1
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Dellière S, Amar Y, Hamane S, Aissaoui N, Denis B, Bergeron A, Tazi A, Alanio A. Bronchial aspirate obtained during bronchoscopy yields increased fungal load compared to bronchoalveolar lavage fluid in patients at risk of invasive aspergillosis and Pneumocystis pneumonia. Med Mycol 2023; 61:myad120. [PMID: 37996394 DOI: 10.1093/mmy/myad120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 11/25/2023] Open
Abstract
Bronchoalveolar lavage fluid (BALF) is a standard respiratory sample for diagnosing invasive fungal diseases like Pneumocystis pneumonia (PCP) and invasive pulmonary aspergillosis (IPA). However, procedural variations exist across medical centers and wards. This study aimed to compare the diagnostic potential of BALF and bronchial aspirate (BA) obtained during bronchoscopy in 173 patients suspected of fungal infections. A prospective observational study was conducted from April 2020 to November 2021. BALF and BA were collected during bronchoscopy and subjected to direct examination, fungal culture, Aspergillus fumigatus qPCR (AfqPCR), and Pneumocystis jirovecii qPCR (PjqPCR). Galactomannan detection was performed on BALF. Patients were classified based on established European Organization for Research and Treatment of Cancer (EORTC) criteria. Out of 173 patients, 75 tested positive for at least one test in BA or BALF. For Aspergillus, proportion of positive AfqPCR (14.5% vs. 9.2%; P < 0.0001) and fungal loads (Cq of 31.3 vs. 32.8; P = 0.0018) were significantly higher in BA compared to BALF. For Pneumocystis, fungal loads by PjqPCR was also higher in BA compared to BALF (Cq of 34.2 vs. 35.7; P = 0.003). BA only detected A. fumigatus and P. jirovecii in 12 (42.9%) and 8 (19.5%) patients, respectively. BA obtained during a BAL procedure can be a suitable sample type for increased detection of P. jirovecii and A. fumigatus by qPCR. The use of BA in diagnostic algorithms requires further investigation in prospective studies.
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Affiliation(s)
- Sarah Dellière
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, Paris, France
- Institut Pasteur, Université de Paris Cité, Immunobiology d'Aspergillus, Paris, France
| | - Yaël Amar
- Service de pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Samia Hamane
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Nesrine Aissaoui
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Blandine Denis
- Service d'infectiologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Anne Bergeron
- Hôpitaux Universitaire de Genève, University of Geneva, Genève, Switzerland
| | - Abdellatif Tazi
- Service de pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Alexandre Alanio
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, Paris, France
- Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology research group, Mycology Department, Paris, France
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2
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Dellière S, Aimanianda V. Humoral Immunity Against Aspergillus fumigatus. Mycopathologia 2023; 188:603-621. [PMID: 37289362 PMCID: PMC10249576 DOI: 10.1007/s11046-023-00742-0] [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: 03/07/2023] [Accepted: 04/27/2023] [Indexed: 06/09/2023]
Abstract
Aspergillus fumigatus is one the most ubiquitous airborne opportunistic human fungal pathogens. Understanding its interaction with host immune system, composed of cellular and humoral arm, is essential to explain the pathobiology of aspergillosis disease spectrum. While cellular immunity has been well studied, humoral immunity has been poorly acknowledge, although it plays a crucial role in bridging the fungus and immune cells. In this review, we have summarized available data on major players of humoral immunity against A. fumigatus and discussed how they may help to identify at-risk individuals, be used as diagnostic tools or promote alternative therapeutic strategies. Remaining challenges are highlighted and leads are given to guide future research to better grasp the complexity of humoral immune interaction with A. fumigatus.
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Affiliation(s)
- Sarah Dellière
- Institut Pasteur, Immunobiology of Aspergillus, Université de Paris Cité, 75015, Paris, France.
- Laboratoire de Parasitologie-Mycologie, AP-HP, Hôpital Saint-Louis, 75010, Paris, France.
| | - Vishukumar Aimanianda
- Institut Pasteur, Immunobiology of Aspergillus, Université de Paris Cité, 75015, Paris, France.
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3
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Jabet A, Dellière S, Seang S, Chermak A, Schneider L, Chiarabini T, Teboul A, Hickman G, Bozonnat A, Brin C, Favier M, Tamzali Y, Chasset F, Barete S, Hamane S, Benderdouche M, Moreno-Sabater A, Dannaoui E, Hennequin C, Fekkar A, Piarroux R, Normand AC, Monsel G. Sexually Transmitted Trichophyton mentagrophytes Genotype VII Infection among Men Who Have Sex with Men. Emerg Infect Dis 2023; 29:1411-1414. [PMID: 37347803 PMCID: PMC10310379 DOI: 10.3201/eid2907.230025] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Transmission of dermatophytes, especially Trichophyton mentagrophytes genotype VII, during sexual intercourse has been recently reported. We report 13 such cases in France. All patients were male; 12 were men who have sex with men. Our findings suggest sexual transmission of this pathogen within a specific population, men who have sex with men.
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Wong SSW, Dellière S, Schiefermeier-Mach N, Lechner L, Perkhofer S, Bomme P, Fontaine T, Schlosser AG, Sorensen GL, Madan T, Kishore U, Aimanianda V. Surfactant protein D inhibits growth, alters cell surface polysaccharide exposure and immune activation potential of Aspergillus fumigatus. Cell Surf 2022; 8:100072. [PMID: 35118215 PMCID: PMC8792412 DOI: 10.1016/j.tcsw.2022.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 10/25/2022] Open
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Ligat G, Ghelfenstein-Ferreira T, Dellière S, Pichon M. Bringing clinical and fundamental young microbiologists together. FEMS Microbes 2022. [DOI: 10.1093/femsmc/xtac025] [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] [Indexed: 11/05/2022] Open
Affiliation(s)
- Gaëtan Ligat
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), INSERM, CNRS, UPS, Université de Toulouse , Toulouse, France
| | | | - Sarah Dellière
- Laboratoire de Parasitologie-Mycologie, AP-HP, Hôpital Saint-Louis , Paris, France
- Institut Pasteur, CNRS, Unité de Mycologie Moléculaire, Université de Paris Cité , UMR2000, F-75015 Paris, France
| | - Maxime Pichon
- CHU de Poitiers, Département des Agents Infectieux, Laboratoire de Bactériologie et Hygiène Hospitalière , Poitiers, France
- Inserm, Pharmacologie des Agents Anti Infectieux et Antibiorésistance UMRS 1070, Université de Poitiers, , Poitiers, France
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6
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Alanio A, Snell HM, Cordier C, Desnos-Olivier M, Dellière S, Aissaoui N, Sturny-Leclère A, Da Silva E, Eblé C, Rouveau M, Thégat M, Zebiche W, Lafaurie M, Denis B, Touratier S, Benyamina M, Dudoignon E, Hamane S, Cuomo CA, Dépret F. First Patient-to-Patient Intrahospital Transmission of Clade I Candida auris in France Revealed after a Two-Month Incubation Period. Microbiol Spectr 2022; 10:e0183322. [PMID: 36094221 PMCID: PMC9604096 DOI: 10.1128/spectrum.01833-22] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/25/2022] [Indexed: 12/31/2022] Open
Abstract
Candida auris is a recently described emerging pathogen in hospital settings. Five genetic clades have been delineated, with each clade being isolated from specific geographic regions. We here describe the first transmission between 2 patients (P0 and P1) of a clade I C. auris strain imported into our burn intensive care unit from the Middle East. The strains have been investigated with whole-genome sequencing, which validated the high similarity of the genomes between isolates from P0 and P1. We repeatedly screened the two patients and contact patients (i.e., other patients present in the same hospital ward at the time of the first positive sample from P0 or P1; n = 49; 268 tests) with fungal culture and a C. auris-specific quantitative PCR assay to assess transmission patterns. We observed that P1 developed C. auris colonization between 41 and 61 days after potential exposure to P0 contamination, despite three negative screening tests as recommended by our national authorities. This study illustrates that transmission of C. auris between patients can lead to long-term incubation times before the detection of colonization. The recommended screening strategy may not be optimal and should be improved in the light of our findings. IMPORTANCE While large outbreaks of C. auris in hospital settings have been described, few clear cases of direct transmission have been documented. We here investigated the transmission of C. auris clade I between two patients with a 41- to 61-day delay between exposure and the development of colonization. This may lead to changes in the recommendations concerning treatment of C. auris cases, as an incubation period of this length is one of the first to be reported.
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Affiliation(s)
- Alexandre Alanio
- Institut Pasteur, Université Paris Cité, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, UMR2000, Paris, France
- Laboratoire de parasitologie-mycologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | | | - Camille Cordier
- Laboratoire de parasitologie-mycologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Marie Desnos-Olivier
- Institut Pasteur, Université Paris Cité, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, UMR2000, Paris, France
| | - Sarah Dellière
- Institut Pasteur, Université Paris Cité, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, UMR2000, Paris, France
- Laboratoire de parasitologie-mycologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
- Université Paris Cité, Paris, France
| | - Nesrine Aissaoui
- Laboratoire de parasitologie-mycologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Aude Sturny-Leclère
- Institut Pasteur, Université Paris Cité, CNRS, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, UMR2000, Paris, France
| | - Elodie Da Silva
- Laboratoire de parasitologie-mycologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Cyril Eblé
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Martine Rouveau
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Micheline Thégat
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Widad Zebiche
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Matthieu Lafaurie
- Equipe Opérationnelle d’Hygiène, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Blandine Denis
- Equipe Opérationnelle d’Hygiène, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sophie Touratier
- Service de maladies infectieuses et tropicales, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mourad Benyamina
- Pharmacie centrale, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
- Département d’anesthésie réanimation, réanimation chirurgicale et centre de traitement des brûlés, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuel Dudoignon
- Pharmacie centrale, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
- Département d’anesthésie réanimation, réanimation chirurgicale et centre de traitement des brûlés, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Samia Hamane
- Laboratoire de parasitologie-mycologie, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | | | - François Dépret
- Université Paris Cité, Paris, France
- Pharmacie centrale, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
- Département d’anesthésie réanimation, réanimation chirurgicale et centre de traitement des brûlés, Groupe Hospitalier Lariboisière, Saint-Louis, Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
- FHU PROMICE, Paris, France
- INSERM UMR-942, Paris, France
- Réseau INI-CRCT, Nancy, France
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7
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Dellière S, Wong S, Chauvin C, Bayry J, Carvalho A, Inforzato A, Aimanianda V. P118 Pentraxin-3 interacts with Aspergillus fumigatus conidia to regulate pro-inflammatory cytokine production. Med Mycol 2022. [PMCID: PMC9516344 DOI: 10.1093/mmy/myac072.p118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM
Objectives
Long pentraxin-3 (PTX3) is a soluble pattern-recognition receptor secreted by phagocytes and non-immune cells at sites of inflammation. It has been reported to have a nonredundant role in the immune response against Aspergillus fumigatus. Indeed, PTX3 knock-out mice show an increased susceptibility to invasive pulmonary aspergillosis (IPA) with a higher mortality rate. In humans, PTX3 genetic deficiency or single nucleotide polymorphism has also been associated with an increased risk of IPA. However, the way in which PTX3 interacts with A. fumigatus and its mechanism of action has yet to be elucidated. The aim of the study was to investigate potential A. fumigatus ligands for PTX3 and the impact of A. fumigatus opsonization by PTX3 on modulating the immune response.
Methods
Aspergillus fumigatus conidia, the infective morphotype, were incubated with PTX3 with or without human serum, stained with anti-PTX3 antibody, and studied by immunofluorescence. Identification of potential fungal ligands for PTX3 was performed by ELISA. Fixed conidia and germinated conidia were opsonized with different serum factors and co-incubated with human monocyte-derived macrophages (hMDM) for 24 h at 37°C. Culture supernatants were collected, and pro-/anti-inflammatory cytokines were measured by sandwich ELISA.
Results
PTX3 did not bind A. fumigatus conidia directly but in the presence of human serum, purified collectins [surfactant protein D (SP-D) or C1q], and complement products (C3b). Pre-opsonization of conidia with these complement proteins or SP-D stimulated proinflammatory cytokine secretion by hMDM upon interaction (Fig. 1a). In contrast, secondary opsonization of complement proteins or SP-D opsonized conidia with PTX3 significantly reduced pro-inflammatory cytokines and increased anti-inflammatory cytokine secretion from hMDM. PTX3 opsonized PFA-fixed germinating conidia significantly reduced pro-inflammatory cytokine and increased anti-inflammatory cytokines secretion from hMDM (Fig. 1b).
Conclusion
PTX3 is an acute phase protein expressed in response to pro-inflammatory stimuli during infection and that is increased in bronchoalveolar lavage of patients with aspergillosis. Our recent data with A. fumigatus suggest that PTX3 is an immunoregulatory protein that reduces pro-inflammatory response. Although an inflammatory response is necessary to fight against fungal pathogens, the tissue damage associated with enhanced inflammation can be deleterious and facilitate A. fumigatus infection.
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Affiliation(s)
- Sarah Dellière
- Institut Pasteur , Université de Paris-Cité, CNRS, Unité de Mycologie Moléculaire, UMR2000, Paris , France
- Laboratoire de Parasitologie-Mycologie , AP-HP, Hôpital Saint-Louis, Paris , France
| | - Sarah Wong
- Institut Pasteur , Université de Paris-Cité, CNRS, Unité de Mycologie Moléculaire, UMR2000, Paris , France
| | - Camille Chauvin
- Institut National de la Santé et de la Recherche Médicale , Centre de recherche des Cordeliers, Université de Paris Cité, Paris , France
| | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale , Centre de recherche des Cordeliers, Université de Paris Cité, Paris , France
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS) , School of Medicine, University of Minho, Braga , Portugal
| | - Antonio Inforzato
- IRCCS Humanitas Research Hospital , Department of Biomedical Sciences, Humanitas University, Rozzano , Italy
| | - Vishukumar Aimanianda
- Institut Pasteur , Université de Paris-Cité, CNRS, Unité de Mycologie Moléculaire, UMR2000, Paris , France
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Dellière S, Guitard J, Sabou M, Angebault C, Moniot M, Cornu M, Hamane S, Bougnoux ME, Imbert S, Pasquier G, Botterel F, Garcia-Hermoso D, Alanio A. Detection of circulating DNA for the diagnosis of invasive fusariosis: retrospective analysis of 15 proven cases. Med Mycol 2022; 60:6679565. [PMID: 36044994 DOI: 10.1093/mmy/myac049] [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: 05/10/2022] [Revised: 06/23/2022] [Accepted: 08/29/2022] [Indexed: 11/15/2022] Open
Abstract
Fusarium spp. are plant pathogens and opportunistic pathogens in severely immunocompromised (hematological malignancy, neutropenia, solid organ transplantation, …) and severely burned patients. Invasive fusariosis often disseminates and mortality remains high partly due to delayed diagnosis in the absence of a positive culture. The aim of our study is to design a qPCR assay and evaluate the detection of Fusarium spp. DNA for early diagnosis of invasive infection. A qPCR assay was designed and optimized to identify all Fusarium species complex and secondarily evaluated on patient samples. A total of 81 blood samples from 15 patients diagnosed with proven invasive fusariosis from 9 centers in France were retrospectively tested. Circulating DNA was detected in 14 patients out of 15 (sensitivity of 93% [IC95, 70.1-99.7]). Detection was possible up to 18 days (median 6 days) before the diagnosis was confirmed by positive blood culture or biopsy. By comparison serum galactomannan and ß-D-glucan were positive in 7.1 and 58.3% of patients respectively. qPCR was negative for all patients with other invasive fungal diseases (IFD) tested (n = 12) and IFD-free control patients (n = 40). No cross-reactions were detected using DNA extracted from 81 other opportunistic fungi. We developed and validated a pan-Fusarium qPCR assay in serum/plasma with high sensitivity, specificity and reproducibility that could facilitates early diagnosis and treatment monitoring of invasive fusariosis.
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Affiliation(s)
- Sarah Dellière
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, F-75010 Paris, France.,Institut Pasteur, Université de Paris Cité, CNRS, Unité de Mycologie Moléculaire, UMR2000, F-75015 Paris, France
| | - Juliette Guitard
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, F-75012 Paris, France
| | - Marcela Sabou
- Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Parasitologie et de Pathologie Tropicale, UR7292 Dynamique des interactions hôte pathogène, Fédération de Médecine Translationnelle, Université de Strasbourg, Strasbourg, France
| | - Cécile Angebault
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpitaux Universitaires Henri Mondor, UR Dynamyc UPEC, EnVA, ANSES, F-94010 Créteil, France
| | - Maxime Moniot
- Service de parasitologie-mycologie, CHU Clermont-Ferrand, 3IHP, France
| | - Marjorie Cornu
- Inserm U1285, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, Univ. Lille, F-59000, Lille, France ; CHU Lille, Laboratoire de Parasitologie-Mycologie, F-59000 Lille, France
| | - Samia Hamane
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, F-75010 Paris, France
| | | | - Sébastien Imbert
- Laboratoire de parasitologie-mycologie, Bordeaux University Hospital, F-33000 Bordeaux, France
| | - Grégoire Pasquier
- University of Montpellier, CNRS, IRD, Academic Hospital (CHU) of Montpellier, MiVEGEC, Montpellier, France
| | - Françoise Botterel
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpitaux Universitaires Henri Mondor, UR Dynamyc UPEC, EnVA, ANSES, F-94010 Créteil, France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Université de Paris Cité, CNRS, Unité de Mycologie Moléculaire, UMR2000, F-75015 Paris, France.,Institut Pasteur, Centre National de Référence Mycologie et Antifongiques, F-75015 Paris, France
| | - Alexandre Alanio
- Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, F-75010 Paris, France.,Institut Pasteur, Université de Paris Cité, CNRS, Unité de Mycologie Moléculaire, UMR2000, F-75015 Paris, France.,Institut Pasteur, Centre National de Référence Mycologie et Antifongiques, F-75015 Paris, France
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9
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Dellière S. [Social networks for scientific integrity: A double-edged sword]. Med Sci (Paris) 2022; 38:477-479. [PMID: 35608472 DOI: 10.1051/medsci/2022061] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sarah Dellière
- Institut Pasteur, université Paris Cité, CNRS, Unité de mycologie moléculaire, UMR2000, 25-28 rue du Dr Roux, F-75015 Paris, France - Laboratoire de parasitologie-mycologie, AP-HP, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, F-75010 Paris, France
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10
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Bouiller K, Peiffer-Smadja N, Cevik M, Last K, Antunović IA, Šterbenc A, Lopes MJ, Barac A, Schweitzer V, Dellière S. Role and perception of clinical microbiology and infectious diseases trainees during the COVID-19 crisis. Future Microbiol 2022; 17:411-416. [PMID: 35285247 PMCID: PMC8958984 DOI: 10.2217/fmb-2021-0129] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate the role and perceptions of trainees during the COVID-19 pandemic. Method: An online survey was designed to provide an insight into the significance of the COVID-19 pandemic on working conditions of infectious diseases and clinical microbiology trainees. Results: The main roles of trainees included management of patients hospitalized for COVID-19 (55%), research (53%) and diagnostic procedures (43%). The majority (82%) of trainees felt useful in managing the crisis. However, more than two-thirds felt more stressed and more tired compared with other rotations. Only 39% of the participants had access to psychological support. Conclusion: Due to the significant impact of the pandemic on infectious diseases and clinical microbiology trainees, further research should focus on their health and welfare in the post-pandemic period.
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Affiliation(s)
- Kevin Bouiller
- Infectious disease department, University hospital of Jean-Minjoz, Besancon, France.,UMR-CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France.,Network of young French infectious diseases specialists (RéJIF)
| | - Nathan Peiffer-Smadja
- Network of young French infectious diseases specialists (RéJIF).,Université de Paris, Service de maladies infectieuses et tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Muge Cevik
- Division of Infection & Global Health Research, School of Medecine, University of St Andrews, St Andrews, UK.,Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID)
| | - Katharina Last
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Center for Infectious Diseases, Institute of Medical Microbiology & Hygiene, Saarland University Hospital, Homburg, Germany
| | - Ivana A Antunović
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Hospital for Infections Diseases, Clinical Microbiology, Mirogojska 8, Zagreb, Croatia
| | - Anja Šterbenc
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Institute of Microbiology & Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Maria J Lopes
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Aleksandra Barac
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Clinic for Infectious & Tropical Diseases, University Clinical Center of Serbia, Belgrade, Serbia
| | - Valentijn Schweitzer
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Sarah Dellière
- Trainee association of European Society of Clinical Microbiology & Infectious Diseases (ESCMID).,Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP, Paris, France
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11
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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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12
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Dellière S, Joannard B, Benderdouche M, Mingui A, Gits-Muselli M, Hamane S, Alanio A, Petit A, Gabison G, Bagot M, Bretagne S. Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France. Emerg Infect Dis 2022; 28:224-228. [PMID: 34932462 PMCID: PMC8714205 DOI: 10.3201/eid2801.210810] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 12/19/2022] Open
Abstract
We describe 7 cases of extensive tinea corporis since 2018 in a hospital in Paris, France, after failure to cure with terbinafine. Molecular analysis indicated Trichophyton mentagrophytes internal transcribed spacer type VIII (T. indotineae). This strain, which has mutations in the squalene epoxidase gene, is spreading on the Indian subcontinent.
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Affiliation(s)
| | | | - Mazouz Benderdouche
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
| | - Anselme Mingui
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
| | - Maud Gits-Muselli
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
| | - Samia Hamane
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
| | - Alexandre Alanio
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
| | - Antoine Petit
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
| | - Germaine Gabison
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
| | - Martine Bagot
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
| | - Stéphane Bretagne
- Hôpital Saint Louis Laboratoire de Parasitologie-Mycologie, Assistance Publique des Hôpitaux de Paris, Paris, France (S. Dellière, B. Joannard, M. Benderdouche, A. Mingui, M. Gits-Muselli, S. Hamane, A. Alanio, S. Bretagne)
- Université de Paris, Paris (S. Dellière, M. Gits-Muselli, A. Alanio, M. Bagot, S. Bretagne)
- Centre National de Référence Mycoses Invasives et Antifongiques Unité de Mycologie Moléculaire, Paris (A. Alanio, S. Bretagne)
- Hôpital Saint-Louis Service de Dermatologie, Assistance Publique des Hôpitaux de Paris, Paris (A. Petit, G. Gabison, M. Bagot); INSERM U976 (M. Bagot)
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13
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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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14
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Aissaoui N, Hamane S, Gits-Muselli M, Petit A, Benderdouche M, Denis B, Alanio A, Dellière S, Bagot M, Bretagne S. Imported leishmaniasis in travelers: a 7-year retrospective from a Parisian hospital in France. BMC Infect Dis 2021; 21:953. [PMID: 34525963 PMCID: PMC8442464 DOI: 10.1186/s12879-021-06631-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/19/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Leishmaniases are regularly seen in non-endemic areas due to the increase of international travels. They include cutaneous leishmaniases (CL) and mucocutaneous (MC) caused by different Leishmania species, and visceral leishmaniases (VL) which present with non-specific symptoms. METHODS We reviewed all consecutive leishmaniasis cases seen between September 2012 and May 2020. The diagnostic strategy included microscopy after May-Grünwald-Giemsa staining, a diagnostic quantitative PCR (qPCR) assay, and species identification based on sequencing of the cytochrome b gene. RESULTS Eighty-nine patients had a definitive leishmaniasis diagnosis. Nine patients had VL with Leishmania infantum. Eighty patients had CL. Twelve patients acquired CL after trips in Latin America (7 Leishmania guyanensis, 2 Leishmania braziliensis, 2 Leishmania mexicana, and 1 Leishmania panamensis). Species could be identified in 63 of the 68 CLs mainly after travel in North Africa (59%) with Leishmania major (65%), Leishmania tropica/killicki (24%), and L. infantum (11%), or in West Sub-Saharan Africa (32%), all due to L. major. The median day between appearance of the lesions and diagnosis was 90 [range 60-127]. CONCLUSIONS Our diagnostic strategy allows both positive diagnoses and species identifications. Travelers in West Sub-Saharan Africa and North Africa should be better aware of the risk of contracting leishmananiasis.
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Affiliation(s)
- Nesrine Aissaoui
- Laboratoire de Parasitologie et de Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 Avenue Claude Vellefaux, 75475, Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie et de Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 Avenue Claude Vellefaux, 75475, Paris, France
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie et de Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 Avenue Claude Vellefaux, 75475, Paris, France.,Université de Paris, Paris, France
| | - Antoine Petit
- Service de Dermatologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Mazouz Benderdouche
- Laboratoire de Parasitologie et de Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 Avenue Claude Vellefaux, 75475, Paris, France
| | - Blandine Denis
- Département de Maladies Infectieuses, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie et de Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 Avenue Claude Vellefaux, 75475, Paris, France.,Université de Paris, Paris, France
| | - Sarah Dellière
- Laboratoire de Parasitologie et de Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 Avenue Claude Vellefaux, 75475, Paris, France.,Université de Paris, Paris, France
| | - Martine Bagot
- Service de Dermatologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,INSERM U976, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie et de Mycologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), 1 Avenue Claude Vellefaux, 75475, Paris, France. .,Université de Paris, Paris, France.
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15
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d'Humières C, Salmona M, Dellière S, Leo S, Rodriguez C, Angebault C, Alanio A, Fourati S, Lazarevic V, Woerther PL, Schrenzel J, Ruppé E. The Potential Role of Clinical Metagenomics in Infectious Diseases: Therapeutic Perspectives. Drugs 2021; 81:1453-1466. [PMID: 34328626 PMCID: PMC8323086 DOI: 10.1007/s40265-021-01572-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 12/24/2022]
Abstract
Clinical metagenomics (CMg) is the process of sequencing nucleic acid of clinical samples to obtain clinically relevant information such as the identification of microorganisms and their susceptibility to antimicrobials. Over the last decades, sequencing and bioinformatic solutions supporting CMg have much evolved and an increasing number of case reports and series covering various infectious diseases have been published. Metagenomics is a new approach to infectious disease diagnosis that is currently being developed and is certainly one of the most promising for the coming years. However, most CMg studies are retrospective, and few address the potential impact CMg could have on patient management, including initiation, adaptation, or cessation of antimicrobials. In this narrative review, we have discussed the potential role of CMg in bacteriology, virology, mycology, and parasitology. Several reports and case-series confirm that CMg is an innovative tool with which one can (i) identify more microorganisms than with conventional methods in a single test, (ii) obtain results within hours, and (iii) tailor the antimicrobial regimen of patients. However, the cost-efficiency of CMg and its real impact on patient management are still to be determined.
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Affiliation(s)
- Camille d'Humières
- Université de Paris, IAME, INSERM, 75018, Paris, France.,AP-HP, Hôpital Bichat, Laboratoire de Bactériologie, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Maud Salmona
- Unité de Paris, INSERM U976, Insight Team, 75010, Paris, France.,AP-HP, Hôpital Saint-Louis, Laboratoire de Virologie, 75010, Paris, France
| | - Sarah Dellière
- AP-HP, Hôpital Saint-Louis, Laboratoire de Parasitologie-Mycologie, 75010, Paris, France.,Molecular Mycology Unit, Institut Pasteur, CNRS UMR2000, 75015, Paris, France
| | - Stefano Leo
- Faculty of Medicine, CMU, University of Geneva, Geneva, Switzerland.,Service of Infectious Diseases, Genomic Research Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Rodriguez
- Département de Microbiologie, AP-HP, Hôpital Henri Mondor, 94000, Créteil, France.,INSERM U955, Université Paris-Est, 94000, Créteil, France
| | - Cécile Angebault
- Département de Microbiologie, AP-HP, Hôpital Henri Mondor, 94000, Créteil, France.,Université Paris Est Créteil, Ecole Nationale Vétérinaire d'Alfort, USC ANSES, EA7380 Dynamic, 94000, Créteil, France
| | - Alexandre Alanio
- AP-HP, Hôpital Saint-Louis, Laboratoire de Parasitologie-Mycologie, 75010, Paris, France.,Molecular Mycology Unit, Institut Pasteur, CNRS UMR2000, 75015, Paris, France
| | - Slim Fourati
- Département de Microbiologie, AP-HP, Hôpital Henri Mondor, 94000, Créteil, France.,INSERM U955, Université Paris-Est, 94000, Créteil, France
| | - Vladimir Lazarevic
- Faculty of Medicine, CMU, University of Geneva, Geneva, Switzerland.,Service of Infectious Diseases, Genomic Research Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Paul-Louis Woerther
- Département de Microbiologie, AP-HP, Hôpital Henri Mondor, 94000, Créteil, France.,Université Paris Est Créteil, Ecole Nationale Vétérinaire d'Alfort, USC ANSES, EA7380 Dynamic, 94000, Créteil, France
| | - Jacques Schrenzel
- Faculty of Medicine, CMU, University of Geneva, Geneva, Switzerland.,Service of Infectious Diseases, Genomic Research Laboratory, Geneva University Hospitals, Geneva, Switzerland
| | - Etienne Ruppé
- Université de Paris, IAME, INSERM, 75018, Paris, France. .,AP-HP, Hôpital Bichat, Laboratoire de Bactériologie, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France.
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16
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Ghelfenstein-Ferreira T, Beaumont AL, Dellière S, Peiffer-Smadja N, Pineros N, Carbonnelle E, Greub G, Abbara S, Luong Nguyen LB, Lescat M. An Educational Game Evening for Medical Residents: A Proof of Concept to Evaluate the Impact on Learning of the Use of Games. J Microbiol Biol Educ 2021; 22:00119-21. [PMID: 34594443 PMCID: PMC8442010 DOI: 10.1128/jmbe.00119-21] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
Insufficient knowledge of bacteria and antimicrobials leads to the emergence of multidrug-resistant-bacterium infections. Diversification of the teaching forms, such as the use of games, could be a solution. We organized an event around 3 games (Bacteria Game, KROBS, and Dawaa) to collect student feedback on the evening and assess their knowledge before and after the evening using multiple-choice questions. The preliminary results suggest a positive effect of this event, but due to the low number of participants, we see this report more as a proof of concept to assess the impact of games on the learning.
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Affiliation(s)
- Théo Ghelfenstein-Ferreira
- Laboratoire de Microbiologie Clinique, Hôpitaux Universitaires de Paris Seine-Saint-Denis Assistance Publique–Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Anne-Lise Beaumont
- Service de Maladies Infectieuses, Hôpital Saint Louis, AP-HP, Paris, France
| | - Sarah Dellière
- Laboratoire de Parasitologie-Mycologie, Hôpital Saint-Louis, AP-HP, Paris, France
- Université de Paris, Paris, France
| | - Nathan Peiffer-Smadja
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude-Bernard, AP-HP, Paris, France
- Université de Paris, Paris, France
- INSERM, IAME, Paris, France
| | | | - Etienne Carbonnelle
- Laboratoire de Microbiologie Clinique, Hôpitaux Universitaires de Paris Seine-Saint-Denis Assistance Publique–Hôpitaux de Paris (AP-HP), Bobigny, France
- Université de Paris, Paris, France
- INSERM, IAME, Paris, France
- Université Sorbonne Paris Nord, Epinay Villetaneuse, France
| | - Gilbert Greub
- Institut de Microbiologie, Département des Laboratoires, Université de Lausanne, CHUV, Lausanne, Switzerland
| | - Salam Abbara
- Institut Pasteur, U1018 Inserm, UVSQ, Paris, France
| | - Liem Binh Luong Nguyen
- Université de Paris, Paris, France
- INSERM, IAME, Paris, France
- Centre d’Investigation Clinique, Hôpital Cochin, AP-HP, Paris, France
| | - Mathilde Lescat
- Laboratoire de Microbiologie Clinique, Hôpitaux Universitaires de Paris Seine-Saint-Denis Assistance Publique–Hôpitaux de Paris (AP-HP), Bobigny, France
- Université de Paris, Paris, France
- INSERM, IAME, Paris, France
- Université Sorbonne Paris Nord, Epinay Villetaneuse, France
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17
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Dellière S, Peiffer-Smadja N, João-Lopes M, Cevik M, Pichon M, Bleibtreu A, Schweitzer V, Last K, Ferreira TG, Lemaignen A, Barac A. Aims and challenges of building national trainee networks in clinical microbiology and infectious disease disciplines. Future Microbiol 2021; 16:687-695. [PMID: 34227395 DOI: 10.2217/fmb-2021-0045] [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] [Indexed: 11/21/2022] Open
Abstract
Trainees represent the medical practice of tomorrow. Interactions and collaborations at the early stage in career will strengthen the future of our specialties, clinical microbiology and infectious diseases. Trainee networks at the national level help access the best education and career opportunities. The aim of this collaborative white paper between the Trainee Association of European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and four national trainee networks is to discuss the motivation for building such networks and offer guidance for their creation and sustainability even during a health crisis.
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Affiliation(s)
- Sarah Dellière
- Université de Paris, Service de Parasitologie-Mycologie, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Nathan Peiffer-Smadja
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Maria João-Lopes
- Infectious & Tropical Diseases Department, Hospital Prof Doutor Fernando Fonseca, Amadora, Portugal
| | - Muge Cevik
- Division of Infection & Global Health Research, School of Medicine, University of St Andrews, St Andrews, UK
| | - Maxime Pichon
- Infectious Agents Department, CHU de Poitiers, Bacteriology & Infection Control Laboratory, Poitiers, France; Université de Poitiers, U1070 INSERM, Pharmacologie des Agents Anti-Infectieux, Poitiers, France
| | - Alexandre Bleibtreu
- Infectious & Tropical Diseases Departement, Pitié Salpêtrière hospital, APHP-SU, Paris, France
| | - Valentijn Schweitzer
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Katharina Last
- Institute of Medical Microbiology & Hygiene, Saarland University, Homburg/Saar, Germany
| | - Théo G Ferreira
- Université de Paris, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Adrien Lemaignen
- Service de Médecine Interne et Maladies Infectieuses, CHRU de Tours, Université de Tours, Tours, France
| | - Aleksandra Barac
- Clinic for Infectious & Tropical Diseases, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
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18
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Last K, Power NR, Dellière S, Velikov P, Šterbenc A, Antunovic IA, Lopes MJ, Schweitzer V, Barac A. Future developments in training. Clin Microbiol Infect 2021; 27:1595-1600. [PMID: 34197928 PMCID: PMC8280350 DOI: 10.1016/j.cmi.2021.06.032] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has demonstrated the value of highly skilled and extensively trained specialists in clinical microbiology (CM) and infectious diseases (ID). Training curricula in CM and ID must constantly evolve to prepare trainees for future pandemics and to allow trainees to reach their full clinical and academic potential. OBJECTIVES In this narrative review, we aim to outline necessary future adaptations in CM and ID training curricula and identify current structural barriers in training with the aim of discussing possibilities to address these shortcomings. SOURCES We reviewed literature from PubMed and included selected books and online publications as appropriate. There was no time constraint on the included publications. CONTENT Drawing from the lessons learnt during the pandemic, we summarize novel digital technologies relevant to CM and ID trainees and highlight interdisciplinary teamwork and networking skills as important competencies. We centre CM and ID training within the One Health framework and discuss gender inequalities and structural racism as barriers in both CM and ID training and patient care. IMPLICATIONS CM and ID trainees should receive training and support developing skills in novel digital technologies, leadership, interdisciplinary teamwork and networking. Equally important is the need for equity of opportunity, with firm commitments to end gender inequality and structural racism in CM and ID. Policy-makers and CM and ID societies should ensure that trainees are better equipped to achieve their professional goals and are better prepared for the challenges awaiting in their fields.
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Affiliation(s)
- Katharina Last
- Centre for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.
| | - Nicholas R Power
- Royal College of Physicians of Ireland, Setanta House, 1 Setanta Pl, Dublin 2, Ireland
| | - Sarah Dellière
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Petar Velikov
- Infectious Diseases Hospital Prof. Ivan Kirov and Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Anja Šterbenc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ivana Antal Antunovic
- Department of Clinical Microbiology, University Hospital for Infectious Diseases, Zagreb, Croatia
| | - Maria João Lopes
- Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Valentijn Schweitzer
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
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Dellière S, Duchateau M, Wong SSW, Giai Gianetto Q, Guegan H, Matondo M, Gangneux JP, Aimanianda V. Proteomic Analysis of Humoral Immune Components in Bronchoalveolar Lavage of Patients Infected or Colonized by Aspergillus fumigatus. Front Immunol 2021; 12:677798. [PMID: 34122441 PMCID: PMC8187748 DOI: 10.3389/fimmu.2021.677798] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/10/2021] [Indexed: 02/04/2023] Open
Abstract
Humoral immune components have been individually studied in the context of interaction of host with Aspergillus fumigatus, a major airborne fungal pathogen. However, a global view of the multitude and complex nature of humoral immune components is needed to bring new insight into host-Aspergillus interaction. Therefore, we undertook comparative proteomic analysis of the bronchoalveolar lavage fluid collected from individuals infected or colonized with A. fumigatus versus controls, to identify those alveolar humoral components affected upon A. fumigatus infection. Complement proteins C1q, C8 beta-chain, factor-H, ficolin-1, ficolin-2, mannan binding lectin serine peptidase 2, pentraxin-3 and the surfactant protein-D were identified as the major humoral immune components affected by A. fumigatus infection and colonization. Based on this observation, we hypothesize that crosstalk between these humoral components is essential during host-Aspergillus interaction giving new specific leads to study for better understanding the pathogenesis. Furthermore, the affected humoral components could be potential diagnostic markers of A. fumigatus infection or colonization.
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Affiliation(s)
- Sarah Dellière
- Institut Pasteur, Molecular Mycology Unit, CNRS, Paris, France.,Université de Paris, Paris, France.,Department of Mycology & Parasitology, Hôpital Saint-Louis, Paris, France
| | - Magalie Duchateau
- Institut Pasteur, Proteomics Platform, Mass Spectrometry for Biology Unit, CNRS, Paris, France
| | | | - Quentin Giai Gianetto
- Institut Pasteur, Proteomics Platform, Mass Spectrometry for Biology Unit, CNRS, Paris, France.,Institut Pasteur, Bioinformatics and Biostatistics Hub, Computational Biology Department, CNRS, Paris, France
| | - Hélène Guegan
- University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Mariette Matondo
- Institut Pasteur, Proteomics Platform, Mass Spectrometry for Biology Unit, CNRS, Paris, France
| | - Jean-Pierre Gangneux
- University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
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20
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Dellière S, Hamane S, Aissaoui N, Gits-Muselli M, Bretagne S, Alanio A. Increased sensitivity of a new commercial reverse transcriptase-quantitative PCR for the detection of Pneumocystis jirovecii in respiratory specimens. Med Mycol 2021; 59:845-848. [PMID: 33983431 DOI: 10.1093/mmy/myab029] [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: 02/18/2021] [Revised: 04/21/2021] [Accepted: 05/10/2021] [Indexed: 12/22/2022] Open
Abstract
Optimal sensitivity to detect low Pneumocystis loads is of importance to take individual and collective measures to avoid evolution towards Pneumocystis pneumonia and outbreaks in immunocompromised patients. This study compares two qPCR procedures, a new automated RTqPCR using the GeneLEAD VIII extractor/thermocycler (GLVIII; ∼2.2 h workflow) and a previously validated in-house qPCR assays (IH; ∼5 h workflow) both targeting mtSSU and mtLSU for detecting P. jirovecii in 213 respiratory samples. GLVIII was found to be more sensitive than IH, detecting eight more specimens. Bland-Altman analysis between the two procedures showed a Cq bias of 1.17 ± 0.07 in favor of GLVIII. LAY SUMMARY The fungus Pneumocystis needs to be detected early in respiratory samples to prevent pneumonia in immunocompromised hosts. We evaluated a new commercial RTqPCR on 213 respiratory samples to detect Pneumocystis and found it more sensitive and faster than our routine sensitive in-house qPCR assay.
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Affiliation(s)
- Sarah Dellière
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010, Paris, France.,Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, 75015, Paris, France
| | - Samia Hamane
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010, Paris, France
| | - Nesrine Aissaoui
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010, Paris, France
| | - Maud Gits-Muselli
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010, Paris, France.,Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, 75015, Paris, France
| | - Stéphane Bretagne
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010, Paris, France.,Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, 75015, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, 75015, Paris, France
| | - Alexandre Alanio
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), 75010, Paris, France.,Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, 75015, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, 75015, Paris, France
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21
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Dellière S, Dudoignon E, Fodil S, Voicu S, Collet M, Oillic PA, Salmona M, Dépret F, Ghelfenstein-Ferreira T, Plaud B, Chousterman B, Bretagne S, Azoulay E, Mebazaa A, Megarbane B, Alanio A. Risk factors associated with COVID-19-associated pulmonary aspergillosis in ICU patients: a French multicentric retrospective cohort. Clin Microbiol Infect 2020; 27:S1198-743X(20)30756-4. [PMID: 33316401 PMCID: PMC7733556 DOI: 10.1016/j.cmi.2020.12.005] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [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] [Received: 10/20/2020] [Revised: 12/02/2020] [Accepted: 12/05/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The main objective of this study was to determine the incidence of invasive pulmonary aspergillosis (IPA) in patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU), and to describe the patient characteristics associated with IPA occurrence and to evaluate its impact on prognosis. METHODS We conducted a retrospective cohort study including all successive COVID-19 patients, hospitalized in four ICUs, with secondary deterioration and one or more respiratory samples sent to the mycology department. We used a strengthened IPA testing strategy including seven mycological criteria. Patients were classified as probable IPA according to the European Organization for Research and Treatment of Cancer (EORTC)/Mycoses Study Group Education and Research Consortium (MSGERC) classification if immunocompromised, and according to the recent COVID-19-associated IPA classification otherwise. RESULTS Probable IPA was diagnosed in 21 out of the 366 COVID-19 patients (5.7%) admitted to the ICU and in the 108 patients (19.4%) who underwent respiratory sampling for deterioration. No significant differences were observed between patients with and without IPA regarding age, gender, medical history and severity on admission and during hospitalization. Treatment with azithromycin for ≥3 days was associated with the diagnosis of probable IPA (odds ratio 3.1, 95% confidence interval 1.1-8.5, p = 0.02). A trend was observed with high-dose dexamethasone and the occurrence of IPA. Overall mortality was higher in the IPA patients (15/21, 71.4% versus 32/87, 36.8%, p < 0.01). CONCLUSION IPA is a relatively frequent complication in severe COVID-19 patients and is responsible for increased mortality. Azithromycin, known to have immunomodulatory properties, may contribute to increase COVID-19 patient's susceptibility to IPA.
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Affiliation(s)
- Sarah Dellière
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Molecular Mycology Unit, CNRS UMR2000, National Reference Centre for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, Paris, France
| | - Emmanuel Dudoignon
- Université de Paris, FHU Promice, Département d'anesthésie-réanimation, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sofiane Fodil
- Université de Paris, Médecine Intensive Réanimation, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sebastian Voicu
- Université de Paris, Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris (AP-HP), INSERM UMRS-1144, Paris, France
| | - Magalie Collet
- Université de Paris, FHU Promice, Département d'anesthésie-réanimation, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Pierre-Antoine Oillic
- Université Paris-Saclay, Department of Anaesthesiology, Critical Care Medecine, Hôpital Universitaire Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Maud Salmona
- Université de Paris, INSERM U976, team INSIGHT, Laboratoire de Virologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - François Dépret
- Université de Paris, FHU Promice, Département d'anesthésie-réanimation, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; INI-CRCT Network, Nancy, France; INSERM U942, Paris, France
| | - Théo Ghelfenstein-Ferreira
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Benoit Plaud
- Université de Paris, FHU Promice, Département d'anesthésie-réanimation, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Benjamin Chousterman
- Université de Paris, FHU Promice, Département d'anesthésie-réanimation, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Stéphane Bretagne
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Molecular Mycology Unit, CNRS UMR2000, National Reference Centre for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, Paris, France
| | - Elie Azoulay
- Université de Paris, Médecine Intensive Réanimation, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Alexandre Mebazaa
- Université de Paris, FHU Promice, Département d'anesthésie-réanimation, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; INI-CRCT Network, Nancy, France; INSERM U942, Paris, France
| | - Bruno Megarbane
- Université de Paris, Réanimation Médicale et Toxicologique, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris (AP-HP), INSERM UMRS-1144, Paris, France
| | - Alexandre Alanio
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Molecular Mycology Unit, CNRS UMR2000, National Reference Centre for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, Paris, France.
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22
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Alanio A, Dellière S, Voicu S, Bretagne S, Mégarbane B. The presence of Pneumocystis jirovecii in critically ill patients with COVID-19. J Infect 2020; 82:84-123. [PMID: 33157150 PMCID: PMC7609246 DOI: 10.1016/j.jinf.2020.10.034] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Université de Paris, Institut Pasteur, CNRS UMR2000, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques.
| | - Sarah Dellière
- Laboratoire de Parasitologie-Mycologie AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Université de Paris, Institut Pasteur, CNRS UMR2000, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques
| | - Sebastian Voicu
- Réanimation Médicale et Toxicologique, INSERM UMRS1144, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Université de Paris, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Université de Paris, Institut Pasteur, CNRS UMR2000, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques
| | - Bruno Mégarbane
- Laboratoire de Parasitologie-Mycologie AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Université de Paris, Institut Pasteur, CNRS UMR2000, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques
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Dellière S, Rivero-Menendez O, Gautier C, Garcia-Hermoso D, Alastruey-Izquierdo A, Alanio A. Emerging mould infections: Get prepared to meet unexpected fungi in your patient. Med Mycol 2020; 58:156-162. [PMID: 31111906 DOI: 10.1093/mmy/myz039] [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: 12/18/2018] [Revised: 03/01/2019] [Accepted: 04/05/2019] [Indexed: 01/19/2023] Open
Abstract
Invasive fungal diseases are increasing issues in modern medicine, where the human immunodeficiency virus (HIV) pandemic and the wider use of immunosuppressive drugs generate an ever-growing number of immunocompromised patients with an increased susceptibility to uncommon fungal pathogens. In the past decade, new species have been reported as being responsible for disseminated and invasive fungal diseases in humans. Among them, the following genera are rare but seem emerging issues: Scopulariopsis, Hormographiella, Emergomyces, Westerdykella, Trametes, Actinomucor, Saksenaea, Apophysomyces, and Rhytidhysteron. Delay in diagnosis, which is often the case in these infections, jeopardizes patients' prognosis and leads to increased mortality. Here we summarize the clinical and biological presentation and the key features to identify these emerging pathogens and we discuss the available antifungal classes to treat them. We focused on Pubmed to recover extensively reported human invasive cases and articles regarding the nine previously cited fungal organisms. Information concerning patient background, macroscopic and microscopic description and pictures of these fungal organisms, histological features in tissues, findings with commonly used antigen tests in practice, and hints on potential efficient antifungal classes were gathered. This review's purpose is to help clinical microbiologists and physicians to suspect, identify, diagnose, and treat newly encountered fungi in hospital settings.
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Affiliation(s)
- Sarah Dellière
- Université de Paris, Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France
| | - Olga Rivero-Menendez
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Cécile Gautier
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Alexandre Alanio
- Université de Paris, Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France.,Institut Pasteur, Molecular Mycology Unit, CNRS UMR2000, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Paris, France.,Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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24
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Dellière S, Dudoignon E, Mebazaa A, Bretagne S, Ferreira TG, Megarbane B, Azoulay E, Alanio A. Infections fongiques invasives chez le patient admis en réanimation avec le COVID-19 : une cohorte rétrospective. Med Mal Infect 2020. [PMCID: PMC7442046 DOI: 10.1016/j.medmal.2020.06.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Introduction Matériels et méthodes Résultats Conclusion
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25
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Dellière S, Salmona M, Minier M, Gabassi A, Alanio A, Le Goff J, Delaugerre C, Chaix ML. Evaluation of the COVID-19 IgG/IgM Rapid Test from Orient Gene Biotech. J Clin Microbiol 2020; 58:e01233-20. [PMID: 32518071 PMCID: PMC7383543 DOI: 10.1128/jcm.01233-20] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Received: 05/22/2020] [Accepted: 06/07/2020] [Indexed: 01/23/2023] Open
Abstract
While the coronavirus disease 2019 (COVID-19) pandemic has peaked in many countries already, the current challenge is to assess population immunity on a large scale. Many serological tests are available and require urgent independent validation. Here, we report performance characteristics of Orient Gene Biotech COVID-19 IgG/IgM Rapid Test Cassette (OG) and compare it to Abbott SARS-CoV-2 IgG immunoassay (ASIA). Patients (n = 102) with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase PCR (RT-PCR) were tested. The patients were asymptomatic (n = 2) or had mild (n = 37) or severe symptoms requiring hospitalization in a medical unit (n = 35) or intensive care unit (n = 28). Specificity was evaluated for 42 patients with previous viral and parasitic diseases as well as a high level of rheumatic factor. The sensitivity of OG was 95.8% (95% confidence interval [CI95%], 89.6 to 98.8) for samples collected ≥10 days after the onset of symptoms, which was equivalent to the sensitivity of ASIA of 90.5% (CI95%, 82.8 to 95.6). OG uncovered six false-negative results of ASIA, of which two had only IgM with OG. Specificity was 100% (CI95%, 93.4 to 100) with both tests on samples, including patients infected with endemic coronavirus. Overall, OG performance characteristics indicate that the test is suitable for routine use in clinical laboratories, and its performance is equivalent to that of immunoassay. Testing OG on a larger asymptomatic population may be needed to confirm these results.
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Affiliation(s)
- Sarah Dellière
- Université de Paris, Département des Agents Infectieux, Service de Parasitologie-Mycologie, Hôpital Saint-Louis, Paris, France
| | - Maud Salmona
- Université de Paris, Département des Agents Infectieux, Service de Virologie, Hôpital Saint-Louis, Paris, France
- INSERM UMR 976, Université de Paris, Paris, France
| | - Marine Minier
- Université de Paris, Département des Agents Infectieux, Service de Virologie, Hôpital Saint-Louis, Paris, France
| | - Audrey Gabassi
- Université de Paris, Département des Agents Infectieux, Service de Virologie, Hôpital Saint-Louis, Paris, France
| | - Alexandre Alanio
- Université de Paris, Département des Agents Infectieux, Service de Parasitologie-Mycologie, Hôpital Saint-Louis, Paris, France
| | - Jérôme Le Goff
- Université de Paris, Département des Agents Infectieux, Service de Virologie, Hôpital Saint-Louis, Paris, France
- INSERM UMR 976, Université de Paris, Paris, France
| | - Constance Delaugerre
- Université de Paris, Département des Agents Infectieux, Service de Virologie, Hôpital Saint-Louis, Paris, France
- INSERM UMR 944, Université de Paris, Paris, France
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26
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Ghelfenstein-Ferreira T, Saade A, Alanio A, Bretagne S, Araujo de Castro R, Hamane S, Azoulay E, Bredin S, Dellière S. Recovery of a triazole-resistant Aspergillus fumigatus in respiratory specimen of COVID-19 patient in ICU - A case report. Med Mycol Case Rep 2020; 31:15-18. [PMID: 32837880 PMCID: PMC7331532 DOI: 10.1016/j.mmcr.2020.06.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [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: 05/29/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022] Open
Abstract
Although invasive pulmonary aspergillosis (IPA) is typically described in immunocompromised host, patient with severe influenzae can develop IPA. Similarly, patients with severe COVID-19 complicated with IPA are increasingly reported. Here, we describe a case of invasive aspergillosis with triazole-resistant A. fumigatus (TR34/L98H mutation) in a 56-year-old patient with COVID-19 in intensive care unit. This report highlights the need to define the available tools for diagnosis of invasive aspergillosis in severe COVID-19 patients. Association between COVID-19 and invasive aspergillosis. Early screening for aspergillosis should be performed in respiratory specimen. This case emphasizes the need to screen isolates for pan-azole resistance.
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Affiliation(s)
| | - Anastasia Saade
- Médecine Intensive et Réanimation, Hôpital Saint-Louis (AP-HP), Université de Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie - Mycologie, Hôpital Saint-Louis (AP-HP), Université de Paris, France.,Unité de Mycologie Moléculaire, Institut Pasteur, CNRS URA 3012, Centre National de Référence des Mycoses Invasives et des Antifongiques, URA, 3012, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie - Mycologie, Hôpital Saint-Louis (AP-HP), Université de Paris, France.,Unité de Mycologie Moléculaire, Institut Pasteur, CNRS URA 3012, Centre National de Référence des Mycoses Invasives et des Antifongiques, URA, 3012, Paris, France
| | - Raffael Araujo de Castro
- Unité de Mycologie Moléculaire, Institut Pasteur, CNRS URA 3012, Centre National de Référence des Mycoses Invasives et des Antifongiques, URA, 3012, Paris, France
| | - Samia Hamane
- Laboratoire de Parasitologie - Mycologie, Hôpital Saint-Louis (AP-HP), Université de Paris, France
| | - Elie Azoulay
- Médecine Intensive et Réanimation, Hôpital Saint-Louis (AP-HP), Université de Paris, France
| | - Swann Bredin
- Médecine Intensive et Réanimation, Hôpital Saint-Louis (AP-HP), Université de Paris, France
| | - Sarah Dellière
- Laboratoire de Parasitologie - Mycologie, Hôpital Saint-Louis (AP-HP), Université de Paris, France
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27
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Dellière S, Sze Wah Wong S, Aimanianda V. Soluble mediators in anti-fungal immunity. Curr Opin Microbiol 2020; 58:24-31. [PMID: 32604018 DOI: 10.1016/j.mib.2020.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
Abstract
Although soluble mediators of our innate immune system have a substantial impact on invading microbes, their role against fungal pathogens has been underexplored. Constituting the humoral immunity, soluble mediators comprise the complement system, collectins, acute-phase proteins, antibodies and antimicrobial peptides. These components can prevent fungal infection either by directly interacting with invading microbes, leading to their aggregation (microbistatic), destruction (microbicidal) or linking them to cellular immunity. The composition of soluble-mediator varies with human body-fluids, resulting in different antifungal mechanisms. Moreover, cellular immune system deploys both oxidative and non-oxidative mechanisms to destroy extracellular or internalized fungal pathogens; however, cellular immune activation is mainly influenced as well as regulated by soluble mediators. This review outlines the antifungal mechanism employed, directly or indirectly, by soluble mediators, and in response, the evading strategies of the fungal pathogens.
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Affiliation(s)
- Sarah Dellière
- Institut Pasteur, Molecular Mycology Unit, UMR2000, CNRS, Paris, France; Parasitology-Mycoloy Laboratory, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
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28
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Dellière S, Pouga L, Neveux N, Hernvann A, De Bandt JP, Cynober L. Assessment of transthyretin cut-off values for a better screening of malnutrition: Retrospective determination and prospective validation. Clin Nutr 2020; 40:907-911. [PMID: 32665102 DOI: 10.1016/j.clnu.2020.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/06/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 11/26/2022]
Abstract
The use of transthyretin (TTR, prealbumin) as a marker of malnutrition and the definition of associated cut-offs are a matter of debate. In order to clarify this issue, we performed a retrospective study and then a prospective validation one. In the first study, data from 23,617 consecutive patients from our University hospital were analysed. Using the 0.11 and 0.05 g/L cut-off values defined by the French Health Authority, only 3.13% and 0.49% appeared malnourished or severely malnourished indicating that these cut-off values are clearly inappropriate. In the prospective study, consecutive patients were stratified for normal (≥0.2 g/L) or low (<0.2 g/L) TTR, and normal (<15 mg/L) or high (≥15 mg/L) C-reactive protein, hence defining 4 groups (n = 50 to 57/group), and data were analysed according to nutritional status estimated from patient files. Receiver operating characteristic (ROC) curve of TTR level associated with malnutrition allowed setting cut-off values at 0.17 and 0.12 g/L for malnutrition and severe malnutrition respectively.
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Affiliation(s)
- Sarah Dellière
- Service de Biochimie, Hôpital Cochin, APHP, Paris, France
| | - Lydia Pouga
- Service de Biochimie, Hôpital Cochin, APHP, Paris, France
| | - Nathalie Neveux
- Service de Biochimie, Hôpital Cochin, APHP, Paris, France; Laboratoire de Biologie de la Nutrition, EA4466 PRETRAM, Faculté de Pharmacie de Paris, Université de Paris, Paris, France
| | - Alain Hernvann
- Service de Biochimie, Hôpital Cochin, APHP, Paris, France
| | - Jean-Pascal De Bandt
- Service de Biochimie, Hôpital Cochin, APHP, Paris, France; Laboratoire de Biologie de la Nutrition, EA4466 PRETRAM, Faculté de Pharmacie de Paris, Université de Paris, Paris, France
| | - Luc Cynober
- Service de Biochimie, Hôpital Cochin, APHP, Paris, France; Laboratoire de Biologie de la Nutrition, EA4466 PRETRAM, Faculté de Pharmacie de Paris, Université de Paris, Paris, France.
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29
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Alanio A, Dellière S, Fodil S, Bretagne S, Mégarbane B. Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19. Lancet Respir Med 2020; 8:e48-e49. [PMID: 32445626 PMCID: PMC7239617 DOI: 10.1016/s2213-2600(20)30237-x] [Citation(s) in RCA: 301] [Impact Index Per Article: 75.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France; Université de Paris, Paris, France; Institut Pasteur, Centre National de la Recherche Scientifique, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, France.
| | - Sarah Dellière
- Laboratoire de Parasitologie-Mycologie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France; Université de Paris, Paris, France; Institut Pasteur, Centre National de la Recherche Scientifique, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, France
| | - Sofiane Fodil
- Médecine Intensive Réanimation, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France; Université de Paris, Paris, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France; Université de Paris, Paris, France; Institut Pasteur, Centre National de la Recherche Scientifique, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, France
| | - Bruno Mégarbane
- Réanimation Médicale et Toxicologique, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France; Université de Paris, Paris, France; Institut National de la Santé et de la Recherche Médicale, Paris, France
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30
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Peiffer-Smadja N, Dellière S, Rodriguez C, Birgand G, Lescure FX, Fourati S, Ruppé E. Machine learning in the clinical microbiology laboratory: has the time come for routine practice? Clin Microbiol Infect 2020; 26:1300-1309. [PMID: 32061795 DOI: 10.1016/j.cmi.2020.02.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/04/2020] [Accepted: 02/06/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Machine learning (ML) allows the analysis of complex and large data sets and has the potential to improve health care. The clinical microbiology laboratory, at the interface of clinical practice and diagnostics, is of special interest for the development of ML systems. AIMS This narrative review aims to explore the current use of ML In clinical microbiology. SOURCES References for this review were identified through searches of MEDLINE/PubMed, EMBASE, Google Scholar, biorXiv, arXiV, ACM Digital Library and IEEE Xplore Digital Library up to November 2019. CONTENT We found 97 ML systems aiming to assist clinical microbiologists. Overall, 82 ML systems (85%) targeted bacterial infections, 11 (11%) parasitic infections, nine (9%) viral infections and three (3%) fungal infections. Forty ML systems (41%) focused on microorganism detection, identification and quantification, 36 (37%) evaluated antimicrobial susceptibility, and 21 (22%) targeted the diagnosis, disease classification and prediction of clinical outcomes. The ML systems used very diverse data sources: 21 (22%) used genomic data of microorganisms, 19 (20%) microbiota data obtained by metagenomic sequencing, 19 (20%) analysed microscopic images, 17 (18%) spectroscopy data, eight (8%) targeted gene sequencing, six (6%) volatile organic compounds, four (4%) photographs of bacterial colonies, four (4%) transcriptome data, three (3%) protein structure, and three (3%) clinical data. Most systems used data from high-income countries (n = 71, 73%) but a significant number used data from low- and middle-income countries (n = 36, 37%). Performance measures were reported for the 97 ML systems, but no article described their use in clinical practice or reported impact on processes or clinical outcomes. IMPLICATIONS In clinical microbiology, ML has been used with various data sources and diverse practical applications. The evaluation and implementation processes represent the main gap in existing ML systems, requiring a focus on their interpretability and potential integration into real-world settings.
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Affiliation(s)
- N Peiffer-Smadja
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK; Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - S Dellière
- Université de Paris, Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - C Rodriguez
- Department of Prevention, Diagnosis and Treatment of Infections, Henri-Mondor Hospital, APHP, Université Paris-Est Créteil, IMRB, INSERM U955, Créteil, France
| | - G Birgand
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK
| | - F-X Lescure
- Université de Paris, IAME, INSERM, F-75018 Paris, France
| | - S Fourati
- Department of Prevention, Diagnosis and Treatment of Infections, Henri-Mondor Hospital, APHP, Université Paris-Est Créteil, IMRB, INSERM U955, Créteil, France
| | - E Ruppé
- Université de Paris, IAME, INSERM, F-75018 Paris, France.
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31
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Mouyna I, Dellière S, Beauvais A, Gravelat F, Snarr B, Lehoux M, Zacharias C, Sun Y, de Jesus Carrion S, Pearlman E, Sheppard DC, Latgé JP. What Are the Functions of Chitin Deacetylases in Aspergillus fumigatus? Front Cell Infect Microbiol 2020; 10:28. [PMID: 32117802 PMCID: PMC7016196 DOI: 10.3389/fcimb.2020.00028] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 10/16/2019] [Accepted: 01/15/2020] [Indexed: 11/13/2022] Open
Abstract
Deacetylation of chitin by chitin deacetylases (Cda) results in the formation of chitosan. Chitosan, a polymer of β1,4 linked glucosamine, plays multiple roles in the function of the fungal cell wall, including virulence and evasion of host immune responses. In this study, the roles of chitosan and putative CDAs in cell wall structure and virulence of Aspergillus fumigatus were investigated. Low levels of chitosan were found in the conidial and cell wall of A. fumigatus. Seven putative CDA genes were identified, disrupted and the phenotype of the single mutants and the septuple mutants were investigated. No alterations in fungal cell wall chitosan levels, changes in fungal growth or alterations in virulence were detected in the single or septuple Δcda1-7 mutant strains. Collectively, these results suggest that chitosan is a minority component of the A. fumigatus cell wall, and that the seven candidate Cda proteins do not play major roles in fungal cell wall synthesis or virulence. However, Cda2 is involved in conidiation, suggesting that this enzyme may play a role in N-acetyl-glucosamine metabolism.
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Affiliation(s)
| | - Sarah Dellière
- Infectious Diseases in Global Health Program, Centre for Translational Biology, McGill University Health Centre, Montréal, QC, Canada
| | | | - Fabrice Gravelat
- Infectious Diseases in Global Health Program, Centre for Translational Biology, McGill University Health Centre, Montréal, QC, Canada
- Departments of Microbiology and Immunology, Medicine, McGill University, Montréal, QC, Canada
| | - Brendan Snarr
- Infectious Diseases in Global Health Program, Centre for Translational Biology, McGill University Health Centre, Montréal, QC, Canada
- Departments of Microbiology and Immunology, Medicine, McGill University, Montréal, QC, Canada
| | - Mélanie Lehoux
- Infectious Diseases in Global Health Program, Centre for Translational Biology, McGill University Health Centre, Montréal, QC, Canada
| | - Caitlin Zacharias
- Infectious Diseases in Global Health Program, Centre for Translational Biology, McGill University Health Centre, Montréal, QC, Canada
- Departments of Microbiology and Immunology, Medicine, McGill University, Montréal, QC, Canada
| | - Yan Sun
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Steven de Jesus Carrion
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Eric Pearlman
- Department of Ophthalmology, University of California, Irvine, Irvine, CA, United States
| | - Donald C. Sheppard
- Infectious Diseases in Global Health Program, Centre for Translational Biology, McGill University Health Centre, Montréal, QC, Canada
- Departments of Microbiology and Immunology, Medicine, McGill University, Montréal, QC, Canada
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32
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Dellière S, Angebault C, Fihman V, Foulet F, Lepeule R, Maitre B, Schlemmer F, Botterel F. Concomitant Presence of Aspergillus Species and Mycobacterium Species in the Respiratory Tract of Patients: Underestimated Co-occurrence? Front Microbiol 2020; 10:2980. [PMID: 31998267 PMCID: PMC6967598 DOI: 10.3389/fmicb.2019.02980] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/10/2019] [Indexed: 01/26/2023] Open
Abstract
Objectives Aspergillus and Mycobacterium are opportunistic pathogens that can cause severe pulmonary diseases. To date, the clinical significance of their concomitant isolation and potential interactions in the lung remains poorly understood. The aim of this study was to assess the prevalence of their concomitant isolation from respiratory samples, and to depict the related clinical and microbiological characteristics. Methods A retrospective monocentric study was conducted from January 2011 to December 2017, including all in-patients from whom positive cultures of Aspergillus and Mycobacterium were obtained on respiratory samples within a 3-month period. Clinical, radiological and laboratory data were analyzed. Patients were categorized by a clinical and microbiological committee as "infected" or "colonized" by both pathogens according to current guidelines. Results Overall, 140 patients had ≥1 respiratory samples positive for Mycobacterium and concomitantly sent for fungal culture, and 708 were positive for Aspergillus, concomitantly sent for mycobacterial culture. Only 50 had at least one positive culture for both Mycobacterium sp. and Aspergillus sp. Men represented 63% of patients, mean age was 61 years. A third of patients were immunocompromised and 92% had underlying lung diseases. Aspergillus was primarily found as a colonizing agent. Proportion of Mycobacterium Avium Complex (p = 0.02) was higher in patients co-carrying Aspergillus spp. Conclusion In this first study focusing on co-isolation of Mycobacteria and Aspergillus in patient's respiratory samples, co-infection remains rare. Further studies are warranted in order to precise the exact relationship between these opportunistic pathogens and the clinical impact of co-isolations.
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Affiliation(s)
- Sarah Dellière
- Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France
| | - Cécile Angebault
- Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France.,Dynamyc, UPEC, EnVA, ANSES, Créteil, France
| | - Vincent Fihman
- Dynamyc, UPEC, EnVA, ANSES, Créteil, France.,Unité de Bactériologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France
| | - Françoise Foulet
- Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France.,Dynamyc, UPEC, EnVA, ANSES, Créteil, France
| | - Raphaël Lepeule
- Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France
| | - Bernard Maitre
- Service de Pneumologie, DHU A-TVB, APHP, CHU Henri Mondor, Créteil, France
| | - Frédéric Schlemmer
- Service de Pneumologie, DHU A-TVB, APHP, CHU Henri Mondor, Créteil, France
| | - Françoise Botterel
- Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène Mycologie-Parasitologie, Unité Transversale du Traitement des Infections (VBHMP - UT2I), DHU VIC, 75 APHP, CHU Henri Mondor, Créteil, France.,Dynamyc, UPEC, EnVA, ANSES, Créteil, France
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Dellière S, Gits-Muselli M, White PL, Mengoli C, Bretagne S, Alanio A. Quantification of Pneumocystis jirovecii: Cross-Platform Comparison of One qPCR Assay with Leading Platforms and Six Master Mixes. J Fungi (Basel) 2019; 6:jof6010009. [PMID: 31888050 PMCID: PMC7151141 DOI: 10.3390/jof6010009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/11/2019] [Revised: 12/23/2019] [Accepted: 12/23/2019] [Indexed: 12/17/2022] Open
Abstract
Diagnosis of Pneumocystis jirovecii pneumonia relies on nucleic acid quantification in respiratory samples. Lack of standardization among molecular assays results in significant differences among assays/centers. To further promote standardization, we compared four thermocyclers and six master mixes for the detection of P. jirovecii. Whole nucleic acid (WNA) was extracted from broncho-alveolar lavages. Positive and negative sample extracts were pooled to get enough homogeneous materials. Three master mixes were tested to detect DNA by qPCR (D1, D2, and D3), and three to detect WNA by reverse transcriptase qPCR (W1, W2, and W3) manufactured by Roche, Eurogentec, Applied Biosystem, Invitrogen and Thermofischer Scientific. Experiments were performed on four thermocyclers (Roche LightCycler 480, Qiagen Rotor-Gene Q, Applied Biosystem ABI7500, and QuantStudio). Comparison of quantitative cycle (Cq) values between the methods targeting WNA versus DNA showed lower Cq values for WNA, independently of thermocycler and master mix. For high and low fungal loads, ∆Cq values between DNA and WNA amplification were 6.97 (±2.95) and 5.81 (±3.30), respectively (p < 0.0001). Regarding DNA detection, lower Cqs were obtained with D1 compared to D2 and D3, with median ∆Cq values of 2.6 (p = 0.015) and 2.9 (p = 0.039) respectively. Regarding WNA detection, no mix was superior to the others. PCR efficiency was not significantly different according to the qPCR platform (p = 0.14). This study confirmed the superiority of WNA over DNA detection. A calibration method (e.g., an international standard) for accurate comparative assessment of fungal load seems necessary.
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Affiliation(s)
- Sarah Dellière
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, 75475 Paris, France; (S.D.); (M.G.-M.); (S.B.)
- Molecular Mycology Unit, Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR2000), Institut Pasteur, CEDEX 15, 75724 Paris, France
- National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, CEDEX 15, 75724 Paris, France
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, 75475 Paris, France; (S.D.); (M.G.-M.); (S.B.)
- Molecular Mycology Unit, Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR2000), Institut Pasteur, CEDEX 15, 75724 Paris, France
| | - P. Lewis White
- Public Health Wales, Microbiology Cardiff, Heath Park, University Hospital of Wales (UHW), Cardiff CF14 4XW, UK;
| | - Carlo Mengoli
- Department of Molecular Medicine, University of Padua, 35122 Padua, Italy;
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, 75475 Paris, France; (S.D.); (M.G.-M.); (S.B.)
- Molecular Mycology Unit, Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR2000), Institut Pasteur, CEDEX 15, 75724 Paris, France
- National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, CEDEX 15, 75724 Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, 75475 Paris, France; (S.D.); (M.G.-M.); (S.B.)
- Molecular Mycology Unit, Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR2000), Institut Pasteur, CEDEX 15, 75724 Paris, France
- National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, CEDEX 15, 75724 Paris, France
- Correspondence: ; Tel.: +33-1406-13255; Fax: +33-1456-88420
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Abstract
Pneumocystis jirovecii pneumonia (PCP) is an important cause of morbidity in immunocompromised patients, with a higher mortality in non-HIV than in HIV patients. P. jirovecii is one of the rare transmissible pathogenic fungi and the only one that depends fully on the host to survive and proliferate. Transmissibility among humans is one of the main specificities of P. jirovecii. Hence, the description of multiple outbreaks raises questions regarding preventive care management of the disease, especially in the non-HIV population. Indeed, chemoprophylaxis is well codified in HIV patients but there is a trend for modifications of the recommendations in the non-HIV population. In this review, we aim to discuss the mode of transmission of P. jirovecii, identify published outbreaks of PCP and describe molecular tools available to study these outbreaks. Finally, we discuss public health and infection control implications of PCP outbreaks in hospital setting for in- and outpatients.
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Affiliation(s)
- Sarah Dellière
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
- Molecular Mycology Unit, CNRS UMR2000, Institut Pasteur, 25 rue du Dr Roux, 75724, Paris Cedex 15, France
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
- Molecular Mycology Unit, CNRS UMR2000, Institut Pasteur, 25 rue du Dr Roux, 75724, Paris Cedex 15, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
- Molecular Mycology Unit, CNRS UMR2000, Institut Pasteur, 25 rue du Dr Roux, 75724, Paris Cedex 15, France
- National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France.
- Molecular Mycology Unit, CNRS UMR2000, Institut Pasteur, 25 rue du Dr Roux, 75724, Paris Cedex 15, France.
- National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Institut Pasteur, Paris, France.
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Dellière S, Rivero-Menendez O, Gautier C, Garcia-Hermoso D, Alastruey-Izquierdo A, Alanio A. Emerging mould infections: Get prepared to meet unexpected fungi in your patient. Med Mycol 2019; 58:e2. [PMID: 31435678 DOI: 10.1093/mmy/myz074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dellière S, Guery R, Candon S, Rammaert B, Aguilar C, Lanternier F, Chatenoud L, Lortholary O. Understanding Pathogenesis and Care Challenges of Immune Reconstitution Inflammatory Syndrome in Fungal Infections. J Fungi (Basel) 2018; 4:E139. [PMID: 30562960 PMCID: PMC6308948 DOI: 10.3390/jof4040139] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 11/19/2018] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 12/16/2022] Open
Abstract
Immune deficiency of diverse etiology, including human immunodeficiency virus (HIV), antineoplastic agents, immunosuppressive agents used in solid organ recipients, immunomodulatory therapy, and other biologics, all promote invasive fungal infections. Subsequent voluntary or unintended immune recovery may induce an exaggerated inflammatory response defining immune reconstitution inflammatory syndrome (IRIS), which causes significant mortality and morbidity. Fungal-associated IRIS raises several diagnostic and management issues. Mostly studied with Cryptococcus, it has also been described with other major fungi implicated in human invasive fungal infections, such as Pneumocystis, Aspergillus, Candida, and Histoplasma. Furthermore, the understanding of IRIS pathogenesis remains in its infancy. This review summarizes current knowledge regarding the clinical characteristics of IRIS depending on fungal species and existing strategies to predict, prevent, and treat IRIS in this patient population, and tries to propose a common immunological background to fungal IRIS.
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Affiliation(s)
- Sarah Dellière
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
| | - Romain Guery
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
| | - Sophie Candon
- Medical School, Paris-Descartes University, INSERM U1151-CNRS UMR 8253APHP, Necker-Enfants Malades Hospital, APHP, Clinical Immunology, 75015 Paris, France.
| | - Blandine Rammaert
- Medical School, Poitiers University, Poitiers, France; Poitiers University Hospital, Infectious Disease Unit, Poitiers, France; INSERM U1070, 86022 Poitiers, France.
| | - Claire Aguilar
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
| | - Fanny Lanternier
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
- Pasteur Institute, Molecular Mycology Unit, National Reference Center for Invasive Fungal Disease and Antifungals, CNRS UMR 2000, 75015 Paris, France.
| | - Lucienne Chatenoud
- Medical School, Paris-Descartes University, INSERM U1151-CNRS UMR 8253APHP, Necker-Enfants Malades Hospital, APHP, Clinical Immunology, 75015 Paris, France.
| | - Olivier Lortholary
- Medical School, Paris-Descartes University, APHP, Necker-Enfants Malades Hospital, Infectious Disease Center Necker-Pasteur, IHU Imagine, 75015 Paris, France.
- Pasteur Institute, Molecular Mycology Unit, National Reference Center for Invasive Fungal Disease and Antifungals, CNRS UMR 2000, 75015 Paris, France.
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Dellière S, Neveux N, De Bandt JP, Cynober L. Évaluation de l’état nutritionnel par la transthyrétine : enquête internationale auprès d’experts en nutrition. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.087] [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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Dellière S, Neveux N, De Bandt JP, Cynober L. Transthyretin for the routine assessment of malnutrition: A clinical dilemma highlighted by an international survey of experts in the field. Clin Nutr 2018; 37:2226-2229. [PMID: 30316537 DOI: 10.1016/j.clnu.2018.09.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 08/09/2018] [Accepted: 09/14/2018] [Indexed: 01/04/2023]
Abstract
The value of transthyretin (TTR) measurement for assessing malnutrition is under debate due to its sensitivity to inflammation and frequent confusion over its meaning (i.e. as a marker of diagnosis, prognosis, or efficacy of refeeding). Moreover, there is still no ESPEN/ASPEN guideline on its use and cut-off values. Here the aim was to evaluate the overall perception of the value of this parameter and its utilization worldwide. A panel of international experts in the field were surveyed on the use of TTR in clinical practice in their country, on the guidelines issued by their national health authorities, and on the cut-off values used to diagnose malnutrition. A total of 31 experts (nutrition [n = 9], surgery [n = 8], critical care [n = 4], geriatrics [n = 4], biology [n = 3], pediatrics [n = 1], internal medicine [n = 1] and gastroenterology [n = 1]) from 16 countries participated. TTR only appears in Italian, Polish, British and French national guidelines giving cut-off values for mild/moderate/severe malnutrition. TTR is frequently used in research yet rarely if ever in clinical practice in most countries, the reasons cited being lack of evidence for its usefulness, lack of specificity, or its high cost/effectiveness ratio. Given the difficulty of finding a consensus tool for the diagnosis of malnutrition, there is every reason to consider such a simple and inexpensive marker as TTR. However, further studies are needed to define and unify international guidelines on the use of TTR in terms of inflammation level and the associated cut-off values.
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Affiliation(s)
- Sarah Dellière
- Service de Biochimie, Hôpital Cochin, Groupe Hospitalier HUPC, APHP, Paris, France
| | - Nathalie Neveux
- Service de Biochimie, Hôpital Cochin, Groupe Hospitalier HUPC, APHP, Paris, France; Laboratoire de biologie de la Nutrition EA4466 PRETRAM, Université Paris Descartes, Paris, France
| | - Jean-Pascal De Bandt
- Service de Biochimie, Hôpital Cochin, Groupe Hospitalier HUPC, APHP, Paris, France; Laboratoire de biologie de la Nutrition EA4466 PRETRAM, Université Paris Descartes, Paris, France
| | - Luc Cynober
- Service de Biochimie, Hôpital Cochin, Groupe Hospitalier HUPC, APHP, Paris, France; Laboratoire de biologie de la Nutrition EA4466 PRETRAM, Université Paris Descartes, Paris, France.
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Corvec S, Dellière S, Guillouzouic A, Aubin GG. Can 16S rRNA PCR be the solution for a rapid detection of Propionibacterium acnes in surgical shoulder or spine samples? Comments on "A rapid method for detecting Propionibacterium acnes in surgical biopsy specimens from the shoulder". J Shoulder Elbow Surg 2017; 26:e203-e204. [PMID: 28526424 DOI: 10.1016/j.jse.2017.02.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 02/27/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Stéphane Corvec
- Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Nantes, France; CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France; Nantes CRIOGO Centre de référence des Infections Ostéo-articulaires du Grand Ouest members, Nantes, France.
| | - Sarah Dellière
- Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Nantes, France
| | | | - Guillaume Ghislain Aubin
- Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Nantes, France; Nantes CRIOGO Centre de référence des Infections Ostéo-articulaires du Grand Ouest members, Nantes, France; EA3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de Médecine, Nantes, France
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Aubin GG, Lavigne JP, Foucher Y, Dellière S, Lepelletier D, Gouin F, Corvec S. Tropism and virulence of Cutibacterium (formerly Propionibacterium) acnes involved in implant-associated infection. Anaerobe 2017; 47:73-78. [PMID: 28454760 DOI: 10.1016/j.anaerobe.2017.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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: 01/18/2017] [Revised: 03/14/2017] [Accepted: 04/20/2017] [Indexed: 11/28/2022]
Abstract
The recognition of the pathogenicity of Cutibacterium acnes in implant-associated infection is not always obvious. In this paper, we aimed to distinguish pathogenic and non-pathogenic C. acnes isolates. To reach this goal, we investigated the clonal complex (CC) of a large collection of C. acnes clinical isolates through Multi-Locus Sequence Typing (MLST), we established a Caenorhabditis elegans model to assess C. acnes virulence and we investigated the presence of virulence factors in our collection. Ours results showed that CC36 and CC53 C. acnes isolates were more frequently observed in prosthetic joint infections (PJI) than CC18 and CC28 C. acnes isolates (p = 0.021). The C. elegans model developed here showed two distinct virulence groups of C. acnes (p < 0.05). These groups were not correlated to CC or clinical origin. Whole genome sequencing allowed us to identify a putative gene linked to low virulent strains. In conclusion, MLST remains a good method to screen pathogenic C. acnes isolates according to their clinical context but mechanisms of C. acnes virulence need to be assess thought transcriptomic analysis to investigate regulatory process.
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Affiliation(s)
- Guillaume Ghislain Aubin
- EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections, IRS 2, Nantes University, Nantes, France; Bacteriology and Hygiene Unit, CHU Nantes, France
| | - Jean-Philippe Lavigne
- INSERM, U1047, University of Montpellier, Nîmes, France; Department of Microbiology, Caremeau University Hospital, Nîmes, France
| | - Yohan Foucher
- EA4275 SPHERE-Biostatistics, Clinical Research and Pharmaco-Epidemiology, IRS 2, 22 Bd Bénoni-Goullin, University of Nantes, Nantes, France
| | | | - Didier Lepelletier
- Bacteriology and Hygiene Unit, CHU Nantes, France; MiHAR Lab, IRS 2, 22 Bd Bénoni-Goullin, University of Nantes, Nantes, France
| | - François Gouin
- Clinique Chirurgicale orthopédique et traumatique, CHU Nantes, Nantes, France
| | - Stéphane Corvec
- Bacteriology and Hygiene Unit, CHU Nantes, France; CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France.
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Dellière S, Healey K, Gits-Muselli M, Carrara B, Barbaro A, Guigue N, Lecefel C, Touratier S, Desnos-Ollivier M, Perlin DS, Bretagne S, Alanio A. Fluconazole and Echinocandin Resistance of Candida glabrata Correlates Better with Antifungal Drug Exposure Rather than with MSH2 Mutator Genotype in a French Cohort of Patients Harboring Low Rates of Resistance. Front Microbiol 2016; 7:2038. [PMID: 28066361 PMCID: PMC5179511 DOI: 10.3389/fmicb.2016.02038] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [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: 10/15/2016] [Accepted: 12/05/2016] [Indexed: 11/21/2022] Open
Abstract
Candida glabrata is a major pathogenic yeast in humans that is known to rapidly acquire resistance to triazole and echinocandin antifungal drugs. A mutator genotype (MSH2 polymorphism) inducing a mismatch repair defect has been recently proposed to be responsible for resistance acquisition in C. glabrata clinical isolates. Our objectives were to evaluate the prevalence of antifungal resistance in a large cohort of patients in Saint-Louis hospital, Paris, France, some of whom were pre-exposed to antifungal drugs, as well as to determine whether MSH2 polymorphisms are associated with an increased rate of fluconazole or echinocandin resistance. We collected 268 isolates from 147 patients along with clinical data and previous antifungal exposure. Fluconazole and micafungin minimal inhibition concentrations (MICs) were tested, short tandem repeat genotyping was performed, and the MSH2 gene was sequenced. According to the European Committee on Antimicrobial Susceptibility breakpoints, 15.7% of isolates were resistant to fluconazole (MIC > 32 mg/L) and 0.7% were resistant to micafungin (MIC > 0.03 mg/L). A non-synonymous mutation within MSH2 occurred in 44% of the isolates, and 17% were fluconazole resistant. In comparison, fluconazole resistant isolates with no MSH2 mutation represented 15% (P = 0.65). MSH2 polymorphisms were associated with the short tandem repeat genotype. The rate of echinocandin resistance is low and correlates with prior exposure to echinocandin. The mutator genotype was not associated with enrichment in fluconazole resistance but instead corresponded to rare and specific genotypes.
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Affiliation(s)
- Sarah Dellière
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Kelley Healey
- Public Health Research Institute, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers Newark, NJ, USA
| | - Maud Gits-Muselli
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-WidalParis, France; Université Paris Diderot, Sorbonne Paris CitéParis, France
| | - Bastien Carrara
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Alessandro Barbaro
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Nicolas Guigue
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Christophe Lecefel
- Service de Pharmacie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Sophie Touratier
- Service de Pharmacie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal Paris, France
| | - Marie Desnos-Ollivier
- Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de la Recherche Scientifique, Centre National de Référence Mycoses Invasives et Antifongiques, URA3012 Paris, France
| | - David S Perlin
- Public Health Research Institute, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers Newark, NJ, USA
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-WidalParis, France; Université Paris Diderot, Sorbonne Paris CitéParis, France; Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de la Recherche Scientifique, Centre National de Référence Mycoses Invasives et Antifongiques, URA3012Paris, France
| | - Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-WidalParis, France; Université Paris Diderot, Sorbonne Paris CitéParis, France; Unité de Mycologie Moléculaire, Institut Pasteur, Centre National de la Recherche Scientifique, Centre National de Référence Mycoses Invasives et Antifongiques, URA3012Paris, France
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