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1. Azole Resistance in Clinical and Environmental Aspergillus Isolates from the French West Indies (Martinique)

Author

Lorra Monpierre, Nicole Desbois-Nogard, Isabel Valsecchi, Marielle Bajal, Cécile Angebault, Charline Miossec, Françoise Botterel, and Éric Dannaoui

Subjects
azole resistance, West Indies, Martinique, Aspergillus fumigatus, Aspergillus terreus, cyp51A gene mutations, Biology (General), QH301-705.5
Abstract

The emergence of azole resistant Aspergillus spp., especially Aspergillus fumigatus, has been described in several countries around the world with varying prevalence depending on the country. To our knowledge, azole resistance in Aspergillus spp. has not been reported in the West Indies yet. In this study, we investigated the antifungal susceptibility of clinical and environmental isolates of Aspergillus spp. from Martinique, and the potential resistance mechanisms associated with mutations in cyp51A gene. Overall, 208 Aspergillus isolates were recovered from clinical samples (n = 45) and environmental soil samples (n = 163). They were screened for resistance to azole drugs using selective culture media. The Minimum Inhibitory Concentrations (MIC) towards voriconazole, itraconazole, posaconazole and isavuconazole, as shown by the resistant isolates, were determined using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) microdilution broth method. Eight isolates (A. fumigatus, n = 6 and A. terreus, n = 2) had high MIC for at least one azole drug. The sequencing of cyp51A gene revealed the mutations G54R and TR34/L98H in two A. fumigatus clinical isolates. Our study showed for the first time the presence of azole resistance in A. fumigatus and A. terreus isolates in the French West Indies.

Published
2021
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2. Reaching the WHO target of testing persons in jails in prisons will need diverse efforts and resources.

Author

Sylvie Abel, Lise Cuzin, Séverine Da Cunha, Jean-Marie Bolivard, Laurence Fagour, Charline Miossec, Mathilde Pircher, Marême Thioune, Raymond Césaire, and André Cabié

Subjects
Medicine, Science
Abstract

BACKGROUND:The Caribbean is the second most affected region in the world by human immunodeficiency virus (HIV), and HIV prevalence is significantly higher among persons in jails and prisons than in the free population. The aim of our study was to assess the screening rates of HIV, hepatitis B and C, syphilis and human T cell leukaemia virus type 1 among newly-arrived persons in 2014, at Ducos facility in Martinique and the testing process performance. METHODS:This is an observational monocentric study conducted within the prison's health unit. The study population consisted of all individuals incarcerated between 01/01/14 and 31/12/14. At the initial medical visit, HIV and STI testing were proposed to every newcomer. The rate of acceptance was calculated, as well as the screening process performance. RESULTS:In 2014 778 new persons were incarcerated, among those, 461 (59.3%) were tested. The main reasons for missing the testing opportunity were due to organization of the judiciary system (persons on electronic monitoring or day parole, transferred or quickly released before completion of the process) or to individual refusal. Finally, 75 persons did not get their results (all of them negative), 41 of them due to the medical staff work overload. CONCLUSIONS:HIV and STI testing rates among newcomers at Ducos have notable room for improvement. The future availability of combined (HIV, HBV, HCV and syphilis) rapid tests may be very useful in case of short term incarceration, if their cost is not prohibitive. Reaching higher levels of testing will also require more resources.

Published
2018
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3. Fungal Integrated Histomolecular Diagnosis Using Targeted Next-Generation Sequencing on Formalin-Fixed Paraffin-Embedded Tissues

Author

Alexis Trecourt, Meja Rabodonirina, Claire Mauduit, Alexandra Traverse-Glehen, Mojgan Devouassoux-Shisheboran, David Meyronet, Frédérique Dijoud, Christophe Ginevra, Emmanuelle Chapey-Picq, Emilie Josse, Patricia Martins-Simoes, Abderrazzak Bentaher, Damien Dupont, Charline Miossec, Florence Persat, Martine Wallon, Tristan Ferry, Félix Pham, Bruno Simon, and Jean Menotti

Subjects
Microbiology (medical)
Abstract

Histopathology is the gold standard for fungal infection (FI) diagnosis, but it does not provide a genus and/or species identification. The objective of the present study was to develop targeted next-generation sequencing (NGS) on formalin-fixed tissue samples (FTs) to achieve a fungal integrated histomolecular diagnosis.

Published
2023
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4. Malaria in Martinique, French West Indies

Author

Nicole Desbois-Nogard, Fabrice Sonor, Elisabeth Fernandes, Charline Miossec, D.T. Nguyen, Pierre L Bonnet, André Yébakima, Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), Université d'Angers (UA), SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques (ICAT), Laboratoire de Parasitologie et Mycologiede [CHRU Brest], and Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)

Subjects
biology, West Indies, [SDV]Life Sciences [q-bio], 030231 tropical medicine, Anopheles, biology.organism_classification, medicine.disease, Malaria, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Geography, medicine, Humans, Martinique, 030212 general & internal medicine, Socioeconomics, ComputingMilieux_MISCELLANEOUS, West indies
Abstract

International audience

Published
2022
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5. P454 Massive parallel fungal sequencing on formalin-fixed tissues: development and contribution in integrated histomolecular diagnosis

Author

Alexis Trecourt, Meja Rabodonirina, Emilie Josse, M. Christophe Ginevra, Emmanuelle Chapey-Picq, Damien Dupont, Charline Miossec, Florence Persat, Claire Mauduit, Alexandra Traverse-Glehen, David Meyronet, Martine Wallon, Brunio Simon, and Jean Menotti

Subjects
Infectious Diseases, General Medicine
Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Histopathology is the gold standard for distinguishing between colonization and fungal infection, but it does not provide a precise diagnosis of genera/species. However, if the culture is negative or if no specimen is sent to the Mycology laboratory, only the specimen sent to the Pathology department is available. Formalin fixation and paraffin embedding (FFPE) cause DNA damage, making it difficult to perform molecular techniques. The objective was to develop and evaluate the contribution of massive parallel sequencing (MPS) to FFPE tissues. Methods Histopathological review of all cases was performed. Then, DNA extraction from FFPE tissues was optimized by: (1) macrodissecting the fungal-rich area on the paraffin block; (2) comparing the efficiency of two DNA extraction kits (QIAamp DNAmicro-kit, QIAGEN; Maxwell 16 LEVRNA FFPE Purification kit, Promega, optimized for RNA and DNA extraction), by comparison of Aspergillus fumigatus and Mucorale specific PCR results for 30 cases. For 124 other cases, the sensitivity of two primer pairs (ITS3/4 and MITS2A/2B) was tested for identification by Sanger sequencing and then MPS. Finally, a histomolecular comparison was performed. This work was funded by the Société de Pathologie Infectieuse de Langue Française (SPILF). Results To optimize extraction, DNA was extracted by both kits from samples of 16 mucormycoses and 14 A. fumigatus infections. PCR sensitivity was better with the QIAGEN extraction kit [100% (30/30)] compared to the Promega kit [86.7% (26/30)]. PCR amplification of fungal DNA from an additional 124 FFPE samples was performed. The primer pairs ITS3/4 and MITS2A/2B, allowed: (1) identification by Sanger sequencing-histopathological analysis in 38.7% (48/124) of the cases in total, and more specifically 33% (41/124) of cases with the ITS3/4 primers and 32.3% (40/124) of cases with the MITS2A/B primers; and (2) identification by integrated SMP-histopathological analysis in 75% (93/124) of all cases (primers ITS3/4 and MITS2A/2B), and more specifically 66.1% (82/124) for ITS3/4 and 62.1% (77/124) for MITS2A/B (both primer pairs did not detect/amplify the same fungal genera/species). The combination of all results from Sanger sequencing and MPS led to fungal identification in 75.8% (94/124) of cases. In total, the addition of NGS to Sanger sequencing increased the diagnostic proportion by 36.3% (45/124; P Conclusion The development of the fungal MPS on FFPE tissues is innovative and unprecedented for the achievement of an integrated histomolecular diagnosis in fungal pathology. It increases significantly the diagnostic proportion by 36.3%. This strategy can be used in hospitals and could improve patient management, especially when no sample is sent to the Mycology laboratory or when the culture is negative.

Published
2022
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6. Pulmonary aspergillosis in critically ill patients with Coronavirus Disease 2019 (COVID-19)

Author

F. Wallet, Laurent Argaud, Florence Persat, Jean Turc, Jean Menotti, Jean-Christophe Richard, Charline Miossec, Martine Wallon, Damien Dupont, S. Paulus, Florence Ader, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3), Université de Lyon-Université de Lyon, Hôpital Edouard Herriot [CHU - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Hôpital Louis Pradel [CHU - HCL], Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques - EA 7426 (PI3), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CarMeN, laboratoire, Centre de recherche en neurosciences de Lyon (CRNL), and Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Illness, [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Aspergillosis, intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Internal medicine, pulmonary aspergillosis, Pandemic, Humans, Medicine, 030212 general & internal medicine, Aged, Aged, 80 and over, Invasive Pulmonary Aspergillosis, 0303 health sciences, Aspergillus, biology, SARS-CoV-2, 030306 microbiology, Critically ill, business.industry, Brief Report, COVID-19, General Medicine, Middle Aged, acute respiratory distress syndrome, medicine.disease, biology.organism_classification, Intensive care unit, 3. Good health, [SDV] Life Sciences [q-bio], Intensive Care Units, Pulmonary aspergillosis, Infectious Diseases, AcademicSubjects/SCI00960, Female, AcademicSubjects/MED00010, business, COVID-19 associated pulmonary aspergillosis (CAPA)
Abstract

Occurrence of putative invasive pulmonary aspergillosis was screened in 153 consecutive adult intensive care unit (ICU) patients with respiratory samples addressed for mycological diagnosis during a 6-week period at the emergence of coronavirus disease 2019 (COVID-19) pandemic. Positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) was observed for 106 patients (69.3%). Nineteen of them (17.9%) with positive Aspergillus results were considered as having putative invasive pulmonary aspergillosis. These observations underline the risk of pulmonary aspergillosis in COVID-19 patients, even in patients not previously known to be immunosuppressed, advocating active search for Aspergillus infection and prompt antifungal treatment. Standardized surveillance protocols and updated definitions for ICU putative invasive pulmonary aspergillosis are needed. Lay Abstract Adult ICU patients with respiratory samples addressed for mycological diagnosis were screened during the emergence of COVID-19 pandemic. Positive SARS-CoV-2 PCR was observed for 106 patients, nineteen of them (17.9%) having aspergillosis. This underlines the risk of aspergillosis in COVID-19 patients.

Published
2020
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7. Diagnostic accuracy of fluorescence flow-cytometry technology using Sysmex XN-31 for imported malaria in a non-endemic setting

Author

Stéphane Picot, Thomas Perpoint, Christian Chidiac, Alain Sigal, Etienne Javouhey, Yves Gillet, Laurent Jacquin, Marion Douplat, Karim Tazarourte, Laurent Argaud, Martine Wallon, Charline Miossec, Guillaume Bonnot, Anne-Lise Bienvenu, HCL Groupement Hospitalier Nord [Lyon], Institut de Chimie et Biochimie Moléculaires et Supramoléculaires (ICBMS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-École Supérieure de Chimie Physique Électronique de Lyon (CPE)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Université de Lyon, Hôpital Edouard Herriot [CHU - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Health Service and Performance Research (HESPER), Université de Lyon-Université de Lyon, Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie du CNRS (INC)-École Supérieure Chimie Physique Électronique de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Sciences, EDP

Subjects
Technology, Plasmodium, Microscopy, Veterinary (miscellaneous), [SDV]Life Sciences [q-bio], Flow Cytometry, Diagnostic accuracy, Malaria, Sysmex XN-31, [SDV] Life Sciences [q-bio], Infectious Diseases, PCR, Artificial Intelligence, LAMP, Insect Science, parasitic diseases, Humans, Animal Science and Zoology, Parasitology, Prospective Studies, RDT
Abstract

Malaria diagnosis based on microscopy is impaired by the gradual disappearance of experienced microscopists in non-endemic areas. Aside from the conventional diagnostic methods, fluorescence flow cytometry technology using Sysmex XN-31, an automated haematology analyser, has been registered to support malaria diagnosis. The aim of this prospective, monocentric, non-interventional study was to evaluate the diagnostic accuracy of the XN-31 for the initial diagnosis or follow-up of imported malaria cases compared to the reference malaria tests including microscopy, loop mediated isothermal amplification, and rapid diagnostic tests. Over a one-year period, 357 blood samples were analysed, including 248 negative and 109 positive malaria samples. Compared to microscopy, XN-31 showed sensitivity of 100% (95% CI: 97.13-100) and specificity of 98.39% (95% CI: 95.56-100) for the initial diagnosis of imported malaria cases. Moreover, it provided accurate species identification asfalciparumor non-falciparumand parasitaemia determination in a very short time compared to other methods. We also demonstrated that XN-31 was a reliable method for patient follow-up on days 3, 7, and 28. Malaria diagnosis can be improved in non-endemic areas by the use of dedicated haematology analysers coupled with standard microscopy or other methods in development, such as artificial intelligence for blood slide reading. Given that XN-31 provided an accurate diagnosis in 1 min, it may reduce the time interval before treatment and thus improve the outcome of patient who have malaria.Précision diagnostique de la technique de cytométrie de flux en fluorescence utilisant le Sysmex XN-31 pour le paludisme d’importation en zone non endémique.Le diagnostic du paludisme basé sur la microscopie est rendu difficile par la disparition progressive des microscopistes expérimentés en zone non-endémique. À côté des méthodes conventionnelles, la technique de cytométrie de flux en fluorescence utilisant le Sysmex XN-31, un automate d’analyse hématologique, a été enregistrée pour participer au diagnostic du paludisme. L’objectif de cette étude prospective, monocentrique et non-interventionelle était d’évaluer la précision diagnostique du XN-31 pour le diagnostic initial et le suivi des cas de paludisme d’importation en comparaison des tests de référence dont la microscopie, l’amplification isothermale en boucle, et des tests de diagnostic rapide. Durant une période d’un an, 357 échantillons de sang ont été analysés, dont 248 négatifs et 109 positifs pour le paludisme. En comparaison de la microscopie, le XN-31 a montré une sensibilité de 100 % (95 % CI : 97.13-100) et une spécificité de 98.39 % (95 % CI : 95.56-100) pour le diagnostic initial des cas de paludisme d’importation. De plus, l’identification des espècesfalciparumet non-falciparumainsi que la parasitémie ont été précises dans un temps très court en comparaison des autres méthodes. Nous avons aussi démontré que le XN-31 était une méthode fiable pour le suivi des patients à J3, J7 et J28. Le diagnostic du paludisme peut être amélioré en zone non-endémique par l’utilisation d’automates d’hématologie spécialisés, associés à la microscopie standard ou d’autres méthodes en développement telle que l’intelligence artificielle appliquée à la lecture des lames de sang. Dans la mesure où le XN-31 produit un diagnostic précis en une minute, cela peut réduire le délai avant le traitement et donc améliorer l’issue pour les patients souffrant de paludisme.

Published
2022
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8. Suboptimal exposure to fluconazole in critically ill patients: Pharmacokinetic analysis and determinants

Author

A.L. Bienvenu, P. Pradat, E. Matusik, V. Piriou, T. Rimmelé, F. Parant, M. Tod, G. Leboucher, S. Goutelle, Florence Ader, Laurent Argaud, Frédéric Aubrun, Jean-Luc Fellahi, Céline Guichon, Laurent Juillard, Vincent Leclerc, Charline Miossec, Carole Paillet, Alexandra Plesa, Jean-Christophe Richard, Sandrine Roux, and Florent Wallet

Subjects
Infectious Diseases
Abstract

This study aims at evaluating fluconazole exposure in critically ill patients and identifying variables associated with the latter.This was a 2-year (2018-2019) retrospective multicenter cohort study. Adult patients 18 years-old with at least one fluconazole concentration measurement during their ICU stay were included.Twenty patients were included. Only 11 patients had a fluconazole trough concentration (Cmin) within the target range (≥15 mg/L). According to bivariable analysis, SOFA score, GGT, fluconazole clearance, Ke, and Vd, were independently associated with a decrease in fluconazole Cmin. The median loading dose required to achieve the Cmin target appeared to be greater in patients with higher SOFA or GGT level and in patients undergoing renal replacement therapy.This study supports recommendation for routine fluconazole therapeutic drug monitoring in ICU patients so as to avoid underexposure, especially if SOFA score is ≥ 7 and/or GGT is ≥ 100 U/L.

Published
2023
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9. Azole Resistance in Clinical and Environmental Aspergillus Isolates from the French West Indies (Martinique)

Author

Charline Miossec, Nicole Desbois-Nogard, Cécile Angebault, Françoise Botterel, Eric Dannaoui, Isabel Valsecchi, Lorra Monpierre, and Marielle Bajal

Subjects
Microbiology (medical), Posaconazole, QH301-705.5, Itraconazole, West Indies, cyp51A gene mutations, Plant Science, Microbiology, Aspergillus fumigatus, 03 medical and health sciences, azole resistance, medicine, Martinique, Aspergillus terreus, Biology (General), skin and connective tissue diseases, Ecology, Evolution, Behavior and Systematics, 030304 developmental biology, chemistry.chemical_classification, Voriconazole, 0303 health sciences, Aspergillus, biology, 030306 microbiology, biology.organism_classification, chemistry, Azole, medicine.drug
Abstract

The emergence of azole resistant Aspergillus spp., especially Aspergillus fumigatus, has been described in several countries around the world with varying prevalence depending on the country. To our knowledge, azole resistance in Aspergillus spp. has not been reported in the West Indies yet. In this study, we investigated the antifungal susceptibility of clinical and environmental isolates of Aspergillus spp. from Martinique, and the potential resistance mechanisms associated with mutations in cyp51A gene. Overall, 208 Aspergillus isolates were recovered from clinical samples (n = 45) and environmental soil samples (n = 163). They were screened for resistance to azole drugs using selective culture media. The Minimum Inhibitory Concentrations (MIC) towards voriconazole, itraconazole, posaconazole and isavuconazole, as shown by the resistant isolates, were determined using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) microdilution broth method. Eight isolates (A. fumigatus, n = 6 and A. terreus, n = 2) had high MIC for at least one azole drug. The sequencing of cyp51A gene revealed the mutations G54R and TR34/L98H in two A. fumigatus clinical isolates. Our study showed for the first time the presence of azole resistance in A. fumigatus and A. terreus isolates in the French West Indies.

Published
2021
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10. Cas groupés d’histoplasmoses à Histoplasma capsulatum var. capsulatum à la Martinique : description des cas et enquête environnementale

Author

Christine Aznar, Charline Miossec, D. Quist, Sandrine Pierre-François, A. Minoza, S. Simon, J. Zecler, N. Desbois, and C. Deligny

Subjects
0301 basic medicine, 03 medical and health sciences, Infectious Diseases, 030106 microbiology
Abstract

Resume Du 24 juin au 6 juillet 2005, neuf hommes se sont presentes successivement aux urgences de l’hopital de Fort-de-France (Martinique, Antilles francaise) avec une symptomatologie pulmonaire plus ou moins marquee associee dans deux cas a la presence de lesions cutanees. Ces neuf hommes avaient tous realise des travaux dans une maison abandonnee trois semaines auparavant. Le diagnostic d’histoplasmose a pu etre etabli grâce aux examens mycologiques realises sur les prelevements pulmonaires (l’examen direct et la culture), la biologie moleculaire et les serologies. L’interrogatoire et l’enquete environnementale sur la zone presumee de l’exposition aux spores d’ H . capsulatum var. capsulatum a permis de confirmer les lieux et les modalites de contamination.

Published
2016
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11. Cerebral phaeohyphomycosis due to Cladophialophora bantiana in a French Guianese child

Author

Patrick Hochedez, N. Desbois, S. Jacob, E. Jolivet, A. Hamlat, L. Peipoch, M. Brard, and Charline Miossec

Subjects
Male, medicine.medical_specialty, Antifungal Agents, Brain Abscess, Cladophialophora bantiana, Ventriculoperitoneal Shunt, Neurosurgical Procedures, Flucytosine, 03 medical and health sciences, Enteral Nutrition, Ascomycota, Central Nervous System Fungal Infections, Humans, Medicine, Child, Abscess, Intubation, Gastrointestinal, Voriconazole, 0303 health sciences, 030306 microbiology, business.industry, Neurological status, Mortality rate, Pathogenicity, medicine.disease, Combined Modality Therapy, French Guiana, Surgery, Infectious Diseases, Cerebral Phaeohyphomycosis, business, Immunocompetence, medicine.drug
Abstract

We report a case of cerebral phaeohyphomycosis, a fungal brain infection due to a dark (dematiaceous) fungi in a 6-year-old French Guyanese boy. The child presented fever and drowsiness due to several paraventricular brain abscesses. Neurological surgeries were performed to reduce intracranial hypertension and to obtain abscess biopsies. Mycological cultures of intraoperative samples led to the diagnosis of cerebral phaeohyphomycosis due to Cladophialophora bantiana. The patient neurological status deteriorated and remained critical after several weeks of combination antifungal therapy with voriconazole 8 mg/kg/day, liposomal amphotericin B 10 mg/kg/day and flucytosine 200 mg/kg/day. A complete surgical resection was not possible because of multiple small abscesses. A multidisciplinary ethical staff decided on home medical care with palliative ventriculoperitoneal shunt, nasogastric feeding and analgesics. One year later, the patient's neurological condition had improved and cerebral lesions had regressed, while he had not received any antifungal treatment but only traditional medicines. Cerebral phaeohyphomycosis are rare diseases affecting immunocompromised but also apparently non-immunocompromised patients, as in this case. A complete surgical resection is not always possible and mortality rates are high in spite of treatments with a combination of antifungals. The diagnosis may be difficult because of these dematiaceous fungi's slowly growing and their potential pathogenicity for laboratory staff.

Published
2020
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12. First cases of Angiostrongylus cantonensis infection reported in Martinique, 2002–2017

Author

Nicole Desbois-Nogard, Eve Tessier, Christopher Swale, Katia de Meuron, André Cabié, Dorothée Harrois, Loïc Epelboin, Charline Miossec, Céline Dard, D.T. Nguyen, Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], University of Kyonggi, Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Université Grenoble Alpes (COMUE) (UGA), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Laboratoire de Parasitologie-Mycologie-Sérologies Bactériennes et Parasitaires [CHU de la Martinique], and Centre Hospitalier Universitaire de la Martinique - CHU Martinique

Subjects
Male, Pediatrics, medicine.medical_specialty, Eosinophilic Meningitis, [SDV]Life Sciences [q-bio], Veterinary (miscellaneous), 030231 tropical medicine, Biology, lcsh:Infectious and parasitic diseases, 030308 mycology & parasitology, 03 medical and health sciences, Fatal Outcome, 0302 clinical medicine, Eosinophilia, Helminth, medicine, Animals, Humans, lcsh:RC109-216, Martinique, Meningitis, Serologic Tests, Child, Retrospective Studies, Strongylida Infections, Anthelmintics, Caribbean, 0303 health sciences, Caribbean island, Angiostrongylus cantonensis, Infant, Middle Aged, medicine.disease, biology.organism_classification, 3. Good health, Infectious Diseases, Insect Science, Parasitic disease, Angiostrongyliasis, Encephalitis, Female, Animal Science and Zoology, Parasitology, Research Article
Abstract

Neuroangiostrongyliasis is a parasitic disease caused by the accidental ingestion of the nematode Angiostrongylus cantonensis in its larval form. Human infection can lead to eosinophilic meningitis, sometimes complicated by life-threatening radiculomyelitis or encephalitis. Although some cases have been reported from other Caribbean Islands, no cases have been diagnosed in Martinique so far. Here, we report the first eight laboratory-confirmed cases of neuroangiostrongyliasis on the island of Martinique, French West Indies, between 1 January 2002 and 31 December 2017. One case was fatal and five resulted in neurological sequelae. The medical community should consider the risk of A. cantonensis infection in patients living in or returning from Martinique.Premiers cas d’angiostrongylose à Angiostrongylus cantonensis à la Martinique, de 2002 à 2017.L’angiostrongylose neuroméningée est une maladie parasitaire causée par l’ingestion accidentelle du nématode Angiostrongylus cantonensis sous sa forme larvaire. L’infection humaine peut conduire à une méningite à éosinophiles, pouvant évoluer en radiculomyélite ou encéphalite menaçant le pronostic vital. Bien que des cas aient été rapportés dans d’autres îles des Caraïbes, aucun cas n’avait été diagnostiqué à la Martinique jusqu’à présent. Dans cet article, nous caractérisons les huit premiers cas d’angiostrongylose neuroméningée biologiquement diagnostiqués à la Martinique, Antilles françaises, entre le 1

Published
2020
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13. Human cryptosporidiosis in immunodeficient patients in France (2015–2017)

Author

Damien Costa, Romy Razakandrainibe, Marc Sautour, Stéphane Valot, Louise Basmaciyan, Gilles Gargala, Denis Lemeteil, Loïc Favennec, Frédéric Dalle, Anne Debourgogne, Adela Angoulvant, Patrice Agnamey, Julie bonhomme, Brigitte Degeilh, Cathy Chemla, Cécile Garnaud, Coralie Lollivier, Cécile angebault, Pascal Delaunay, Guillaume Desoubeaux, Emilie Fréalle, Frédéric Grenouillet, Florent Morio, Françoise Botterel, Ghania Belkadi, Hélène Yera, Gilles Nevez, Xavier Iriart, Isabelle Accoceberry, Julie Brunet, Marc Thellier, Meja Rabodonirina, Milene Sasso, Charline Miossec, Murielle Nicolas, Nicole Desbois, Philippe Poirier, Christelle Pomares, Sandrine Houze, Yohann Le govic, Anne Pauline Bellanger, Franck Labbe, Marie Laure Darde, Olivier Duquesnoy, Pierre Flori, Patrick Bastien, Thomas Gueudet, Isabelle Villena, Dominique Aubert, Estelle Cateau, Marie-Elisabeth Bougnoux, Nathalie Kapel, Eric Dannaoui, Alexis Valentin, Anne Totet, Jean Menotti, Denis Blanchet, Magalie Demar, Emmanuel Dutoit, Renaud Piarroux, Emilie Sitterle, Denis Magne, Samsa Hamane, Antoine Berry, Cecile Ramade, CHU Rouen, Normandie Université (NU), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Laboratoire de parasitologie mycologie (CHU de Dijon), Infections Parasitaires : Transmission, Physiopathologie et Thérapeutiques (IP-TPT), Service de Santé des Armées-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Institut de Recherche pour le Développement (IRD), Epidémiosurveillance de protozooses à transmission alimentaire et vectorielle (ESCAPE), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Reims Champagne-Ardenne (URCA), Appareil Digestif Environnement Nutrition (ADEN ), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Service de Parasitologie-Mycologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Stress, Immunité, Pathogènes (SIMPA), Université de Lorraine (UL), Anofel Cryptosporidium National Network, Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 (AGIR ), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Université de Caen Normandie (UNICAEN), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Centre Hospitalier Universitaire de Reims (CHU Reims), Université Grenoble Alpes - UFR Pharmacie (UGA UFRP), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Paris Descartes - Paris 5 (UPD5), Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut Pasteur de Dakar, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre hospitalier universitaire de Nantes (CHU Nantes), École nationale vétérinaire d'Alfort (ENVA), Service de parasitologie-mycologie [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM), Université de Brest (UBO), CHU Bordeaux [Bordeaux], Microbiologie cellulaire et moléculaire et pathogénicité (MCMP), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Dynamique des interactions Hôte pathogène, Université de Strasbourg (UNISTRA), Immunité et Infection, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Parasitologie et Mycologie, Hospices Civils de Lyon (HCL), Biologie, Génétique et Pathologie des Pathogènes Eucaryotes (MIVEGEC-BioGEPPE), Pathogènes, Environnement, Santé Humaine (EPATH), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Laboratoire de Parasitologie-Mycologie-Sérologies Bactériennes et Parasitaires [CHU de la Martinique], Centre Hospitalier Universitaire de la Martinique - CHU Martinique, Parasitologie-Mycologie Fort de France, CHU Fort de France, Laboratoire Microorganismes : Génome et Environnement (LMGE), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Hôpital Bichat - Claude Bernard, Service de parasitologie et mycologie [CHRU de Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP), Université Jean Monnet [Saint-Étienne] (UJM), CHU Clermont-Ferrand, Laboratoire de Parasitologie-Mycologie (LPM), IFR 53, Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)-CHU Maison Blanche-UPRES EA 2070, Centre de formation et de recherche sur l'environnement marin (CEFREM), Université de Perpignan Via Domitia (UPVD)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS), Ecologie et biologie des interactions (EBI), Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Departments of Medical Parasitology and Mycology, Service de réanimation médicale, Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Université des Antilles (UA)-Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université de la Méditerranée - Aix-Marseille 2, Laboratoire de parasitologie mycologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe hospitalier Albert Chenevier – Henri Mondor, Service de Parasitologie et Mycologie, CHU Toulouse [Toulouse]-Institut Fédératif de Biologie (IFB) - Hôpital Purpan, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Région Haute Normandie, Projet COS Sesa, 2015-2018, Université de Reims Champagne-Ardenne (URCA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Service de Santé des Armées, Université de Rennes (UR), Laboratoire Chrono-environnement (UMR 6249) (LCE), École nationale vétérinaire - Alfort (ENVA), Microbiologie Fondamentale et Pathogénicité (MFP), Université Jean Monnet - Saint-Étienne (UJM), Université de Toulouse (UT), Service de Parasitologie et Mycologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
0301 basic medicine, Male, Pediatrics, Epidemiology, Cryptosporidiosis, 0302 clinical medicine, Risk Factors, Child, Immunodeficiency, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, biology, Mortality rate, Cryptosporidium, General Medicine, Middle Aged, 3. Good health, Diarrhea, Infectious Diseases, Cryptosporidium parvum, Child, Preschool, Protozoan, Cyclosporine, Female, Immunotherapy, France, medicine.symptom, Cryptosporidium hominis, Immunosuppressive Agents, Adult, medicine.medical_specialty, Adolescent, 030231 tropical medicine, 030106 microbiology, Immunology, Context (language use), Tacrolimus, 03 medical and health sciences, Immunocompromised Host, Young Adult, medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Immunocompromised, Aged, Immunosuppression Therapy, Infant, Newborn, Infant, Mycophenolic Acid, medicine.disease, biology.organism_classification, Parasitology
Abstract

International audience; Cryptosporidiosis is a common disease in children and immunodeficient individuals. In 2006, a national network was set up on the surveillance of human cryptosporidiosis in France. Since January 2015, the 41 tertiary care hospitals and the 3 private laboratories of the French National Network on the surveillance of human cryptosporidiosis have been able to declare confirmed cases of cryptosporidiosis online. Between 2015 and 2017, 210 cases of cryptosporidiosis were declared in immunodeficient patients in France; Cryptosporidium parvum and Cryptosporidium hominis represented 66% and 22% of cases, respectively. A peak was observed in autumn. Cryptosporidiosis occurred mainly in a context of solid organ transplantation (SOT) (49%) and of HIV infection (30%). In SOT recipients, cryptosporidiosis appeared more frequently in the first 6 months post transplantation. Regarding cases declared in SOT recipients, mycophenolate mofetil was used in 68%. A mortality rate of 6% was observed. Present results underline the importance of screening for cryptosporidiosis in immunocompromised patients suffering from diarrhea, especially in the course of major cell mediated immunodeficiency or even systematic screening before SOT. Exclusive Cryptosporidium free water feeding could be suggested during major cell mediated immunodeficiency.

Published
2018
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14. New Surge of Syphilis among Patients Living with Human Immunodeficiency Virus in Martinique in 2015

Author

Alain Putot, Nicole Desbois, Ingrid Laudarin, Patrick Hochedez, Charline Miossec, K Guitteaud, Sylvie Abel, André Cabié, Benoît Rozé, Sandrine Pierre-François, Mathilde Pircher, Rosalie Vilain, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Laboratoire de Parasitologie Mycologie Immunologie [Fort de France], CHU Fort de France, Parasitologie-Mycologie Fort de France, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), This work was funded by Centre Hospitalier Universitaire de Martinique, France, CHU Fort de France-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-CHU de la Martinique [Fort de France], Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, and Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]

Subjects
0301 basic medicine, Adult, Male, Sexual Behavior, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Medicine, Humans, Martinique, 030212 general & internal medicine, Syphilis, business.industry, Incidence (epidemiology), Outbreak, virus diseases, Articles, medicine.disease, 3. Good health, Infectious Diseases, Sexual behavior, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Parasitology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract

International audience; A syphilis outbreak began in Martinique, French Antilles, in 2004, initially among men who had sex with men (MSM) and who were living with human immunodeficiency virus (HIV). The outbreak subsequently affected all groups at risk, leading to a first epidemic peak in 2008. After an initial decrease, the outbreak started growing again in 2014 among patients living with HIV with unprecedented incidence among MSM. Herein, we describe the change in medical and social parameters of the outbreak since 2005.

Published
2017
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15. IST-06 - Réémergence de la syphilis chez les personnes infectées par le VIH en Martinique en 2015

Author

R. Vilain, Benoît Rozé, André Cabié, Sandrine Pierre-François, Patrick Hochedez, Mathilde Pircher, Alain Putot, Charline Miossec, Sylvie Abel, N. Desbois, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], and ADENIS, ANTOINE

Subjects
0303 health sciences, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, 030306 microbiology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine
Abstract

National audience; En 2004 a débuté une épidémie de syphilis en Martinique chez les hommes ayant des rapports sexuels avec des hommes (HSH) et vivant avec le VIH, pour se généraliser secondairement à l’ensemble des groupes à risque. L’objectif de cette étude était d’estimer l’évolution, depuis 2005, de l’incidence et des caractéristiques des cas de syphilis récente dans la cohortede patients vivant avec le VIH (PVVIH) suivis en Martinique.

Published
2016

16. Fatal Invasive Infection with Fungemia Due to Microascus cirrosus after Heart and Lung Transplantation in a Patient with Cystic Fibrosis

Author

Patrice Le Pape, Dea Garcia-Hermoso, Charline Miossec, Michel Miegeville, Françoise Gay-Andrieu, Thierry Lepoivre, Alain Haloun, Michele Treilhaud, Florent Morio, François Leclair, Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Nantes (UN), Centre National de Référence des Mycoses invasives et antifongiques - Mycologie moléculaire (CNRMA), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), We are grateful to Francoise Dromer for fruitful discussions on the manuscript. We acknowledge Bernard Besse, Olivier Barre, and Damien Hoinard for technical assistance., and Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, MESH: Histocytochemistry, MESH: Sequence Analysis, DNA, MESH: Fatal Outcome, Antifungal Agents, Cystic Fibrosis, medicine.medical_treatment, Case Reports, Cystic fibrosis, Echinocandins, chemistry.chemical_compound, Fatal Outcome, 0302 clinical medicine, MESH: Lipopeptides, Caspofungin, MESH: Immunocompromised Host, 030212 general & internal medicine, DNA, Fungal, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Fungemia, Microscopy, 0303 health sciences, Histocytochemistry, MESH: Heart Transplantation, MESH: Voriconazole, 3. Good health, MESH: Caspofungin, Microascus, Pleura, Radiography, Thoracic, MESH: Tomography, X-Ray Computed, Lung Transplantation, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, MESH: Microscopy, MESH: Cystic Fibrosis, Molecular Sequence Data, MESH: Ascomycota, Biology, Immunocompromised Host, Lipopeptides, 03 medical and health sciences, MESH: Mycoses, Ascomycota, MESH: Fungemia, medicine, Humans, Lung transplantation, Voriconazole, MESH: Humans, MESH: Molecular Sequence Data, 030306 microbiology, MESH: Echinocandins, MESH: Adult, Sequence Analysis, DNA, Triazoles, MESH: Radiography, Thoracic, MESH: Antifungal Agents, medicine.disease, biology.organism_classification, Dermatology, MESH: Male, Surgery, MESH: DNA, Fungal, Transplantation, Pyrimidines, MESH: Pleura, Mycoses, MESH: Triazoles, chemistry, MESH: Pyrimidines, Scopulariopsis, Heart Transplantation, MESH: Lung Transplantation, Tomography, X-Ray Computed
Abstract

Scopulariopsis species are rarely but increasingly recognized as opportunistic pathogens in immunocompromised patients. We report on a patient suffering from cystic fibrosis who developed disseminated fungal infection due to a rare Scopulariopsis species, Microascus cirrosus , after heart and lung transplantation. Despite antifungal combination therapy with voriconazole and caspofungin, the patient died 4 weeks after transplantation. Diagnostic difficulties and optimal management of disseminated Scopulariopsis / Microascus infections are discussed.

Published
2011
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18. Reaching the WHO target of testing persons in jails in prisons will need diverse efforts and resources

Author

Raymond Césaire, Marême Thioune, Charline Miossec, Séverine Da Cunha, Jean-Marie Bolivard, André Cabié, Lise Cuzin, Mathilde Pircher, Laurence Fagour, Sylvie Abel, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Unité Médicale Pénitentiaire [Fort-de-France, Martinique], Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Laboratoire de Parasitologie-Mycologie-Sérologies Bactériennes et Parasitaires [CHU de la Martinique], Centre Hospitalier Universitaire de la Martinique - CHU Martinique, Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424

Subjects
Adult, Male, medicine.medical_specialty, media_common.quotation_subject, Population, lcsh:Medicine, HIV Infections, Prison, World Health Organization, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, Mass Screening, Medicine, Martinique, Syphilis, 030212 general & internal medicine, Young adult, lcsh:Science, education, Mass screening, media_common, Human T-lymphotropic virus 1, education.field_of_study, 030505 public health, Multidisciplinary, business.industry, Prisoners, lcsh:R, virus diseases, Hepatitis B, medicine.disease, HTLV-I Infections, Hepatitis C, 3. Good health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Prisons, Family medicine, Population study, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Observational study, 0305 other medical science, business
Abstract

Background The Caribbean is the second most affected region in the world by human immunodeficiency virus (HIV), and HIV prevalence is significantly higher among persons in jails and prisons than in the free population. The aim of our study was to assess the screening rates of HIV, hepatitis B and C, syphilis and human T cell leukaemia virus type 1 among newly-arrived persons in 2014, at Ducos facility in Martinique and the testing process performance. Methods This is an observational monocentric study conducted within the prison’s health unit. The study population consisted of all individuals incarcerated between 01/01/14 and 31/12/14. At the initial medical visit, HIV and STI testing were proposed to every newcomer. The rate of acceptance was calculated, as well as the screening process performance. Results In 2014 778 new persons were incarcerated, among those, 461 (59.3%) were tested. The main reasons for missing the testing opportunity were due to organization of the judiciary system (persons on electronic monitoring or day parole, transferred or quickly released before completion of the process) or to individual refusal. Finally, 75 persons did not get their results (all of them negative), 41 of them due to the medical staff work overload. Conclusions HIV and STI testing rates among newcomers at Ducos have notable room for improvement. The future availability of combined (HIV, HBV, HCV and syphilis) rapid tests may be very useful in case of short term incarceration, if their cost is not prohibitive. Reaching higher levels of testing will also require more resources.

Published
2018
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19. Manifestations cliniques de l’angiostrongylose humaine en Martinique (2000–2017)

Author

Charline Miossec, K. de Meuron, N. Desbois, Benoît Rozé, Céline Dard, J. Pasquier, E. Tessier, André Cabié, and D.T. Nguyen

Subjects
Infectious Diseases
Abstract

Introduction L’angiostrongylose humaine est une zoonose transmise par un nematode du genre Angiostrongylus. Les 2 principales especes pathogenes identifiees chez l’Homme sont Angiostrongylus cantonensis ( A. cantonensis ) et Angiostrongylus costaricensis ( A. costaricensis ) responsables respectivement d‘angiostrongylose nerveuse (meningo-encephalite a eosinophiles) et d’angiostrongylose intestinale (pseudo-appendicite aigue avec hypereosinophilie). Cette pathologie est endemique sur le continent asiatique et en ocean pacifique mais reste peu decrite dans la Caraibe. La presence conjointe de ces 2 especes d’ Angiostrongylus dans un meme ecosysteme est exceptionnelle et n’a jamais ete rapportee, a notre connaissance, dans les petites Antilles. L’objectif de cette etude etait donc de decrire les donnees epidemiologiques sur l’angiostrongylose humaine en Martinique. Materiels et methodes Une etude observationnelle retrospective monocentrique a ete menee dans notre centre hospitalier entre le 01/01/2000 et le 31/12/2017. Tout patient ayant un diagnostic parasitologique (serologie ou PCR) ou anatomo-pathologique confirme d’angiostrongylose nerveuse ou intestinale etait inclus. Resultats Douze cas de d’angiostrongylose humaine ont ete identifies dans notre etude, incluant 8 cas d’angiostrongylose nerveuse a A. cantonensis et 4 cas d’angiostrongylose intestinale a A. costaricensis . L’âge median etait de 14 ans (IQR : 1–27) avec un sex-ratio homme/femme de 2. Une fievre (> 38 °C) etait observee dans 92 % des cas (11/12). Tous les patients presentaient une hypereosinophilie (> 0,5 G/L) avec une duree mediane de persistance de l’eosinophilie de 23,5 jours (IQR : 14,5–34,5). Tous les patients avaient une confirmation diagnostique serologique (sang ou LCR) ou anatomopathologique pour les cas d’ A. costaricensis . Le mode de transmission probable etait l’ingestion ou un contact etroit dans l’environnement avec Achatina fulica (hote intermediaire) dans 83 % des cas (10/12). Onze patients ont recu un traitement par albendazole (10/12) ou ivermectine (1/12). L’evolution etait favorable dans 11 cas sur 12. Un deces d’angiostrongylose neurologique a ete observe. Conclusion Nous decrivons la plus grande serie de cas d’angiostrongylose humaine dans la Caraibe. L’angiostrongylose, pathologie negligee, doit cependant etre evoquee devant toute hypereosinophilie avec atteinte neurologique ou abdominale en Martinique. Une meilleure connaissance de son hote intermediaire, Achatina fulica , devrait permettre d’ameliorer les strategies de prevention primaire et secondaire.

Published
2018
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20. First Case of Visceral Leishmaniasis Caused by Leishmania martiniquensis

Author

Yves Plumelle, Christophe Ravel, Moumini Kone, Charline Miossec, Nicole Desbois, Nicolas Vignier, Delphine . Delta, André Cabié, Bernard Liautaud, CHU de la Martinique [Fort de France], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biologie, Génétique et Pathologie des Pathogènes Eucaryotes (MIVEGEC-BioGEPPE), Pathogènes, Environnement, Santé Humaine (EPATH), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), and Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]

Subjects
Male, Anemia, AIDS-Related Opportunistic Infections, Hepatosplenomegaly, Cutaneous leishmaniasis, Amphotericin B, Virology, Humans, Medicine, Martinique, Leishmania, biology, business.industry, Leishmaniasis, Articles, Middle Aged, medicine.disease, biology.organism_classification, Trypanocidal Agents, 3. Good health, Infectious Diseases, Visceral leishmaniasis, Immunology, Leishmaniasis, Visceral, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, business
Abstract

International audience; We report the first case of visceral leishmaniasis (VL) caused by Leishmania martiniquensis in the Caribbean, which until now, was known only to cause cutaneous leishmaniasis. The disease presented with fatigue, anemia, and hepatosplenomegaly in a 61-year-old man with human immunodeficiency virus (HIV) infection who was receiving antiretroviral therapy. Diagnosis was made by bone marrow biopsy. VL is life-threatening, and its emergence in the Caribbean is of concern.

Published
2015
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21. A 43-year-old Brazilian man with a chronic ulcerated lesion

Author

Charline Miossec, Sarah Milley, Christine Aznar, Pierre Couppié, Denis Blanchet, and Marie Cheuret

Subjects
Microbiology (medical), Adult, Male, Pathology, medicine.medical_specialty, Lacazia, Biopsy, Lesion, Skin Ulcer, medicine, Humans, Lobomycosis, Lepromatous leprosy, Microscopy, Chromoblastomycosis, Sporotrichosis, biology, medicine.diagnostic_test, business.industry, Histocytochemistry, medicine.disease, biology.organism_classification, Infectious Diseases, Skin biopsy, medicine.symptom, business, Brazil
Abstract

Diagnosis: lacaziosis, or lobomycosis [1]. The diagnosis was confirmed by direct examination of the skin biopsy, highlighting the presence of round or oval yeastlike organisms 6–12 μm in diameter, either isolated or in chains, with a birefringent membrane (Figure 1). The periodic acid-Schiff–stained and the Gomori-Grocott methenamine silver–stained sections of the sample revealed short chains of lemon-shaped fungal cells connected by thin, tubelike bridges (Figure 2). Morphology was consistent with the appearance of Lacazia loboi. There was a minor improvement of the lesion after pentamidine treatment, whereas the Leishmania research by microscopic examination, culture, and molecular biology was negative. However, these exams were done after treatment initiation, so an initial coinfection cannot be ruled out. Mycological culturesonSabouraud-gentamicin-cycloheximide withandwithout actidionewereperformedandwerenegativeafter 2 months. The patient is currently under treatment with terbinafine (250 mg twice daily), awaiting surgical excision of the lesion. Lacaziosis, or lobomycosis [1], is a chronic infectious disease that was first described in 1930 in Brazil by the dermatologist Jorge Lobo [2]. Since then, >500 human cases have been reported [3], mainly in Central and South America. The etiological agent, Lacazia loboi ( formerly known as Loboa loboi), an Onygenales dimorphic fungus [4], seems to be saprophytic in vegetation, soil, and water. It gains access to the skin following cutaneous traumatism, or animal bites [5]. After the initial lesion, there is a slow local dissemination period leading to pleomorphic lesions. The typical clinical aspect is generally multiple keloidal lesions, with a smooth, shiny aspect, but can also appear as papules, nodules, ulcers, sclerodermiform, or verrucous plaques [6]. These lesions are painless and hypoor hyperchromic. Clinical diagnosis is generally difficult because of pathology scarcity and frequently atypical cases. For example, infiltrated plaque-type lesions can be mistaken for cutaneous leishmaniasis; lesions with a keloidal aspect can be mistaken for lepromatous leprosy [7]; and lesions with a verrucous, vegetating, or nodular aspect can be mistaken for sporotrichosis, chromoblastomycosis, paracoccidioidomycosis, keloids, or neoplastic processes [6]. The diagnosis is based onmacroscopic examination of the lesions and on direct microscopic examination of biopsy or curettage. The diagnostic feature of Lacazia loboi is the chain of samesized buds, unlike Paracoccidioides, whose buds are smaller than the mother cell. Figure 1. Skin biopsy: round or oval yeast-like organisms from 6 to 12 μm in diameter, isolated or in chains with a bi-refringent membrane; direct microscopic examination (×1000 magnification). Figure 2. Skin biopsy section. Short chains of lemon-shaped fungal cells connected by thin, tubelike bridges (arrow). A, Periodic acidSchiff stain. B, Gomori-Grocott methenamine silver stain (×1000 magnification).

Published
2014

22. Épidémiologie des candidémies en réanimation : étude observationnelle rétrospective au CHU de la Martinique (2001–2013)

Author

Nicole Desbois, Christophe Courdurie, Charline Miossec, Hossein Mehdaoui, and Yohann Le Govic

Subjects
Infectious Diseases
Abstract

Objectif Preciser la repartition et la sensibilite des souches de levures isolees d’hemocultures de patients hospitalises dans le service de reanimation du CHU de la Martinique sur la periode 2001–2013. Methode Analyse retrospective des resultats de l’ensemble des candidemies (et levures apparentees) diagnostiquees au laboratoire de microbiologie entre le 1er janvier 2001 et le 31 decembre 2013. Identification a l’espece basee sur des caracteres morphologiques et biochimiques. Sensibilite aux antifongiques determinee par comparaison des CMI obtenues par bandelette E-test (bioMerieux) vis-a-vis des concentrations critiques actuellement definies par l’EUCAST et le CLSI, lorsque disponibles. Resultats Cent trente-deux souches de levures correspondant a 128 episodes septiques (moy. 9,8/an) furent isolees chez 121 patients. Candida albicans etait l’espece la plus prevalente (n = 40 ; 30,3 %), suivie de C. tropicalis (n = 30 ; 22,7 %), C. parapsilosis (n = 24 ; 18,2 %), C. glabrata (n = 17 ; 12,9 %), C. haemulonii (n = 13 ; 9,8 %) et S. cerevisiae (n = 5 ; 3,8 %). Candida krusei, C. dubliniensis et T. asahii furent chacune impliquees dans un episode septique (0,8 %). La proportion de souches fluconazole-R ou SDD etait de 6,1 %, 9,1 % et 13,6 % pour C. albicans, C. tropicalis et C. parapsilosis, respectivement, tandis que 76,9 % des souches de C. haemulonii presentaient une CMI elevee au fluconazole (> 2 μg/mL). Tous les isolats de C. albicans et C. tropicalis etaient sensibles au voriconazole contre 95 % des souches de C. parapsilosis, tandis que 91,7 % des souches de C. glabrata etaient considerees comme « sauvages » (CMI ≤ ECOFF). Le pourcentage de resistance a la caspofungine etait de 0 %, 3,6 % et 12,5 % pour C. tropicalis, C. albicans, C. parapsilosis, respectivement ; une proportion importante de C. glabrata (66,7 %) presentait une CMI superieure au breakpoint defini par le CLSI. Enfin, toutes les souches etaient sensibles a l’amphotericine B hormis la majorite des isolats de C. haemulonii (84,6 % avaient une CMI > 2 μg/mL). Discussion Nos resultats soulignent la frequence ainsi que les particularites epidemiologiques des candidemies survenues dans notre service de reanimation ces 13 dernieres annees. La part belle est faite aux levures autres que C. albicans (∼ 70 % contre 43 % dans l’etude AMARCAND), notamment C. tropicalis, C. glabrata, C. parapsilosis et la levure emergente C. haemulonii. Cette derniere, conformement a la litterature, presente des CMI souvent tres elevees pour l’amphotericine B et le fluconazole. La frequence de CMI elevees de C. glabrata a la caspofungine nous interpelle quant a sa capacite a predire la sensibilite aux echinocandines. Conclusion Cette etude met l’accent sur l’originalite des candidemies a la Martinique. Le role du laboratoire reste primordial dans leur prise en charge. Cela passe en priorite par une identification correcte des isolats afin d’orienter les cliniciens dans leur choix therapeutique dans l’attente des resultats de l’antifongigramme.

Published
2015
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23. À propos d’un cas d’infection pulmonaire à Magnusiomyces capitatus associé à Geotrichum candidum chez une patiente immunodéprimée

Author

D. Nguyen, N. Desbois, André Cabié, and Charline Miossec

Subjects
Infectious Diseases
Abstract

Introduction Les infections a Magnusiomyces capitatus (anciennement Geotrichum capitatum ) et a Geotrichum candidum sont rares. M. capitatus et G. candidum sont des levures cosmopolites. M. capitatus est considere comme pathogene emergent opportuniste chez les patients immunodeprimes. Nous decrivons le premier cas de co-infection pulmonaire a M. capitatus et a G. candidum chez une patiente presentant un adenocarcinome mammaire. Observation Une patiente de 65 ans etait hospitalisee pour un bilan de dyspnee d’apparition recente dans un contexte d’alteration de l’etat general. Cette patiente avait beneficie d’une mastectomie en 2012 pour un carcinome canalaire in situ droit. L’examen clinique revelait un syndrome cave superieur. Le scanner thoracique montrait des plages de condensation des lobes superieurs et moyens droits associees a une lymphangite carcinomateuse avec des polyadenopathies mediastinales et hilaires ainsi que des metastases hepatiques. Des epanchements pericardiques et pleuraux de grande abondance etaient egalement objectives. Les resultats anatomo-pathologiques de la biopsie ganglionnaire au niveau mediastinal confirmaient un adenocarcinome moyennement differencie en faveur d’une origine mammaire. Les bilans bacteriologiques et virologiques etaient negatifs. L’examen mycologique du lavage broncho-alveolaire a permis la visualisation de filaments myceliens arthrospores et de rares levures bourgeonnantes, a l’examen direct (coloration May-Grunwald Giemsa) et l’isolement en culture, sur Sabouraud chloramphenicol ± actidione, a 30 °C et 37 °C de M. capitatus et G. candidum . Un traitement antifongique n’a pas ete initie devant le refus de la patiente. Apres concertation pluridisciplinaire, la patiente a beneficie d’une prise en charge palliative. L’evolution etait rapidement defavorable conduisant au deces de la patiente 4 jours apres le diagnostic mycologique. Discussion Il existe moins de 100 cas rapportes d’infections disseminees a M. capitatus et a G. candidum . Ces champignons sont des levures ascomycetes pour lesquelles un portage pulmonaire est souvent retrouve. Leur pathogenicite dans les infections survient souvent sur un terrain d’immunodepression lie a une hemopathie pour les quelques cas decrits. Le diagnostic mycologique de ces deux levures est base sur la presence commune de filaments et d’arthrospores a l’examen direct. L’isolement en culture sur milieu de Sabouraud a 30 °C et 37 °C permet l’isolement de colonies blanches avec presence de filaments arthrospores de grand diametre, des arthrospores ± blastospores en fonction de l’espece. Le traitement antifongique repose generalement sur une association d’amphotericine B et de 5-fluorocytosine. Le role de la pathologie neoplasique sous-jacente et des pathogenes opportunistes dans l’evolution fatale de ce cas sont a discuter et renvoient au benefice d’une therapeutique antifongique systemique. Conclusion La co-infection a M. capitatus et G. candidum sur un terrain neoplasique est exceptionnelle et permet de nous sensibiliser sur l’emergence de mycoses profondes atypiques.

Published
2016
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24. Ovarian reserve in young women of reproductive age with Crohn's disease

Author

Stanislas Bruley des Varannes, Mathurin Flamant, Arnaud Bourreille, Paul Barrière, Kalyane Bach-Ngohou, Charline Miossec, Olivier Maillard, Thomas Dejoie, Damien Masson, Marc G. Denis, and Thomas Fréour

Subjects
Adult, Anti-Mullerian Hormone, endocrine system, medicine.medical_specialty, Physiology, Inflammatory bowel disease, Young Adult, Crohn Disease, Pregnancy, medicine, Immunology and Allergy, Humans, Young adult, Ovarian reserve, Retrospective Studies, Gynecology, Crohn's disease, biology, business.industry, Reproduction, Ovary, Gastroenterology, Case-control study, Age Factors, Retrospective cohort study, Anti-Müllerian hormone, medicine.disease, Prognosis, Case-Control Studies, biology.protein, Female, France, business, Biomarkers, Follow-Up Studies
Abstract

Background: Crohn's disease (CD) mainly affects young adults of reproductive age. Whereas a large amount of data is available concerning pregnancy in young CD women, no study has been conducted on their ovarian reserve status. This study aimed to investigate the potential effect of CD on ovarian reserve in young women in remission, as reflected by serum anti-Mullerian hormone (AMH). Methods: This retrospective case-control study was conducted in the University Hospital of Nantes, France. Serum levels of AMH were retrospectively measured in 50 women with CD in remission and in 163 control women with normal ovarian reserve, matched by age. Results: No statistical difference was found between mean serum AMH levels in CD and control women. Serum AMH levels remained comparable between CD and control women

Published
2011

27. Active Surveillance Program to Increase Awareness on Invasive Fungal Diseases: the French RESSIF Network (2012 to 2018)

Author

Bretagne, Stéphane, Sitbon, Karine, Desnos-Ollivier, Marie, Garcia-Hermoso, Dea, Letscher-Bru, Valérie, Cassaing, Sophie, Millon, Laurence, Morio, Florent, Gangneux, Jean-Pierre, Hasseine, Lilia, Favennec, Loïc, Cateau, Estelle, Bailly, Eric, Moniot, Maxime, Bonhomme, Julie, Desbois-Nogard, Nicole, Chouaki, Taieb, Paugam, André, Bouteille, Bernard, Pihet, Marc, Dalle, Frédéric, Eloy, Odile, Sasso, Milène, Demar, Magalie, Mariani-Kurkdjian, Patricia, Robert, Vincent, Lortholary, Olivier, Dromer, Françoise, French Mycoses Study Group, The, Damiani, Céline, Dupont, Hervé, Maizel, Julien, Totet, Anne, Bouchara, Jean-Philippe, Bellanger, Anne Pauline, Berceanu, Ana, Navellou, Jean Christophe, Scherer, Emeline, Abboud, Philippe, Aznar, Christine, Blanchet, Denis, Djossou, Félix, Cayot, Sophie, Garrouste, Cyril, Lesens, Olivier, Moluçon, Cécile, Nourrisson, Céline, Poirier, Philippe, Bailly, Éloïse, Basmaciyan, Louise, Belaid, Bouhemad, Blot, Mathieu, Caillot, Denis, Charles, Pierre-Emmanuel, Quenot, Jean Pierre, Amazan, Emmanuelle, Baubion, Emilie, Cabie, André, Chabartier, Cyrille, Deligny, Christophe, Emal, Violaine, Flechelle, Olivier, Hatchuel, Yves, Le Govic, Yohann, Merle, Harold, Miossec, Charline, Turmel, Jean-Marie, Valentino, Ruddy, Durieux, Marie-Fleur, Turlure, Pascal, Mercier, Victor, Gari-Toussaint, Martine, Risso, Karine, Simon, Loïc, Bretonnière, Cedric, Boutoille, David, Gastinne, Thomas, Lakhal, Karim, Launay, Elise, Lepoivre, Thierry, Peterlin, Pierre, Rialland, Fanny, Le Pape, Patrice, Canoui, Etienne, Dahane, Naima, Kerneis, Solène, Angebault, Cécile, Bougnoux, Marie-Elisabethh, Guennouni, Nadia, Lanternier, Fanny, Neven, Bennedicte, Oualha, Mehdi, Scemla, Anne, Sitterlé, Emilie, Suarez, Felipe, Toubiana, Julie, Bonacorci, Stéphane, Alanio, Alexandre, Bergeron, Anne, Denis, Blandine, Gits-Muselli, Maud, Hamane, Samia, Touratier, Sophie, Chaumeil, Christine, Merabet, Lilia, Claudéon, Joelle, Curlier, Elodie, Galantine, Valérie, Gallois, Jean Claude, Markowicz, Samuel, Nicolas, Muriel, Musson, Pascal, Schepers, Kinda, Minoza, Alida, Kauffmann-Lacroix, Catherine, Guégan, Hélène, Costa, Damien, Dehais, Marion, Gargala, Gilles, Bajolet, Odile, Banisadr, Firouze, Cousson, Joel, Himberlin, Chantal, Huguenin, Antoine, Toubas, Dominique, Flori, Pierre, Mahinc, Caroline, Raberin, Hélène, Denis, Julie, Herbrecht, Raoul, Mertes, Paul-Michel, Meziani, Fehrat, Sabou, Marcela, Schneider, Francis, Bertozzi, Anne-Isabelle, Chauvin, Pamela, Charpentier, Elena, Cointault, Olivier, Cottrel, Claire, Delavigne, Karen, Faguer, Stanislas, Fillaux, Judith, Guemas, Emilie, Iriart, Xavier, Lelièvre, Lucie, Ruiz, Jean, Bastides, Frédéric, Chesnay, Adélaïde, Desoubeaux, Guillaume, Therby, Audrey, Chachaty, Elisabeth, Gachot, Bertrand, Westerdijk Fungal Biodiversity Institute, Westerdijk Fungal Biodiversity Institute - Software and Databasing, Mycologie moléculaire - Molecular Mycology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals (CNRMA), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Dynamique des interactions hôte pathogène (DIHP), Université de Strasbourg (UNISTRA), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Nantes Université (Nantes Univ), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Rouen, Normandie Université (NU), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Ecologie et biologie des interactions (EBI), Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU de la Martinique [Fort de France], CHU Amiens-Picardie, Hôpital Cochin [AP-HP], CHU Limoges, SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques (ICAT), Université d'Angers (UA), Laboratoire de Parasitologie-Mycologie (CHU d'Angers), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Infections Respiratoires Fongiques (IRF), Université d'Angers (UA)-Université de Brest (UBO), Procédés Alimentaires et Microbiologiques [Dijon] (PAM), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut Agro Dijon, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Centre Hospitalier de Versailles André Mignot (CHV), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Hôpital Robert Debré Paris, Hôpital Robert Debré, Westerdijk Fungal Biodiversity Institute [Utrecht] (WI), Royal Netherlands Academy of Arts and Sciences (KNAW), Service des Maladies infectieuses et tropicales [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 (AGIR ), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Laboratoire de Parasitologie-Mycologie [CHU Angers], Hôpital Bretonneau, Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), This work was supported by recurrent financial support from Santé Publique France and Institut Pasteur. The funders had no role in study design, data collection, analysis, interpretation of data, or the decision to submit the work for publication., We thank Didier Che (Direction des Maladies Infectieuses, Santé Publique France) for his continuous support and interest in invasive fungal infections and Etienne Sevin (EpiConcept, Paris, France) for his contribution in the development of the RESSIF website using the VOOZANOO platform. We are thankful for the technical help of Catherine Blanc, Anne Boullié, Cécile Gautier, Virginie Geolier, and Damien Hoinard (Institut Pasteur) for the characterization of the isolates received at the NRCMA., The French Mycoses Study Group includes collaborators who contributed to these data by their involvement in the management of patients, expertise in diagnostic tools, and/or characterization of fungal isolates. They are listed in alphabetical order of a city in France and for each center, in alphabetical order of the last names: in Amiens, Céline Damiani, Hervé Dupont, Julien Maizel, and Anne Totet, in Angers, Jean-Philippe Bouchara, in Besançon, Anne Pauline Bellanger, Ana Berceanu, Jean Christophe Navellou, and Emeline Scherer, in Cayenne, Philippe Abboud, Christine Aznar, Denis Blanchet, and Félix Djossou, in Clermont-Ferrand, Sophie Cayot, Cyril Garrouste, Olivier Lesens, Cécile Moluçon, Céline Nourrisson, and Philippe Poirier, in Dijon, Éloïse Bailly, Louise Basmaciyan, Bouhemad Belaid, Mathieu Blot, Denis Caillot, Pierre-Emmanuel Charles, and Jean Pierre Quenot, in Fort de France, Emmanuelle Amazan, Emilie Baubion, André Cabie, Cyrille Chabartier, Christophe Deligny, Violaine Emal, Olivier Flechelle, Yves Hatchuel, Yohann Le Govic, Harold Merle, Charline Miossec, Jean-Marie Turmel, and Ruddy Valentino, in Limoges, Marie-Fleur Durieux and Pascal Turlure, in Nîmes, Victor Mercier, in Nice, Martine Gari-Toussaint, Karine Risso, and Loïc Simon, in Nantes, Cedric Bretonnière, David Boutoille, Thomas Gastinne, Karim Lakhal, Elise Launay, Thierry Lepoivre, Pierre Peterlin, Fanny Rialland, and Patrice Le Pape, in Paris, in Hôpital Cochin, Etienne Canoui, Naima Dahane, and Solène Kerneis, in Hôpital Necker-Enfants Malades, Cécile Angebault, Marie-Elisabethh Bougnoux, Nadia Guennouni, Fanny Lanternier, Bennedicte Neven, Mehdi Oualha, Anne Scemla, Emilie Sitterlé, Felipe Suarez, and Julie Toubiana, in Hôpital Robert-Debré, Stéphane Bonacorci, in Hôpital Saint-Louis, Alexandre Alanio, Anne Bergeron, Blandine Denis, Maud Gits-Muselli, Samia Hamane, and Sophie Touratier, in hôpital des XV-XX, Christine Chaumeil and Lilia Merabet, in Pointe-à-Pitre, Joelle Claudéon, Elodie Curlier, Valérie Galantine, Jean Claude Gallois, Samuel Markowicz, Muriel Nicolas, Pascal Musson, and Kinda Schepers, in Poitiers, Alida Minoza and Catherine Kauffmann-Lacroix, in Rennes, Hélène Guégan, in Rouen, Damien Costa, Marion Dehais, and Gilles Gargala, in Reims, Odile Bajolet, Firouze Banisadr, Joel Cousson, Chantal Himberlin, Antoine Huguenin, and Dominique Toubas, in Saint Etienne, Pierre Flori, Caroline Mahinc, and Hélène Raberin, in Strabourg, Julie Denis, Raoul Herbrecht, Paul-Michel Mertes, Fehrat Meziani, Marcela Sabou, and Francis Schneider, in Toulouse, Anne-Isabelle Bertozzi, Pamela Chauvin, Elena Charpentier, Olivier Cointault, Claire Cottrel, Karen Delavigne, Stanislas Faguer, Judith Fillaux, Emilie Guemas, Xavier Iriart, Lucie Lelièvre, and Jean Ruiz, in Tours, Frédéric Bastides, Adélaïde Chesnay, and Guillaume Desoubeaux, in Versailles, Audrey Therby, and in Villejuif, Elisabeth Chachaty and Bertrand Gachot., and CLEMENT, Nathalie

Subjects
Antifungal Agents, pneumocytosis, invasive fungal infections, Pneumonia, Pneumocystis, [SDV]Life Sciences [q-bio], candidemia, Microbiology, [SDV.MP.MYC] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, mucormycosis, [SDV] Life Sciences [q-bio], [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Virology, Humans, aspergillosis, epidemiology, Watchful Waiting, Fungemia, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Aged
Abstract

International audience; The French National Reference Center for Invasive Mycoses and Antifungals leads an active and sustained nationwide surveillance program on probable and proven invasive fungal diseases (IFDs) to determine their epidemiology in France. Between 2012 and 2018, a total of 10,886 IFDs were recorded. The incidence increased slightly over time (2.16 to 2.36/10,000 hospitalization days, P = 0.0562) in relation with an increase of fungemia incidence (1.03 to 1.19/10,000, P = 0.0023), while that of other IFDs remained stable. The proportion of ≥65-year-old patients increased from 38.4% to 45.3% (P < 0.0001). Yeast fungemia (n = 5,444) was due mainly to Candida albicans (55.6%) with stable proportions of species over time. Echinocandins became the main drug prescribed (46.7% to 61.8%), but global mortality rate remained unchanged (36.3% at 1 month). Pneumocystis jirovecii pneumonia (n = 2,106) was diagnosed mostly in HIV-negative patients (80.7%) with a significantly higher mortality than in HIV-positive patients (21.9% versus 5.4% at 1 month, P < 0.0001). Invasive aspergillosis (n = 1,661) and mucormycosis (n = 314) were diagnosed mostly in hematology (>60% of the cases) with a global mortality rate of 42.5% and 59.3%, respectively, at 3 months and significant changes in diagnosis procedure over time. More concurrent infections were also diagnosed over time (from 5.4% to 9.4% for mold IFDs, P = 0.0115). In conclusion, we observed an aging of patients with IFD with a significant increase in incidence only for yeast fungemia, a trend toward more concurrent infections, which raises diagnostic and therapeutic issues. Overall, global survival associated with IFDs has not improved despite updated guidelines and new diagnostic tools.IMPORTANCE The epidemiology of invasive fungal diseases (IFDs) is hard to delineate given the difficulties in ascertaining the diagnosis that is often based on the confrontation of clinical and microbiological criteria. The present report underlines the interest of active surveillance involving mycologists and clinicians to describe the global incidence and that of the main IFDs. Globally, although the incidence of Pneumocystis pneumonia, invasive aspergillosis, and mucormycosis remained stable over the study period (2012 to 2018), that of yeast fungemia increased slightly. We also show here that IFDs seem to affect older people more frequently. The most worrisome observation is the lack of improvement in the global survival rate associated with IFDs despite the increasing use of more sensitive diagnostic tools, the availability of new antifungal drugs very active in clinical trials, and a still low/marginal rate of acquired in vitro resistance in France. Therefore, other tracks of improvement should be investigated actively.

Published
2022
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28. Guillain-Barré Syndrome Associated With Zika Virus Infection in Martinique in 2016: A Prospective Study

Author

Benoît, Rozé, Fatiha, Najioullah, Jean-Louis, Fergé, Frédérique, Dorléans, Kossivi, Apetse, Jose-Luis, Barnay, Elise, Daudens-Vaysse, Yannick, Brouste, Raymond, Césaire, Laurence, Fagour, Ruddy, Valentino, Martine, Ledrans, Hossein, Mehdaoui, Sylvie, Abel, Isabelle, Leparc-Goffart, Aissatou, Signate, André, Cabié, Rosalie, Vilain, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Unité de soins intensifs [CHU Martinique], Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-CHU de la Martinique [Fort de France], Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Unité Régionale Antilles Guyane [Saint-Maurice] (Agence Nationale de la Santé Publique ), Département d'Electrophysiologie [Fort de France, Martinique], Unité de Réhabilitation [Fort de France, Martinique], Hôpital Le Lamentin Bourg [CHU de la Martinique], Service d'Urgence [Fort de France, Martinique], Institut de Recherche Biomédicale des Armées [Antenne Marseille] (IRBA), Environnement, Santé, Sociétés (ESS), Centre National de la Recherche Scientifique (CNRS), Service de neurologie [Fort-de-France, Martinique], CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), This research was sponsored by University Hospital of Martinique (UHM) for regulatory and ethic submission and supported by the Clinical Research Hospital Program from the French Ministry of Health (PHRC 2009, NCT01099852). This research was support by the French network for Research and Action targeting emerging infectious diseases (REACTING)., Guillain-Barré Syndrome Zika Working Group of Martiniquea : Gwenole Jean Abgrall, Véronique Aïm, Alessandro Arrigo, Philippe Cabre, Cyrille Chabartier, Sylvie Colombani, Julien Cuziat, Christophe Deligny, Nicole Desbois, Anne-Laure Dessoy, Gaëlle Dunoyer, Régis Duvauferrier, N’Guyen Duc, Mireille Edimonana, Pierre Garrigou, Stéphane Gaucher, Sarah Gourgoudou, Karine Guitteaud, Patrick Hochedez, Gwladys Ivanes, Yolène Jacquens, Sandrine Julié, Armelle Jean-Etienne, Séverine Jeannin, Joux Julien, Pasquier Jérémie, Jean- Louis Lamaignère, Ingrid Laudarin, Maud Le Gall, Véronique Legris- Allusson, Mehdi Mejdoubi, Corinne Michel, Franck Michel, Charline Miossec, Florence Moinet, Cervantes Minerva, Claude Olive, Pascale Olive, Karine Pailla, Céline Paysant, Sandrine Pierre-François, Mathilde Pircher, Katlyne Polomat, Alain Putot, Patrick René-Corail, Dabor Resiere, Christiane Richer, Jean-Romain Risson, Karen Rome, Marie Sabia, Michel Schloesser, Pauline Simonnet-Vigeral, Rafaelle Théodose, Rosalie Vilain., Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and BUISINE, Soline

Subjects
Microbiology (medical), Male, Pediatrics, medicine.medical_specialty, 030231 tropical medicine, Guillain-Barre Syndrome, Zika virus, Serology, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Intensive care, Medicine, Humans, Martinique, Prospective Studies, Aged, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, biology, Guillain-Barre syndrome, business.industry, Outbreak, Retrospective cohort study, vector-borne infections, Zika Virus, Middle Aged, Zika virus infection, biology.organism_classification, medicine.disease, bacterial infections and mycoses, Guillain-Barré syndrome, 3. Good health, Infectious Diseases, outbreaks, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Etiology, Female, business, 030217 neurology & neurosurgery
Abstract

International audience; Background: Guillain-Barré syndrome (GBS) has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies, mostly on the basis of serological tests, with the problematic cross-reacting antibodies of the Flavivirus genus. Some GBS cases do not exhibit a high level of diagnostic certainty. This prospective study aimed to describe the clinical profiles and the frequency of GBS associated with ZIKV during the ZIKV outbreak in Martinique in 2016.Methods: We recorded prospective data from GBS meeting levels 1 or 2 of diagnostic certainty for the Brighton Collaboration, with proof of recent ZIKV infection and negative screening for etiologies of GBS.Results: Of the sample of 34 patients with suspected GBS during the outbreak, 30 had a proven presence of GBS, and 23 had a recent ZIKV infection. The estimated GBS incidence rate ratio (2016 vs 2006-2015) was 4.52 (95% confidence interval, 2.80-7.64; P = .0001). Recent ZIKV infection was confirmed by urine reverse-transcription polymerase chain reaction (RT-PCR) analysis in 17 cases and by serology in 6 cases. Patients, 65% of whom were male, had a median age of 61 years (interquartile range, 56-71 years) and experienced severe GBS. Electrophysiological tests were consistent with the primary demyelinating form of the disease.Conclusions: ZIKV infection is usually benign, when symptomatic, but in countries at risk of ZIKV epidemics, adequate intensive care bed capacity is required for management of severe GBS cases. Arbovirus RNA detection by RT-PCR should be part of the management of GBS cases.

Published
2017
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