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Van Praet JT, Huysman A, De Knijf E, De Buyser S, Snauwaert S, Van Droogenbroeck J, Lodewyck T, Schauwvlieghe A, Selleslag D, Reynders M. Epidemiological characteristics and outcome of viral respiratory tract infections in the first year after allogeneic hematopoietic cell transplantation. J Infect Dis 2024:jiae108. [PMID: 38427774 DOI: 10.1093/infdis/jiae108] [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: 11/10/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
Adverse outcomes of viral respiratory tract infections (RTI) have been reported in recipients of allogeneic hematopoietic cell transplantation. Using a laboratory-developed multiparameter PCR in a consecutive series of 242 patients, we found the highest incidence of viral RTI in the pre-engraftment phase. The occurrence of multiple episodes of viral RTI or viral pneumonia was significantly associated with a higher hazard of non-relapse mortality in the first year after transplantation. We observed a 90-day mortality of 19.7% after viral RTI, which was significantly different between patient groups stratified according to the ISI score.
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Affiliation(s)
- Jens T Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge AV, Brugge, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Andreas Huysman
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Eline De Knijf
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stefanie De Buyser
- Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sylvia Snauwaert
- Department of Hematology, AZ Sint-Jan Brugge AV, Brugge, Belgium
| | | | - Tom Lodewyck
- Department of Hematology, AZ Sint-Jan Brugge AV, Brugge, Belgium
| | | | | | - Marijke Reynders
- Department of Medical Microbiology, AZ Sint-Jan Brugge AV, Brugge, Belgium
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2
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Potter BI, Thijssen M, Trovão NS, Pineda-Peña A, Reynders M, Mina T, Alvarez C, Amini-Bavil-Olyaee S, Nevens F, Maes P, Lemey P, Van Ranst M, Baele G, Pourkarim MR. Contemporary and historical human migration patterns shape hepatitis B virus diversity. Virus Evol 2024; 10:veae009. [PMID: 38361827 PMCID: PMC10868554 DOI: 10.1093/ve/veae009] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/16/2023] [Accepted: 01/26/2024] [Indexed: 02/17/2024] Open
Abstract
Infection by hepatitis B virus (HBV) is responsible for approximately 296 million chronic cases of hepatitis B, and roughly 880,000 deaths annually. The global burden of HBV is distributed unevenly, largely owing to the heterogeneous geographic distribution of its subtypes, each of which demonstrates different severity and responsiveness to antiviral therapy. It is therefore crucial to the global public health response to HBV that the spatiotemporal spread of each genotype is well characterized. In this study, we describe a collection of 133 newly sequenced HBV strains from recent African immigrants upon their arrival in Belgium. We incorporate these sequences-all of which we determine to come from genotypes A, D, and E-into a large-scale phylogeographic study with genomes sampled across the globe. We focus on investigating the spatio-temporal processes shaping the evolutionary history of the three genotypes we observe. We incorporate several recently published ancient HBV genomes for genotypes A and D to aid our analysis. We show that different spatio-temporal processes underlie the A, D, and E genotypes with the former two having originated in southeastern Asia, after which they spread across the world. The HBV E genotype is estimated to have originated in Africa, after which it spread to Europe and the Americas. Our results highlight the use of phylogeographic reconstruction as a tool to understand the recent spatiotemporal dynamics of HBV, and highlight the importance of supporting vulnerable populations in accordance with the needs presented by specific HBV genotypes.
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Affiliation(s)
- Barney I Potter
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Rega Institute, Laboratory for Clinical and Epidemiological Virology, Herestraat 49, Leuven BE-3000, Belgium
| | - Marijn Thijssen
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Rega Institute, Laboratory for Clinical and Epidemiological Virology, Herestraat 49, Leuven BE-3000, Belgium
| | - Nídia Sequeira Trovão
- Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, United States
| | - Andrea Pineda-Peña
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT; Universidade Nova de Lisboa, UNL, Portugal Rua da Junqueira No 100, Lisbon 1349-008, Portugal
- Molecular Biology and Immunology Department, Fundacion Instituto de Inmunología de Colombia (FIDIC); Faculty of Animal Science, Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A.), Avenida 50 No. 26-20, Bogota 0609, Colombia
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Ruddershove 10, Bruges B-8000, Belgium
| | - Thomas Mina
- Nonis Lab Microbiology—Virology Unit, Gregori Afxentiou 5, Limassol 4003, Cyprus
| | - Carolina Alvarez
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Rega Institute, Laboratory for Clinical and Epidemiological Virology, Herestraat 49, Leuven BE-3000, Belgium
| | - Samad Amini-Bavil-Olyaee
- Cellular Sciences Department, Process Virology, Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, USA
| | - Frederik Nevens
- Department of Gastroenterology and Hepatology, University Hospital Leuven, KU Leuven, Herestraat 49, Leuven 3000, Belgium
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Rega Institute, Laboratory for Clinical and Epidemiological Virology, Herestraat 49, Leuven BE-3000, Belgium
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Rega Institute, Laboratory for Clinical and Epidemiological Virology, Herestraat 49, Leuven BE-3000, Belgium
| | - Marc Van Ranst
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Rega Institute, Laboratory for Clinical and Epidemiological Virology, Herestraat 49, Leuven BE-3000, Belgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Rega Institute, Laboratory for Clinical and Epidemiological Virology, Herestraat 49, Leuven BE-3000, Belgium
| | - Mahmoud Reza Pourkarim
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Rega Institute, Laboratory for Clinical and Epidemiological Virology, Herestraat 49, Leuven BE-3000, Belgium
- Health Policy Research Centre, Institute of Health, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
- Blood Transfusion Research Centre, High Institute for Research and Education in Transfusion, Hemmat Exp.Way, Tehran 14665-1157, Iran
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3
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De Baetselier I, Smet H, Kehoe K, Loosen I, Reynders M, Mansoor I, Filippin L, Cauchie M, Van Even E, Makki N, Schiettekatte G, Vandewal W, Glibert B, Matheeussen V, Van der Beken Y, Cartuyvels R, Steyaert S, Lemmens A, Garrino MG, Paridaens H, Lazarova E, Lissoir B, Deffontaine M, Heinrichs A, Saegeman V, Padalko E, Lecompte A, Vanden Berghe W, Kenyon C, Van den Bossche D. Estimation of antimicrobial resistance of Mycoplasma genitalium, Belgium, 2022. Euro Surveill 2024; 29:2300318. [PMID: 38362626 PMCID: PMC10986661 DOI: 10.2807/1560-7917.es.2024.29.7.2300318] [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: 06/21/2023] [Accepted: 08/25/2023] [Indexed: 02/17/2024] Open
Abstract
BackgroundAntimicrobial resistance (AMR) of Mycoplasma genitalium (MG) is a growing concern worldwide and surveillance is needed. In Belgium, samples are sent to the National Reference Centre of Sexually Transmitted Infections (NRC-STI) on a voluntary basis and representative or robust national AMR data are lacking.AimWe aimed to estimate the occurrence of resistant MG in Belgium.MethodsBetween July and November 2022, frozen remnants of MG-positive samples from 21 Belgian laboratories were analysed at the NRC-STI. Macrolide and fluoroquinolone resistance-associated mutations (RAMs) were assessed using Sanger sequencing of the 23SrRNA and parC gene. Differences in resistance patterns were correlated with surveillance methodology, socio-demographic and behavioural variables via Fisher's exact test and logistic regression analysis.ResultsOf the 244 MG-positive samples received, 232 could be sequenced for macrolide and fluoroquinolone RAMs. Over half of the sequenced samples (55.2%) were resistant to macrolides. All sequenced samples from men who have sex with men (MSM) (24/24) were macrolide-resistant. Fluoroquinolone RAMs were found in 25.9% of the samples and occurrence did not differ between socio-demographic and sexual behaviour characteristics.ConclusionAlthough limited in sample size, our data suggest no additional benefit of testing MG retrieved from MSM for macrolide resistance in Belgium, when making treatment decisions. The lower occurrence of macrolide resistance in other population groups, combined with emergence of fluoroquinolone RAMs support macrolide-resistance testing in these groups. Continued surveillance of resistance in MG in different population groups will be crucial to confirm our findings and to guide national testing and treatment strategies.
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Affiliation(s)
- Irith De Baetselier
- National Reference Centre of Sexually Transmitted Infections Belgium, Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium
| | - Hilde Smet
- National Reference Centre of Sexually Transmitted Infections Belgium, Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium
| | - Kaat Kehoe
- Algemeen Medisch Laboratorium, Antwerp, Belgium
| | | | - Marijke Reynders
- AZ (General Hospital) Sint-Jan Brugge-Oostende AV, Laboratory Medicine, Molecular Microbiology, Bruges, Belgium
| | | | | | | | - Ellen Van Even
- Clinical Laboratory of Microbiology, Heilig Hart (HH) Hospital Lier, Lier, Belgium
| | - Nadia Makki
- Algemeen Medisch Laboratorium, Antwerp, Belgium
| | | | | | | | - Veerle Matheeussen
- Department of Microbiology, University Hospital Antwerp, Edegem, Belgium
| | | | | | | | - Ann Lemmens
- AZ Sint-Maarten Hospital, Department Clinical Microbiology, Mechelen, Belgium
| | | | - Henry Paridaens
- Laboratory of Molecular Biology, Citadelle Hospital, Liege, Belgium
| | - Elena Lazarova
- Clinical laboratory, Regional Hospital de la Haute Senne, Soignies, Belgium
| | | | - Marine Deffontaine
- Laboratoire de Biologie Clinique, Centre Hospitalier de Mouscron, Mouscron, Belgium
| | - Amélie Heinrichs
- Laboratory of Clinical Biology, Hospital Arlon, Vivalia, Arlon, Belgium
| | | | - Elizaveta Padalko
- Ghent University Hospital, Department of Laboratory Medicine, Ghent, Belgium
| | - Amaryl Lecompte
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Wim Vanden Berghe
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Chris Kenyon
- STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dorien Van den Bossche
- National Reference Centre of Sexually Transmitted Infections Belgium, Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Belgium
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Vanhee M, Floré K, Vanthourenhout S, Hellemans J, Muyldermans A, Reynders M. Implementation of full-length 16S nanopore sequencing for bacterial identification in a clinical diagnostic setting. Diagn Microbiol Infect Dis 2024; 108:116156. [PMID: 38061217 DOI: 10.1016/j.diagmicrobio.2023.116156] [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: 08/16/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 01/22/2024]
Abstract
This study describes the implementation of 16S nanopore sequencing in a diagnostic lab for pathogen identification without prior enrichment. First, the universality of the test and taxonomic resolution was evaluated for 78 clinically relevant bacteria (69 known and 9 unknown bacterial cultures). Next, the diagnostic value of the test was evaluated based on clinical samples. It was shown that 16S sequencing can be used both for identification of unknown cultures and to find bacteria directly in the clinical sample without cultivation. All culture-positive samples (n=11) tested positive with 16S sequencing directly performed on the sample, but bacteria were found as well in 15/30 culture-negative samples. Pathogenic bacteria were found in a background of commensal flora, and even complex polymicrobial infections could be unraveled. This study demonstrates the feasibility of implementing 16S nanopore sequencing in a clinical diagnostic setting and demonstrates its value for the diagnosis of culture-negative and polymicrobial infections.
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Affiliation(s)
- Merijn Vanhee
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge, Ruddershove 10, 8000, Brugge, Belgium.
| | - Katelijne Floré
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge, Ruddershove 10, 8000, Brugge, Belgium
| | - Sanne Vanthourenhout
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge, Ruddershove 10, 8000, Brugge, Belgium
| | - Jorn Hellemans
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge, Ruddershove 10, 8000, Brugge, Belgium
| | - Astrid Muyldermans
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge, Ruddershove 10, 8000, Brugge, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, General Hospital Sint-Jan Brugge, Ruddershove 10, 8000, Brugge, Belgium
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5
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Denayer S, Dufrasne FE, Monsieurs B, van Eycken R, Houben S, Seyler L, Demuyser T, van Nedervelde E, Bourgeois M, Delaere B, Magerman K, Jouck D, Lissoir B, Sion C, Reynders M, Petit E, Dauby N, Hainaut M, Laenen L, Maes P, Baele G, Dellicour S, Cuypers L, André E, Couvreur S, Brondeel R, Barbezange C, Bossuyt N, van Gucht S. Genomic monitoring of SARS-CoV-2 variants using sentinel SARI hospital surveillance. Influenza Other Respir Viruses 2023; 17:e13202. [PMID: 37840842 PMCID: PMC10570899 DOI: 10.1111/irv.13202] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Background To support the COVID-19 pandemic response, many countries, including Belgium, implemented baseline genomic surveillance (BGS) programs aiming to early detect and characterize new SARS-CoV-2 variants. In parallel, Belgium maintained a sentinel network of six hospitals that samples patients with severe acute respiratory infections (SARI) and integrated SARS-CoV-2 detection within a broader range of respiratory pathogens. We evaluate the ability of the SARI surveillance to monitor general trends and early signals of viral genetic evolution of SARS-CoV-2 and compare it with the BGS as a reference model. Methods Nine-hundred twenty-five SARS-CoV-2 positive samples from patients fulfilling the Belgian SARI definition between January 2020 and December 2022 were sequenced using the ARTIC Network amplicon tiling approach on a MinION platform. Weekly variant of concern (VOC) proportions and types were compared to those that were circulating between 2021 and 2022, using 96,251 sequences of the BGS. Results SARI surveillance allowed timely detection of the Omicron (BA.1, BA.2, BA.4, and BA.5) and Delta (B.1.617.2) VOCs, with no to 2 weeks delay according to the start of their epidemic growth in the Belgian population. First detection of VOCs B.1.351 and P.1 took longer, but these remained minor in Belgium. Omicron BA.3 was never detected in SARI surveillance. Timeliness could not be evaluated for B.1.1.7, being already major at the start of the study period. Conclusions Genomic surveillance of SARS-CoV-2 using SARI sentinel surveillance has proven to accurately reflect VOCs detected in the population and provides a cost-effective solution for long-term genomic monitoring of circulating respiratory viruses.
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Affiliation(s)
- Sarah Denayer
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - François E. Dufrasne
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - Bert Monsieurs
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - Reinout van Eycken
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - Sarah Houben
- Observational Clinical Trials, Scientific Directorate of infectious Diseases in HumansSciensanoUkkelBelgium
| | - Lucie Seyler
- Department of Internal Medicine and Infectiology, Universitair Ziekenhuis Brussel (UZB)Vrije Universiteit Brussel (VUB)BrusselsBelgium
| | - Thomas Demuyser
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel (UZB)Vrije Universiteit Brussel (VUB)BrusselsBelgium
- AIMS Lab, Center for Neurosciences, Faculty of Medicine and PharmacyVrije Universiteit Brussel (VUB)BrusselsBelgium
| | - Els van Nedervelde
- Department of Internal Medicine and Infectiology, Universitair Ziekenhuis Brussel (UZB)Vrije Universiteit Brussel (VUB)BrusselsBelgium
| | | | | | - Koen Magerman
- Infection Control and Clinical LaboratoryJessa ZiekenhuisHasseltBelgium
- Department of Immunology and InfectionHasselt UniversityHasseltBelgium
| | - Door Jouck
- Infection ControlJessa ZiekenhuisHasseltBelgium
| | | | - Catherine Sion
- Laboratory Site St‐JosephGrand Hôpital de CharleroiGillyBelgium
| | | | - Evelyn Petit
- Laboratory MedicineAZ Sint‐Jan Brugge‐Oostende AVBrugesBelgium
| | - Nicolas Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint‐PierreUniversité Libre de Bruxelles (ULB)BrusselsBelgium
- Institute for Medical Immunology, ULB Center for Research in Immunology (U‐CRI)Université Libre de Bruxelles (ULB)BrusselsBelgium
- School of Public HealthUniversité Libre de Bruxelles (ULB)BrusselsBelgium
| | - Marc Hainaut
- Pediatrics Department, CHU Saint‐PierreUniversité Libre de Bruxelles (ULB)BrusselsBelgium
| | - Lies Laenen
- National Reference Center for Respiratory Pathogens, UZ LeuvenUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and TransplantationKU LeuvenLeuvenBelgium
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Rega InstituteKU LeuvenLeuvenBelgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega InstituteKU LeuvenLeuvenBelgium
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega InstituteKU LeuvenLeuvenBelgium
- Spatial Epidemiology Lab (SpELL)Université Libre de BruxellesBrusselsBelgium
| | - Lize Cuypers
- National Reference Center for Respiratory Pathogens, UZ LeuvenUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and TransplantationKU LeuvenLeuvenBelgium
| | - Emmanuel André
- National Reference Center for Respiratory Pathogens, UZ LeuvenUniversity Hospitals LeuvenLeuvenBelgium
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and TransplantationKU LeuvenLeuvenBelgium
| | - Simon Couvreur
- Epidemiology and public Health, Epidemiology of Infectious DiseasesSciensanoBrusselsBelgium
| | - Ruben Brondeel
- Epidemiology and public Health, Epidemiology of Infectious DiseasesSciensanoBrusselsBelgium
| | - Cyril Barbezange
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
| | - Nathalie Bossuyt
- Epidemiology and public Health, Epidemiology of Infectious DiseasesSciensanoBrusselsBelgium
| | - Steven van Gucht
- Viral Diseases, National Influenza Centre, Scientific Directorate of Infectious Diseases in HumansSciensanoUkkelBelgium
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6
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Huygens S, Dunbar A, Buil JB, Klaassen CHW, Verweij PE, van Dijk K, de Jonge N, Janssen JJWM, van der Velden WJFM, Biemond BJ, Bart A, Bruns AHW, Haas PJA, Demandt AMP, Oudhuis G, von dem Borne P, van der Beek MT, Klein SK, Godschalk P, Span LFR, Postma DF, Kampinga GA, Maertens J, Lagrou K, Mercier T, Moors I, Boelens J, Selleslag D, Reynders M, Zandijk W, Doorduijn JK, Cornelissen JJ, Schauwvlieghe AFAD, Rijnders BJA. Clinical Impact of Polymerase Chain Reaction-Based Aspergillus and Azole Resistance Detection in Invasive Aspergillosis: A Prospective Multicenter Study. Clin Infect Dis 2023; 77:38-45. [PMID: 36905147 PMCID: PMC10320047 DOI: 10.1093/cid/ciad141] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Invasive aspergillosis (IA) by a triazole-resistant Aspergillus fumigatus is associated with high mortality. Real-time resistance detection will result in earlier initiation of appropriate therapy. METHODS In a prospective study, we evaluated the clinical value of the AsperGenius polymerase chain reaction (PCR) assay in hematology patients from 12 centers. This PCR assay detects the most frequent cyp51A mutations in A. fumigatus conferring azole resistance. Patients were included when a computed tomography scan showed a pulmonary infiltrate and bronchoalveolar fluid (BALf) sampling was performed. The primary end point was antifungal treatment failure in patients with azole-resistant IA. RESULTS Of 323 patients enrolled, complete mycological and radiological information was available for 276 (94%), and probable IA was diagnosed in 99/276 (36%). Sufficient BALf for PCR testing was available for 293/323 (91%). Aspergillus DNA was detected in 116/293 (40%) and A. fumigatus DNA in 89/293 (30%). The resistance PCR was conclusive in 58/89 (65%) and resistance detected in 8/58 (14%). Two had a mixed azole-susceptible/azole-resistant infection. In the 6 remaining patients, treatment failure was observed in 1. Galactomannan positivity was associated with mortality (P = .004) while an isolated positive Aspergillus PCR was not (P = .83). CONCLUSIONS Real-time PCR-based resistance testing may help to limit the clinical impact of triazole resistance. In contrast, the clinical impact of an isolated positive Aspergillus PCR on BALf seems limited. The interpretation of the EORTC/MSGERC PCR criterion for BALf may need further specification (eg, minimum cycle threshold value and/or PCR positive on >1 BALf sample).
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Affiliation(s)
- Sammy Huygens
- Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Albert Dunbar
- Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jochem B Buil
- Department of Medical Microbiology, Radboud University Center, Nijmegen, The Netherlands
| | - Corné H W Klaassen
- Department of Medical Microbiology & Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Paul E Verweij
- Department of Medical Microbiology, Radboud University Center, Nijmegen, The Netherlands
| | - Karin van Dijk
- Department of Medical Microbiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Nick de Jonge
- Department of Hematology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jeroen J W M Janssen
- Department of Hematology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Bart J Biemond
- Department of Hematology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Aldert Bart
- Department of Medical Microbiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Anke H W Bruns
- Department of Internal Medicine, Infectious Diseases, University Medical Center Utrecht, The Netherlands
| | - Pieter-Jan A Haas
- Department of Medical Microbiology, University Medical Center Utrecht, The Netherlands
| | - Astrid M P Demandt
- Department of Hematology, Maastricht University Medical Center, The Netherlands
| | - Guy Oudhuis
- Department of Medical Microbiology, Maastricht University Medical Center, The Netherlands
| | - Peter von dem Borne
- Department of Medical Microbiology, Leiden University Medical Center, The Netherlands
| | | | - Saskia K Klein
- Department of Hematology, Meander Medical Center, Amersfoort, The Netherlands
- Department of Hematology, University Medical Center Groningen, The Netherlands
| | - Peggy Godschalk
- Department of Medical Microbiology, Meander Medical Center, Amersfoort, The Netherlands
| | - Lambert F R Span
- Department of Hematology, University Medical Center Groningen, The Netherlands
| | - Douwe F Postma
- Department of Internal Medicine and Infectious Diseases, University Medical Center Groningen, The Netherlands
| | - Greetje A Kampinga
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Johan Maertens
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Laboratory Medicine and National Reference Centre for Mycosis, University Hospitals Leuven, Leuven, Belgium
| | - Toine Mercier
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Ine Moors
- Department of Hematology, Ghent University Hospital, Ghent, Belgium
| | - Jerina Boelens
- Department of Medical Microbiology, Ghent University Hospital, Ghent, Belgium
| | - Dominik Selleslag
- Department of Hematology, AZ St-Jan Brugge-Oostende Hospital, Bruges, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ St-Jan Brugge-Oostende Hospital, Bruges, Belgium
| | - Willemien Zandijk
- Department of Medical Microbiology & Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jeanette K Doorduijn
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan J Cornelissen
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Bart J A Rijnders
- Department of Internal Medicine, Section of Infectious Diseases and Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Fischer N, Moreels S, Dauby N, Reynders M, Petit E, Gérard M, Lacor P, Daelemans S, Lissoir B, Holemans X, Magerman K, Jouck D, Bourgeois M, Delaere B, Quoilin S, Van Gucht S, Thomas I, Bossuyt N, Barbezange C. Influenza versus other respiratory viruses - assessing severity among hospitalised children, Belgium, 2011 to 2020. Euro Surveill 2023; 28:2300056. [PMID: 37470740 PMCID: PMC10360368 DOI: 10.2807/1560-7917.es.2023.28.29.2300056] [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: 01/21/2023] [Accepted: 05/29/2023] [Indexed: 07/21/2023] Open
Abstract
BackgroundKnowledge on the burden attributed to influenza viruses vs other respiratory viruses in children hospitalised with severe acute respiratory infections (SARI) in Belgium is limited.AimThis observational study aimed at describing the epidemiology and assessing risk factors for severe disease.MethodsWe retrospectively analysed data from routine national sentinel SARI surveillance in Belgium. Respiratory specimens collected during winter seasons 2011 to 2020 were tested by multiplex real-time quantitative PCR (RT-qPCR) for influenza and other respiratory viruses. Demographic data and risk factors were collected through questionnaires. Patients were followed-up for complications or death during hospital stay. Analysis focused on children younger than 15 years. Binomial logistic regression was used to identify risk factors for severe disease in relation to infection status.ResultsDuring the winter seasons 2011 to 2020, 2,944 specimens met the study case definition. Complications were more common in children with underlying risk factors, especially asthma (adjusted risk ratio (aRR): 1.87; 95% confidence interval (CI): 1.46-2.30) and chronic respiratory disease (aRR: 1.88; 95% CI: 1.44-2.32), regardless of infection status and age. Children infected with non-influenza respiratory viruses had a 32% higher risk of complications (aRR: 1.32; 95% CI: 1.06-1.66) compared with children with influenza only.ConclusionMulti-virus testing in children with SARI allows a more accurate assessment of the risk of complications and attribution of burden to respiratory viruses beyond influenza. Children with asthma and respiratory disease should be prioritised for clinical care, regardless of their virological test result and age, and targeted for prevention campaigns.
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Affiliation(s)
- Natalie Fischer
- National Influenza Centre, Sciensano, Brussels, Belgium
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Sarah Moreels
- Health Services Research - Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Nicolas Dauby
- Centre for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Centre Hospitalier Universitaire St-Pierre, Brussels, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, Algemeen Ziekenhuis Sint-Jan, Brugge-Oostende AV, Belgium
| | - Evelyn Petit
- Department of Laboratory Medicine, Medical Microbiology, Algemeen Ziekenhuis Sint-Jan, Brugge-Oostende AV, Belgium
| | - Michèle Gérard
- Centre for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Patrick Lacor
- Internal Medicine-Infectious Diseases, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Siel Daelemans
- Paediatric Pulmonary and Infectious Diseases, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - Xavier Holemans
- General Internal Medicine and Infectiology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Koen Magerman
- Clinical Laboratory, Jessa Ziekenhuis, Hasselt, Belgium
- Infection Control, Jessa Ziekenhuis, Hasselt, Belgium
| | - Door Jouck
- Infection Control, Jessa Ziekenhuis, Hasselt, Belgium
| | - Marc Bourgeois
- Centre Hospitalier Universitaire UCL Namur, Yvoir, Belgium
| | | | - Sophie Quoilin
- Epidemiology of Infectious Diseases - Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | | | - Nathalie Bossuyt
- Epidemiology of Infectious Diseases - Epidemiology and Public Health, Sciensano, Brussels, Belgium
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Buil JB, Huygens S, Dunbar A, Schauwvlieghe A, Reynders M, Langerak D, van Dijk K, Bruns A, Haas PJ, Postma DF, Biemond B, Delma FZ, de Kort E, Melchers WJG, Verweij PE, Rijnders B. Retrospective Multicenter Evaluation of the VirClia Galactomannan Antigen Assay for the Diagnosis of Pulmonary Aspergillosis with Bronchoalveolar Lavage Fluid Samples from Patients with Hematological Disease. J Clin Microbiol 2023; 61:e0004423. [PMID: 37097150 PMCID: PMC10204623 DOI: 10.1128/jcm.00044-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 01/10/2023] [Accepted: 04/04/2023] [Indexed: 04/26/2023] Open
Abstract
Galactomannan (GM) testing of bronchoalveolar lavage (BAL) fluid samples has become an essential tool to diagnose invasive pulmonary aspergillosis (IPA) and is part of diagnostic guidelines. Enzyme-linked immunosorbent assays (ELISAs) (enzyme immunoassays [EIAs]) are commonly used, but they have a long turnaround time. In this study, we evaluated the performance of an automated chemiluminescence immunoassay (CLIA) with BAL fluid samples. This was a multicenter retrospective study in the Netherlands and Belgium. BAL fluid samples were collected from patients with underlying hematological diseases with a suspected invasive fungal infection. Diagnosis of IPA was based on the 2020 European Organisation for Research and Treatment of Cancer (EORTC)/Mycoses Study Group Education and Research Consortium (MSGERC) consensus definitions. GM results were reported as optical density index (ODI) values. ODI cutoff values for positive results that were evaluated were 0.5, 0.8, and 1.0 for the EIA and 0.16, 0.18, and 0.20 for the CLIA. Probable IPA cases were compared with two control groups, one with no evidence of IPA and another with no IPA or possible IPA. Qualitative agreement was analyzed using Cohen's κ, and quantitative agreement was analyzed by Spearman's correlation. We analyzed 141 BAL fluid samples from 141 patients; 66 patients (47%) had probable IPA, and 56 cases remained probable IPA when the EIA GM result was excluded as a criterion, because they also had positive culture and/or duplicate positive PCR results. Sixty-three patients (45%) had possible IPA and 12 (8%) had no IPA. The sensitivity and specificity of the two tests were quite comparable, and the overall qualitative agreement between EIA and CLIA results was 81 to 89%. The correlation of the actual CLIA and EIA values was strong at 0.72 (95% confidence interval, 0.63 to 0.80). CLIA has similar performance, compared to the gold-standard EIA, with the benefits of faster turnaround because batching is not required. Therefore, CLIA can be used as an alternative GM assay for BAL fluid samples.
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Affiliation(s)
- Jochem B. Buil
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud University Medical Center-Canisius Wilhelmina Hospital, Center of Expertise for Mycology, Nijmegen, The Netherlands
| | - Sammy Huygens
- Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Albert Dunbar
- Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Marijke Reynders
- Unit of Molecular Microbiology, Medical Microbiology, Department of Laboratory Medicine, AZ Sint-Jan Brugge AV, Bruges, Belgium
| | - Diana Langerak
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karin van Dijk
- Department of Medical Microbiology, Amsterdam University Medical Centers, Vrije Universiteit University Medical Center, Amsterdam, The Netherlands
| | - Anke Bruns
- Department of Internal Medicine, Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pieter-Jan Haas
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Douwe F. Postma
- Department of Internal Medicine and Infectious Diseases, University Medical Center Groningen, Groningen, The Netherlands
| | - Bart Biemond
- Department of Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, The Netherlands
| | - Fatima Zohra Delma
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elizabeth de Kort
- Radboud University Medical Center-Canisius Wilhelmina Hospital, Center of Expertise for Mycology, Nijmegen, The Netherlands
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willem J. G. Melchers
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud University Medical Center-Canisius Wilhelmina Hospital, Center of Expertise for Mycology, Nijmegen, The Netherlands
| | - Paul E. Verweij
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud University Medical Center-Canisius Wilhelmina Hospital, Center of Expertise for Mycology, Nijmegen, The Netherlands
| | - Bart Rijnders
- Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
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Callens R, Colman S, Delie A, Schauwvlieghe A, Lodewyck T, Selleslag D, Reynders M, Kerre T, Padalko E. Immunological monitoring after allogeneic stem cell transplantation: T-SPOT.CMV and QuantiFERON-CMV, are they the same? Transplant Cell Ther 2023:S2666-6367(23)01177-6. [PMID: 36963722 DOI: 10.1016/j.jtct.2023.03.018] [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: 01/03/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND CMV-reactivation and -disease is still a major concern after allogeneic stem cell transplantation [allo-HSCT], despite prophylactic and pre-emptive strategies. In recent years, immunologic monitoring using CMV-IGRA has gained interest to better risk stratify immunocompromised patients or to guide prophylactic therapies. CMV-IGRA can quantify CMV cell-mediated immunity by measuring the interferon-gamma that is released by CD4+ and CD8+ T-lymphocytes in the presence of CMV-antigens. However, the two most widely used CMV-IGRAs, T-SPOT.CMV and QuantiFERON-CMV, have not yet been compared in the setting of an allo-HSCT. OBJECTIVE To perform a method comparison between the T-SPOT.CMV and QuantiFERON-CMV 28 and 100 days after allo-HSCT, and to assess predictive values of both tests for CMV-reactivation. STUDY DESIGN In a bicentric prospective trial, 27 patients were included. Samples were taken on day +28 and day +100 after allo-HSCT. Patients' clinical information was collected up to 270 days after the transplant. Method comparison was performed using Cohen's kappa. RESULTS On day +28 (n=26) after allo-HSCT T-SPOT.CMV gave three positive test results, and QuantiFERON-CMV only two. On day +100 (n=24) T-SPOT.CMV gave seven positive test results, and QuantiFERON-CMV nine. One discordant result was obtained at day +28 (n=26), while six results were discordant at day +100 (n=24). Method comparison showed a strong agreement on day +28 (κ = 0.780 [95% CI: 0.366-1.000]), but only a moderate agreement on day +100 (κ = 0.442 [95% CI: 0.070-0.814]) and on pooled data from both time points (κ = 0.578 [95% CI: 0.300-0.856]). Four clinically significant CMV infections, (CS-CMVi) were observed, all occurring after discontinuation of letermovir-prophylaxis. None of those four patients had a positive result with either test at day +100 (or day +28). Negative predictive values (NPV) and sensitivity are therefore very high at 100% (for both tests, for NPV and sensitivity, measured at day +100). At day+100, positive predictive values (PPV) and specificity were considerably lower (T-SPOT.CMV: PPV 23.5% and specificity 35% - QuantiFERON-CMV: PPV 26.7% and specificity 45%). CONCLUSION T-SPOT.CMV and QuantiFERON-CMV only have a moderate agreement (at day +100) after allo-HSCT. Although these IGRAs are very promising, as shown by their very high negative predictive values for protection against CS-CMVi, they are not interchangeable. Future research should stipulate which IGRA was used, and future guidelines should preferably be assay-specific. As the QuantiFERON-CMV to date still lacks a large validation study after allo-HSCT, the moderate agreement with the T-SPOT.CMV poses a significant hurdle in the routine implementation of this test.
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Affiliation(s)
- Rutger Callens
- Department of Hematology, Ghent University Hospital, Ghent, Belgium; Department of Hematology, AZ Delta, Roeselare, Belgium
| | - Sofie Colman
- Department of Laboratory Medicine, O.L.V. van Lourdes Hospital, Waregem, Belgium
| | - Anke Delie
- Department of Hematology, Ghent University Hospital, Ghent, Belgium
| | | | - Tom Lodewyck
- Department of Hematology, AZ Sint-Jan Hospital, Bruges, Belgium
| | | | - Marijke Reynders
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Tessa Kerre
- Department of Hematology, Ghent University Hospital, Ghent, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Elizaveta Padalko
- Department of Medical Microbiology, Ghent University Hospital, Ghent, Belgium; Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.
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10
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Ko T, Jou C, Grau-Perales A, Reynders M, Fenton A, Trauner D. A Photoactivated Protein Degrader for Optical Control of Synaptic Function. bioRxiv 2023:2023.02.13.528397. [PMID: 36824807 PMCID: PMC9949324 DOI: 10.1101/2023.02.13.528397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Hundreds of proteins determine the function of synapses, and synapses define the neuronal circuits that subserve myriad brain, cognitive, and behavioral functions. It is thus necessary to precisely manipulate specific proteins at specific sub-cellular locations and times to elucidate the roles of particular proteins and synapses in brain function. We developed PHOtochemically TArgeting Chimeras (PHOTACs) as a strategy to optically degrade specific proteins with high spatial and temporal precision. PHOTACs are small molecules that, upon wavelength-selective illumination, catalyze ubiquitylation and degradation of target proteins through endogenous proteasomes. Here we describe the design and chemical properties of a PHOTAC that targets Ca 2+ /calmodulin-dependent protein kinase II alpha (CaMKIIα), which is abundant and crucial for baseline synaptic function of excitatory neurons. We validate the PHOTAC strategy, showing that the CaMKIIα-PHOTAC is effective in mouse brain tissue. Light activation of CaMKIIα-PHOTAC removed CaMKIIα from regions of the mouse hippocampus only within 25 μm of the illuminated brain surface. The optically-controlled degradation decreases synaptic function within minutes of light activation, measured by the light-initiated attenuation of evoked field excitatory postsynaptic potential (fEPSP) responses to physiological stimulation. The PHOTACs methodology should be broadly applicable to other key proteins implicated in synaptic function, especially for evaluating their precise roles in the maintenance of long-term potentiation and memory within subcellular dendritic domains.
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Affiliation(s)
- T. Ko
- Department of Chemistry, University of Pennsylvania, 231 South 34th Street Philadelphia, PA 19104-6323, USA
- Department of Chemistry, New York University, 100 Washington Square East, New York, NY 10003, USA
| | - C. Jou
- Department of Psychology, Hunter College, 695 Park Avenue, New York, NY, 10065, USA
| | - A.B. Grau-Perales
- Center for Neural Science, New York University, 4 Washington Place, New York, NY 10003, USA
| | - M. Reynders
- Department of Chemistry, New York University, 100 Washington Square East, New York, NY 10003, USA
| | - A.A. Fenton
- Center for Neural Science, New York University, 4 Washington Place, New York, NY 10003, USA
| | - D. Trauner
- Department of Chemistry, University of Pennsylvania, 231 South 34th Street Philadelphia, PA 19104-6323, USA
- Department of Chemistry, New York University, 100 Washington Square East, New York, NY 10003, USA
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11
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Van Praet JT, Huysman A, De Knijf E, De Buyser S, Snauwaert S, Van Droogenbroeck J, Lodewyck T, Schauwvlieghe A, Selleslag D, Reynders M. Infectious diarrhea after allogeneic hematopoietic cell transplantation assessed by a multiplex polymerase chain reaction assay. Int J Infect Dis 2023; 127:17-22. [PMID: 36481487 DOI: 10.1016/j.ijid.2022.11.045] [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: 08/04/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To determine the incidence of infectious diarrhea after allogeneic hematopoietic cell transplantation (HCT) using a multiplex polymerase chain reaction assay and assess risk factors for developing infectious diarrhea. METHODS This was a single-center retrospective study of 140 consecutive allogeneic HCT recipients. Infectious diarrhea was assessed using a laboratory-developed multiplex polymerase chain reaction the first year after transplantation. RESULTS The incidence rate of infectious diarrhea episodes was 47 per 100 person-years, with the highest rate observed in the pre-engraftment phase. Most episodes were seen as nosocomial infections (38%) and most affected patients (82%) had only one episode of infectious diarrhea. The cumulative incidence of at least one episode of infectious diarrhea was 32% after 1 year. Nonrelapse mortality was higher in transplant recipients with at least one episode of infectious diarrhea (hazard ratio (HR) 2.02, 95% CI = 1.07-3.80). The most frequently observed pathogens were Clostridium difficile, adenovirus, Enteropathogenic Escherichia coli, and Campylobacter jejuni. Patients with acute lower gastrointestinal graft-vs-host disease stage 3 or 4 (HR 3.68, 95% CI = 1.57-8.63) conferred a higher risk for a first infectious diarrhea episode. CONCLUSION Infectious diarrhea after allogeneic HCT was seen in about one-third of the patients, mostly as nosocomial infection in the pre-engraftment phase.
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Affiliation(s)
- Jens T Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium; Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Andreas Huysman
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Eline De Knijf
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stefanie De Buyser
- Biostatistics Unit, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sylvia Snauwaert
- Department of Hematology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Tom Lodewyck
- Department of Hematology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Dominik Selleslag
- Department of Hematology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Marijke Reynders
- Department of Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
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12
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Peeters M, Schenk J, De Somer T, Roskams T, Locus T, Klamer S, Subissi L, Suin V, Delwaide J, Stärkel P, De Maeght S, Willems P, Colle I, Van Hoof M, Van Acker J, Van Steenkiste C, Moreno C, Janssens F, Reynders M, Steverlynck M, Verlinden W, Lasser L, de Galocsy C, Geerts A, Maus J, Gallant M, Van Outryve S, Marot A, Reynaert H, Decaestecker J, Bottieau E, Schreiber J, Mulkay JP, de Goeij S, Salame M, Dooremont D, Dastis SN, Boes J, Nijs J, Beyls J, Hens N, Nevens F, Van Gucht S, Vanwolleghem T. Viral clade is associated with severity of symptomatic genotype 3 hepatitis E virus infections in Belgium, 2010-2018. J Hepatol 2023; 78:67-77. [PMID: 36075495 DOI: 10.1016/j.jhep.2022.08.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 07/29/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND & AIMS HEV genotype (gt) 3 infections are prevalent in high-income countries and display a wide spectrum of clinical presentations. Host - but not viral - factors are reported to be associated with worse clinical outcomes. METHODS Demographic, clinical, and biochemical data laboratory-confirmed HEV infections (by PCR and/or a combination of IgM and IgG serology) at the Belgian National Reference Centre between January 2010 and June 2018 were collected using standardised case report forms. Genotyping was based on HEV open reading frame 2 sequences. Serum CXCL10 levels were measured by a magnetic bead-based assay. H&E staining was performed on liver biopsies. RESULTS A total of 274 HEV-infected individuals were included. Subtype assignment was possible for 179/218 viraemic cases, confirming gt3 as dominant with an almost equal representation of clades abchijklm and efg. An increased hospitalisation rate and higher peak serum levels of alanine aminotransferase, bilirubin, and alkaline phosphatase were found in clade efg-infected individuals in univariate analyses. In multivariable analyses, clade efg infections remained more strongly associated with severe disease presentation than any of the previously identified host risk factors, being associated with a 2.1-fold higher risk of hospitalisation (95% CI 1.1-4.4, p = 0.034) and a 68.2% higher peak of bilirubin levels (95% CI 13.3-149.9, p = 0.010), independently of other factors included in the model. In addition, acute clade efg infections were characterised by higher serum CXCL10 levels (p = 0.0005) and a more pronounced liver necro-inflammatory activity (p = 0.022). CONCLUSIONS In symptomatic HEV gt3 infections, clade efg is associated with a more severe disease presentation, higher serum CXCL10 levels, and liver necro-inflammatory activity, irrespective of known host risk factors. CLINICAL TRIAL REGISTRATION The protocol was submitted to clinicaltrials.gov (NCT04670419). IMPACT AND IMPLICATIONS HEV genotype (gt) 3 infections display a wide spectrum of clinical presentations currently ascribed to host factors. Here we examined the role of viral factors on liver disease outcomes by combining viral phylogeny with clinical, biochemical, cytokine, and histological data from 274 Belgian adults infected with HEV presenting between 2010 and 2018. HEV gt 3 clade efg infections were associated with a more severe disease presentation, higher serum CXCL10 levels and liver necro-inflammatory activity, irrespective of known host risk factors. HEV gt3 clade-dependent clinical outcomes call for broad HEV gt3 subtyping in clinical practice and research to help identify those at higher risk for worse outcomes and to further unravel underlying virus-host interactions.
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Affiliation(s)
- Michael Peeters
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium
| | - Julie Schenk
- University of Antwerp, Faculty of Medicine and Health Sciences, Vaccine & Infectious Disease Institute, Centre for Health Economic Research and Modelling Infectious Diseases, Antwerp, Belgium; Hasselt University, Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt, Belgium
| | - Thomas De Somer
- University Hospital Antwerp, Gastroenterology & Hepatology, Antwerp, Belgium; Maria Middelares Hospital, Gastroenterology & Hepatology, Ghent, Belgium
| | - Tania Roskams
- KU Leuven, Pathology, Translational Cell and Tissue Research, Leuven, Belgium
| | - Tatjana Locus
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium
| | - Sofieke Klamer
- Sciensano, Epidemiology of Infectious Diseases, Brussels, Belgium
| | - Lorenzo Subissi
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium; European Public Health Microbiology Training Program (EUPHEM), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Vanessa Suin
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium
| | - Jean Delwaide
- University Hospital Liege, Gastroenterology & Hepatology, Liege, Belgium
| | - Peter Stärkel
- Cliniques Universitaires Saint-Luc (CUSL), Gastroenterology & Hepatology, Brussels, Belgium
| | | | | | - Isabelle Colle
- A.S.Z. Aalst, Gastroenterology & Hepatology, Aalst, Belgium; Ghent University Hospital, Department of Hepatology and Gastroenterology, Ghent, Belgium
| | - Marc Van Hoof
- Clinique Saint-Luc, Gastroenterology & Hepatology, Bouge, Belgium
| | - Jos Van Acker
- AZ Sint-Lucas, Clinical Microbiology, Ghent, Belgium
| | - Christophe Van Steenkiste
- University Hospital Antwerp, Gastroenterology & Hepatology, Antwerp, Belgium; Maria Middelares Hospital, Gastroenterology & Hepatology, Ghent, Belgium
| | - Christophe Moreno
- CUB Hôpital Erasme, Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Université Libre de Bruxelles, Brussels, Belgium
| | - Filip Janssens
- Jessa Hospital, Gastroenterology & Hepatology, Hasselt, Belgium
| | - Marijke Reynders
- AZ Sint-Jan Brugge-Oostende AV, Medical Microbiology, Laboratory Medicine, Brugge, Belgium
| | | | - Wim Verlinden
- University Hospital Antwerp, Gastroenterology & Hepatology, Antwerp, Belgium; Vitaz, Gastroenterology & Hepatology, Sint-Niklaas, Belgium; University of Antwerp, Laboratory of Experimental Medicine and Pediatrics, Viral Hepatitis Research Group, Antwerp, Belgium
| | - Luc Lasser
- CHU Brugmann, Gastroenterology & Hepatology, Brussels, Belgium
| | | | - Anja Geerts
- Ghent University Hospital, Gastroenterology & Hepatology, Ghent, Belgium
| | - Jeroen Maus
- ZNA Middelheim, Gastroenterology & Hepatology, Antwerp, Belgium
| | - Marie Gallant
- Jan Yperman Ziekenhuis, Gastroenterology & Hepatology, Ieper, Belgium
| | | | - Astrid Marot
- CHU UCL Namur, Université Catholique de Louvain, Department of Gastroenterology and Hepatology, Yvoir, Belgium
| | - Hendrik Reynaert
- University Hospital UZ Brussel, Gastroenterology & Hepatology, Brussels, Belgium
| | | | | | - Jonas Schreiber
- CHIREC Delta Hospital, Gastroenterology & Hepatology, Brussels, Belgium
| | | | | | - Mikhaël Salame
- Centre Hospitalier Régional Haute Senne, Soignies, Belgium
| | | | | | | | - Jochen Nijs
- Sint-Trudo Ziekenhuis, Department of Gastroenterology, Sint-Truiden, Belgium
| | - Jan Beyls
- Sint-Andriesziekenhuis, Department of Gastroenterology, Tielt, Belgium
| | - Niel Hens
- University of Antwerp, Faculty of Medicine and Health Sciences, Vaccine & Infectious Disease Institute, Centre for Health Economic Research and Modelling Infectious Diseases, Antwerp, Belgium; Hasselt University, Data Science Institute, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt, Belgium
| | - Frederik Nevens
- University Hospitals KU Leuven, Gastroenterology & Hepatology, Leuven, Belgium
| | - Steven Van Gucht
- Sciensano, Infectious Diseases in Humans, Viral Diseases, National Reference Centre of Hepatitis Viruses, Brussels, Belgium.
| | - Thomas Vanwolleghem
- University Hospital Antwerp, Gastroenterology & Hepatology, Antwerp, Belgium; University of Antwerp, Laboratory of Experimental Medicine and Pediatrics, Viral Hepatitis Research Group, Antwerp, Belgium.
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Nevejan L, Ombelet S, Laenen L, Keyaerts E, Demuyser T, Seyler L, Soetens O, Van Nedervelde E, Naesens R, Geysels D, Verstrepen W, Cattoir L, Martens S, Michel C, Mathieu E, Reynders M, Evenepoel A, Hellemans J, Vanhee M, Magerman K, Maes J, Matheeussen V, Boogaerts H, Lagrou K, Cuypers L, André E. Severity of COVID-19 among Hospitalized Patients: Omicron Remains a Severe Threat for Immunocompromised Hosts. Viruses 2022; 14:v14122736. [PMID: 36560741 PMCID: PMC9783877 DOI: 10.3390/v14122736] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in the general population in the context of a relatively high immunity gained through the early waves of coronavirus disease 19 (COVID-19), and vaccination campaigns. Despite this context, a significant number of patients were hospitalized, and identifying the risk factors associated with severe disease in the Omicron era is critical for targeting further preventive, and curative interventions. We retrospectively analyzed the individual medical records of 1501 SARS-CoV-2 positive hospitalized patients between 13 December 2021, and 13 February 2022, in Belgium, of which 187 (12.5%) were infected with Delta, and 1036 (69.0%) with Omicron. Unvaccinated adults showed an increased risk of moderate/severe/critical/fatal COVID-19 (crude OR 1.54; 95% CI 1.09-2.16) compared to vaccinated patients, whether infected with Omicron or Delta. In adults infected with Omicron and moderate/severe/critical/fatal COVID-19 (n = 323), immunocompromised patients showed an increased risk of in-hospital mortality related to COVID-19 (adjusted OR 2.42; 95% CI 1.39-4.22), compared to non-immunocompromised patients. The upcoming impact of the pandemic will be defined by evolving viral variants, and the immune system status of the population. The observations support that, in the context of an intrinsically less virulent variant, vaccination and underlying patient immunity remain the main drivers of severe disease.
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Affiliation(s)
- Louis Nevejan
- Department of Laboratory Medicine, National Reference Center for Respiratory Pathogens, UZ Leuven—University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Correspondence: (L.N.); (L.C.); (E.A.)
| | - Sien Ombelet
- Department of Laboratory Medicine, National Reference Center for Respiratory Pathogens, UZ Leuven—University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, 3000 Leuven, Belgium
| | - Lies Laenen
- Department of Laboratory Medicine, National Reference Center for Respiratory Pathogens, UZ Leuven—University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, 3000 Leuven, Belgium
| | - Els Keyaerts
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, 3000 Leuven, Belgium
| | - Thomas Demuyser
- Department of Microbiology and Infection Control, Vrije Universiteit Brussel (VUB), UZ Brussel—University Hospitals Brussels, 1090 Brussels, Belgium
- Center for Neurosciences, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - Lucie Seyler
- Department of Internal Medicine and Infectious Diseases, Vrije Universiteit Brussel (VUB), UZ Brussel—University Hospitals Brussels, 1090 Brussels, Belgium
| | - Oriane Soetens
- Department of Microbiology and Infection Control, Vrije Universiteit Brussel (VUB), UZ Brussel—University Hospitals Brussels, 1090 Brussels, Belgium
| | - Els Van Nedervelde
- Department of Internal Medicine and Infectious Diseases, Vrije Universiteit Brussel (VUB), UZ Brussel—University Hospitals Brussels, 1090 Brussels, Belgium
| | - Reinout Naesens
- Department of Medical Microbiology, Department of infection prevention and control, ZNA Middelheim, 2020 Antwerp, Belgium
| | - Dieter Geysels
- Department of Medical Microbiology, Department of infection prevention and control, ZNA Middelheim, 2020 Antwerp, Belgium
| | - Walter Verstrepen
- Department of Medical Microbiology, Department of infection prevention and control, ZNA Middelheim, 2020 Antwerp, Belgium
| | - Lien Cattoir
- Clinical Laboratory of Microbiology, OLV Hospital, 9300 Aalst, Belgium
| | - Steven Martens
- Clinical Laboratory of Microbiology, OLV Hospital, 9300 Aalst, Belgium
| | - Charlotte Michel
- Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Elise Mathieu
- Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine—Medical Microbiology, AZ Sint Jan Brugge-Oostende, 8000 Brugge, Belgium
| | - Anton Evenepoel
- Department of Laboratory Medicine—Medical Microbiology, AZ Sint Jan Brugge-Oostende, 8000 Brugge, Belgium
| | - Jorn Hellemans
- Department of Laboratory Medicine—Medical Microbiology, AZ Sint Jan Brugge-Oostende, 8000 Brugge, Belgium
| | - Merijn Vanhee
- Department of Laboratory Medicine—Medical Microbiology, AZ Sint Jan Brugge-Oostende, 8000 Brugge, Belgium
| | - Koen Magerman
- Clinical Laboratory, Jessa Hospital, 3500 Hasselt, Belgium
| | - Justine Maes
- Clinical Laboratory, Jessa Hospital, 3500 Hasselt, Belgium
| | - Veerle Matheeussen
- Department of Microbiology, University Hospital Antwerp, 2650 Antwerp, Belgium
| | - Hélène Boogaerts
- Department of Microbiology, University Hospital Antwerp, 2650 Antwerp, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine, National Reference Center for Respiratory Pathogens, UZ Leuven—University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, 3000 Leuven, Belgium
| | - Lize Cuypers
- Department of Laboratory Medicine, National Reference Center for Respiratory Pathogens, UZ Leuven—University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, 3000 Leuven, Belgium
- Correspondence: (L.N.); (L.C.); (E.A.)
| | - Emmanuel André
- Department of Laboratory Medicine, National Reference Center for Respiratory Pathogens, UZ Leuven—University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology, 3000 Leuven, Belgium
- Correspondence: (L.N.); (L.C.); (E.A.)
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14
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Van Praet JT, De Groote M, De Bacquer D, Verhalleman E, Welvaert Z, Emmerechts J, Reynders M, De Vriese AS. Immune Senescence Markers Predict the Cellular Immune Response to BNT162b2 Vaccination in Hemodialysis Patients. Open Forum Infect Dis 2022; 9:ofac585. [PMCID: PMC9669454 DOI: 10.1093/ofid/ofac585] [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: 08/25/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
Chronic kidney disease is associated with increased risk of frailty and accelerated immune senescence, potentially affecting the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.
Methods
Humoral and cellular responses against the spike protein of SARS-CoV-2 were determined in 189 COVID-naive hemodialysis patients at week 4 and 8 after vaccination with 2 doses of BNT162b2. Frailty indicators and immune senescence markers were determined at baseline to identify predictors of the immune response.
Results
Controlling for age, activities of daily living (ADLs), instrumental ADLs, walking pace, and the clinical frailty score correlated negatively and hand grip strength positively with the humoral response. Controlling for age, the proportions of memory CD4+ T cells, memory CD8+ T cells, CD28null T cells, and CD57+CD8+ T cells correlated negatively with the humoral response, whereas the proportions of memory CD4+ T cells and CD28null T cells correlated negatively and the CD4/CD8 ratio positively with the cellular response. In a multivariate model, only the proportions of memory CD4+ T cells and CD28null T cells independently predicted the cellular response.
Conclusions
Markers of immune senescence, but not frailty indicators, independently predict the cellular immune response after vaccination in hemodialysis patients, overruling the effect of chronological age.
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Affiliation(s)
- Jens T Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
- Department of Internal Medicine and Pediatrics, Ghent University , Ghent , Belgium
| | - Marie De Groote
- Department of Geriatrics, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University , Ghent , Belgium
| | - Ellen Verhalleman
- Department of Occupational Therapy, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - Ziggy Welvaert
- Department of Occupational Therapy, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - Jan Emmerechts
- Department of Laboratory Hematology, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - Marijke Reynders
- Department of Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
| | - An S De Vriese
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV , Brugge , Belgium
- Department of Internal Medicine and Pediatrics, Ghent University , Ghent , Belgium
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15
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Cuypers L, Dellicour S, Hong SL, Potter BI, Verhasselt B, Vereecke N, Lambrechts L, Durkin K, Bours V, Klamer S, Bayon-Vicente G, Vael C, Ariën KK, De Mendonca R, Soetens O, Michel C, Bearzatto B, Naesens R, Gras J, Vankeerberghen A, Matheeussen V, Martens G, Obbels D, Lemmens A, Van den Poel B, Van Even E, De Rauw K, Waumans L, Reynders M, Degosserie J, Maes P, André E, Baele G. Two Years of Genomic Surveillance in Belgium during the SARS-CoV-2 Pandemic to Attain Country-Wide Coverage and Monitor the Introduction and Spread of Emerging Variants. Viruses 2022; 14:2301. [PMID: 36298856 PMCID: PMC9612291 DOI: 10.3390/v14102301] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/21/2022] Open
Abstract
An adequate SARS-CoV-2 genomic surveillance strategy has proven to be essential for countries to obtain a thorough understanding of the variants and lineages being imported and successfully established within their borders. During 2020, genomic surveillance in Belgium was not structurally implemented but performed by individual research laboratories that had to acquire the necessary funds themselves to perform this important task. At the start of 2021, a nationwide genomic surveillance consortium was established in Belgium to markedly increase the country's genomic sequencing efforts (both in terms of intensity and representativeness), to perform quality control among participating laboratories, and to enable coordination and collaboration of research projects and publications. We here discuss the genomic surveillance efforts in Belgium before and after the establishment of its genomic sequencing consortium, provide an overview of the specifics of the consortium, and explore more details regarding the scientific studies that have been published as a result of the increased number of Belgian SARS-CoV-2 genomes that have become available.
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Affiliation(s)
- Lize Cuypers
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Simon Dellicour
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, 1000 Brussels, Belgium
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Samuel L. Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Barney I. Potter
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Bruno Verhasselt
- Department of Diagnostic Sciences, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Nick Vereecke
- PathoSense BV, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium
| | - Laurens Lambrechts
- HIV Cure Research Center, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
- BioBix, Department of Data Analysis and Mathematical Modelling, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium
| | - Keith Durkin
- Laboratory of Human Genetics, GIGA Research Institute, 4000 Liège, Belgium
| | - Vincent Bours
- Laboratory of Human Genetics, GIGA Research Institute, 4000 Liège, Belgium
- Department of Human Genetics, University Hospital of Liège, 4000 Liège, Belgium
| | - Sofieke Klamer
- Scientific Directorate of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium
| | - Guillaume Bayon-Vicente
- Department of Proteomic and Microbiology, Research Institute for Biosciences, University of Mons, 7000 Mons, Belgium
| | - Carl Vael
- Clinical Laboratory, AZ Klina, 2930 Brasschaat, Belgium
| | - Kevin K. Ariën
- Virology Unit, Department of Biomedical Sciences, Institute of Tropical Medicine Antwerp, 2000 Antwerp, Belgium
- Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerp, Belgium
| | - Ricardo De Mendonca
- Department of Microbiology, CUB-Hôpital Erasme, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Oriane Soetens
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Charlotte Michel
- Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB), 1000 Brussels, Belgium
| | - Bertrand Bearzatto
- Center for Applied Molecular Technologies (CTMA), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1000 Brussels, Belgium
| | - Reinout Naesens
- Department of Medical Microbiology, Ziekenhuis Netwerk Antwerpen, 2020 Antwerp, Belgium
| | - Jeremie Gras
- Institute of Pathology and Genetics (IPG), 6041 Gosselies, Belgium
| | - Anne Vankeerberghen
- Laboratory of Molecular Biology, Campus Aalst-Asse-Ninove, Onze-Lieve-Vrouwziekenhuis, 9300 Aalst, Belgium
| | - Veerle Matheeussen
- Laboratory of Medical Microbiology, Department of Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, 2610 Wilrijk, Belgium
| | - Geert Martens
- Department of Laboratory Medicine, AZ Delta General Hospital, 8800 Roeselare, Belgium
| | - Dagmar Obbels
- Clinical Laboratory, Imelda Hospital, 2820 Bonheiden, Belgium
| | - Ann Lemmens
- Laboratory of Clinical Biology, AZ Sint-Maarten Hospital, 2800 Mechelen, Belgium
| | - Bea Van den Poel
- Clinical Laboratory, General Hospital Jan Portaels, 1800 Vilvoorde, Belgium
| | - Ellen Van Even
- Clinical Laboratory of Microbiology, HH Hospital Lier, 2500 Lier, Belgium
| | - Klara De Rauw
- Laboratory of Clinical Biology, AZ Sint Lucas Hospital, 9000 Ghent, Belgium
| | - Luc Waumans
- Clinical Laboratory, Jessa Hospital, 3500 Hasselt, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Bruges-Ostend AV, 8000 Bruges, Belgium
| | - Jonathan Degosserie
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, CHU UCL Namur, 5530 Yvoir, Belgium
- Next Generation Sequencing Platform, Molecular Diagnostic Center, CHU UCL Namur, 5530 Yvoir, Belgium
| | - Piet Maes
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
| | - Emmanuel André
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Guy Baele
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
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16
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Schalkwijk HH, Gillemot S, Reynders M, Selleslag D, Andrei G, Snoeck R. Heterogeneity and viral replication fitness of HSV-1 clinical isolates with mutations in the thymidine kinase and DNA polymerase. J Antimicrob Chemother 2022; 77:3153-3162. [PMID: 36059135 DOI: 10.1093/jac/dkac297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/04/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Prolonged antiviral therapy in immunocompromised individuals can result in the emergence of (multi)drug-resistant herpes simplex virus 1 (HSV-1) infections, forming a therapeutic challenge. OBJECTIVES To evaluate spatial and temporal differences in drug resistance of HSV-1 samples from a HSCT recipient and to determine the effect of resistance mutations on viral replication fitness. PATIENTS AND METHODS Five HSV-1 isolates were recovered from a HSCT recipient who suffered from persistent HSV-1 lesions, consecutively treated with aciclovir, foscarnet, cidofovir and a combination of ganciclovir and cidofovir. Spatial and temporal differences in HSV-1 drug resistance were evaluated genotypically [Sanger sequencing and next-generation sequencing (NGS) of the viral thymidine kinase (TK) and DNA polymerase (DP)] and phenotypically (plaque reduction assay). Viral replication fitness was determined by dual infection competition assays. RESULTS Rapid evolution to aciclovir and foscarnet resistance was observed due to acquisition of TK (A189V and R222H) and DP (L778M and L802F) mutations. Virus isolates showed heterogeneous populations, spatial virus compartmentalization and minor viral variants in three out of five isolates (detectable by NGS but not by Sanger sequencing). Mutations in the TK and DP genes did not alter replication fitness without drug pressure. TK and/or DP mutants influenced replication fitness under antiviral pressure and showed increased fitness under pressure of the drug they showed resistance to. CONCLUSIONS The use of NGS and dual infection competition assays revealed rapid evolution of HSV-1 drug resistance in a HSCT recipient with spatial and temporal compartmentalization of viral variants that had altered replication fitness under antiviral pressure.
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Affiliation(s)
- Hanna Helena Schalkwijk
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Sarah Gillemot
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, AZ Sint-Jan Brugge, Brugge, Belgium
| | - Dominik Selleslag
- Department of Internal Medicine, AZ Sint-Jan Brugge, Brugge, Belgium
| | - Graciela Andrei
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Robert Snoeck
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
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17
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Simsek C, Bloemen M, Jansen D, Descheemaeker P, Reynders M, Van Ranst M, Matthijnssens J. Rotavirus vaccine-derived cases in Belgium: Evidence for reversion of attenuating mutations and alternative causes of gastroenteritis. Vaccine 2022; 40:5114-5125. [PMID: 35871871 DOI: 10.1016/j.vaccine.2022.06.082] [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: 11/15/2021] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 02/07/2023]
Abstract
Since the introduction of live-attenuated rotavirus vaccines in Belgium in 2006, surveillance has routinely detected rotavirus vaccine-derived strains. However, their genomic landscape and potential role in gastroenteritis have not been thoroughly investigated. We compared VP7 and VP4 nucleotide sequences obtained from rotavirus surveillance with the Rotarix vaccine sequence. As a result, we identified 80 vaccine-derived strains in 5125 rotavirus-positive infants with gastroenteritis from 2007 to 2018. Using both viral metagenomics and reverse transcription qPCR, we evaluated the vaccine strains and screened for co-infecting enteropathogens. Among the 45 patients with known vaccination status, 39 were vaccinated and 87% received the vaccine less than a month before the gastroenteritis episode. Reconstruction of 30 near complete vaccine-derived genomes revealed 0-11 mutations per genome, with 88% of them being non-synonymous. This, in combination with several shared amino acid changes among strains, pointed at selection of minor variant(s) present in the vaccine. We also found that some of these substitutions were true revertants (e.g., F167L on VP4, and I45T on NSP4). Finally, co-infections with known (e.g., Clostridioides difficile and norovirus) and divergent or emerging (e.g., human parechovirus A1, salivirus A2) pathogens were detected, and we estimated that 35% of the infants likely had gastroenteritis due to a 'non-rotavirus' cause. Conversely, we could not rule out the vaccine-derived gastroenteritis in over half of the cases. Continued studies inspecting reversion to pathogenicity should monitor the long-time safety of live-attenuated rotavirus vaccines. All in all, the complementary approach with NGS and qPCR provided a better understanding of rotavirus vaccine strain evolution in the Belgian population and epidemiology of co-infecting enteropathogens in suspected rotavirus vaccine-derived gastroenteritis cases.
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Affiliation(s)
- Ceren Simsek
- KU Leuven - University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Mandy Bloemen
- KU Leuven - University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Daan Jansen
- KU Leuven - University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Patrick Descheemaeker
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan, Brugge-Oostende AV, Bruges, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan, Brugge-Oostende AV, Bruges, Belgium
| | - Marc Van Ranst
- KU Leuven - University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Jelle Matthijnssens
- KU Leuven - University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium.
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18
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Lebbe B, Reynders M, Van Praet JT. The transfer of vaccine-generated SARS-CoV-2 antibodies into infantile circulation via breastmilk. Int J Gynaecol Obstet 2022; 158:219-220. [PMID: 35212411 PMCID: PMC9087763 DOI: 10.1002/ijgo.14152] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/23/2022] [Indexed: 11/11/2022]
Abstract
The contents of this page will be used as part of issue TOC only. It will not be published as part of main article Vaccine‐generated maternal anti‐SARS‐CoV‐2 IgG antibodies are not transferred into infantile circulation via breastmilk.
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Affiliation(s)
- Barbara Lebbe
- Department of Obstetrics and Gynecology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Marijke Reynders
- Department of Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Jens T Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.,Ghent University, Ghent, Belgium
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19
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Cuypers L, Bode J, Beuselinck K, Laenen L, Dewaele K, Janssen R, Capron A, Lafort Y, Paridaens H, Bearzatto B, Cauchie M, Huwart A, Degosserie J, Fagnart O, Overmeire Y, Rouffiange A, Vandecandelaere I, Deffontaine M, Pilate T, Yin N, Micalessi I, Roisin S, Moons V, Reynders M, Steyaert S, Henin C, Lazarova E, Obbels D, Dufrasne FE, Pirenne H, Schepers R, Collin A, Verhasselt B, Gillet L, Jonckheere S, Van Lint P, Van den Poel B, Van der Beken Y, Stojkovic V, Garrino MG, Segers H, Vos K, Godefroid M, Pede V, Nollet F, Claes V, Verschraegen I, Bogaerts P, Van Gysel M, Leurs J, Saegeman V, Soetens O, Vanhee M, Schiettekatte G, Huyghe E, Martens S, Lemmens A, Nailis H, Laffineur K, Steensels D, Vanlaere E, Gras J, Roussel G, Gijbels K, Boudewijns M, Sion C, Achtergael W, Maurissen W, Iliano L, Chantrenne M, Vanheule G, Flies R, Hougardy N, Berth M, Verbeke V, Morent R, Vankeerberghen A, Bontems S, Kehoe K, Schallier A, Ho G, Bafort K, Raymaekers M, Pypen Y, Heinrichs A, Schuermans W, Cuigniez D, Lali SE, Drieghe S, Ory D, Le Mercier M, Van Laethem K, Thoelen I, Vandamme S, Mansoor I, Vael C, De Sloovere M, Declerck K, Dequeker E, Desmet S, Maes P, Lagrou K, André E. Nationwide Harmonization Effort for Semi-Quantitative Reporting of SARS-CoV-2 PCR Test Results in Belgium. Viruses 2022; 14:1294. [PMID: 35746765 PMCID: PMC9230955 DOI: 10.3390/v14061294] [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] [Received: 05/10/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 02/05/2023] Open
Abstract
From early 2020, a high demand for SARS-CoV-2 tests was driven by several testing indications, including asymptomatic cases, resulting in the massive roll-out of PCR assays to combat the pandemic. Considering the dynamic of viral shedding during the course of infection, the demand to report cycle threshold (Ct) values rapidly emerged. As Ct values can be affected by a number of factors, we considered that harmonization of semi-quantitative PCR results across laboratories would avoid potential divergent interpretations, particularly in the absence of clinical or serological information. A proposal to harmonize reporting of test results was drafted by the National Reference Centre (NRC) UZ/KU Leuven, distinguishing four categories of positivity based on RNA copies/mL. Pre-quantified control material was shipped to 124 laboratories with instructions to setup a standard curve to define thresholds per assay. For each assay, the mean Ct value and corresponding standard deviation was calculated per target gene, for the three concentrations (107, 105 and 103 copies/mL) that determine the classification. The results of 17 assays are summarized. This harmonization effort allowed to ensure that all Belgian laboratories would report positive PCR results in the same semi-quantitative manner to clinicians and to the national database which feeds contact tracing interventions.
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Affiliation(s)
- Lize Cuypers
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Jannes Bode
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Kurt Beuselinck
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Lies Laenen
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Klaas Dewaele
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Reile Janssen
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Arnaud Capron
- Epidemiology of Infectious Diseases and Quality Service Unit, Scientific Directorate of Epidemiology and Public Health, Sciensano, 1000 Brussels, Belgium; (A.C.); (Y.L.)
| | - Yves Lafort
- Epidemiology of Infectious Diseases and Quality Service Unit, Scientific Directorate of Epidemiology and Public Health, Sciensano, 1000 Brussels, Belgium; (A.C.); (Y.L.)
| | - Henry Paridaens
- Clinical Laboratory, Centre Hospitalier Régional de la Citadelle, 4000 Liège, Belgium;
| | - Bertrand Bearzatto
- Federal Testing Platform COVID-19, Centre des Technologies Moléculaires Appliquées (CTMA), Institute of Experimental and Clinical Research (IREC), Cliniques Universitaires Saint-Luc and Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium;
| | | | | | - Jonathan Degosserie
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, CHU UCL Namur, 5530 Yvoir, Belgium;
| | - Olivier Fagnart
- Saint-Jean Hospital Laboratory, Cebiodi, 1000 Brussels, Belgium;
| | - Yarah Overmeire
- Microbiology, Labo Nuytinck, Anacura, 9940 Evergem, Belgium;
| | | | | | - Marine Deffontaine
- Laboratory of Clinical Biology, Centre Hopsitalier de Mouscron, 7700 Mouscron, Belgium;
| | - Thomas Pilate
- Clinical Laboratory, Laboratory Medicine, AZ Diest, 3290 Diest, Belgium;
| | - Nicolas Yin
- Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles—Universitair Laboratorium Brussel (LHUB-ULB), Université de Bruxelles (ULB), 1000 Brussels, Belgium;
| | - Isabel Micalessi
- Clinical Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium;
| | - Sandrine Roisin
- Microbiology, Centre Hospitalier Universitaire de Tivoli, 7100 La Louvière, Belgium;
| | - Veronique Moons
- Microbiology, LKO-LMC Medical Laboratory, 3800 Sint-Truiden, Belgium;
| | - Marijke Reynders
- Laboratory Medicine, AZ Sint-Jan Brugge-Oostende AV, 8000 Brugge, Belgium;
| | - Sophia Steyaert
- Clinical Laboratory, AZ Maria Middelares, 9000 Gent, Belgium;
| | - Coralie Henin
- Federal Testing Platform COVID-19, Université Libre de Bruxelles, 1070 Brussels, Belgium;
| | - Elena Lazarova
- Centre Hospitalier Régional de la Haute Senne, Department of Clinical Biology, 7060 Soignies, Belgium;
| | - Dagmar Obbels
- Imelda, Clinical Laboratory, 2820 Bonheiden, Belgium;
| | | | - Hendri Pirenne
- Synlab Belgium, Synlab Laboratory Collard, 4020 Liège, Belgium;
| | - Raf Schepers
- Synlab Belgium, Synlab Laboratory Heppignies, 6220 Heppignies, Belgium;
| | | | - Bruno Verhasselt
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, Ghent University and Ghent University Hospital, 9000 Gent, Belgium;
| | - Laurent Gillet
- Federal Testing Platform COVID-19, University of Liège, 4000 Liège, Belgium;
| | - Stijn Jonckheere
- Jan Yperman Hospital, Laboratory of Clinical Biology, 8900 Ieper, Belgium;
| | | | - Bea Van den Poel
- Clinical Laboratory, General Hospital Jan Portaels, 1800 Vilvoorde, Belgium;
| | - Yolien Van der Beken
- Military Medicine Lab Capacity, Military Hospital Queen Astrid, 1120 Brussels, Belgium;
| | - Violeta Stojkovic
- Centre Hospitalier Bois de l’Abbaye, Laboratory Service, 4100 Seraing, Belgium;
| | | | | | - Kevin Vos
- RZ Heilig Hart Tienen, Clinical Biology, 3300 Tienen, Belgium;
| | | | - Valerie Pede
- AZ Sint-Elisabeth Zottegem, Laboratory of Clinical Biology, 9600 Zottegem, Belgium;
| | - Friedel Nollet
- Biogazelle NV, Diagnostic Testing, 9052 Zwijnaarde, Belgium;
| | - Vincent Claes
- Institute of Clinical Biology ULB-IBC, 1170 Brussels, Belgium;
| | | | - Pierre Bogaerts
- CHU UCL Namur, Department of Laboratory Medicine, Molecular Diagnostics Center, 5530 Yvoir, Belgium;
| | | | | | | | - Oriane Soetens
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Merijn Vanhee
- Clinical Laboratory, Laboratory Medicine, AZ Delta, 8800 Roeselare, Belgium;
| | | | - Evelyne Huyghe
- ZNA Middelheim, Clinical Laboratory, 2020 Antwerp, Belgium;
| | | | - Ann Lemmens
- AZ Sint-Maarten, Laboratory of Clinical Biology, 2800 Mechelen, Belgium;
| | | | | | - Deborah Steensels
- Clinical Laboratory, Campus Sint-Jan, Hospital Oost-Limburg, 3600 Genk, Belgium;
| | - Elke Vanlaere
- Clinical Laboratory, AZ Sint-Lucas Hospital, 9000 Gent, Belgium;
| | - Jérémie Gras
- Institute of Pathology and Genetics, 6041 Gosselies, Belgium;
| | - Gatien Roussel
- Clinique Saint Pierre, Laboratory, 1340 Ottignies, Belgium;
| | | | - Michael Boudewijns
- Clinical Laboratory, Campus Kennedylaan, AZ Groeninge, 8500 Kortrijk, Belgium;
| | - Catherine Sion
- Grand Hôpital de Charleroi, Clinical Biology and Microbiology, 6060 Gilly, Belgium;
| | - Wim Achtergael
- Clinical Laboratory, Algemeen Stedelijk Ziekenhuis Aalst, 9300 Aalst, Belgium;
| | | | - Luc Iliano
- Laboratory for Medical Biology Iliano, 9070 Destelbergen, Belgium;
| | | | | | | | - Nicolas Hougardy
- Clinical Biology Unit, Vivalia Clinique du Sud-Luxembourg, 6700 Arlon, Belgium;
| | - Mario Berth
- Clinical Laboratory, AZ Alma, 9900 Eeklo, Belgium;
| | | | - Robin Morent
- Department of Laboratory Medicine, Campus Henri Serruys, AZ Sint-Jan Brugge, 8400 Oostende, Belgium;
| | - Anne Vankeerberghen
- Laboratory of Molecular Biology, Campus Aalst-Asse-Ninove, Onze-Lieve-Vrouwziekenhuis, 9300 Aalst, Belgium;
| | - Sébastien Bontems
- Clinical Laboratory, Unit of Clinical Microbiology, CHU Liège, 4000 Liège, Belgium;
| | - Kaat Kehoe
- Microbiology, Algemeen Medisch Laboratorium, 2020 Antwerp, Belgium;
| | | | - Giang Ho
- Laboratory, Clinique du MontLégia, Groupe Santé CHC, 4000 Liège, Belgium;
| | - Kristof Bafort
- Clinical Laboratory, Mariaziekenhuis Noorderhart, 3900 Pelt, Belgium;
| | - Marijke Raymaekers
- Laboratory for Molecular Diagnostics, Jessa Hospital, 3500 Hasselt, Belgium;
| | - Yolande Pypen
- Microbiology, Laboratory Somedi, 2220 Heist-op-den-Berg, Belgium;
| | - Amelie Heinrichs
- Laboratory of Clinical Biology, Hospital Arlon—Vivalia, 6700 Arlon, Belgium;
| | - Wim Schuermans
- Clinical Laboratory, Ziekenhuis Geel, 2440 Geel, Belgium;
| | | | | | - Stefanie Drieghe
- Microbiology, Algemeen Medisch Laboratorium West, 8850 Ardooie, Belgium;
| | - Dieter Ory
- Clinical Laboratory, Heilig Hart Ziekenhuis Mol, 2400 Mol, Belgium;
| | - Marie Le Mercier
- Federal Testing Platform COVID-19, University Hospitals Antwerp, 2650 Edegem, Belgium;
| | - Kristel Van Laethem
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium;
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Rega Institute for Medical Research, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium;
| | - Inge Thoelen
- Clinical Laboratory, AZ Vesalius Tongeren, 3700 Tongeren, Belgium;
| | - Sarah Vandamme
- Microbiology Laboratory, University Hospitals Antwerp, 2650 Edegem, Belgium;
| | - Iqbal Mansoor
- Clinical Laboratory, Hospital Hornu Epicura, 7301 Boussu, Belgium;
| | - Carl Vael
- Clinical Laboratory, AZ Klina, 2930 Brasschaat, Belgium;
| | | | | | - Elisabeth Dequeker
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
| | - Stefanie Desmet
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Piet Maes
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Rega Institute for Medical Research, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium;
| | - Katrien Lagrou
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
| | - Emmanuel André
- National Reference Centre for Respiratory Pathogens, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; (J.B.); (K.B.); (L.L.); (K.D.); (R.J.); (E.D.); (S.D.); (K.L.); (E.A.)
- Federal Testing Platform COVID-19, Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium;
- Laboratory of Clinical Microbiology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
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20
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Proesmans M, Rector A, Keyaerts E, Vandendijck Y, Vermeulen F, Sauer K, Reynders M, Verschelde A, Laffut W, Garmyn K, Fleischhackl R, Bollekens J, Ispas G. Risk factors for disease severity and increased medical resource utilization in respiratory syncytial virus (+) hospitalized children: A descriptive study conducted in four Belgian hospitals. PLoS One 2022; 17:e0268532. [PMID: 35666728 PMCID: PMC9170098 DOI: 10.1371/journal.pone.0268532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background We aimed to provide regional data on clinical symptoms, medical resource utilization (MRU), and risk factors for increased MRU in hospitalized respiratory syncytial virus (RSV)-infected Belgian pediatric population. Methods This prospective, multicenter study enrolled RSV (+) hospitalized children (aged ≤5y) during the 2013–2015 RSV seasons. RSV was diagnosed within 24h of hospitalization. Disease severity of RSV (+) patients was assessed until discharge or up to maximum six days using a Physical Examination Score (PES) and a derived score based on ability to feed, dyspnea and respiratory effort (PES3). MRU (concomitant medications, length of hospitalization [LOH], and oxygen supplementation) was evaluated. Kaplan-Meier survival analysis was performed to compare MRU by age and presence of risk factors for severe disease. Association between baseline covariates and MRU was analyzed using Cox regression models. Results In total, 75 children were included, Median (range) age was 4 (0–41) months, risk factors were present in 18.7%, and early hospitalization (≤3 days of symptom onset) was observed in 57.3% of patients. Cough (100%), feeding problems (82.2%), nasal discharge (87.8%), and rales and rhonchi (82.2%) were frequently observed. Median (range) LOH and oxygen supplementation was 5 (2–7) and 3 (1–7) days. Oxygen supplementation, bronchodilators, and antibiotics were administered to 58.7%, 64.0%, and 41.3% of the patients, respectively. Age <3 months and baseline total PES3 score were associated with probability and the duration of receiving oxygen supplementation. LOH was not associated with any covariate. Conclusion RSV is associated with high disease burden and MRU in hospitalized children. Oxygen supplementation but not length of hospitalization was associated with very young age and the PES3 score. These results warrant further assessment of the PES3 score as a predictor for the probability of receiving and length of oxygen supplementation in RSV hospitalized children. Registration NCT02133092
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Affiliation(s)
- Marijke Proesmans
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Annabel Rector
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium
| | - Els Keyaerts
- KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Clinical and Epidemiological Virology, Leuven, Belgium
| | | | | | - Kate Sauer
- Department of Pediatrics, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium
| | - Marijke Reynders
- Department of Microbiology, AZ Sint-Jan Brugge—Oostende, Campus Brugge, Brugge, Belgium
| | - Ann Verschelde
- Department of Pediatrics, AZ Sint-Jan Brugge–Oostende, Campus Henri Serruys, Oostende, Belgium
| | - Wim Laffut
- Department of Microbiology, Heilig-Hartziekenhuis, Lier, Belgium
| | - Kristien Garmyn
- Department of Pediatrics, Heilig-Hartziekenhuis, Lier, Belgium
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21
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Hodcroft EB, Dyrdak R, Andrés C, Egli A, Reist J, García Martínez de Artola D, Alcoba-Flórez J, Niesters HGM, Antón A, Poelman R, Reynders M, Wollants E, Neher RA, Albert J. Evolution, geographic spreading, and demographic distribution of Enterovirus D68. PLoS Pathog 2022; 18:e1010515. [PMID: 35639811 PMCID: PMC9212145 DOI: 10.1371/journal.ppat.1010515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 06/21/2022] [Accepted: 04/10/2022] [Indexed: 12/26/2022] Open
Abstract
Worldwide outbreaks of enterovirus D68 (EV-D68) in 2014 and 2016 have caused serious respiratory and neurological disease. We collected samples from several European countries during the 2018 outbreak and determined 53 near full-length genome (‘whole genome’) sequences. These sequences were combined with 718 whole genome and 1,987 VP1-gene publicly available sequences. In 2018, circulating strains clustered into multiple subgroups in the B3 and A2 subclades, with different phylogenetic origins. Clusters in subclade B3 emerged from strains circulating primarily in the US and Europe in 2016, though some had deeper roots linking to Asian strains, while clusters in A2 traced back to strains detected in East Asia in 2015-2016. In 2018, all sequences from the USA formed a distinct subgroup, containing only three non-US samples. Alongside the varied origins of seasonal strains, we found that diversification of these variants begins up to 18 months prior to the first diagnostic detection during a EV-D68 season. EV-D68 displays strong signs of continuous antigenic evolution and all 2018 A2 strains had novel patterns in the putative neutralizing epitopes in the BC- and DE-loops. The pattern in the BC-loop of the USA B3 subgroup had not been detected on that continent before. Patients with EV-D68 in subclade A2 were significantly older than patients with a B3 subclade virus. In contrast to other subclades, the age distribution of A2 is distinctly bimodal and was found primarily among children and in the elderly. We hypothesize that EV-D68’s rapid evolution of surface proteins, extensive diversity, and high rate of geographic mixing could be explained by substantial reinfection of adults. Better understanding of evolution and immunity across diverse viral pathogens, including EV-D68 and SARS-CoV-2, is critical to pandemic preparedness in the future. Enterovirus D68 (EV-D68) has caused punctuated, global outbreaks of respiratory illness and neurological disease, including being implicated as the cause of acute flaccid myelitis (AFM). Serology studies and surveillance data suggests almost everyone is infected during early childhood. The majority of sequences collected are from young children, while adults retain high antibody titers against strains that circulated when they were young. However, little is known about how outbreaks are connected and how the virus evolves and spreads around the globe. Despite EV-D68’s apparent reliance on young, naive hosts, EV-D68 antibody binding sites are reportedly evolving under antigenic pressure, and EV-D68 seems to spread rapidly during outbreaks. In this multi-center European collaboration, we confirm that subclade specific age differences are present in those infected. Further, we were able to quantify between- and within-country migration and the ‘hidden’ diversification that indicates unsampled circulation between outbreaks. We conclude that the evolution of EV-D68 may be driven by substantial re-infection of adults, explaining the rapid geographic mixing and continuous antigenic evolution. The presence of largely unsampled circulation prior to outbreaks suggests there are gaps in current surveillance practices which could be addressed by expanding genetic surveillance.
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Affiliation(s)
- Emma B. Hodcroft
- Biozentrum, University of Basel, Basel, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Swiss Institute of Bioinformatics, Basel, Switzerland
- * E-mail:
| | - Robert Dyrdak
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - Cristina Andrés
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Adrian Egli
- Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Josiane Reist
- Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland
- Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - Julia Alcoba-Flórez
- Department of Clinical Microbiology, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
| | - Hubert G. M. Niesters
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Division of Clinical Virology, Groningen, The Netherlands
| | - Andrés Antón
- Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Randy Poelman
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology, Division of Clinical Virology, Groningen, The Netherlands
| | - Marijke Reynders
- Unit of Molecular Microbiology, Medical Microbiology, Department of Laboratory Medicine, AZ Sint-Jan Brugge AV, Bruges, Belgium
| | - Elke Wollants
- KU Leuven, Rega Institute, Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical & Epidemiological Virology, Leuven, Belgium
| | - Richard A. Neher
- Biozentrum, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Jan Albert
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
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22
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De Vriese AS, Van Praet J, Reynders M, Heylen L, Viaene L, Caluwé R, Schoutteten M, De Bacquer D. Longevity and clinical effectiveness of the humoral and cellular response to SARS-CoV-2 vaccination in hemodialysis patients. Kidney Int Rep 2022; 7:1103-1107. [PMID: 35224315 PMCID: PMC8861256 DOI: 10.1016/j.ekir.2022.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/10/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- An S. De Vriese
- Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
- Department of Internal Medicine, Ghent University, Ghent, Belgium
- Correspondence: An S. De Vriese, Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Ruddershove 10, 8000 Brugge, Belgium.
| | - Jens Van Praet
- Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
- Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Marijke Reynders
- Division of Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Line Heylen
- Division of Nephrology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | | | - Rogier Caluwé
- Division of Nephrology, OLV Hospital, Aalst, Belgium
| | - Melanie Schoutteten
- Division of Nephrology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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23
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Van Praet J, Reynders M, De Bacquer D, Viaene L, Schoutteten MK, Caluwé R, Doubel P, Heylen L, De Bel AV, Van Vlem B, Steensels D, De Vriese AS. Predictors and Dynamics of the Humoral and Cellular Immune Response to SARS-CoV-2 mRNA Vaccines in Hemodialysis Patients: A Multicenter Observational Study. J Am Soc Nephrol 2021; 32:3208-3220. [PMID: 34588184 PMCID: PMC8638385 DOI: 10.1681/asn.2021070908] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [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: 07/08/2021] [Accepted: 09/03/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Preliminary evidence suggests patients on hemodialysis have a blunted early serological response to SARS-CoV-2 vaccination. Optimizing the vaccination strategy in this population requires a thorough understanding of predictors and dynamics of humoral and cellular immune responses to different SARS-CoV-2 vaccines. METHODS This prospective multicenter study of 543 patients on hemodialysis and 75 healthy volunteers evaluated the immune responses at 4 or 5 weeks and 8 or 9 weeks after administration of the BNT162b2 or mRNA-1273 vaccine, respectively. We assessed anti-SARS-CoV-2 spike antibodies and T cell responses by IFN-γ secretion of peripheral blood lymphocytes upon SARS-CoV-2 glycoprotein stimulation (QuantiFERON assay) and evaluated potential predictors of the responses. RESULTS Compared with healthy volunteers, patients on hemodialysis had an incomplete, delayed humoral immune response and a blunted cellular immune response. Geometric mean antibody titers at both time points were significantly greater in patients vaccinated with mRNA-1273 versus BNT162b2, and a larger proportion of them achieved the threshold of 4160 AU/ml, corresponding with high neutralizing antibody titers in vitro (53.6% versus 31.8% at 8 or 9 weeks, P <0.0001). Patients vaccinated with mRNA-1273 versus BNT162b2 exhibited significantly greater median QuantiFERON responses at both time points, and a larger proportion achieved the threshold of 0.15 IU/ml (64.4% versus 46.9% at 8 or 9 weeks, P <0.0001). Multivariate analysis identified COVID-19 experience, vaccine type, use of immunosuppressive drugs, serum albumin, lymphocyte count, hepatitis B vaccine nonresponder status, and dialysis vintage as independent predictors of the humoral and cellular responses. CONCLUSIONS The mRNA-1273 vaccine's greater immunogenicity may be related to its higher mRNA dose. This suggests a high-dose vaccine might improve the impaired immune response to SARS-CoV-2 vaccination in patients on hemodialysis.
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Affiliation(s)
- Jens Van Praet
- Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge, Brugge, Belgium,Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Marijke Reynders
- Division of Medical Microbiology, AZ Sint-Jan Brugge, Brugge, Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Belgium
| | | | - Melanie K. Schoutteten
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium,Department of Future Health, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Rogier Caluwé
- Division of Nephrology, OLV Hospital Aalst, Aalst, Belgium
| | - Peter Doubel
- Division of Nephrology, AZ Groeninge, Kortrijk, Belgium
| | - Line Heylen
- Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium,Division of Nephrology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Annelies V. De Bel
- Laboratory of Clinical Biology, Department of Microbiology, AZ Groeninge, Kortrijk, Belgium
| | - Bruno Van Vlem
- Division of Nephrology, OLV Hospital Aalst, Aalst, Belgium
| | - Deborah Steensels
- Department of Laboratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - An S. De Vriese
- Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge, Brugge, Belgium,Department of Internal Medicine, Ghent University, Ghent, Belgium
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24
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Simsek C, Bloemen M, Jansen D, Beller L, Descheemaeker P, Reynders M, Van Ranst M, Matthijnssens J. High Prevalence of Coinfecting Enteropathogens in Suspected Rotavirus Vaccine Breakthrough Cases. J Clin Microbiol 2021; 59:e0123621. [PMID: 34586890 PMCID: PMC8601229 DOI: 10.1128/jcm.01236-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022] Open
Abstract
Despite the global use of rotavirus vaccines, vaccine breakthrough cases remain a pediatric health problem. In this study, we investigated suspected rotavirus vaccine breakthrough cases using next-generation sequencing (NGS)-based viral metagenomics (n = 102) and a panel of semiquantitative reverse transcription-PCR (RT-qPCR) (n = 92) targeting known enteric pathogens. Overall, we identified coinfections in 80% of the cases. Enteropathogens such as adenovirus (32%), enterovirus (15%), diarrheagenic Escherichia coli (1 to 14%), astrovirus (10%), Blastocystis spp. (10%), parechovirus (9%), norovirus (9%), Clostridioides (formerly Clostridium) difficile (9%), Dientamoeba fragilis (9%), sapovirus (8%), Campylobacter jejuni (4%), and Giardia lamblia (4%) were detected. Except for a few reassortant rotavirus strains, unusual genotypes or genotype combinations were not present. However, in addition to well-known enteric viruses, divergent variants of enteroviruses and nonclassic astroviruses were identified using NGS. We estimated that in 31.5% of the patients, rotavirus was likely not the cause of gastroenteritis, and in 14.1% of the patients, it contributed together with another pathogen(s) to disease. The remaining 54.4% of the patients likely had a true vaccine breakthrough infection. The high prevalence of alternative enteropathogens in the suspected rotavirus vaccine breakthrough cases suggests that gastroenteritis is often the result of a coinfection and that rotavirus vaccine effectiveness might be underestimated in clinical and epidemiological studies.
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Affiliation(s)
- Ceren Simsek
- KU Leuven—University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Mandy Bloemen
- KU Leuven—University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Daan Jansen
- KU Leuven—University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Leen Beller
- KU Leuven—University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Patrick Descheemaeker
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Marc Van Ranst
- KU Leuven—University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
| | - Jelle Matthijnssens
- KU Leuven—University of Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium
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25
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Benschop KS, Albert J, Anton A, Andrés C, Aranzamendi M, Armannsdóttir B, Bailly JL, Baldanti F, Baldvinsdóttir GE, Beard S, Berginc N, Böttcher S, Blomqvist S, Bubba L, Calvo C, Cabrerizo M, Cavallero A, Celma C, Ceriotti F, Costa I, Cottrell S, Del Cuerpo M, Dean J, Dembinski JL, Diedrich S, Diez-Domingo J, Dorenberg D, Duizer E, Dyrdak R, Fanti D, Farkas A, Feeney S, Flipse J, De Gascun C, Galli C, Georgieva I, Gifford L, Guiomar R, Hönemann M, Ikonen N, Jeannoël M, Josset L, Keeren K, López-Labrador FX, Maier M, McKenna J, Meijer A, Mengual-Chuliá B, Midgley SE, Mirand A, Montes M, Moore C, Morley U, Murk JL, Nikolaeva-Glomb L, Numanovic S, Oggioni M, Palminha P, Pariani E, Pellegrinelli L, Piralla A, Pietsch C, Piñeiro L, Rabella N, Rainetova P, Uceda Renteria SC, Romero MP, Reynders M, Roorda L, Savolainen-Kopra C, Schuffenecker I, Soynova A, Swanink CM, Ursic T, Verweij JJ, Vila J, Vuorinen T, Simmonds P, Fischer TK, Harvala H. Re-emergence of enterovirus D68 in Europe after easing the COVID-19 lockdown, September 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 34763750 PMCID: PMC8646978 DOI: 10.2807/1560-7917.es.2021.26.45.2100998] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.
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Affiliation(s)
- Kimberley Sm Benschop
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Jan Albert
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Andres Anton
- Respiratory Virus Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Cristina Andrés
- Respiratory Virus Unit, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maitane Aranzamendi
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | | | - Jean-Luc Bailly
- Université d'Auvergne, LMGE UMR CNRS 6023, Equipe EPIE - Epidémiologie et physiopathologie des infections à entérovirus, Faculté de Médecine, Clermont-Ferrand, France.,CHU Clermont-Ferrand, National Reference Centre for enteroviruses and parechoviruses - Associated laboratory, Clermont-Ferrand, France
| | - Fausto Baldanti
- Department of Clinical Surgical Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Pavia, Italy.,Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | | | - Stuart Beard
- UK Health Security Agency, Colindale, United Kingdom
| | - Natasa Berginc
- National laboratory of health, environment and food, Laboratory for public health virology, Ljubljana, Slovenia
| | - Sindy Böttcher
- National Reference Center for Poliomyelitis and Enteroviruses, Robert-Koch Institute, Berlin, Germany
| | - Soile Blomqvist
- National Institute for Health and Welfare, Helsinki, Finland
| | - Laura Bubba
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | | | - Maria Cabrerizo
- National Centre for Microbiology, Instituto de Salud Carlos III, Enterovirus and Viral Gastroenteritis Unit/Polio National Lab, Madrid, Spain
| | - Annalisa Cavallero
- Laboratory of Microbiology, ASST Monza, San Gerardo Hospital, Monza (MB), Italy
| | | | - Ferruccio Ceriotti
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Inês Costa
- National Institute of Health (INSA), Lisbon, Portugal
| | | | - Margarita Del Cuerpo
- Microbiology Department Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jonathan Dean
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | | | - Sabine Diedrich
- National Reference Center for Poliomyelitis and Enteroviruses, Robert-Koch Institute, Berlin, Germany
| | - Javier Diez-Domingo
- Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | | | - Erwin Duizer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Robert Dyrdak
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Diana Fanti
- Chemical-clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Agnes Farkas
- National Public Health Center, Budapest, Hungary
| | - Susan Feeney
- Regional Virus Laboratory, Belfast Health and Social Care Trust (BHSCT, Royal Victoria Hospital, Belfast, United Kingdom
| | - Jacky Flipse
- Laboratory for Medical Microbiology and Immunology, Rijnstate, Velp, the Netherlands
| | - Cillian De Gascun
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Cristina Galli
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Irina Georgieva
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | | | - Mario Hönemann
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - Niina Ikonen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Marion Jeannoël
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Laurence Josset
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Kathrin Keeren
- Secretary of the commission for Polio Eradication in Germany, Robert-Koch Institute, Berlin, Germany
| | - F Xavier López-Labrador
- CIBERESP, Instituto de Salud Carlos III, Madrid, Spain.,Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | - Melanie Maier
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - James McKenna
- Regional Virus Laboratory, Belfast Health and Social Care Trust (BHSCT, Royal Victoria Hospital, Belfast, United Kingdom
| | - Adam Meijer
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Beatriz Mengual-Chuliá
- Center for Public Health Research (FISABIO-Public Health), Generalitat Valenciana, Valencia, Spain
| | - Sofie E Midgley
- The Danish WHO National Reference Laboratory for Poliovirus, Statens Serum Institut, Copenhagen, Denmark
| | - Audrey Mirand
- Université d'Auvergne, LMGE UMR CNRS 6023, Equipe EPIE - Epidémiologie et physiopathologie des infections à entérovirus, Faculté de Médecine, Clermont-Ferrand, France.,CHU Clermont-Ferrand, National Reference Centre for enteroviruses and parechoviruses - Associated laboratory, Clermont-Ferrand, France
| | - Milagrosa Montes
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | | | - Ursula Morley
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Jean-Luc Murk
- Elisabeth Tweesteden Hospital, Tilburg, the Netherlands
| | - Lubomira Nikolaeva-Glomb
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Sanela Numanovic
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Massimo Oggioni
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Elena Pariani
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Laura Pellegrinelli
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | - Antonio Piralla
- Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Italy
| | - Corinna Pietsch
- Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany
| | - Luis Piñeiro
- Microbiology Department, Donostia University Hospital and Biodonostia Health Research Institute, San Sebastián, Spain
| | - Núria Rabella
- Microbiology Department Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Sara Colonia Uceda Renteria
- Virology Unit, Division of Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - María P Romero
- Department of Biomedical Sciences of Health, University of Milan, Milan, Italy
| | | | | | | | - Isabelle Schuffenecker
- National Reference Center for Enteroviruses and Parechoviruses, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Aysa Soynova
- National Reference Laboratory for Enteroviruses, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Caroline Ma Swanink
- Laboratory for Medical Microbiology and Immunology, Rijnstate, Velp, the Netherlands
| | - Tina Ursic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Jorgina Vila
- Pediatric Hospitalization Unit, Department of Pediatrics, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Tytti Vuorinen
- Clinical Microbiology, Turku University Hospital and Institute of Biomedicine, University of Turku, Turku, Finland
| | | | - Thea K Fischer
- Nordsjaellands Hospital, Hillerod, Denmark.,University of Sothern Denmark, Odense, Denmark
| | - Heli Harvala
- University College London (UCL), Department of infection and Immunity, London, United Kingdom.,NHS Blood and Transplant, Microbiology Services, Colindale, United Kingdom
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26
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Heireman L, Abrams S, Bruynseels P, Cartuyvels R, Cuypers L, De Schouwer P, Laffut W, Lagrou K, Hens N, Ho E, Padalko E, Reynders M, Vandamme S, Van der Moeren N, Verstrepen W, Willems P, Naesens R. Evaluation of the SARS-CoV-2 positivity ratio and upper respiratory tract viral load among asymptomatic individuals screened before hospitalization or surgery in Flanders, Belgium. PLoS One 2021; 16:e0259908. [PMID: 34762704 PMCID: PMC8584712 DOI: 10.1371/journal.pone.0259908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/28/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in the Belgian community is mainly estimated based on test results of patients with coronavirus disease (COVID-19)-like symptoms. The aim of this study was to investigate the evolution of the SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) positivity ratio and distribution of viral loads within a cohort of asymptomatic patients screened prior hospitalization or surgery, stratified by age category. MATERIALS/METHODS We retrospectively studied data on SARS-CoV-2 real-time RT-PCR detection in respiratory tract samples of asymptomatic patients screened pre-hospitalization or pre-surgery in nine Belgian hospitals located in Flanders over a 12-month period (1 April 2020-31 March 2021). RESULTS In total, 255925 SARS-CoV-2 RT-PCR test results and 2421 positive results for which a viral load was reported, were included in this study. An unweighted overall SARS-CoV-2 real-time RT-PCR positivity ratio of 1.27% was observed with strong spatiotemporal differences. SARS-CoV-2 circulated predominantly in 80+ year old individuals across all time periods except between the first and second COVID-19 wave and in 20-30 year old individuals before the second COVID-19 wave. In contrast to the first wave, a significantly higher positivity ratio was observed for the 20-40 age group in addition to the 80+ age group compared to the other age groups during the second wave. The median viral load follows a similar temporal evolution as the positivity rate with an increase ahead of the second wave and highest viral loads observed for 80+ year old individuals. CONCLUSION There was a high SARS-CoV-2 circulation among asymptomatic patients with a predominance and highest viral loads observed in the elderly. Moreover, ahead of the second COVID-19 wave an increase in median viral load was noted with the highest overall positivity ratio observed in 20-30 year old individuals, indicating they could have been the hidden drivers of this wave.
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Affiliation(s)
- Laura Heireman
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Steven Abrams
- Data Science Institute, Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
- Global Health Institute, Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Peggy Bruynseels
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | | | - Lize Cuypers
- Department of Laboratory Medicine and National Reference Center for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Pieter De Schouwer
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Wim Laffut
- Department of Laboratory Medicine, Heilig Hart Hospital, Lier, Belgium
| | - Katrien Lagrou
- Department of Laboratory Medicine and National Reference Center for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
| | - Niel Hens
- Data Science Institute, Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BioStat), UHasselt, Hasselt, Belgium
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
| | - Erwin Ho
- Department of Laboratory Medicine, Sint-Maarten Hospital, Mechelen, Belgium
| | - Elizaveta Padalko
- Department of Laboratory Medicine, University Hospital Ghent, Ghent, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Sint-Jan Hospital, Bruges, Belgium
| | - Sarah Vandamme
- Department of Laboratory Medicine, Antwerp University Hospital, Antwerp, Belgium
| | | | - Walter Verstrepen
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
| | - Philippe Willems
- Department of Laboratory Medicine GasthuisZusters Antwerpen, Antwerp, Belgium
| | - Reinout Naesens
- Department of Laboratory Medicine, ZiekenhuisNetwerk Antwerpen, Antwerp, Belgium
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27
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De Vriese AS, Van Praet J, Reynders M, Heylen L, Viaene L, Caluwé R, Schoutteten M, De Bacquer D. Longevity and correlation with disease severity of the humoral and cellular response to SARS-CoV-2 infection in haemodialysis patients. Clin Kidney J 2021; 14:2446-2448. [PMID: 34754442 PMCID: PMC8573012 DOI: 10.1093/ckj/sfab147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/10/2021] [Indexed: 12/31/2022] Open
Affiliation(s)
- An S De Vriese
- Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Jens Van Praet
- Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Marijke Reynders
- Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Line Heylen
- Division of Nephrology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | | | - Rogier Caluwé
- Division of Nephrology, OLV Hospital, Aalst, Belgium
| | | | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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28
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Janssen NAF, Nyga R, Vanderbeke L, Jacobs C, Ergün M, Buil JB, van Dijk K, Altenburg J, Bouman CSC, van der Spoel HI, Rijnders BJA, Dunbar A, Schouten JA, Lagrou K, Bourgeois M, Reynders M, van Regenmortel N, Rutsaert L, Lormans P, Feys S, Debavaye Y, Tamion F, Costa D, Maizel J, Dupont H, Chouaki T, Nseir S, Sendid B, Brüggemann RJM, van de Veerdonk FL, Wauters J, Verweij PE. Multinational Observational Cohort Study of COVID-19-Associated Pulmonary Aspergillosis 1. Emerg Infect Dis 2021; 27:2892-2898. [PMID: 34519638 PMCID: PMC8544971 DOI: 10.3201/eid2711.211174] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We performed an observational study to investigate intensive care unit incidence, risk factors, and outcomes of coronavirus disease-associated pulmonary aspergillosis (CAPA). We found 10%-15% CAPA incidence among 823 patients in 2 cohorts. Several factors were independently associated with CAPA in 1 cohort and mortality rates were 43%-52%.
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29
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Maelegheer K, Reynders M, Floré K, Vanacker J, Vanlaere E, Cartuyvels R, Raymaekers M. Multicenter evaluation of the FilmArray Meningitis/Encephalitis assay in a routine setting. J Med Microbiol 2021; 70. [PMID: 34665115 DOI: 10.1099/jmm.0.001438] [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] [Indexed: 11/18/2022] Open
Abstract
Introduction. The FilmArray Meningitis/Encephalitis (FA-ME) Panel (Biofire, Salt Lake City, Utah, US) enables fast and automated detection of 14 pathogens in cerebrospinal fluid (CSF).Gap statement. The performance of the FA-ME panel in a real routine setting has not yet been described and could lead to better patient management in cases of good performance.Aim. This multicenter study verified the FA-ME panel analytical performance in a routine hospital setting.Methodology. Between April 2016 and April 2018, 454 CSF samples were analysed with the FA-ME panel and compared with routine diagnostics. In cases of discrepancy or lack of a comparator result, a profound analysis based on patient records and other laboratory results was performed.Results. A first analysis of 65 frozen samples, suspicious for meningitis had a 89 % concordance with routine diagnostics. The limit of detection (LOD) was confirmed for all pathogens except for Streptococcus agalactiae and a strain of Haemophilus influenzae (Escherichia coli K1 and Cryptococcus gattii LOD experiments were not performed). The routine evaluation showed a positive result in 114 (25 %) clinical samples for at least one target. In three samples co-infections were found. After discrepancy analysis, overall sensitivity was 98 % (false negative FA-ME results for one HSV2, two HSV1 and two parechovirus). Four FA-ME results were considered false positive (two HHV6, one VZV and one E. coli K1), resulting in an overall specificity of >99 %. A clinical added value of the assay was seen in the diagnosis of eight cases of bacterial meningitis.Conclusion. Because of its rapidity and ease of use, the FA-ME panel has great potential in the diagnosis of central nervous infections. Implementation can improve clinical management, but costs and analytical limitations need to be addressed to convince clinicians and laboratories of its value.
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Affiliation(s)
- Karel Maelegheer
- Laboratory Medicine, Medical Microbiology, AZ Sint Lucas, Sint Lucaslaan 29, B-8310 Brugge, Belgium
| | - Marijke Reynders
- Laboratory Medicine, Medical Microbiology, AZ Sint-Jan, Ruddershove 10, B-8000 Brugge, Belgium
| | - Katelijne Floré
- Laboratory Medicine, Medical Microbiology, AZ Sint-Jan, Ruddershove 10, B-8000 Brugge, Belgium
| | - Jos Vanacker
- Laboratory Medicine, Medical Microbiology, AZ Sint Lucas, Groenebriel 1, B-9000 Gent, Belgium
| | - Elke Vanlaere
- Laboratory Medicine, Medical Microbiology, AZ Sint Lucas, Groenebriel 1, B-9000 Gent, Belgium
| | - Reinoud Cartuyvels
- Clinical Biology, Laboratory for Molecular Diagnostics, Jessa Hospital, Salvatorstraat 20, 3500 Hasselt, Belgium
| | - Marijke Raymaekers
- Clinical Biology, Laboratory for Molecular Diagnostics, Jessa Hospital, Salvatorstraat 20, 3500 Hasselt, Belgium
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30
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Moerman A, Vernelen K, China B, Capron A, Bossche DVD, Mariën J, Ariën KK, Van Acker J, Delforge ML, Reynders M, Boel A, Depypere M, Van Gasse N, Vijgen S, Brauner J, Dujardin B, Padalko E. Importance of anti-SARS-CoV-2 assay antigenic composition as revealed by the results of the Belgian external quality assessment (EQA) scheme. Diagn Microbiol Infect Dis 2021; 102:115561. [PMID: 34773801 PMCID: PMC8503966 DOI: 10.1016/j.diagmicrobio.2021.115561] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022]
Abstract
We report on sample IS/17575 since it generated highly divergent results in the Belgian SARS-CoV-2 serology external quality assessment scheme. Sample IS/17575 was serum originating from a 30 years old male patient. 124 diagnostic laboratories analysed this sample. A total of 168 results was returned (including 5 doubles). Overall, 38 were positive. All tests against S1 were positive except the Euroimmun IgG ELISA and the Ortho clinical Diagnostics VITROS IgG CLIA. All tests against S1/S2 (Liaison, Diasorin) resulted in a signal above cutoff. Assays against RBD, mostly generate a negative result. An exception are the Wantai SARS-CoV-2 ELISA's. All tests targeting N protein were negative. The survey shows, when >6 months post-infection, assays targeting at least S1, and preferably S1 combined with S2, are the most sensitive. This finding accentuates the necessity of external quality assessment schedules and importance of antigenic composition of serologic SARS-CoV-2 assays.
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Affiliation(s)
- Alena Moerman
- Laboratory of Medical Microbiology, Ghent University Hospital, Ghent, Belgium.
| | - Kris Vernelen
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Bernard China
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Arnaud Capron
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Dorien Van Den Bossche
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Kevin K Ariën
- Institute of Tropical Medicine, Antwerp, Belgium; University of Antwerp, Antwerp, Belgium
| | - Jos Van Acker
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Laboratory of Clinical Microbiology, AZ Sint-Lucas, Ghent, Belgium
| | - Marie-Luce Delforge
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; CUB-Hôpital Erasme, ULB, Brussels, Belgium
| | - Marijke Reynders
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; AZ St. Jan, Bruges-Ostend, Belgium
| | - An Boel
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Department of Medical Microbiology, OLVZ Aalst, Aalst, Belgium
| | - Melissa Depypere
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Natasja Van Gasse
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Hospital Network Antwerp, Antwerp, Belgium
| | - Sara Vijgen
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; Department of Laboratory Medicine, Jessa Hospital, Hasselt, Belgium
| | - Jonathan Brauner
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; University Centre Tivoli, La Louvière, Belgium
| | - Barbara Dujardin
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium; University Centre Tivoli, La Louvière, Belgium
| | - Elizaveta Padalko
- Laboratory of Medical Microbiology, Ghent University Hospital, Ghent, Belgium; Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
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Dumont S, Balduyck J, Reynders M, Vanwalleghem L, Lebbe B. Acute SARS-CoV-2 alpha variant infection leading to placental insufficiency and fetal distress. J Med Virol 2021; 94:1196-1200. [PMID: 34617608 PMCID: PMC8662159 DOI: 10.1002/jmv.27379] [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: 07/19/2021] [Revised: 09/23/2021] [Accepted: 10/05/2021] [Indexed: 02/06/2023]
Abstract
The effect of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Alpha variant (also known as B.1.1.7 lineage, 20I/501Y.V1, the UK variant or VOC 202012/01) infection on pregnancy is currently unknown. We present a case of a 37‐year‐old woman admitted to our tertiary hospital at a gestational age of 29 weeks and 1 day because of oligohydramnios with reduced fetal movements for 10 days. About 20 days before admission, she tested positive for SARS‐CoV‐2 Alpha variant. The following day, due to abnormal cardiotocography, increased brain sparing, and absent end‐diastolic flow in the umbilical artery, an urgent cesarean section was performed. The neonate had an uneventful admission to the neonatal intensive care unit. All neonatal samples proved negative for SARS‐CoV‐2. Pathological examination of the placenta revealed intervillous fibrin deposition, ischemic necrosis of villi and histiocytic intervillositis, corresponding with the SARS‐CoV‐2 placentitis triad. The placental tissue demonstrated a high viral load, possibly explaining the acute onset of placental insufficiently and subsequent fetal distress. This case demonstrates the importance of seeking medical care when experiencing reduced fetal movement in SARS‐CoV‐2 infected patients since acute infection can induce significant placental and subsequent fetal pathology.
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Affiliation(s)
- Sander Dumont
- Department of Gynecology, Obstetrics, and Fertility, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.,Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Jonas Balduyck
- Department of Gynecology, Obstetrics, and Fertility, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.,Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Marijke Reynders
- Department of Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Lieve Vanwalleghem
- Department of Pathology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Barbara Lebbe
- Department of Gynecology, Obstetrics, and Fertility, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
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Subissi L, Bossuyt N, Reynders M, Gérard M, Dauby N, Lacor P, Daelemans S, Lissoir B, Holemans X, Magerman K, Jouck D, Bourgeois M, Delaere B, Quoilin S, Van Gucht S, Thomas I, Barbezange C. Spotlight influenza: Extending influenza surveillance to detect non-influenza respiratory viruses of public health relevance: analysis of surveillance data, Belgium, 2015 to 2019. ACTA ACUST UNITED AC 2021; 26. [PMID: 34558405 PMCID: PMC8462033 DOI: 10.2807/1560-7917.es.2021.26.38.2001104] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BackgroundSeasonal influenza-like illness (ILI) affects millions of people yearly. Severe acute respiratory infections (SARI), mainly influenza, are a leading cause of hospitalisation and mortality. Increasing evidence indicates that non-influenza respiratory viruses (NIRV) also contribute to the burden of SARI. In Belgium, SARI surveillance by a network of sentinel hospitals has been ongoing since 2011.AimWe report the results of using in-house multiplex qPCR for the detection of a flexible panel of viruses in respiratory ILI and SARI samples and the estimated incidence rates of SARI associated with each virus.MethodsWe defined ILI as an illness with onset of fever and cough or dyspnoea. SARI was defined as an illness requiring hospitalisation with onset of fever and cough or dyspnoea within the previous 10 days. Samples were collected in four winter seasons and tested by multiplex qPCR for influenza virus and NIRV. Using catchment population estimates, we calculated incidence rates of SARI associated with each virus.ResultsOne third of the SARI cases were positive for NIRV, reaching 49.4% among children younger than 15 years. In children younger than 5 years, incidence rates of NIRV-associated SARI were twice that of influenza (103.5 vs 57.6/100,000 person-months); co-infections with several NIRV, respiratory syncytial viruses, human metapneumoviruses and picornaviruses contributed most (33.1, 13.6, 15.8 and 18.2/100,000 person-months, respectively).ConclusionEarly testing for NIRV could be beneficial to clinical management of SARI patients, especially in children younger than 5 years, for whom the burden of NIRV-associated disease exceeds that of influenza.
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Affiliation(s)
- Lorenzo Subissi
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control, Stockholm, Sweden.,National Influenza Centre, Sciensano, Brussels, Belgium
| | - Nathalie Bossuyt
- Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, Algemeen Ziekenhuis Sint-Jan, Brugge-Oostende AV, Belgium
| | - Michèle Gérard
- Centre Hospitalier Universitaire St-Pierre, Brussels, Belgium
| | - Nicolas Dauby
- Centre for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Centre Hospitalier Universitaire St-Pierre, Brussels, Belgium
| | - Patrick Lacor
- Internal Medicine-Infectious Diseases, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Siel Daelemans
- Pediatric Pulmonary and Infectious Diseases, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - Xavier Holemans
- Infectiology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Koen Magerman
- Infection Control, Jessa Ziekenhuis, Hasselt, Belgium.,Clinical Laboratory, Jessa Ziekenhuis, Hasselt, Belgium
| | - Door Jouck
- Infection Control, Jessa Ziekenhuis, Hasselt, Belgium
| | - Marc Bourgeois
- Centre Hospitalier Universitaire UCL Namur, Ysoir, Belgium
| | | | - Sophie Quoilin
- Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
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33
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Van Praet JT, Vandecasteele S, De Roo A, Vynck M, De Vriese AS, Reynders M. Dynamics of the cellular and humoral immune response after BNT162b2 mRNA Covid-19 vaccination in Covid-19 naive nursing home residents. J Infect Dis 2021; 224:1690-1693. [PMID: 34514509 DOI: 10.1093/infdis/jiab458] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 06/07/2021] [Accepted: 09/10/2021] [Indexed: 12/15/2022] Open
Abstract
Short-term humoral and cellular immune responses are diminished after BNT162b2 mRNA Covid-19 vaccination in Covid-19 naive nursing home residents, a population particularly vulnerable to the disease. We found both responses to decline after four weeks and remain lower than those of healthcare workers after twenty-four weeks, with an estimated half-life of the antibody response of 47 days. At four weeks, older age was significantly associated with a decreased humoral response, and diabetes mellitus and active malignancy with a decreased cellular response. Our results imply that Covid-19 naive nursing home residents are a target group for booster vaccination trials.
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Affiliation(s)
- Jens T Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Gent, Belgium
| | - Stefaan Vandecasteele
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - Matthijs Vynck
- Department of Laboratory Medicine, Molecular Hematology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - An S De Vriese
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Gent, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
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34
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Prattes J, Wauters J, Giacobbe DR, Salmanton-García J, Maertens J, Bourgeois M, Reynders M, Rutsaert L, Van Regenmortel N, Lormans P, Feys S, Reisinger AC, Cornely OA, Lahmer T, Valerio M, Delhaes L, Jabeen K, Steinmann J, Chamula M, Bassetti M, Hatzl S, Rautemaa-Richardson R, Koehler P, Lagrou K, Hoenigl M. Risk factors and outcome of pulmonary aspergillosis in critically ill coronavirus disease 2019 patients-a multinational observational study by the European Confederation of Medical Mycology. Clin Microbiol Infect 2021; 28:580-587. [PMID: 34454093 PMCID: PMC8387556 DOI: 10.1016/j.cmi.2021.08.014] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [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: 07/14/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 12/30/2022]
Abstract
Objectives Coronavirus disease 2019 (COVID-19) -associated pulmonary aspergillosis (CAPA) has emerged as a complication in critically ill COVID-19 patients. The objectives of this multinational study were to determine the prevalence of CAPA in patients with COVID-19 in intensive care units (ICU) and to investigate risk factors for CAPA as well as outcome. Methods The European Confederation of Medical Mycology (ECMM) conducted a multinational study including 20 centres from nine countries to assess epidemiology, risk factors and outcome of CAPA. CAPA was defined according to the 2020 ECMM/ISHAM consensus definitions. Results A total of 592 patients were included in this study, including 11 (1.9%) patients with histologically proven CAPA, 80 (13.5%) with probable CAPA, 18 (3%) with possible CAPA and 483 (81.6%) without CAPA. CAPA was diagnosed a median of 8 days (range 0–31 days) after ICU admission predominantly in older patients (adjusted hazard ratio (aHR) 1.04 per year; 95% CI 1.02–1.06) with any form of invasive respiratory support (HR 3.4; 95% CI 1.84–6.25) and receiving tocilizumab (HR 2.45; 95% CI 1.41–4.25). Median prevalence of CAPA per centre was 10.7% (range 1.7%–26.8%). CAPA was associated with significantly lower 90-day ICU survival rate (29% in patients with CAPA versus 57% in patients without CAPA; Mantel–Byar p < 0.001) and remained an independent negative prognostic variable after adjusting for other predictors of survival (HR 2.14; 95% CI 1.59–2.87, p ≤ 0.001). Conclusion Prevalence of CAPA varied between centres. CAPA was significantly more prevalent among older patients, patients receiving invasive ventilation and patients receiving tocilizumab, and was an independent strong predictor of ICU mortality.
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Affiliation(s)
- Juergen Prattes
- Medical University of Graz, Department of Infectious Diseases, Excellence Centre for Medical Mycology (ECMM), Graz, Austria
| | | | - Daniele Roberto Giacobbe
- San Martino Polyclinic Hospital IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Jon Salmanton-García
- University of Cologne, Medical Faculty and University Hospital Cologne, Department I of Internal Medicine, Excellence Centre for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | | | - Marc Bourgeois
- Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Bruges, Belgium
| | | | - Lynn Rutsaert
- Ziekenhusnetwerk Antwerp, Campus Stuivenberg, Antwerp, Belgium
| | | | | | - Simon Feys
- Algemeen Ziekenhuis Delta, Roeselare, Belgium
| | | | - Oliver A Cornely
- University of Cologne, Medical Faculty and University Hospital Cologne, Department I of Internal Medicine, Excellence Centre for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Tobias Lahmer
- Klinik und Poliklinik für Innere Medizin II, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - Maricela Valerio
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Laurence Delhaes
- Centre Hospitalier Universitaire de Bordeaux, ISERM U1045, Bordeaux, France
| | | | - Joerg Steinmann
- Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - Mathilde Chamula
- Manchester University NHS Foundation Trust, Wythenshawe Hospital and Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Matteo Bassetti
- San Martino Polyclinic Hospital IRCCS, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Stefan Hatzl
- Medical University of Graz, Department of Internal Medicine, Intesive Care Unit, Graz, Austria
| | - Riina Rautemaa-Richardson
- Manchester University NHS Foundation Trust, Wythenshawe Hospital and Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Philipp Koehler
- University of Cologne, Medical Faculty and University Hospital Cologne, Department I of Internal Medicine, Excellence Centre for Medical Mycology (ECMM), Cologne, Germany
| | | | - Martin Hoenigl
- Medical University of Graz, Department of Infectious Diseases, Excellence Centre for Medical Mycology (ECMM), Graz, Austria; Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Clinical and Translational Fungal-Working Group, University of California San Diego, San Diego, CA, USA.
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35
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Muyldermans A, Van Droogenbroeck J, Descheemaeker P, Reynders M. Hepatitis E virus-associated haemophagocytic lymphohistiocytosis. Acta Clin Belg 2021; 76:314-317. [PMID: 32089126 DOI: 10.1080/17843286.2020.1733179] [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] [Indexed: 10/25/2022]
Abstract
We report the first documented case of hepatitis E virus-associated haemophagocytic lymphohistiocytosis. This case emphasizes the fact that infectious agents other than those classically described should be taken into consideration as a potential trigger of virus-associated haemophagocytic syndrome. Prompt recognition is crucial to start early treatment of the underlying infection and possibly improve the outcome of this frequently fatal syndrome.
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Affiliation(s)
- Astrid Muyldermans
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Hospital, Bruges, Belgium
| | | | - Patrick Descheemaeker
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Hospital, Bruges, Belgium
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36
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Van den Abeele T, Delforge ML, Boel A, Reynders M, Padalko E. Comparison of 4 commercial enzyme immunoassays for serology testing of human parvovirus B19 infection. Diagn Microbiol Infect Dis 2021; 101:115489. [PMID: 34352435 DOI: 10.1016/j.diagmicrobio.2021.115489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/25/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Parvovirus B19 is a pathogenic virus often diagnosed by serology, yet little is known about analytical performance of commercial enzyme immunoassays (EIAs). OBJECTIVE To investigate performance of 4 EIAs for parvovirus B19 IgM and IgG: Liaison, Euroimmun, Mikrogen and Virion/Serion. STUDY DESIGN To compare 4 EIAs to Biotrin's ELISA on 168 samples and determine consensus score for discordant samples using Mikrogen's confirmatory line assay. RESULTS Two thirds of results for IgM/IgG were identical for all 4 EIAs and Biotrin. Liaison shows the highest IgM sensitivity, but has low specificity. Euroimmun lacks IgM sensitivity. Mikrogen had a good overall performance, but had the lowest IgG specificity. Virion/Serion had variable performance with a low IgM specificity and the most borderline and cross-reactive results. CONCLUSIONS Liaison and Mikrogen have similar performance to Biotrin's ELISA. Euroimmun lacks sensitivity and Virion/Serion produced many borderline and cross-reactive results.
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Affiliation(s)
- Tim Van den Abeele
- Laboratory of Medical Microbiology, Ghent University Hospital, Gent, Belgium
| | - Marie-Luce Delforge
- National Reference Center for Congenital Infections, Erasme University Hospital, Brussels, Belgium
| | - An Boel
- Department of Microbiology, OLV Hospital, Aalst, Belgium
| | - Marijke Reynders
- Department of Medical Microbiology, Sint-Jan Hospital, Bruges, Belgium
| | - Elizaveta Padalko
- Laboratory of Medical Microbiology, Ghent University Hospital, Gent, Belgium.
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37
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Colman S, Vernelen K, China B, Van den Bossche D, Cornelissen L, Delforge ML, Reynders M, Berth M, Depypere M, Van Gasse N, Vijgen S, Van Acker J, Boel A, Padalko E. Pitfalls of rubella serology while on the brink of elimination: evaluation of national data, Belgium, 2017. ACTA ACUST UNITED AC 2021; 26. [PMID: 34018485 PMCID: PMC8138961 DOI: 10.2807/1560-7917.es.2021.26.20.2000074] [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] [Indexed: 01/11/2023]
Abstract
BackgroundIn Belgium, rubella serology is frequently requested in women of childbearing age, despite high vaccination coverage and a near-absence of congenital rubella cases. Different test kits are available and should be standardised by an international standard preparation.AimTo analyse and compare rubella serology practices in Belgian laboratories.MethodsAs part of the mandatory External Quality Assessment programme for rubella serology in Belgium, the national public health institute, Sciensano, sent a voluntary questionnaire concerning anti-rubella IgM/IgG analyses in women aged 15 to 45 years in 2017 to 130 laboratories.ResultsThe questionnaire response rate was 83.8% (109/130). The majority of 169,494 IgG analyses were performed on Roche (55%), Abbott (17%) and Diasorin (13%) analysers. Not all laboratories used the proposed international cut-off of 10 IU/mL. Assumed median seroprevalence ranged from 76.3% with Liaison (Diasorin) to 96.3% with Modular (Roche). Despite very low rubella incidence in Belgium, 93 laboratories performed 85,957 IgM analyses, with 748 positive and 394 grey zone results. The National Reference Centre for Measles, Mumps and Rubella virus and the National Reference Centre for Congenital infections did not confirm any positive rubella cases in 2017.ConclusionThis retrospective analysis shows that rubella serology results may differ considerably according to the assay used. It is therefore important to use the same test when comparing results or performing follow-up testing. The number of anti-rubella IgM analyses was very high. Incorrect use of IgM for screening women of childbearing age can lead to unwarranted anxiety and overuse of confirmation tests.
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Affiliation(s)
- Sofie Colman
- Clinical Laboratory of Microbiology, OLVZ Aalst, Aalst, Belgium
| | - Kris Vernelen
- Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Bernard China
- Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Dorien Van den Bossche
- Institute of Tropical Medicine, Antwerp, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
| | | | - Marie-Luce Delforge
- University Hospital Erasme, Brussels, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Marijke Reynders
- General Hospital Sint-Jan Bruges, Bruges, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Mario Berth
- General Hospital AZ Alma, Eeklo, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Melissa Depypere
- University Hospital Leuven, Leuven, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Natasja Van Gasse
- Hospital Network Antwerp, Antwerp, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Sara Vijgen
- General Hospital Jessa, Hasselt, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
| | - Jos Van Acker
- General Hospital AZ Sint-Lucas, Ghent, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
| | - An Boel
- Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium.,Clinical Laboratory of Microbiology, OLVZ Aalst, Aalst, Belgium
| | - Elizaveta Padalko
- University Hospital Ghent, Ghent, Belgium.,Experts Committee EQA Infectious serology, Quality of Laboratories, Sciensano, Brussels, Belgium
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38
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Vanderbeke L, Janssen NAF, Bergmans DCJJ, Bourgeois M, Buil JB, Debaveye Y, Depuydt P, Feys S, Hermans G, Hoiting O, van der Hoven B, Jacobs C, Lagrou K, Lemiale V, Lormans P, Maertens J, Meersseman P, Mégarbane B, Nseir S, van Oers JAH, Reynders M, Rijnders BJA, Schouten JA, Spriet I, Thevissen K, Thille AW, Van Daele R, van de Veerdonk FL, Verweij PE, Wilmer A, Brüggemann RJM, Wauters J. Posaconazole for prevention of invasive pulmonary aspergillosis in critically ill influenza patients (POSA-FLU): a randomised, open-label, proof-of-concept trial. Intensive Care Med 2021; 47:674-686. [PMID: 34050768 PMCID: PMC8164057 DOI: 10.1007/s00134-021-06431-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE Influenza-associated pulmonary aspergillosis (IAPA) is a frequent complication in critically ill influenza patients, associated with significant mortality. We investigated whether antifungal prophylaxis reduces the incidence of IAPA. METHODS We compared 7 days of intravenous posaconazole (POS) prophylaxis with no prophylaxis (standard-of-care only, SOC) in a randomised, open-label, proof-of-concept trial in patients admitted to an intensive care unit (ICU) with respiratory failure due to influenza (ClinicalTrials.gov, NCT03378479). Adult patients with PCR-confirmed influenza were block randomised (1:1) within 10 days of symptoms onset and 48 h of ICU admission. The primary endpoint was the incidence of IAPA during ICU stay in patients who did not have IAPA within 48 h of ICU admission (modified intention-to-treat (MITT) population). RESULTS Eighty-eight critically ill influenza patients were randomly allocated to POS or SOC. IAPA occurred in 21 cases (24%), the majority of which (71%, 15/21) were diagnosed within 48 h of ICU admission, excluding them from the MITT population. The incidence of IAPA was not significantly reduced in the POS arm (5.4%, 2/37) compared with SOC (11.1%, 4/36; between-group difference 5.7%; 95% CI - 10.8 to 21.7; p = 0.32). ICU mortality of early IAPA was high (53%), despite rapid antifungal treatment. CONCLUSION The higher than expected incidence of early IAPA precludes any definite conclusion on POS prophylaxis. High mortality of early IAPA, despite timely antifungal therapy, indicates that alternative management strategies are required. After 48 h, still 11% of patients developed IAPA. As these could benefit from prophylaxis, differentiated strategies are likely needed to manage IAPA in the ICU.
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Affiliation(s)
- Lore Vanderbeke
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Nico A F Janssen
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Center of Expertise in Mycology Radboudumc/CWZ, Radboudumc Center for Infectious Diseases (RCI), Nijmegen, The Netherlands
| | - Dennis C J J Bergmans
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marc Bourgeois
- Department of Intensive Care, Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Brugge, Belgium
| | - Jochem B Buil
- Center of Expertise in Mycology Radboudumc/CWZ, Radboudumc Center for Infectious Diseases (RCI), Nijmegen, The Netherlands.,Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yves Debaveye
- Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.,Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Pieter Depuydt
- Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Simon Feys
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Greet Hermans
- Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.,Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Oscar Hoiting
- Department of Intensive Care Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Ben van der Hoven
- Department of Intensive Care Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Cato Jacobs
- Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals Leuven, Leuven, Belgium
| | - Virginie Lemiale
- Department of Intensive Care Medicine, Saint-Louis Hospital, Paris, France
| | - Piet Lormans
- Department of Anesthesiology and Intensive Care Medicine, Algemeen Ziekenhuis Delta, Roeselare, Belgium
| | - Johan Maertens
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Haematology, University Hospitals Leuven, Leuven, Belgium
| | - Philippe Meersseman
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, INSERM UMRS-1144, University of Paris, Paris, France
| | - Saad Nseir
- Department of Intensive Care Medicine, Critical Care Center, University Hospital Lille, INSERM U995-E2, Lille Inflammation Research International Center, University of Lille, Lille, France
| | - Jos A H van Oers
- Department of Intensive Care Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Marijke Reynders
- Department of Laboratory Medicine, Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Brugge, Belgium
| | - Bart J A Rijnders
- Department of Internal Medicine, Section of Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeroen A Schouten
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Isabel Spriet
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.,Department of Pharmacy, University Hospitals Leuven, Leuven, Belgium
| | - Karin Thevissen
- Department of Microbial and Molecular Systems, Center of Microbial and Plant Genetics (CMPG), KU Leuven, Leuven, Belgium
| | - Arnaud W Thille
- Department of Intensive Care Medicine, University Hospital Poitiers, Poitiers, France
| | - Ruth Van Daele
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.,Department of Pharmacy, University Hospitals Leuven, Leuven, Belgium
| | - Frank L van de Veerdonk
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Center of Expertise in Mycology Radboudumc/CWZ, Radboudumc Center for Infectious Diseases (RCI), Nijmegen, The Netherlands
| | - Paul E Verweij
- Center of Expertise in Mycology Radboudumc/CWZ, Radboudumc Center for Infectious Diseases (RCI), Nijmegen, The Netherlands.,Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alexander Wilmer
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Roger J M Brüggemann
- Center of Expertise in Mycology Radboudumc/CWZ, Radboudumc Center for Infectious Diseases (RCI), Nijmegen, The Netherlands.,Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joost Wauters
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium. .,Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.
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Van Praet JT, Vandecasteele S, De Roo A, De Vriese AS, Reynders M. Humoral and cellular immunogenicity of the BNT162b2 mRNA Covid-19 Vaccine in nursing home residents. Clin Infect Dis 2021; 73:2145-2147. [PMID: 33825869 PMCID: PMC8083580 DOI: 10.1093/cid/ciab300] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jens T Van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Gent, Belgium
| | - Stefaan Vandecasteele
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | - An S De Vriese
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium.,Department of Internal Medicine and Pediatrics, Ghent University, Gent, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
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Mercier T, Dunbar A, de Kort E, Schauwvlieghe A, Reynders M, Guldentops E, Blijlevens NMA, Vonk AG, Rijnders B, Verweij PE, Lagrou K, Maertens J. Lateral flow assays for diagnosing invasive pulmonary aspergillosis in adult hematology patients: A comparative multicenter study. Med Mycol 2021; 58:444-452. [PMID: 31290552 DOI: 10.1093/mmy/myz079] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [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: 05/27/2019] [Revised: 06/18/2019] [Accepted: 06/24/2019] [Indexed: 01/18/2023] Open
Abstract
Fast diagnosis of invasive pulmonary aspergillosis (IPA) is essential as early adequate therapy improves survival. However, current microbiological methods suffer from a low sensitivity or a long turnaround time, often as a result of batching. Recently, two lateral flow assays for diagnosing IPA have been CE (Conformité Européenne)-marked and commercialized. These assays can be used for fast single sample testing. However, clinical validation and comparative studies are lacking. We therefore sought to evaluate and compare these assays in adult hematology patients. We retrospectively tested 235 bronchoalveolar lavage fluid (BALf) samples of adult hematology patients from four centers using the AspLFD (OLM Diagnostics) and the sōna Aspergillus galactomannan LFA (IMMY). Both tests were read out independently by two researchers and by a digital reader. We included 11 patients with proven IPA, 64 with probable IPA, 43 with possible fungal disease, and 117 controls with no signs of IPA. In cases of proven IPA, the performance of both assays was similar. In cases of proven and probable IPA, we found an identical specificity for both assays, but a higher sensitivity (0.83 vs 0.69, P = .008) and a better negative predictive value (0.89 vs 0.82, P = .009) for the LFA. Digital readout improved the diagnostic performance of both tests. In conclusion, both assays showed a good performance for the diagnosis of IPA in BALf from adult hematology patients. Results were further improved by using a digital reader, especially for weakly positive results.
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Affiliation(s)
- Toine Mercier
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Hematology, University Hospitals Leuven, Leuven, Belgium
| | - Albert Dunbar
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Elizabeth de Kort
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alexander Schauwvlieghe
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ St Jan Bruges, Bruges, Belgium
| | - Ellen Guldentops
- Department of Hematology, University Hospitals Leuven, Leuven, Belgium
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alieke G Vonk
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bart Rijnders
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Paul E Verweij
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.,Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine and National Reference Centre for Mycosis, University Hospitals Leuven, Leuven, Belgium
| | - Johan Maertens
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Hematology, University Hospitals Leuven, Leuven, Belgium
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Fischer N, Dauby N, Bossuyt N, Reynders M, Gérard M, Lacor P, Daelemans S, Lissoir B, Holemans X, Magerman K, Jouck D, Bourgeois M, Delaere B, Quoilin S, Van Gucht S, Thomas I, Barbezange C, Subissi L. Monitoring of human coronaviruses in Belgian primary care and hospitals, 2015-20: a surveillance study. Lancet Microbe 2021; 2:e105-e114. [PMID: 33937883 PMCID: PMC8064766 DOI: 10.1016/s2666-5247(20)30221-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Seasonal human coronaviruses (hCoVs) broadly circulate in humans. Their epidemiology and effect on the spread of emerging coronaviruses has been neglected thus far. We aimed to elucidate the epidemiology and burden of disease of seasonal hCoVs OC43, NL63, and 229E in patients in primary care and hospitals in Belgium between 2015 and 2020. Methods We retrospectively analysed data from the national influenza surveillance networks in Belgium during the winter seasons of 2015–20. Respiratory specimens were collected through the severe acute respiratory infection (SARI) and the influenza-like illness networks from patients with acute respiratory illness with onset within the previous 10 days, with measured or reported fever of 38°C or greater, cough, or dyspnoea; and for patients admitted to hospital for at least one night. Potential risk factors were recorded and patients who were admitted to hospital were followed up for the occurrence of complications or death for the length of their hospital stay. All samples were analysed by multiplex quantitative RT-PCRs for respiratory viruses, including seasonal hCoVs OC43, NL63, and 229E. We estimated the prevalence and incidence of seasonal hCoV infection, with or without co-infection with other respiratory viruses. We evaluated the association between co-infections and potential risk factors with complications or death in patients admitted to hospital with seasonal hCoV infections by age group. Samples received from week 8, 2020, were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Findings 2573 primary care and 6494 hospital samples were included in the study. 161 (6·3%) of 2573 patients in primary care and 371 (5·7%) of 6494 patients admitted to hospital were infected with a seasonal hCoV. OC43 was the seasonal hCoV with the highest prevalence across age groups and highest incidence in children admitted to hospital who were younger than 5 years (incidence 9·0 [95% CI 7·2–11·2] per 100 000 person-months) and adults older than 65 years (2·6 [2·1–3·2] per 100 000 person-months). Among 262 patients admitted to hospital with seasonal hCoV infection and with complete information on potential risk factors, 66 (73·3%) of 90 patients who had complications or died also had at least one potential risk factor (p=0·0064). Complications in children younger than 5 years were associated with co-infection (24 [36·4%] of 66; p=0·017), and in teenagers and adults (≥15 years), more complications arose in patients with a single hCoV infection (49 [45·0%] of 109; p=0·0097). In early 2020, the Belgian SARI surveillance detected the first SARS-CoV-2-positive sample concomitantly with the first confirmed COVID-19 case with no travel history to China. Interpretation The main burden of severe seasonal hCoV infection lies with children younger than 5 years with co-infections and adults aged 65 years and older with pre-existing comorbidities. These age and patient groups should be targeted for enhanced observation when in medical care and in possible future vaccination strategies, and co-infections in children younger than 5 years should be considered during diagnosis and treatment. Our findings support the use of national influenza surveillance systems for seasonal hCoV monitoring and early detection, and monitoring of emerging coronaviruses such as SARS-CoV-2. Funding Belgian Federal Public Service Health, Food Chain Safety, and Environment; Belgian National Insurance Health Care (Institut national d'assurance maladie-invalidité/Rijksinstituut voor ziekte-en invaliditeitsverzekering); and Regional Health Authorities (Flanders Agentschap zorg en gezondheid, Brussels Commission communautaire commune, Wallonia Agence pour une vie de qualité).
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Affiliation(s)
- Natalie Fischer
- National Influenza Centre, Sciensano, Brussels, Belgium.,European Public Health Microbiology Training Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Nicolas Dauby
- Centre Hospitalier Universitaire St-Pierre, Brussels, Belgium.,Centre for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Nathalie Bossuyt
- Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, Algemeen Ziekenhuis Sint-Jan, Brugge-Oostende AV, Bruge, Belgium
| | - Michèle Gérard
- Centre Hospitalier Universitaire St-Pierre, Brussels, Belgium
| | - Patrick Lacor
- Internal Medicine-Infectious Diseases, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Siel Daelemans
- Pediatric Pulmonary and Infectious Diseases, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Bénédicte Lissoir
- Department of Microbiology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Xavier Holemans
- Infectiology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Koen Magerman
- Clinical Laboratory, Jessa Ziekenhuis, Hasselt, Belgium.,Department of Infection Control, Jessa Ziekenhuis, Hasselt, Belgium
| | - Door Jouck
- Department of Infection Control, Jessa Ziekenhuis, Hasselt, Belgium
| | - Marc Bourgeois
- Centre Hospitalier Universitaire UCL Namur, Yvoir, Belgium
| | | | - Sophie Quoilin
- Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
| | | | | | | | - Lorenzo Subissi
- National Influenza Centre, Sciensano, Brussels, Belgium.,European Public Health Microbiology Training Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
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Subissi L, Bossuyt N, Reynders M, Gérard M, Dauby N, Bourgeois M, Delaere B, Quoilin S, Van Gucht S, Thomas I, Barbezange C. Capturing respiratory syncytial virus season in Belgium using the influenza severe acute respiratory infection surveillance network, season 2018/19. ACTA ACUST UNITED AC 2021; 25. [PMID: 33006303 PMCID: PMC7531071 DOI: 10.2807/1560-7917.es.2020.25.39.1900627] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Respiratory syncytial virus (RSV) is a common cause of severe respiratory illness in young children (< 5 years old) and older adults (≥ 65 years old) leading the World Health Organization (WHO) to recommend the implementation of a dedicated surveillance in countries. Aim We tested the capacity of the severe acute respiratory infection (SARI) hospital network to contribute to RSV surveillance in Belgium. Methods During the 2018/19 influenza season, we started the SARI surveillance for influenza in Belgium in week 40, earlier than in the past, to follow RSV activity, which usually precedes influenza virus circulation. While the WHO SARI case definition for influenza normally used by the SARI hospital network was employed, flexibility over the fever criterion was allowed, so patients without fever but meeting the other case definition criteria could be included in the surveillance. Results Between weeks 40 2018 and 2 2019, we received 508 samples from SARI patients. We found an overall RSV detection rate of 62.4% (317/508), with rates varying depending on the age group: 77.6% in children aged < 5 years (253/326) and 34.4% in adults aged ≥ 65 years (44/128). Over 90% of the RSV-positive samples also positive for another tested respiratory virus (80/85) were from children aged < 5 years. Differences were also noted between age groups for symptoms, comorbidities and complications. Conclusion With only marginal modifications in the case definition and the period of surveillance, the Belgian SARI network would be able to substantially contribute to RSV surveillance and burden evaluation in children and older adults, the two groups of particular interest for WHO.
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Affiliation(s)
- Lorenzo Subissi
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control, Stockholm, Sweden.,National Influenza Centre, Sciensano, Brussels, Belgium
| | - Nathalie Bossuyt
- Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, Algemeen Ziekenhuis Sint-Jan, Brugge-Oostende AV, Belgium
| | - Michèle Gérard
- Centre Hospitalier Universitaire St-Pierre, Brussels, Belgium
| | - Nicolas Dauby
- Centre for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Centre Hospitalier Universitaire St-Pierre, Brussels, Belgium
| | - Marc Bourgeois
- Centre Hospitalier Universitaire UCL Namur, Ysoir, Belgium
| | | | - Sophie Quoilin
- Epidemiology of Infectious Diseases, Sciensano, Brussels, Belgium
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Van Praet JT, Claeys B, Coene AS, Floré K, Reynders M. Prevention of nosocomial COVID-19: Another challenge of the pandemic. Infect Control Hosp Epidemiol 2020; 41:1355-1356. [PMID: 32321612 PMCID: PMC7198455 DOI: 10.1017/ice.2020.166] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/11/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Jens T. Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Bram Claeys
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Katelijne Floré
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
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44
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Verbeke V, Bourgeois T, Lodewyck T, Van Praet J, Lagrou K, Reynders M, Nulens E. Successful Outcome of Disseminated Fusarium musae Fungemia with Skin Localization Treated with Liposomal Amphotericin B and Voriconazole in a Patient with Acute Myeloid Leukemia. Mycopathologia 2020; 185:1085-1089. [PMID: 33119817 DOI: 10.1007/s11046-020-00499-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/08/2020] [Indexed: 11/28/2022]
Abstract
Fusarium spp. may cause invasive disseminated infections in immunocompromised patients, associated with significant morbidity and mortality. We describe a case of disseminated fusariosis with fungemia and skin localization caused by Fusarium musae in a patient with acute myeloid leukemia successfully treated using liposomal amphotericin B and voriconazole.
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Affiliation(s)
- Vanessa Verbeke
- Department of Medical Microbiology, AZ Sint-Jan Bruges, Ruddershove 10, 8000, Brugge, Belgium
| | - Thibault Bourgeois
- Department of Hematology, AZ Sint-Jan Bruges, Ruddershove 10, 8000, Brugge, Belgium
| | - Tom Lodewyck
- Department of Hematology, AZ Sint-Jan Bruges, Ruddershove 10, 8000, Brugge, Belgium
| | - Jens Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Bruges, Ruddershove 10, 8000, Brugge, Belgium
| | - Katrien Lagrou
- Department of Medical Microbiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Marijke Reynders
- Department of Medical Microbiology, AZ Sint-Jan Bruges, Ruddershove 10, 8000, Brugge, Belgium
| | - Eric Nulens
- Department of Medical Microbiology, AZ Sint-Jan Bruges, Ruddershove 10, 8000, Brugge, Belgium.
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De Vriese AS, Reynders M. In Reply to ‘Is SARS-CoV-2 Serology Relevant for Hemodialysis Patients With COVID-19?’. Am J Kidney Dis 2020; 76:598-599. [PMID: 32603712 PMCID: PMC7320694 DOI: 10.1053/j.ajkd.2020.06.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 06/24/2020] [Indexed: 12/03/2022]
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De Vriese AS, Reynders M. IgG Antibody Response to SARS-CoV-2 Infection and Viral RNA Persistence in Patients on Maintenance Hemodialysis. Am J Kidney Dis 2020; 76:440-441. [PMID: 32512038 PMCID: PMC7273159 DOI: 10.1053/j.ajkd.2020.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/29/2020] [Indexed: 11/15/2022]
Affiliation(s)
- An S De Vriese
- Division of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium; Department of Internal Medicine, Ghent University, Ghent, Belgium.
| | - Marijke Reynders
- Division of Medical Microbiology, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
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Dunbar A, Schauwvlieghe A, Algoe S, van Hellemond JJ, Reynders M, Vandecasteele S, Boelens J, Depuydt P, Rijnders B. Epidemiology of Pneumocystis jirovecii Pneumonia and (Non-)use of Prophylaxis. Front Cell Infect Microbiol 2020; 10:224. [PMID: 32500040 PMCID: PMC7243458 DOI: 10.3389/fcimb.2020.00224] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 02/26/2020] [Accepted: 04/22/2020] [Indexed: 01/21/2023] Open
Abstract
Objectives: Pneumocystis jirovecii pneumonia (PCP) is an AIDS-defining illness. In patients with HIV, the benefit of PCP prophylaxis is well-defined when the CD4 T-cell count decreases below 200 cells/μL. In other immunocompromised patients, the value of PCP prophylaxis is not always as well-established. This study aimed to describe the epidemiology of PCP in recent years and assess how many patients with PCP did or did not receive prophylaxis in the month preceding the infection. Material and Methods: A multicenter retrospective study was performed in 3 tertiary care hospital. A list of patients that underwent broncho-alveolar lavage sampling and Pneumocystis jirovecii (PJ) PCR testing was retrieved from the microbiology laboratories. An in-house PJ quantitative PCR (qPCR) was used in each center. A cycle threshold (Ct) value of ≤ 28.5-30 was considered a probable PCP. For patients with a positive PJ qPCR but above this threshold, a predefined case definition of possible PCP was defined as a qPCR Ct value ≤ 34-35 and both of the following criteria: 1. Clinical and radiological features compatible with PCP and 2. The patient died or received PCP therapy and survived. Patient files from those with a qPCR Ct value ≤ 35 were reviewed to determine whether the patient fulfilled the case definition and if PCP prophylaxis had been used in the weeks preceding the PCP. Disease-specific guidelines, as well as hospital-wide guidelines, were used to evaluate if prophylaxis could be considered indicated. Results: From 2012 to 2018, 482 BAL samples were tested. Two hundred and four had a qPCR Ct value ≤ 35 and were further evaluated: 90 fulfilled the definition of probable and 63 of possible PCP while the remaining 51 were considered colonized. Seventy-four percentages of the patients with PCP were HIV-negative. Only 11 (7%) of the 153 patients had received prophylaxis, despite that in 133 (87%) cases prophylaxis was indicated according to guidelines. Conclusion: In regions where HIV testing and treatment is available without restrictions, PCP is mainly diagnosed in non-HIV immunocompromised patients. More than four out of five patients with PCP had not received prophylaxis. Strategies to improve awareness of antimicrobial prophylaxis guidelines in immunocompromised patients are urgently needed.
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Affiliation(s)
- Albert Dunbar
- Department of Internal Medicine, Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Alexander Schauwvlieghe
- Department of Internal Medicine, Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.,Department of Hematology, Ghent University Hospital, Ghent, Belgium
| | - Sheruna Algoe
- Department of Internal Medicine, Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jaap J van Hellemond
- Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ St-Jan Brugge-Oostende Hospital, Bruges, Belgium
| | - Stefaan Vandecasteele
- Departments of Nephrology and Infectious Diseases, AZ St-Jan Brugge-Oostende Hospital, Bruges, Belgium
| | - Jerina Boelens
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Pieter Depuydt
- Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Bart Rijnders
- Department of Internal Medicine, Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
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48
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Van Praet JT, Steyaert S, Vandecasteele S, Van Den Bergh B, Mahieu H, De Buyser S, Grootaert V, Descheemaeker P, Reynders M. Mycoplasma genitalium acquisition and macrolide resistance after initiation of HIV pre-exposure prophylaxis in men who have sex with men. Sex Transm Infect 2020; 96:396-398. [PMID: 31896737 DOI: 10.1136/sextrans-2019-054335] [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: 10/24/2019] [Revised: 11/29/2019] [Accepted: 12/12/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Recent evidence shows that patients using HIV pre-exposure prophylaxis (PrEP) have an increased rate of bacterial STIs, including syphilis, chlamydia and gonorrhoea. Our study aimed to describe the acquisition and the susceptibility for macrolides of Mycoplasma genitalium in men who have sex with men (MSM) on PrEP. METHODS We studied all MSM who started PrEP in the AZ Sint-Jan Hospital Bruges from 1 June 2017 to 31 March 2019 with at least one follow-up visit. Patients were screened for M. genitalium and other STIs with pooled rectal swabs, pharyngeal swabs and first-voided urine, and blood samples at baseline and quarterly intervals after initiating PrEP. TaqMan Array Card technology was used to detect M. genitalium and determine macrolide-resistance mediating mutations in region V of the 23S rRNA gene (A2058G, A2059G, A2058C and others). Patients with an STI were treated based on a national guideline. RESULTS 131 MSM (median age 40 years, range 20-79) were included in the study. The median follow-up time was 12 months (IQR 6.1-17). Baseline prevalence of M. genitalium was 6.9% and incidence rate after PrEP initiation was 28.8 per 100 person-years (95% CI 21.7 to 37.2), without significant differences in proportions between the first four quarterly intervals. All but one acquisitions were asymptomatic. Younger age and positivity for M. genitalium at baseline were significantly associated with incident M. genitalium acquisition. The observed proportion of macrolide resistance increased not significantly from 44% at baseline to 57%-86% after PrEP initiation. None of the 27 macrolide-resistant M. genitalium acquisitions could be linked to azithromycin exposure in the three preceding months. CONCLUSIONS After initiation of PrEP, we found a stable incidence of almost exclusively asymptomatic M. genitalium. However, a non-significant trend of an increased percentage of macrolide-resistant strains was observed.
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Affiliation(s)
- Jens Tomas Van Praet
- Nephrology and Infectious Diseases, AZ Sint-Jan AV, Brugge, Belgium .,Internal Medicine and Pediatrics, Ghent University, Gent, Belgium
| | - Sanne Steyaert
- Nephrology and Infectious Diseases, AZ Sint-Jan AV, Brugge, Belgium
| | | | | | - Hilde Mahieu
- Nephrology and Infectious Diseases, AZ Sint-Jan AV, Brugge, Belgium
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Muyldermans A, Descheemaeker P, Boel A, Desmet S, Van Gasse N, Reynders M. What is the risk of missing legionellosis relying on urinary antigen testing solely? A retrospective Belgian multicenter study. Eur J Clin Microbiol Infect Dis 2019; 39:729-734. [PMID: 31838606 DOI: 10.1007/s10096-019-03785-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/02/2019] [Indexed: 12/25/2022]
Abstract
Currently, diagnosis of legionellosis relies mainly on urinary antigen testing (UAT) for Legionella pneumophila serogroup 1 (Lp1). However, this test has several limitations, particularly missing non-Lp1 infections. The purpose of this large multicenter study was to investigate the risk of missing legionellosis relying on UAT solely. Molecular results of Legionella detection as part of a first-line (syndromic) testing algorithm for severe respiratory tract infections were investigated retrospectively and compared with UAT results in 14 Belgian laboratories. Overall, 44.4% (20/45) UAT results appeared false negative and were reclassified as legionellosis based on PCR findings [Legionnaires' disease, 37.5% (15/40); Pontiac fever, 100% (5/5)]. A total of 39.4% (26/66) diagnosis probably would have been missed or delayed without a syndromic approach, as UAT or specific molecular testing for Legionella was not requested by the clinician. Furthermore, we confirmed the higher sensitivity of molecular Legionella detection in lower respiratory tract compared with upper respiratory tract specimens (p = 0.010).
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Affiliation(s)
- Astrid Muyldermans
- Department of Medical Microbiology, AZ Sint-Jan Hospital, Ruddershove 10, 8000, Bruges, Belgium
| | - Patrick Descheemaeker
- Department of Medical Microbiology, AZ Sint-Jan Hospital, Ruddershove 10, 8000, Bruges, Belgium
| | - An Boel
- Department of Medical Microbiology, OLVZ Aalst, Aalst, Belgium
| | - Stefanie Desmet
- Department of Medical Microbiology, University Hospitals Leuven, Leuven, Belgium
| | | | - Marijke Reynders
- Department of Medical Microbiology, AZ Sint-Jan Hospital, Ruddershove 10, 8000, Bruges, Belgium.
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Mercier T, Reynders M, Beuselinck K, Guldentops E, Maertens J, Lagrou K. Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation. J Fungi (Basel) 2019; 5:jof5040113. [PMID: 31816976 PMCID: PMC6958450 DOI: 10.3390/jof5040113] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 10/30/2019] [Revised: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 12/13/2022] Open
Abstract
Invasive mucormycosis is a fungal infection with high mortality. Early diagnosis and initiation of appropriate treatment is essential to improve survival. However, current diagnostic tools suffer from low sensitivity, leading to delayed or missed diagnoses. Recently, several PCR assays for the detection of Mucorales DNA have been developed. We retrospectively assessed the diagnostic and kinetic properties of a commercial Mucorales PCR assay (MucorGenius®, PathoNostics) on serial blood samples from patients with culture-positive invasive mucormycosis and found an overall sensitivity of 75%. Importantly, a positive test preceded a positive culture result by up to 81 days (median eight days, inter-quartile range 1.75–16.25). After initiation of appropriate therapy, the average levels of circulating DNA decreased after one week and stabilized after two weeks. In conclusion, detection of circulating Mucorales DNA appears to be a good, fast diagnostic test that often precedes the final diagnosis by several days to weeks. This test could be especially useful in cases in which sampling for culture or histopathology is not feasible.
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Affiliation(s)
- Toine Mercier
- Department of Microbiology, Immunology and Transplantation, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
- Department of Hematology, University Hospitals Leuven, 3000 Leuven, Belgium
- Correspondence:
| | - Marijke Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ St Jan Bruges, 8000 Bruges, Belgium
| | - Kurt Beuselinck
- Department of Laboratory Medicine and National Reference Centre for Mycosis, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Ellen Guldentops
- Department of Hematology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Johan Maertens
- Department of Microbiology, Immunology and Transplantation, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
- Department of Hematology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Katrien Lagrou
- Department of Microbiology, Immunology and Transplantation, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
- Department of Laboratory Medicine and National Reference Centre for Mycosis, University Hospitals Leuven, 3000 Leuven, Belgium
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