysts from North Africa. Parasitological material was collected from 5 types of intermediate hosts, in 5 different countries. The primers chosen to amplify DNA targets were defined either in nuclear DNA, or in mitochondrial DNA. After amplification, PCR products were sequenced. The sequences obtained were aligned and comparisons were made within the group and with GenBank sequences. Whether the target was nuclear or mitochondrial, the same 2 main groups of genotypes were found. The first one, the 'sheep' strain, was found in the human, sheep and cattle samples collected in North Africa. The second one, the 'camel' strain, was found in the camel cysts and cattle and human cysts from Mauritania. These findings further confirm the congruence of the data given by the nuclear and the mitochondrial genome.
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Affiliation(s)
- J M Bart
- Santé Environnement Rural Franche-Comté and WHO Centre Collaborating for Prevention and Treatment of Human Echinococcosis, University of Franche-Comté, 25000 Besançon, France.
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13
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Roussel S, Reboux G, Dalphin JC, Bardonnet K, Millon L, Piarroux R. Microbiological evolution of hay and relapse in patients with farmer's lung. Occup Environ Med 2004; 61:e3. [PMID: 14691284 PMCID: PMC1757806] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND Recent studies in France have shown that Absidia corymbifera and, to a lesser degree Eurotium amstelodami and Wallemia sebi, play a role in farmer's lung disease (FLD), but that Saccharopolyspora rectivirgula, classically incriminated, does not. Little is known about farmers' reactions to these fungi or the circumstances which lead to exposure. AIMS To investigate the conditions which favour the development of these microorganisms in hay and to analyse the relation between their concentration and the risk of occurrence of FLD. METHODS Sequential microbiological analyses of each batch of hay stored in 10 farms at risk for FLD and a serological survey of 10 farmers (five with a past history of FLD). RESULTS Exposure to microorganisms varied widely according to farms and periods. These microorganisms usually reached a peak in January and proliferated when harvesting conditions favoured excessive humidity in hay (rain during harvest, soil in the hay). Three of the five FLD patients presented with FLD respiratory recurrence and positive serology for A corymbifera during the winter (2000-01), after exposure to a significantly higher amount of A corymbifera than other farmers. Similar, but less significant, results were found for E amstelodami exposure, but not with W sebi. CONCLUSIONS Results contribute to confirming A corymbifera as a major aetiological agent of FLD in Doubs, and encourage further studies with a view to implementing preventive measures.
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Affiliation(s)
- S Roussel
- Department of Mycology, University Hospital, Besançon, France
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14
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Bardonnet K, Benchikh-Elfegoun MC, Bart JM, Harraga S, Hannache N, Haddad S, Dumon H, Vuitton DA, Piarroux R. Cystic echinococcosis in Algeria: cattle act as reservoirs of a sheep strain and may contribute to human contamination. Vet Parasitol 2003. [PMID: 14519325 DOI: 10.1016/s0304-40170300255-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
In Algeria, cystic echinococcosis (CE) is a serious economic and public health problem. The common sheep/dog cycle is usually considered as the major source of human contamination. But to date the main strain of Echinococcus granulosus involved in the human contamination and the role of other hosts are still unknown. This paper reports an original work performed in northern Algeria combining field observations and molecular analysis. In a first step, examination of 6237 carcasses in slaughterhouses showed high infection and fertility rates in cattle and dromedaries. Then, in a second step, we used a molecular biology approach to identify the E. granulosus strain(s) involved. Forty-six samples from various origins were collected. They were analysed using comparison of PCR-amplified DNA sequences with one genomic (BG 1/3) and two mitochondrial (COI and NDI) targets. Results show the presence of a "sheep" strain of E. granulosus in North Algeria circulating between cattle and ovines and infectious to humans, whereas in South Algeria, a "camel" strain and a "sheep" strain were found to circulate in camels and in sheep, respectively. This study also reports an ambiguous genotype which resembled the "sheep" strain genotype (Gl) on the basis of the partial COI gene sequence, whereas on the basis of the partial NDI gene sequence, it was similar either to the "sheep" strain (Gl) or to the "camel" strain (G6). Besides its basic interest, our study confirms the role of other hosts (mainly cattle) in leading to transmission to humans and suggests that control measures should not only target sheep.
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Affiliation(s)
- K Bardonnet
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis and Health and Rural Environment Research Unit, University of Franche-Comte (SERF), School of Medicine and Pharmacy, 25 030 Cedex, Besançon, France
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15
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Bardonnet K, Benchikh-Elfegoun MC, Bart JM, Harraga S, Hannache N, Haddad S, Dumon H, Vuitton DA, Piarroux R. Cystic echinococcosis in Algeria: cattle act as reservoirs of a sheep strain and may contribute to human contamination. Vet Parasitol 2003; 116:35-44. [PMID: 14519325 DOI: 10.1016/s0304-4017(03)00255-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In Algeria, cystic echinococcosis (CE) is a serious economic and public health problem. The common sheep/dog cycle is usually considered as the major source of human contamination. But to date the main strain of Echinococcus granulosus involved in the human contamination and the role of other hosts are still unknown. This paper reports an original work performed in northern Algeria combining field observations and molecular analysis. In a first step, examination of 6237 carcasses in slaughterhouses showed high infection and fertility rates in cattle and dromedaries. Then, in a second step, we used a molecular biology approach to identify the E. granulosus strain(s) involved. Forty-six samples from various origins were collected. They were analysed using comparison of PCR-amplified DNA sequences with one genomic (BG 1/3) and two mitochondrial (COI and NDI) targets. Results show the presence of a "sheep" strain of E. granulosus in North Algeria circulating between cattle and ovines and infectious to humans, whereas in South Algeria, a "camel" strain and a "sheep" strain were found to circulate in camels and in sheep, respectively. This study also reports an ambiguous genotype which resembled the "sheep" strain genotype (Gl) on the basis of the partial COI gene sequence, whereas on the basis of the partial NDI gene sequence, it was similar either to the "sheep" strain (Gl) or to the "camel" strain (G6). Besides its basic interest, our study confirms the role of other hosts (mainly cattle) in leading to transmission to humans and suggests that control measures should not only target sheep.
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Affiliation(s)
- K Bardonnet
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis and Health and Rural Environment Research Unit, University of Franche-Comte (SERF), School of Medicine and Pharmacy, 25 030 Cedex, Besançon, France
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16
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Kern P, Bardonnet K, Renner E, Auer H, Pawlowski Z, Ammann RW, Vuitton DA, Kern P. European echinococcosis registry: human alveolar echinococcosis, Europe, 1982-2000. Emerg Infect Dis 2003. [PMID: 12643830 DOI: 10.3201/0903.020341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Surveillance for alveolar echinococcosis in central Europe was initiated in 1998. On a voluntary basis, 559 patients were reported to the registry. Most cases originated from rural communities in regions from eastern France to western Austria; single cases were reported far away from the disease-"endemic" zone throughout central Europe. Of 210 patients, 61.4% were involved in vocational or part-time farming, gardening, forestry, or hunting. Patients were diagnosed at a mean age of 52.5 years; 78% had symptoms. Alveolar echinococcosis primarily manifested as a liver disease. Of the 559 patients, 190 (34%) were already affected by spread of the parasitic larval tissue. Of 408 (73%) patients alive in 2000, 4.9% were cured. The increasing prevalence of Echinococcus multilocularis in foxes in rural and urban areas of central Europe and the occurrence of cases outside the alveolar echinococcosis-endemic regions suggest that this disease deserves increased attention.
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Godot V, Harraga S, Podoprigora G, Liance M, Bardonnet K, Vuitton DA. IFN alpha-2a protects mice against a helminth infection of the liver and modulates immune responses. Gastroenterology 2003; 124:1441-50. [PMID: 12730883 DOI: 10.1016/s0016-5085(03)00273-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS Hepatic alveolar echinococcosis (AE), caused by the larval growth of Echinococcus multilocularis, is one of the most lethal helminthic diseases with no satisfactory treatment. Advances in the understanding of the host's immune response (Th2 responses associated with a progressive form of AE), have driven the research towards immune stimulation as an alternative possibility to treat patients. We previously reported clinical stabilization associated with a shift from a Th2 to a Th1 cytokine profile in an AE patient treated with interferon (IFN)alpha. METHODS The effects of recombinant IFN alpha-2a were analyzed in the susceptible C57BL/6J E. multilocularis infected mice. Parasitic burden, macrophage functions, and specific T-cell responses were studied 15, 45, and 90 days postinfection. RESULTS After 90 days postinfection, 75% of infected IFN alpha-2a-treated mice had no hepatic lesions and half were fully protected. IFN alpha-2a treatment markedly decreased the abnormally elevated production of IL-10 in both spleen cell cultures and peritoneal macrophage cultures from infected mice and restored phagocytosis and oxidative metabolism of macrophages. It also inhibited IL-6 and IL-13 antigen-induced secretions in spleen cell cultures. CONCLUSIONS Through its immunoregulatory properties, IFN alpha-2a may be effective in a helminthic liver infection and is a promising candidate for clinical application in AE.
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Affiliation(s)
- Véronique Godot
- World Health Organization Collaborating Center on Prevention and Treatment of Human Echinococcosis, Faculté de Médecine et de Pharmacie et Centre Hospitalier Universitaire, Université de Franche-Comte, Besançon, France
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18
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Kern P, Bardonnet K, Renner E, Auer H, Pawlowski Z, Ammann RW, Vuitton DA, Kern P. European echinococcosis registry: human alveolar echinococcosis, Europe, 1982-2000. Emerg Infect Dis 2003; 9:343-9. [PMID: 12643830 PMCID: PMC2958541 DOI: 10.3201/eid0903.020341] [Citation(s) in RCA: 256] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Surveillance for alveolar echinococcosis in central Europe was initiated in 1998. On a voluntary basis, 559 patients were reported to the registry. Most cases originated from rural communities in regions from eastern France to western Austria; single cases were reported far away from the disease-"endemic" zone throughout central Europe. Of 210 patients, 61.4% were involved in vocational or part-time farming, gardening, forestry, or hunting. Patients were diagnosed at a mean age of 52.5 years; 78% had symptoms. Alveolar echinococcosis primarily manifested as a liver disease. Of the 559 patients, 190 (34%) were already affected by spread of the parasitic larval tissue. Of 408 (73%) patients alive in 2000, 4.9% were cured. The increasing prevalence of Echinococcus multilocularis in foxes in rural and urban areas of central Europe and the occurrence of cases outside the alveolar echinococcosis-endemic regions suggest that this disease deserves increased attention.
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19
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Ito A, Xiao N, Liance M, Sato MO, Sako Y, Mamuti W, Ishikawa Y, Nakao M, Yamasaki H, Nakaya K, Bardonnet K, Bresson-Hadni S, Vuitton DA. Evaluation of an enzyme-linked immunosorbent assay (ELISA) with affinity-purified Em18 and an ELISA with recombinant Em18 for differential diagnosis of alveolar echinococcosis: results of a blind test. J Clin Microbiol 2002; 40:4161-5. [PMID: 12409391 PMCID: PMC139688 DOI: 10.1128/jcm.40.11.4161-4165.2002] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Alveolar echinococcosis (AE) is the most potentially lethal parasitic zoonosis of the nontropical areas in the northern hemisphere, where cystic echinococcosis (CE) is also endemic. Both AE and CE are highly endemic in China, and both serologic detection of echinococcosis, either AE or CE, and differentiation of AE from CE are crucial problems. Evaluation of Western blot analysis (WB) and enzyme-linked immunosorbent assay (ELISA) for the Em18 antigen, using affinity-purified and recombinant Em18, was carried out "blindly" using 60 human sera from patients diagnosed in France. The results were compared with those obtained using a commercially available Echinococcus WB immunoglobulin G (IgG) kit developed in France. The Em18 WB and Echinococcus WB IgG showed very similar results for detection of AE. Both affinity-purified Em18 or a recombinant Em18 WB and Echinococcus WB IgG seem useful for identification of AE, and the latter seems appropriate for both AE and CE, whereas affinity-purified Em18 ELISA and the newly developed recombinant Em18 ELISA appear to be suitable for detection of AE, especially for epidemiological surveys.
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Affiliation(s)
- Akira Ito
- Department of Parasitology. Animal Laboratory for Medical Research, Asahikawa Medical College, Asahikawa, Japan.
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20
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Bardonnet K, Piarroux R, Dia L, Schneegans F, Beurdeley A, Godot V, Vuitton DA. Combined eco-epidemiological and molecular biology approaches to assess Echinococcus granulosus transmission to humans in Mauritania: occurrence of the 'camel' strain and human cystic echinococcosis. Trans R Soc Trop Med Hyg 2002; 96:383-6. [PMID: 12497974 DOI: 10.1016/s0035-9203(02)90369-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Mauritania lies between West-Central Africa where human cystic echinococcosis (CE) is considered extremely rare and West Maghreb where CE accounts for a real public health problem. Until 1992, Mauritania was considered as human CE-free even through CE seemed well known in livestock. In 1992, the introduction of ultrasonography led to the diagnosis of the first human CE cases. In 1997, a veterinary study revealed that dogs living around Nouakchott were commonly infected by Echinococcus granulosus. To assess E. granulosus transmission and to identify the most relevant animal reservoir responsible for human CE emerging in Mauritania, a simultaneous eco-epidemiological and molecular biology approach was performed. The fieldwork included sample collection and investigation of relationship between intermediate hosts, definitive hosts and humans. Typing of E. granulosus strains was performed using comparison of polymerase chain reaction (PCR)-amplified DNA sequences with one nuclear (BG 1/3) and 2 mitochondrial (COI, NDI) targets. Results show that the 'camel' strain is actually infectious to humans and circulates between intermediate hosts including camels and cattle. It is suggested that preventive measures at slaughtering places could reduce human contamination.
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Affiliation(s)
- K Bardonnet
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, Research Unit Health and Rural Environment, University of Franche-Comté (SERF), School of Medicine and Pharmacy, 25 030 Besançon, France.
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21
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Bardonnet K, Piarroux R, Dia L, Schneegans F, Beurdeley A, Godot V, Vuitton DA. Combined eco-epidemiological and molecular biology approaches to assess Echinococcus granulosus transmission to humans in Mauritania: occurrence of the 'camel' strain and human cystic echinococcosis. Trans R Soc Trop Med Hyg 2002. [PMID: 12497974 DOI: 10.1016/s0035-92030290369-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Mauritania lies between West-Central Africa where human cystic echinococcosis (CE) is considered extremely rare and West Maghreb where CE accounts for a real public health problem. Until 1992, Mauritania was considered as human CE-free even through CE seemed well known in livestock. In 1992, the introduction of ultrasonography led to the diagnosis of the first human CE cases. In 1997, a veterinary study revealed that dogs living around Nouakchott were commonly infected by Echinococcus granulosus. To assess E. granulosus transmission and to identify the most relevant animal reservoir responsible for human CE emerging in Mauritania, a simultaneous eco-epidemiological and molecular biology approach was performed. The fieldwork included sample collection and investigation of relationship between intermediate hosts, definitive hosts and humans. Typing of E. granulosus strains was performed using comparison of polymerase chain reaction (PCR)-amplified DNA sequences with one nuclear (BG 1/3) and 2 mitochondrial (COI, NDI) targets. Results show that the 'camel' strain is actually infectious to humans and circulates between intermediate hosts including camels and cattle. It is suggested that preventive measures at slaughtering places could reduce human contamination.
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Affiliation(s)
- K Bardonnet
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, Research Unit Health and Rural Environment, University of Franche-Comté (SERF), School of Medicine and Pharmacy, 25 030 Besançon, France.
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22
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Piarroux R, Bardonnet K. [Visceral leishmaniases]. Rev Prat 2001; 51:2104-7. [PMID: 11842729] [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] [Indexed: 02/23/2023]
Abstract
Leishmanioses are a group of infections caused by the protozoa Leishmania. Humans are infected by female sandfly bites. Leishmaniosis is found in Mediterranean Europe, America, Africa and Asia. Various clinical expressions are possible: visceral (kala-azar) or cutaneous (Old world cutaneous leishmaniosis). In Mediterranean Europe, visceral leishmaniosis with the classical triad, splenomegaly, pallor, fever, was traditionally a childhood disease whereas today the disease with atypical clinical expressions strikes immunocompromised patients. In these atypical forms of visceral leishmaniosis, diagnosis and treatment are particularly difficult. Leishmania-DNA research using polymerase chain reaction is often necessary to perform the diagnosis, and lipid-associated formulations of amphotericin B, rapidly effective and well-tolerated in patients without immunodeficiency, do not prevent recurrences in immunocompromised patients.
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Affiliation(s)
- R Piarroux
- Laboratoire de parasitologie-mycologie Hôpital Jean-Minjoz 25030 Besançon
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Reboux G, Piarroux R, Mauny F, Madroszyk A, Millon L, Bardonnet K, Dalphin JC. Role of molds in farmer's lung disease in Eastern France. Am J Respir Crit Care Med 2001; 163:1534-9. [PMID: 11401869 DOI: 10.1164/ajrccm.163.7.2006077] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Farmer's lung disease (FLD) is common in the east of France. In the absence of the primary recognized FLD agent, Saccharopolyspora rectivirgula, its etiology remains unknown. A prospective case-control study was performed to find the etiology of FLD in this area. Eleven patients were matched with 11 healthy control farmers. Twenty-two urban subjects constituted the nonexposed control group. Microorganisms from cowshed air and fodder were identified and counted. The antigens of the microorganisms most frequently isolated at the 22 farms were used for serological tests. Farms of patients with FLD contained more Absidia corymbifera than those of healthy farmers (p < 0.05 in air, p < 0.01 in fodder). Electrosyneresis, performed with A. corymbifera somatic antigen, differentiated 9 of 11 patients with FLD from control subjects (p < 0.01). Other significant results were obtained with Eurotium amstelodami (p < 0.01) and Wallemia sebi (p < 0.05). In contrast, no significant results were obtained with the other seven antigens tested, including S. rectivirgula. Absidia corymbifera and, to a lesser degree, W. sebi or E. amstelodami are likely to be the main causes of FLD in this area. Modifications in working conditions over time could explain the emergence of these new contributing etiologies.
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Affiliation(s)
- G Reboux
- Department of Mycology, University Hospital, Besançon, France
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Giraudoux P, Raoul F, Bardonnet K, Vuillaume P, Tourneux F, Cliquet F, Delattre P, Vuitton D. Alveolar echinococcosis: characteristics of a possible emergence and new perspectives in epidemiosurveillance. Med Mal Infect 2001. [DOI: 10.1016/s0399-077x(01)80065-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bourezane Y, Thalamy B, Viel JF, Bardonnet K, Drobacheff C, Gil H, Vuitton DA, Hoen B. Ingrown toenail and indinavir: case-control study demonstrates strong relationship. AIDS 1999; 13:2181-2. [PMID: 10546880 DOI: 10.1097/00002030-199910220-00030] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bardonnet K, Gil H, Lebrun C, de Wazières B, Dupond JL. [Diabetes mellitus associated with protease inhibitors in HIV infected patients]. Rev Med Interne 1998; 19:675-6. [PMID: 9793159 DOI: 10.1016/s0248-8663(99)80051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Gil H, de Wazières B, Bardonnet K, Duchenne F, Vuitton DA, Dupond JL. Syndrome d’activation macrophagique multirécurrent chez un adulte jeune: une origine auto-immune? Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80048-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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