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 However, apart from Puerto Rico, information regarding human fascioliasis in islands of the Caribbean is out of date or unavailable, or even nonexistent as in Haiti.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

Pneumocystis jiroveci Dihydropteroate Synthase Genotypes in Immunocompetent Infants and Immunosuppressed Adults, Amiens, France

To date, investigations of Pneumocystis jiroveci circulation in the human reservoir through the dihydropteroate synthase (DHPS) locus analysis have only been conducted by examining P. jirovecii isolates from immunosuppressed patients with Pneumocystis pneumonia (PCP). Our study identifies P. jirovecii genotypes at this locus in 33 immunocompetent infants colonized with P. jirovecii contemporaneously with a bronchiolitis episode and in 13 adults with PCP; both groups of patients were monitored in Amiens, France. The results have pointed out identical features of P. jirovecii DHPS genotypes in the two groups, suggesting that in these two groups, transmission cycles of P. jirovecii infections are linked. If these two groups represent sentinel populations for P. jirovecii infections, our results suggest that all persons parasitized by P. jirovecii, whatever their risk factor for infection and the form of parasitism they have, act as interwoven circulation networks of P. jirovecii

Primary Pneumocystis Infection in Infants Hospitalized with Acute Respiratory Tract Infection

Primary P. jirovecii infection may appear as a self-limiting upper respiratory tract infection in infants

Strain Typing Methods and Molecular Epidemiology of Pneumocystis Pneumonia

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

Molecular Evidence of Interhuman Transmission of Pneumocystis Pneumonia among Renal Transplant Recipients Hospitalized with HIV-Infected Patients

Molecular evidence indicates that P. jirovecii may be nosocomially transmitted to severely immunosuppressed patients

Distinction entre pneumonie et colonisation à pneumocystis jirovecii (intérêt des nouveaux outils biologiques)

L objectif de notre travail a été de discriminer, d un point de vue biologique, les pneumonies à P.jirovecii (PPC) et les colonisations. Pour cela, nous avons travaillé de manière rétrospective sur 59 prélèvements respiratoires et 29 échantillons sériques provenant de 17 patients développant une PPC et de 36 patients colonisés par le champignon, hospitalisés au CHU d Amiens entre le 10 janvier 2008 et le 8 janvier 2009. Les prélèvements respiratoires correspondaient à 44 lavages broncho-alvéolaires, neuf expectorations spontanées, cinq aspirations bronchiques et un lavage oro-pharyngé. La distinction des cas de PPC et de colonisation a été établie par l analyse des dossiers cliniques. La quantification de P.jirovecii dans les prélèvements respiratoires a été réalisée à l aide d une technique de PCR ( polymerase chain reaction ) en temps réel. Dans la mesure où les prélèvements respiratoires étaient de nature différente, la quantité d ADN de P.jirovecii amplifié a ensuite été rapportée à la quantité d ADN humain amplifié. Parallèlement, le taux sérique de (1-3) b-D-glucane a été mesuré à l aide d une technique ELISA. La quantité moyenne d ADN de P.jirovecii était significativement plus importante dans les prélèvements respiratoires des patients présentant une PPC que dans ceux des patients colonisés (8,25.106 vs 5,27.102, p<0,05). Le seuil moyen de détection de l ADN de P.jirovecii rapporté au seuil moyen de détection de l ADN humain était significativement plus bas chez les patients présentant une PPC que chez les patients colonisés (1,07 vs 1,49, p<0,05). Le taux sérique moyen de (1-3) b-D-glucane était significativement plus élevé chez les patients présentant une PPC que chez les patients colonisés (1467 vs 77 pg/mL, p<0,05). Au total, la détection quantitative de P.jirovecii, ajustée à la nature du prélèvement respiratoire et associée à la détermination du taux sérique de (1-3) b-D-glucane, apporte de nouvelles données biologiques visant à distinguer les PPC et les colonisations. Ces données, complétées par les éléments cliniques, devraient permettre d adapter au mieux la prise en charge médicale des patients infectés par P.jirovecii.The aim of this study was to develop a method for distinguishing PCP and pulmonary colonisation with P.jirovecii, using a quantitative real time PCR assay for the fungus detection in pulmonary specimens combined with the quantification of (1-3) b-D-glucans in sera. Fifty three patients, who were hospitalized to Amiens University Hospital (Amiens, France) between January 2008 and January 2009, were retrospectively enrolled in the study. They were initially diagnosed with PCP (17 patients) and pulmonary colonization with P.jirovecii (36 patients) based on the detection of the fungus in pulmonary specimens using microscopy or a conventional PCR assay, the clinical presentation of the pulmonary disease and the outcome. Archival pulmonary specimens of the patients were assayed using a quantitative real time PCR assay amplifying the mtLSUrRNA gene of P.jirovecii and a human house keeping gene. A ratio P.jirovecii DNA/human DNA was established. (1-3) b-D-glucans were quantified in patients sera using a commercially available ELISA. P.jirovecii DNA levels were significantly higher in PCP patients than those in colonized patients (8.25.106 vs 5.27.102, p<0.05). The ratio P.jirovecii DNA/human DNA in PCP patients was significantly lower than those in colonized patients (1.05 vs 1.49, p<0.05). (1-3) b-D-glucan levels was significantly higher in PCP patients than those in colonized patients (814.2 pg/mL vs 149 pg/mL, p<0.05). The results show that the quantitative detection of P.jirovecii DNAs correlated with the quantitative detection of human DNAs in pulmonary specimens combined with the quantification of (1 3) b-D-glucans in sera appears as a discriminative method for PCP and pulmonary colonisation diagnoses.AMIENS-BU Santé (800212102) / SudocSudocFranceF