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Molecular Diagnosis of Toxoplasmosis in Immunocompromised Patients: a 3-Year Multicenter Retrospective Study
- Source :
- Journal of Clinical Microbiology, Journal of Clinical Microbiology, American Society for Microbiology, 2015, 53 (5), pp.1677-1684. ⟨10.1128/JCM.03282-14⟩
- Publication Year :
- 2015
- Publisher :
- American Society for Microbiology, 2015.
-
Abstract
- Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood ( n = 337 samples), cerebrospinal fluid ( n = 101 samples), and aqueous humor ( n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV + ; the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers ( P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome.
- Subjects :
- Microbiology (medical)
Microbiological Techniques
medicine.medical_specialty
MESH: Molecular Diagnostic Techniques
Asymptomatic
Polymerase Chain Reaction
law.invention
Immunocompromised Host
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
law
Internal medicine
medicine
MESH: Immunocompromised Host
Prevalence
Humans
ComputingMilieux_MISCELLANEOUS
Polymerase chain reaction
Immunodeficiency
Survival analysis
MESH: Prevalence
Retrospective Studies
[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health
MESH: Humans
business.industry
Incidence (epidemiology)
MESH: Toxoplasma
MESH: Microbiological Techniques
Retrospective cohort study
MESH: Polymerase Chain Reaction
MESH: Retrospective Studies
medicine.disease
Survival Analysis
Toxoplasmosis
3. Good health
Surgery
MESH: France
[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology
Molecular Diagnostic Techniques
MESH: Survival Analysis
Chemoprophylaxis
MESH: Toxoplasmosis
Parasitology
France
medicine.symptom
business
Toxoplasma
Subjects
Details
- Language :
- English
- ISSN :
- 00951137
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Microbiology, Journal of Clinical Microbiology, American Society for Microbiology, 2015, 53 (5), pp.1677-1684. ⟨10.1128/JCM.03282-14⟩
- Accession number :
- edsair.doi.dedup.....ea0a4b8816090485b7e6822831580f91