Epidemiologie des colonisations et infections fongiques dans la mucoviscidose (étude chez les patients suivis au Centre de ressources et de Compétences de la Mucoviscidose de Rennes sur une période de 7 ans (2000-2007))

RENNES1-BU Santé (352382103) / SudocSudocFranceF

Evaluation of DPC immulite 2000 Toxoplasma quantitative IgG/IgM kits for automated toxoplasmosis serology with immulite 2000.

International audienceIn this study, we evaluated a new immunoassay for the automated detection of anti-toxoplasma IgG and IgM with Immulite 2000 (DPC-Siemens, La Garenne-Colombes, France). We tested 280 sera from 112 patients with past infection (PI), 40 PI with residual IgM, 75 seronegatives, 16 infants (31 sera) monitored for neonatal screening of congenital toxoplasmosis, and 13 patients with recent seroconversion (SC) (22 sequential sera). Detection sensitivity and specificity for IgG were 99 and 100%, respectively. IgG titers obtained with Immulite 2000 were higher than with Vidas (BioMérieux, Marcy I'Etoile, France) and Access (Beckman-Coulter, Villepinte, France) (paired Wilcoxon test z=4.44 and z=3.67, respectively, P<0.001). IgM specificity was 100%. Detection sensitivity for IgM was 100% in the SC group, 86% in congenitally infected infants, and 75% in PI with persistent IgM. IgM detection seemed less prolonged in time than with the IgM Access and ISAGA IgM techniques

Insémination artificielle sans antibiotique chez le porc

National audienceThe addition of antibiotics, either alone or in cocktail mixtures, represents today the only way to control bacterial growth during swine semen production and conservation. In general, raw ejaculates are handed at 30-34 °C while delivering and storage of AI doses occur at temperatures around 16-17 °C. However, the risk of inducing bacterial resistance represents a great challenge to overcome. During this study, we set to develop an antibiotic free semen processing technique that at the same time allows for maintenance of sperm quality and does not affect the fertility performance of swine herds. Ejaculates collected from boars of proven fertility were split in two portions and diluted in two different semen extenders. One portion was diluted in a commercial semen extender supplemented with a classical antibiotic mixture and packed in standard semen bags. The second portion was diluted in a new semen extender with no antibiotic addition and packed in bacteriostatic semen bags. Doses were cooled down up to 4°C after packing and kept in a regigerator until inseminations were performed. Computed assisted semen analysis and flow cytometry analysis were carried for evaluating motility, viability and bacterial charge. Further, sixty gilts (n=60) of the cross breed Large-White x Landrace were selected and aleatory grouped. For heat synchronization, eighteen doses of Regumate (20mg) were given daily to the experimental animals. Only gilts found in heat after the synchronization were included in the study. A total of 30 gilts were inseminated with semen doses supplemented with antibiotics and the other 30 with semen doses without antibiotics. Twenty two days after insemination, pregnancy was checked by transabdominal echography, and pregnant gilts were slaughtered for controlling embryo development and number of corpora lutea present in the ovaries at day 30 post insemination. Neither number of embryos, nor ovulation rates (controlled by the number of corpora lutea formed after ovulation) were affected by the antibiotic free AI doses. These results show that antibiotics are no longer necessary for preservation of boar ejaculates as long as minimal hygienic conditions are kept during semen processing

Performance of Molecular Approaches for Aspergillus Detection and Azole Resistance Surveillance in Cystic Fibrosis

International audienceAspergillus fumigatus triazole resistance is an emerging concern for treating chronically infected/colonized patients. This study sought to evaluate the performance of PCR assays to detect Aspergillus fungi together with azole resistance in sputum samples from cystic fibrosis (CF) patients. In total, 119 sputum samples from 87 CF patients were prospectively processed for Aspergillus detection by means of mycological culture and four qPCR assays, 2 in-house methods and two commercial multiplex real-time PCR assays simultaneously detecting Aspergillus and the most relevant cyp51A gene mutations (MycoGENIE (R) and AsperGenius (R)). Azole susceptibility of A. fumigatus isolates was assessed using Etest (R) method and cyp51A gene mutation were characterized by sequencing. The overall rate of Aspergillus detection with the four qPCR assays ranged from 47.9 to 57.1%, contrasting with 42/119 (35.3%) positive cultures with A. fumigatus. The high sensitivity of PCR on sputum could then contribute to more effective grading of Aspergillus disease in CF patients. Five out of 41 isolated strains (12.2%) exhibited azoleresistant MIC patterns, three of which harbored cyp51A mutations and only 1/3 with the sequence TR34/L98H. Combined with culture, PCR assay achieved high sensitivity Aspergillus screening in CF samples. However, cyp51A targeting was only moderately effective for azole resistance monitoring, while Aspergillus resistance remains of great concern

Asthma and Indoor Environment Usefulness of a Global Allergen Avoidance Method on Asthma Control and Exposure to Molds

International audienceThe usefulness and feasibility of a global allergens avoidance method with counselors visiting patients' home for allergens measures and adapted advices were prospectively evaluated through asthma control and environment evaluation. Twenty seven patients were prospectively included and compared to a cohort of 30 control patients. The level of control of asthma at inclusion and after 1 year was evaluated by the clinical signs, the evolution of the FEV1, and the healthcare use. Environmental measurements included the fungal load of 5 surfaces of the dwellings and the evaluation of moisture. A significant clinical improvement in the population that benefited from the home counselors visit was observed compared to the baseline (p < 0.0001), as well as a decreased number of hospitalizations for asthma and of the consumption of anti-asthma drugs (p < 0.01). Dampness markers slightly improved with an improvement of the fungal loads in two-third of the dwellings

Utilité clinique de la sérologie pour le diagnostic de la strongyloïdose chez les voyageurs et les migrants : une étude rétrospective de 4 ans utilisant le test ELISA Strongyloides ratti Bordier IVD®

International audienceStrongyloides stercoralis serology is a sensitive method for strongyloidiasis diagnosis, but it is prone to cross-reactions with other helminthiases. This four-year retrospective study aimed at estimating the performance of the Bordier IVD® Strongyloides ratti ELISA assay in a non-endemic country (France). The study included all patients tested for strongyloidiasis in our center between 2015 and 2019, by both serology and stool examination. Cases were defined using an algorithm considering serological results, microscopic examination of stools, and other biological, clinical or epidemiological data. The study included 805 stools from 341 patients (70% migrants, 20% travelers, 10% without travel to a highly endemic area). Thirty patients (8.8%) had positive serology, 9 had microscopically proven strongyloidiasis, and 11 and 10 were classified as probable and possible strongyloidiasis, respectively. Performances of microscopy and serology were compared, considering proven and probable strongyloidiasis as true infections. The sensitivity, specificity, positive predictive value and negative predictive value of serology were 100%, 97%, 67% and 100%, respectively, and those of microscopic examination of stools were 45% (p < 0.01), 100% (p < 0.01), 100% (p = 0.079) and 96% (p < 0.001), respectively. Eosinophilia did not help in discriminating true-positive from false-positive results. Overall, these results underline the high value of the S. stercoralis serologic assay, compared to stool examination. The systematic use of this technique for screening purposes in travelers or migrants, or before onset of immunosuppressive therapy, could help to improve patient management and epidemiological knowledge.La sérologie de Strongyloides stercoralis est une méthode sensible pour le diagnostic de la strongyloïdose, mais elle est sujette à des réactions croisées avec d’autres helminthes. Cette étude rétrospective sur 4 ans visait à estimer les performances du test ELISA Strongyloides ratti Bordier IVD® dans un pays non endémique (la France). L’étude a inclus tous les patients testés pour la strongyloïdose dans notre centre entre 2015 et 2019, à la fois par sérologie et examen des selles. La définition des cas a été faite à l’aide d’un algorithme tenant compte des résultats sérologiques, de l’examen microscopique des selles et d’autres données biologiques, cliniques ou épidémiologiques. L’étude a inclus 805 selles de 341 patients (70 % de migrants, 20 % de voyageurs, 10 % sans voyage dans une zone de forte endémie). Trente patients (8,8 %) avaient une sérologie positive, 9 avaient une strongyloïdose prouvée au microscope, et 11 et 10 ont été classés respectivement comme strongyloïdose probable et possible. Les performances de la microscopie et de la sérologie ont été comparées, en considérant les strongyloïdoses avérées et probables comme de véritables infections. La sensibilité, la spécificité, la valeur prédictive positive et la valeur prédictive négative de la sérologie étaient de 100 %, 97 %, 67 % et 100 %, respectivement, et celles de l’examen microscopique des selles étaient de 45 % (p < 0,01), 100 % (p < 0,01), 100 % (p = 0,079) et 96 % (p < 0,001), respectivement. L’éosinophilie n’a pas aidé à distinguer les vrais positifs des faux positifs. Dans l’ensemble, ces résultats soulignent la valeur élevée du test sérologique de S. stercoralis, par rapport à l’examen des selles. L’utilisation systématique de cette technique à des fins de dépistage chez les voyageurs ou les migrants, ou avant le début d’un traitement immunosuppresseur, pourrait contribuer à améliorer la prise en charge des patients et les connaissances épidémiologiques

Bacterial and fungal counts in hospital air: comparative yields for 4 sieve impactor air samplers with 2 culture media.

International audienceWe compared the yields of 4 recently developed sieve impactor air samplers that meet international standard ISO 14698-1, using 2 growth media (tryptic soy agar and malt extract agar) in real conditions of use. Several hospital sites expected to have different densities of airborne microflora were selected in 2 hospitals. The Samplair MK2, Air Ideal, and Mas-100 samplers yielded higher bacterial counts than did the SAS Super-100 device (P<.05). No significant differences in fungal counts were noted between the 4 devices. The use of malt extract agar in addition to tryptic soy agar significantly improved the fungal yield