Laboratory Of Parasitology-Mycology Research Articles

Champignons non dermatophytiques et non candidosiques isolés au CHU Le Dantec de Dakar en 2014 : étude épidémiologique, clinique et mycologique

In recent years, the incidence of superficial fungal infections involving nondermatophytic and noncandidal fungi increased considerably. The objective of this work was to analyze the epidemiological, clinical and mycological fungal infections due to nondermatophytic and noncandidal fungi diagnosed in the laboratory of parasitology-mycology of Le Dantec hospital in Dakar. With a retrospective study of the various cases of nondermatophytic and noncandidal fungi isolated in the laboratory of parasitology-mycology during the period of November 2013 to December 2014, we collected 22 cases of infections in 11 men and 11 women; age ranging from 17 to 75 years with a mean of 45.3 years (sex ratio=1): eight cases of intertrigo, seven cases of onychomycosis, four cases of palmoplantar keratoderma (KPP), a case of onychomycosis associated with interdigital intertrigo, a case of infectious myositis and one case of African histoplasmosis. We have isolated and identified a total of 22 nondermatophytic and noncandidal fungi: ten Fusarium, five Trichosporon, two Chrysosporium, two Geotrichum, one Rhodotorula, one Neoscytalidium dimidiatum and one Histoplasma capsulatum var. duboisii. So we are seeing the emergence of nondermatophytic and noncandidal increasingly isolated from superficial and local lesions. These fungi, generally contaminants or commensal, cause a problem regarding their direct involvement in pathological processes in which they are isolated. So we should respect the recommendations proposed for their involvement in pathological processes and, by a collaboration between clinician and biologist, demonstrate their real involvement through effective, targeted treatment.

Séroprévalence de la toxoplasmose chez les femmes enceintes dans la wilaya d’Annaba, Algérie

BackgroundThe aim of the study was to estimate the seroprevalence and risk factors of toxoplasmosis in pregnant women in the department of Annaba, Algeria. MethodsWe performed a cross-sectional study with analytical purposes. The study was collaboration between the laboratory of Parasitology-Mycology, Faculty of Medicine of Annaba and Parasite Biology Department at the Pasteur Institute of Algeria. A total of 1028 pregnant women who underwent prenatal diagnosis/visit were included over a period of 4 years from January 2006 to December 2009. Immunoglobulin G and M were assayed, using the microparticle enzyme method. The avidity test was used to determine the date of contamination according to age of pregnancy. Search for the parasite was made by inoculation of the placenta and cord blood in white mice. The study compared mother-to-child serological profiles using Western Blot (WB) IgG and IgM. Direct (not well-cooked meat) and indirect (presence of cat, gardening) indicators were recorded to search for parasite exposure. ResultsSeroprevalence was 47.8 % (95 % CI: 44.8 to 51.0) and the rate of active toxoplasmosis was 1.1 % (95 % CI 0.6 to 1.8). According to their immune status, this was the first serology for 41 % (CI95 %: 38.0–44.0) of women; 12 % (CI95 %: 10.5–14.6) of primiparous women had only one serology test during their entire pregnancy. Major risk factors were consumption of poorly-cooked meat and exposure to cats. ConclusionToxoplasmosis during pregnancy is a serious issue and an effective prevention program is needed.

Prevalence of toxoplasmosis in France in 1998: Is there a difference between men and women? At what age do children become infected?

BackgroundThe only national seroprevalence data currently available on toxoplasmosis in France are from the national perinatal surveys of pregnant women conducted in 1995 and 2003. These surveys are national, exhaustive and cross-sectional studies of all pregnant women who give birth in France during one specified week. These cross-sectional studies, conducted among women of childbearing age (defined as 18 to 45 years), showed a positive correlation between seroprevalence and age, with a significant regional disparity. This study was performed in order to compare the prevalence of toxoplasmosis antibodies in men and women in the 18–45 age group, to confirm regional variations and to estimate the seroprevalence of toxoplasmosis in France for different age groups, particularly among children and among adults aged over 45 years. MethodsSerum samples from 2060 subjects were available from a national serum bank that was established in 1997 as part of a European study on vaccine preventable diseases. The sera were tested for IgG antibodies in 2008–2009, by ELISA test, at the laboratory of parasitology-mycology, CHU Grenoble. ResultsThe seroprevalence for the population aged 1–64 years was 55.4%. Seroprevalence did not vary between the sexes, except among those aged over 45 years, where it was higher in men than in women. Toxoplasmosis seroprevalence varied significantly by regions for all ages. It increased with age and we noted a stronger increase in prevalence in adolescents (10–20 years) than in other age groups. ConclusionThis study showed that children have limited exposure to Toxoplasma gondii and that seroprevalence in men and women does not differ for the population aged 45 years and under. This study confirms the geographical disparity in prevalence in France that has been found in other studies in women of childbearing age. This disparity cannot be explained by different laboratory techniques, because sera were tested in a single laboratory. The study also raises the possibility of extrapolating seroprevalences from ENP to the general population and thus estimating the seroprevalence in the French population.

Dépistage de la toxoplasmose materno-foetale : étude des cas suivis à l’Institut Pasteur de Tunis (2007–2010)

Toxoplasmosis when occurring during pregnancy can be transmitted to the fetus and lead to congenital toxoplasmosis (CT). Therefore, pregnant women are a risk group, for which it is necessary to determine the serologic profile. The objective of this study is to determine the serologic profile of toxoplasmosis in pregnant women followed at the Parasitology Laboratory of the Pasteur Institute in Tunis, to establish the prevalence of toxoplasmic infections during pregnancy and the incidence of the CT, noting the difficulties faced in the interpretation of serological results. This is a retrospective study concerning 2833 toxoplasmic serologies practiced on 2070 pregnant women, followed at the Parasitology-Mycology Laboratory of the Pasteur Institute of Tunis, between 2007 and 2010. Serological diagnosis of toxoplasmosis was done by ELISA (Enzyme Linked Immunosorbent Assay) for the detection of Immunoglobulin (Ig) G and M and the study of toxoplasmosis IgG avidity. Prenatal diagnosis was performed for 58 women by amniotic fluid sampling. Toxoplasma gondii was detected by Polymerase Chain Reaction (PCR). At birth, the diagnosis of congenital toxoplasmosis was established based on serology. The toxoplasmic serologies carried out have shown that 45.6% of the pregnant women were formerly immunized while 49.6% had a negative serology. A toxoplasmosis primary infection acquired during pregnancy was detected in 79 cases (3.8%). Among them, 33% had a true seroconversion while 67% had a recent toxoplasmosis infection in view of the positivity of IgG and IgM on the first sample with a low index of avidity (IA). For 21 parturients whose serology showed the presence of IgG, IgM and an intermediate or high IA. Among the 58 parturients in whom prenatal diagnosis was performed, PCR was positive in four cases. After birth, six cases of congenital toxoplasmosis were detected by serology.

Profil épidémiologique de 290 cas d’échinococcose kystique humaine diagnostiqués au CHU Mustapha d’Alger (2006 à 2011)

The aim of the studyThis study reports a series of 290 cases of hydatidosis confirmed by the surgery and/or the imagery with a positive immuno-diagnosis collected between 1st January 2006 and 31 March 2011 at parasitology-mycology laboratory of hospital university center of Mustapha of Algiers. Our aim is to specify, through the listed cases, the epidemiological aspects of this affection and compared with those obtained in two previous Algerian epidemiological investigations carried out, between 1963–1964 and 1966–1975. Patients and methodsIt is a retrospective (2006–2008) and prospective (2008–2011) study. The parasitological diagnosis was carried out by the direct macroscopic and/or microscopic identification of the parasite and indirect diagnosis based on four techniques: passive hemagglutination, Elisa IgG “Echinococcus granulosus”, Western Blot IgG “Echinococcus” and electrophoresis. ResultsThe study shows that this affection is still prerogative of the young adult. It bring out also in this study that the child of school age (ten years), in particular the boy, pays a heavy tribute. At the child, the preferential pulmonary seat of the hydatic disease is not devoid of risk. At adult, this parasitic disease mainly affect the active woman. ConclusionGenerally, the epidemiological and clinical characteristics join the endemic countries data and confirmed the row of our country among them. The transmission seems as strong as in the past, in spite of a much better social educational level.

VOC Contamination in Hospital, from Stationary Sampling of a Large Panel of Compounds, in View of Healthcare Workers and Patients Exposure Assessment

BackgroundWe aimed to assess, for the first time, the nature of the indoor air contamination of hospitals.Methods and FindingsMore than 40 volatile organic compounds (VOCs) including aliphatic, aromatic and halogenated hydrocarbons, aldehydes, alcohols, ketones, ethers and terpenes were measured in a teaching hospital in France, from sampling in six sampling sites – reception hall, patient room, nursing care, post-anesthesia care unit, parasitology-mycology laboratory and flexible endoscope disinfection unit – in the morning and in the afternoon, during three consecutive days. Our results showed that the main compounds found in indoor air were alcohols (arithmetic means ± SD: 928±958 µg/m3 and 47.9±52.2 µg/m3 for ethanol and isopropanol, respectively), ethers (75.6±157 µg/m3 for ether) and ketones (22.6±20.6 µg/m3 for acetone). Concentrations levels of aromatic and halogenated hydrocarbons, ketones, aldehydes and limonene were widely variable between sampling sites, due to building age and type of products used according to health activities conducted in each site. A high temporal variability was observed in concentrations of alcohols, probably due to the intensive use of alcohol-based hand rubs in all sites. Qualitative analysis of air samples led to the identification of other compounds, including siloxanes (hexamethyldisiloxane, octamethyltrisiloxane, decamethylcyclopentasiloxane), anesthetic gases (sevoflurane, desflurane), aliphatic hydrocarbons (butane), esters (ethylacetate), terpenes (camphor, α-bisabolol), aldehydes (benzaldehyde) and organic acids (benzoic acid) depending on sites.ConclusionFor all compounds, concentrations measured were lower than concentrations known to be harmful in humans. However, results showed that indoor air of sampling locations contains a complex mixture of VOCs. Further multicenter studies are required to compare these results. A full understanding of the exposure of healthcare workers and patients to complex mixtures of chemical compounds can then be related to potential health outcomes.

Acanthamoeba T4 genotype associated with keratitis infections in Tunisia

Acanthamoeba keratitis (AK) is a sight-threatening infection. We report five cases of AK diagnosed from 2005 to 2009 in the Laboratory of Parasitology-Mycology at Habib Bourguiba Sfax Hospital, Tunisia. All were associated with improper care of contact lenses (rinsing of contact lenses with tap water and inappropriate cleaning) and lens storage. The patients displayed different clinical presentations: corneal inflammation, corneal ulceration, and corneal abscess. The diagnosis was made after direct examination, culture, and polymerase chain reaction amplification with specific primers. The genotype classification was based on the highly variable DF3 region in the 18S rRNA gene. This is the first study characterizing Acanthamoeba genotype in Tunisia and North Africa. All Acanthamoeba isolates were associated to the T4 genotype. Three different DF3 sequence types were related to AK infections T4/10, T4/15, and T4/16.

Les onychomycoses à moisissure au Maroc : à propos de 150 cas isolés en 20 ans

the involvement of moulds in the fungal ungueal pathology is very variable. In fact a big confusion reigns because of numerous errors in the clinico-biological diagnosis, which could be responsible for therapeutic failure of onychomycosis. The aim of this study was to evaluate the relative frequency of moulds involved in onychomycosis over a period of 20 years. This is a retrospective study, conducted at the laboratory of parasitology-mycology of the Ibn Sina hospital over a period of 20 years. The patients were referred by dermatologists or general practitioners for suspected onychomycosis. The samples were studied according to good rules for performing mycological analysis. One hundred and fifty cases of onychomycosis were diagnosed with mould, with global prevalency of 2.78%. They mainly concern the toes (95%) with a slight female predominance (60%). The total dystrophy of the nail was the predominant clinical representation (88.3%). Moulds isolated were Aspergillus spp. in 53 cases (35.3%) and Fusarium spp. in 45 cases (30%), 19 cases (12.7%) of Scopulariopsis brevicaulis, 17 cases (11.3%) of Penicillium spp., 14 cases (9.3%) of Acremonium spp., one case of Onychocola canadensis (0.7%) and one case of Scytalidium dimitiatum (0.7%). A significant number of onychomycosis remains attributed to moulds, which highlights the contribution of the laboratory, which remains essential for the clinician to confirm the involvement of mould in onychomycosis, which allows taking into support early treatment avoiding the emergence of aesthetic complications.

Minimum inhibitory concentrations of amphotericin B against Candida krusei isolates from a French teaching hospital laboratory: a retrospective study over 8 years

Recent studies have shown decreased susceptibility of Candida krusei to amphotericin B (AmB), in addition to its inherent resistance to fluconazole. The susceptibility of C. krusei to AmB was studied in the Parasitology-Mycology laboratory of Grenoble Teaching Hospital, France. Between 2003 and 2011, we analysed 200 C. krusei isolates from 130 patients. The isolates were mainly collected in intensive care, cardio-thoracic and cancer/haematology units. Minimum inhibitory concentrations (MICs) were determined by the E-test method. The modal MIC was 0.5 μg ml(-1); the MIC(50) and MIC(90) (MICs encompassing 50% and 90% of all isolates tested, respectively) were 0.5 μg ml(-1) and 1 μg ml(-1). The Cuzick's and Kendall's tests showed a significant increase in MIC values between 2003 and 2011 (P = 0.001 and P ≤ 0.001, respectively), regardless of age or gender. No statistical difference was reached with these tests when the first 100 or 50 data were excluded. Despite the increase observed in the first period of the study, our results confirm the low AmB MICs reported in previous studies. However, some authors have recently reported much higher MICs. This discrepancy cannot be explained by method biases and could reflect C. krusei epidemiological differences among populations.

Les fongémies mixtes. À propos de quatre cas tunisiens

Fungemia is classically caused by a single species and the detection of more than one species in blood samples is uncommon. We report four cases of mixed fungemia (MF) diagnosed in the parasitology-mycology laboratory of Farhat-Hached hospital in Sousse, Tunisia. The MF episodes occurred in two neonates and two adults suffering from acute myeloid leukemia. Two fungal species were detected concomitantly within the same blood culture in all cases. Species combination was detected by the subculture of the blood culture on Candida ID(®) chromogenic medium in three cases and on Sabouraud agar in one case. Predisposing factors were: indwelling catheters (4/4), broad-spectrum antibiotics (3/4), neutropenia (2/4), exclusive parenteral nutrition (2/4) and Candida colonization (1/4). Patients presented febrile sepsis with no response to broad-spectrum antibiotic therapy in all cases. Outcome under antifungal treatment was favorable in two cases and the two other patients died. MF appears similar to the more common monomicrobial fungemia. The use of chromogenic media in routine can improve the detection of MF episodes allowing appropriate antifungal therapy.

État actuel de la toxoplasmose dans la région de Sfax, Tunisie

The frequency of toxoplasmosis depends on lifestyle and environment. Our objective was to study different epidemiological, clinical and biological aspects of toxoplasmosis in the Sfax area (Tunisia). This retrospective study has been performed on seria of 40,566 pregnant women in the Parasitology-Mycology Laboratory of Habib-Bourguiba Sfax hospital-Tunisia for 13 years from 1994 to 2006; 1,691 patients presenting with lymphadenopathy; 191 immunocompromised patients (78 HIV infected patients and 113 transplanted patients) and 21 patients presenting clinical signs of ocular toxoplasmosis. In pregnant women, the seroprevalence was 39.3% (15,952/40,567). Among 24,089 seronegative women, only 6,890 (28.6%) had been followed up during their pregnancy. An active toxoplasmosis possibly acquired during pregnancy was detected in 1.3% of cases. Sixteen congenital toxoplasmosis were detected. Toxoplasmosis was confirmed in 13.7% of the 169 patients with lymphadenitis. For HIV positive patients, 11.7% had cerebral toxoplasmosis. It revealed the HIV infection in four cases. Among transplant recipients, one case of active toxoplasmosis was diagnosed in a renal transplant recipient who received transplant from a seronegative donor. Twentyone patients presenting toxoplasmic retinochoroiditis were treated by subconjonctival injections of clindamycin and systemic corticotherapy at a dose of 1 mg/kg per day. This clinical toxoplasmosis diversity explains the need for bioclinical confrontation to establish diagnosis.

Mycétome

Eumycetomas are chronic subcutaneous pseudo-tumoral infections, endemic in arid tropical areas, which are caused by exogenous fungi that produce grains in vivo. The objective of our work is to establish their epidemiological, clinical and mycological profile in our Moroccan context. Therefore, we conducted a retrospective study, extending from 1975 to 2019, compiling all cases of eumycetomas that were diagnosed in the parasitology-mycology laboratory of the Ibn Sina University Hospital of Rabat. The diagnosis, based on the swabbing of exudates and eventual grains or the study of biopsies, included the direct examination of 30% KOH mounts, the realization of appositions colored by May-Grünwald-Giemsa and the incubation on 3 Sabouraud media at 27° and 37 °C. In 44 years, 12 cases of eumycetoma have been diagnosed, with a male to female ratio of 5:1 and a mean age of 44.8 years. The lesions, evolving from 1 to 30 years, were podal in 10 cases, popliteal and gluteal in one case each, with osteolysis in 3 patients. The collected grains were black in 9 cases, white in 2 others. Direct examination was unanimously positive, revealing entangled hyphae, whilst culture isolated Madurella sp. in 9 cases, Trichophyton rubrum, Acremonium sp. in one case each and remained sterile in the last case. The treatment was medical in 8 cases, medico-surgical in 3 others, with loss of sight of most patients.