Cross-Sectional Serological Survey of Human Fascioliasis in Haiti

Fasciola hepatica, the aetiological agent of fascioliasis in the Caribbean region, occurs throughout the major islands of the Greater Antilles and in localised zones on two islands (Martinique and Saint Lucia) of the Lesser Antilles. However, apart from Puerto Rico, information regarding human fascioliasis in islands of the Caribbean is out of date or unavailable, or even nonexistent as in Haiti. The authors conducted a retrospective, cross-sectional serological survey in Port-au-Prince using a Western blotting test (LDBIO Diagnostics) on human fascioliasis in Haiti. A total of 216 serum samples obtained from apparently healthy adults were tested. The frequency of antibodies in serum samples of the study population was 6.5% (14/216). The immunodominant bands recognised in Western blots were 27-28 kDa (100%), 42 kDa (64%), 60 kDa, and 8-9 kDa (28%). This is the first survey to reveal a relatively low proportion of asymptomatic F. hepatica-infected humans in Haiti

Childhood Cryptosporidiosis: A Case Report

Cryptosporidium has emerged as an important cause of diarrheal illness worldwide, especially amongst young children and patients with infectious or iatrogenic immune deficiencies. The authors describe a case of mild cryptosporidiosis in a well-nourished, immunocompetent, one-year-old child. Rapid clinical and parasitological improvement was observed after a 3-day course of nitazoxanide

Strain Typing Methods and Molecular Epidemiology of Pneumocystis Pneumonia

Several typing methods, with different strengths and weaknesses, are available for studies of Pneumocystis pneumonia

Pneumocystis jirovecii genotypes and granulomatous pneumocystosis

International audienceThis study describes the initial data concerning molecular typing of Pneumocystis jirovecii in a patient having developed granulomatous Pneumocystis pneumonia (PCP). Three types, B(1)a(3), B(1)a(4), B(1)b(2), were identified. All three had been described in reports concerning patients with common diffuse alveolar PCP. The present data show that identical microorganisms can be involved in both granulomatous PCP and diffuse alveolar PCP and that the pathogenesis of the granulomatous response to P. jirovecii may more likely be related to host factors. = Nous présentons les premières données concernant l'identification des génotypes de Pneumocystis jirovecii chez un patient ayant développé une pneumocystose (PPC) granulomateuse. Trois génotypes, B1a3, B1a4, B1b2, ont été identifiés. Ces génotypes sont usuellement retrouvés dans la forme classique alvéolaire de la PPC. Ces résultats montrent que des micro-organismes identiques peuvent être impliqués dans ces deux formes histologiques de la PPC et suggèrent que l'étiologie de la réaction granulomateuse se rapporterait plutôt à des facteurs liés aux patients

Transmission de Pneumocystis = Pneumocystis transmission

star, openConférence présentée au Symposium « Pneumocystis et pneumocystose 100 ans après », présidence Patricia Roux et Eduardo Dei-Cas, faculté de médecine Necker, Paris le 29 novembre 2008. Congrès SFMM – 29 novembre 2008, Paris/Congress of the French Society of medical mycology – November 29, 2008, ParisInternational audienceLes microorganismes du genre Pneumocystis sont des micro-champignons cosmopolites adhérant aux cellules épithéliales alvéolaires du poumon de l'homme et d'autres mammifères. Ils déterminent des pneumonies mortelles chez les sujets traversant des situations de profonde immunodépression. L'étroite spécificité d'hôte des populations naturelles de Pneumocystis spp. suggère que les populations humaines représentent le réservoir de Pneumocystis jirovecii, seule espèce du genre identifiée chez l'homme. La transmission aérienne d'un hôte infecté à un hôte susceptible a été bien établie chez l'animal et différentes observations suggèrent l'existence d'une transmission inter-humaine du parasite. Chez la souris, un seul jour de contact suffit pour que l'infection soit transmise. Par ailleurs, l'utilisation d'un modèle expérimental murin de transmission naturelle de Pneumocystis a permis de mettre en évidence que les hôtes immunocompétents, porteurs transitoires du champignon, peuvent transmettre l'infection à des hôtes immunodéprimés ou à d'autres hôtes immunocompétents. Ainsi aujourd'hui, l'infection par Pneumocystis chez des sujets non immunocompromis prend une nouvelle dimension en santé publique. Enfin, une transmission verticale de Pneumocystis spp. par voie transplacentaire semble fréquente chez le lapin, mais absente chez les modèles rat et souris. L'hypothèse d'une transmission transplacentaire du champignon chez l'homme, longtemps suspectée, vient quant à elle d'être renforcée par une étude récente dans laquelle l'ADN de P. jirovecii a été détecté dans les poumons de fœtus et de placentas de femmes ayant subi des fausses couches. The genus Pneumocystis contains multiple species that attach specifically to type-I alveolar epithelial cells in the lungs of mammalian hosts, including humans. These fungi can cause severe pneumonitis, particularly in hosts with marked impairment of the immune system. The strong host species specificity of Pneumocystis strains suggests that Pneumocystis infection in humans is an anthroponosis, and that humans serve as reservoirs of Pneumocystis jirovecii, the sole species found in humans. Airborne transmission of Pneumocystis spp. from host to host has been demonstrated in rodent models and several observations suggest that inter-individual transmission occurs in humans in both hospitals and the community. In mice, a one-day exposure is enough for airborne transmission of the infection. An airborne transmission mouse model of Pneumocystis, which mimics the route and intensity of natural Pneumocystis infection, revealed that non-immunocompromised hosts transiently infected with Pneumocystis are able to transmit the infection to either immunocompromised or immunocompetent hosts. Consequently, Pneumocystis infection of non-immunocompromised hosts is increasingly becoming a recognized public health issue. Finally, vertical transmission of Pneumocystis via the transplacental route has been demonstrated in rabbits, but it does not appear to occur in rats or SCID mice. In humans, congenital transmission was suspected for many years, and a recent report documented the presence of Pneumocystis jirovecii DNA in foetal lung and placenta samples, recovered from non-immunodepressed pregnant women who had a miscarriage

Nosocomial

Airborne transmission of Pneumocystis sp. from host to host has been demonstrated in rodent models and several observations suggest that interindividual transmission occurs in humans. Moreover, it is accepted that the Pneumocystis organisms infecting each mammalian species are host specific and that the hypothesis of an animal reservoir for Pneumocystis jirovecii (P. jirovecii), the human-specific Pneumocystis species, can be excluded. An exosaprophytic form of the fungus cannot be strictly ruled out. However, these data point toward the potential for the specific host to serve as its own reservoir and for Pneumocystis infection in humans as an anthroponosis with humans as a reservoir for P. jirovecii. This review highlights the main data on host-to-host transmission of Pneumocystis in rodent models and in humans by the airborne route and provides a rationale for considering the occurrence of nosocomial infections and measures for their preventio