6533b861fe1ef96bd12c5097
RESEARCH PRODUCT
Molecular Diagnosis of Toxoplasmosis in Immunocompromised Patients: a 3-Year Multicenter Retrospective Study
Jean MenottiLaurence DelhaesFrédéric DallePatrick BastienMarie-pierre Brenier-pinchartHervé PellouxEmeline SchererFeriel TouafekEmmanuelle Varlet-marieIsabelle AccoceberrySophie CassaingJulie BonhommeChristophe HennequinHélène YeraDenis FilisettiIsabelle VillenaYvon SterkersFlorence Robert-gangneuxsubject
Microbiology (medical)Microbiological Techniquesmedicine.medical_specialtyMESH: Molecular Diagnostic TechniquesAsymptomaticPolymerase Chain Reactionlaw.inventionImmunocompromised Host[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseaseslawInternal medicinemedicineMESH: Immunocompromised HostPrevalenceHumansComputingMilieux_MISCELLANEOUSPolymerase chain reactionImmunodeficiencySurvival analysisMESH: PrevalenceRetrospective Studies[SDV.EE.SANT]Life Sciences [q-bio]/Ecology environment/HealthMESH: Humansbusiness.industryIncidence (epidemiology)MESH: ToxoplasmaMESH: Microbiological TechniquesRetrospective cohort studyMESH: Polymerase Chain ReactionMESH: Retrospective Studiesmedicine.diseaseSurvival AnalysisToxoplasmosis3. Good healthSurgeryMESH: France[SDV.MP]Life Sciences [q-bio]/Microbiology and ParasitologyMolecular Diagnostic TechniquesMESH: Survival AnalysisChemoprophylaxisMESH: ToxoplasmosisParasitologyFrancemedicine.symptombusinessToxoplasmaToxoplasmosisdescription
ABSTRACT Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood ( n = 337 samples), cerebrospinal fluid ( n = 101 samples), and aqueous humor ( n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV + ; the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers ( P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-04-16 |