Rapid diagnostic tests relying on antigen detection from stool as an efficient point of care testing strategy for giardiasis and cryptosporidiosis? Evaluation of a new immunochromatographic duplex assay

Microscopy is the gold standard for the diagnosis of gastrointestinal parasites but is time-consuming and dependent on operator skills. Rapid diagnostic tests represent alternative methods but most evaluations have been conducted on a limited number of samples preventing their implementation in the clinical setting. We evaluated a new CE-IVD marked immunochromatographic assay (Crypto/Giardia K-SeT®, Coris Bioconcept) for the detection of G. intestinalis and Cryptosporidium spp. in 2 phases (retrospective and prospective) on a set of 482 stool samples including rare Cryptosporidium species. Besides G. intestinalis, this test could represent a rapid and reliable alternative to the modified Ziehl-Neelsen staining for the diagnosis of cryptosporidiosis (sensitivity/specificity were 89.2%/99.3% and 86.7%/100% for G. intestinalis and Cryptosporidium resp.), reducing diagnostic delays. Such strategy would also be time-saving by avoiding wet mount microscopy and concentrations steps, being particularly appropriate for laboratories having little expertise in microscopy or not able to implement molecular diagnostic methods

Should the poultry red mite Dermanyssus gallinae be of wider concern for veterinary and medical science?

The poultry red mite Dermanyssus gallinae is best known as a threat to the laying-hen industry; adversely affecting production and hen health and welfare throughout the globe, both directly and through its role as a disease vector. Nevertheless, D. gallinae is being increasingly implemented in dermatological complaints in non-avian hosts, suggesting that its significance may extend beyond poultry. The main objective of the current work was to review the potential of D. gallinae as a wider veterinary and medical threat. Results demonstrated that, as an avian mite, D. gallinae is unsurprisingly an occasional pest of pet birds. However, research also supports that these mites will feed from a range of other animals including: cats, dogs, rodents, rabbits, horses and man. We conclude that although reported cases of D. gallinae infesting mammals are relatively rare, when coupled with the reported genetic plasticity of this species and evidence of permanent infestations on non-avian hosts, potential for host-expansion may exist. The impact of, and mechanisms and risk factors for such expansion are discussed, and suggestions for further work made. Given the potential severity of any level of host-expansion in D. gallinae, we conclude that further research should be urgently conducted to confirm the full extent of the threat posed by D. gallinae to (non-avian) veterinary and medical sectors

European candidaemia is characterised by notable differential epidemiology and susceptibility pattern: Results from the ECMM Candida III study.

The objectives of this study were to assess Candida spp. distribution and antifungal resistance of candidaemia across Europe. Isolates were collected as part of the third ECMM Candida European multicentre observational study, conducted from 01 to 07-07-2018 to 31-03-2022. Each centre (maximum number/country determined by population size) included ∼10 consecutive cases. Isolates were referred to central laboratories and identified by morphology and MALDI-TOF, supplemented by ITS-sequencing when needed. EUCAST MICs were determined for five antifungals. fks sequencing was performed for echinocandin resistant isolates. The 399 isolates from 41 centres in 17 countries included C. albicans (47.1%), C. glabrata (22.3%), C. parapsilosis (15.0%), C. tropicalis (6.3%), C. dubliniensis and C. krusei (2.3% each) and other species (4.8%). Austria had the highest C. albicans proportion (77%), Czech Republic, France and UK the highest C. glabrata proportions (25-33%) while Italy and Turkey had the highest C. parapsilosis proportions (24-26%). All isolates were amphotericin B susceptible. Fluconazole resistance was found in 4% C. tropicalis, 12% C. glabrata (from six countries across Europe), 17% C. parapsilosis (from Greece, Italy, and Turkey) and 20% other Candida spp. Four isolates were anidulafungin and micafungin resistant/non-wild-type and five resistant to micafungin only. Three/3 and 2/5 of these were sequenced and harboured fks-alterations including a novel L657W in C. parapsilosis. The epidemiology varied among centres and countries. Acquired echinocandin resistance was rare but included differential susceptibility to anidulafungin and micafungin, and resistant C. parapsilosis. Fluconazole and voriconazole cross-resistance was common in C. glabrata and C. parapsilosis but with different geographical prevalence

Overview about Candida auris: What's up 12 years after its first description?

Candida auris has been described as an emerging yeast species during the last decade. As many as 25% of its strains may naturally exhibit multi-drug resistance to the currently available antifungal drugs. Probably due to its ability to survive more than two weeks on inert surfaces, several large outbreaks have been reported, primarily due to nosocomial transmissions. In addition, due to a rapid worldwide spreading, C. auris is now considered as a major public health threat. This review aims at describing the current knowledge about C. auris, with specific focuses on its global epidemiology, virulence features, most reliable diagnostic approaches, and the current and future therapeutic options

Scabiose de l'appareil unguéal chez un nourrisson

International audienceIntroduction.-La prise en charge de la gale du nourrisson n'est pas codifiée et les récidives sont fréquentes à cet âge. Nous rapportons un cas exceptionnel d'atteinte sous-unguéale et d'onychopathie des pieds, séquellaires d'une gale commune chez un nourrisson. Observation.-Un nourrisson de 7 mois, traité par esdépalléthrine pour une gale 6 semaines auparavant, était vu en consultation pour des modifications unguéales acquises des orteils. Il existait un épaississement unguéal de trois orteils avec hyperkératose sous-unguéale. Le reste de l'examen cutanéo-muqueux et des phanères était normal. L'analyse mycologique de pré-lèvements d'ongles était négative, mais l'examen direct en microscopie optique trouvait de nombreuses larves de Sarcoptes scabiei, ainsi que des débris d'oeufs. Le traitement consis-tait en une avulsion chimique des ongles atteints (urée à 40 %) associée à des applications d'esdépalléthrine topique et à une prise orale d'ivermectine ; l'enfant a été perdu de vue. Discussion.-L'atteinte unguéale a été rapportée dans la gale hyperkératosique et exception-nellement dans la gale commune de l'adulte. La localisation sous-unguéale et unguéale de * Auteur correspondant. Adresse e-mail : [email protected] (A. Finon)

Mycétome fongique du pied dû à Exophiala jeanselmei chez une femme guinéenne

International audienceEumycetomas are chronic infectious entities characterized by presence of mycotic grains in (sub-)cutaneous tissues, after accidental inoculation of an exogenous filamentous fungus in the skin. The lesions evolve towards painless pseudotumor of the soft parts. We report the original case of a Guinean woman exhibiting eumycetoma of the right foot. Both laboratory tests identified a dematiaceous fungus, Exophiala jeanselmei, as the responsible infectious agent. A medical treatment with voriconazole alone was sufficient to notice a substantial clinical improvement. This finding is unusual as E. jeanselmei is uncommon in Guinea-Conakry, and as optimal treatment rather associate antifungal azoles and surgical excision.Les eumycétomes constituent des entités infectieuses chroniques caractérisées par la présence de grains fongiques au sein des tissus (sous-)cutanés, après inoculation accidentelle d’un champignon filamenteux exogène. Les lésions évoluent sur un mode indolore vers des pseudo-tumeurs des parties molles. Nous rapportons ici le cas original d’une femme guinéenne avec un eumycétome du pied droit. Les différents examens de laboratoire ont permis d’identifier le champignon dématié Exophiala jeanselmei comme agent responsable. Un traitement médicamenteux par voriconazole seul était suffisant pour visualiser une amélioration clinique sensible. Ce constat est intéressant car E. jeanselmei est une espèce peu commune en Guinée-Conakry et le traitement habituel associe plutôt un antifongique azolé à la chirurgie d’exérèse