0000000000330731

AUTHOR

Emilie Fréalle

Factors associated with Pneumocystis colonization and circulating genotypes in chronic obstructive pulmonary disease patients with acute exacerbation or at stable state and their homes

Abstract Pneumocystis jirovecii colonization is frequent during chronic obstructive pulmonary disease (COPD) and patients constitute potential contributors to its interhuman circulation. However, the existence of an environmental reservoir cannot be excluded. We assessed the prevalence and factors associated with Pneumocystis colonization during COPD, and studied circulation between patients and their domestic environment. Pneumocystis molecular detection and mtLSU genotyping were performed in oro-pharyngeal washes (OPW) sampled in 58 patients with COPD acute exacerbation, and in indoor dust, sampled in patients’ homes using electrostatic dust collectors (EDCs). Lung and systemic inflammati…

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Impact of domestic mould exposure on Aspergillus biomarkers and lung function in patients with chronic obstructive pulmonary disease

International audience; Patients with chronic obstructive pulmonary disease (COPD) are frequently colonised or sensitised by Aspergillus, but clinical significance remains unclear. Furthermore, little is known on the impact of indoor mould exposure during COPD. In this study, we assessed the relationship between domestic mould exposure, Aspergillus biomarkers and COPD severity during acute exacerbation and at stable state. Aspergillus section Fumigati culture in sputum and anti-Aspergillus antibodies detection (IgG and precipitins) were followed up in COPD patients that were prospectively recruited during exacerbation (n = 62), and underwent a visit at stable state after 18 months (n = 33).…

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Emergence of Aspergillus fumigatus azole resistance in azole-naïve patients with chronic obstructive pulmonary disease and their homes.

Azole-resistant Aspergillus fumigatus (ARAF) has been reported in patients with chronic obstructive pulmonary disease (COPD) but has not been specifically assessed so far. Here, we evaluated ARAF prevalence in azole-naïve COPD patients and their homes, and assessed whether CYP51A mutations were similar in clinical and environmental reservoirs. Sixty respiratory samples from 41 COPD patients with acute exacerbation and environmental samples from 36 of these patient's homes were prospectively collected. A. fumigatus was detected in respiratory samples from 11 of 41 patients (27%) and in 15 of 36 domiciles (42%). Cyp51A sequencing and selection on itraconazole medium of clinical (n = 68) and e…

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Méthodes d’identification et de quantification des moisissures de l’habitat : méthodes classiques, méthodes moléculaires

Resume Introduction Pour apprehender les repercussions de l’inhalation constante et inevitable de spores de moisissures il est necessaire de les prelever, les identifier et les quantifier. Etat des lieux Les prelevements sont de trois types : (i) surfaces, de realisation facile mais non quantifiables, (ii) air, faciles a calibrer mais limites dans le temps, et (iii) poussieres, plus representatifs dans le temps d’une exposition aux moisissures. La strategie d’echantillonnage depend des objectifs (exposition des personnes, objectiver la contamination, efficacite de la remediation). L’identification des colonies obtenues en culture est realisee par microscopie, Maldi-TOF, et/ou par sequencage…

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Impact de l’exposition domestique aux moisissures sur le risque de colonisation ou sensibilisation par Aspergillus fumigatus des patients atteints de BPCO

Objectif Les patients atteints de BPCO sont frequemment colonises par Aspergillus fumigatus (49–87 %) et a risque de developper des formes invasives d’aspergillose dont la mortalite est importante et l’incidence (environ 2 %) probablement sous-estimee. Afin de mieux comprendre le role de l’exposition environnementale aux moisissures dans ces infections, nous avons caracterise la flore fongique domiciliaire de patients atteints de BPCO et evalue son impact sur le risque de colonisation et sensibilisation fongiques par A. fumigatus . Methodes Soixante-deux patients ont ete prospectivement recrutes au CHRU de Lille entre aout 2011 et novembre 2015. La flore fongique domiciliaire a ete caracter…

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