Epidemiological and clinical study of microsporidiosis in French kidney transplant recipients from 2005 to 2019: TRANS‐SPORE registry

Dumond, C.; Aulagnon, Florence; Étienne, Isabelle; Heng, Anne-Élisabeth; Favennec, Loïc; Kamar, Nassim; Iriart, Xavier; Pereira, Bruno; Büchler, Mathias; Désoubeaux, Guillaume; Kaminski, Hannah; Lussac-Sorton, Florian; Gargala, Gilles; Anglicheau, Dany; Poirier, Philippe; Scemla, Anne; Garrouste, Cyril; Labbé, F.; Damiani, Céline; Govic, Yohann Le; Totet, Anne; Gentile, Ludovic de; Lemoine, Jean‐Philippe; Bellanger, Anne Pauline; Accoceberry, Isabelle; Delhaès, Laurence; Gabriel, Frédéric; Millet, Pascal; Gal, Solène Le; Nevez, Gilles; Bonhomme, Julie; Capitaine, Agathe; Demar, Magalie; Moniot, Maxime; Nourrisson, Céline; Angebault, Cécile; Botterel, Françoise; Foulet, F.; Basmaciyan, Louise; Dalle, Frédéric; Valot, Stéphane; Desbois‐Nogard, Nicole; Robert, Gladys; Deleplancque, Anne‐Sophie; Fréalle, Émilie; Leroy, Jordan; Ajzenberg, Daniel; Durieux, Marie‐Fleur; Chapey‐Picq, Emmanuelle; Dupont, Damien; Menotti, Jean; Rabodonirina, Méja; l'Ollivier, Coralie; Bastien, Patrick; Debourgogne, Anne; Machouart, Marie; Lavergne, Rose‐Anne; Morio, Florent; Delaunay, Pascal; Pomarès, Christelle; Simon, Loïc; Sasso, Milène; Argy, Nicolas; Houzé, Sandrine; Yera, Hélène; Dannaoui, Éric; Bougnoux, Marie‐Elisabeth; Sitterle, Emilie; Kapel, Nathalie; Tantaoui, Ilhame; Thellier, Marc; Belkadi, G.; Moreno‐Sabater, Alicia; Hamane, Samia; Nicolas, Muriel; Perraud, Estelle; Chemla, Cathy; Villena, Isabelle; Autier, Brice; Costa, Damien; Flori, Pierre; Brunet, Julie; Berry, Antoine; Chesnay, Adélaïde; Artur, Fabienne; Verdurme, Laura; Foulquier, Jean‐Baptiste; Prigent, Gwenole; Chatelain, Rémi; Lesthelle, Sophie

doi:10.1111/tid.13708

Cited by 5 publications

(4 citation statements)

References 52 publications

(127 reference statements)

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“…12,13 For gastroenteritis, enteric multiplex molecular assays are useful as part of the initial workup but inadequate as sole diagnostic tests due to exclusion of important opportunistic pathogens (e.g., CMV, non-40/41 ADV serotypes, and microsporidia) and lack of susceptibility data for bacterial pathogens. 14,15 Additionally, a high rate of false positives has been reported among SOTR in the absence of gastrointestinal symptoms. 16 Though multiplex molecular assays are often dubbed as "syndromic," each umbrella syndrome (such as meningoencephalitis) encompasses a wide array of unique clinical presentations (such as chronic lymphocytic meningitis be difficult to interpret and requires input from transplant infectious disease and microbiology experts.…”

Section: Multiplex Molecular Assaysmentioning

confidence: 99%

“…For sepsis, multiplex panels from positive blood cultures are potentially useful to shorten the time to identification, especially for candidemia, for tailoring treatment, and for withholding empiric treatment altogether in some situations where pre‐test probability for bloodstream infection is low 12,13 . For gastroenteritis, enteric multiplex molecular assays are useful as part of the initial workup but inadequate as sole diagnostic tests due to exclusion of important opportunistic pathogens (e.g., CMV, non‐40/41 ADV serotypes, and microsporidia) and lack of susceptibility data for bacterial pathogens 14,15 . Additionally, a high rate of false positives has been reported among SOTR in the absence of gastrointestinal symptoms 16 …”

Section: Consensus Conference Findingsmentioning

confidence: 99%

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A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients

Azar

Turbett

Gaston

et al. 2022

American Journal of Transplantation

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A virtual consensus conference proposal on advanced diagnostics for transplant infectious diseases was submitted by the AST Transplant Diagnostics Community of Practice (TxDxCOP) for consideration and subsequently approved for funding. The consensus conference was fully virtual; participants received no funds from private enterprises. AST provided organizational and technical support for pre-conference and conference proceedings. A steering committee comprising members of TxDxCOP and the Infectious Diseases Community of Practice developed conference definitions, aims, scope, and format. Advanced or novel assays were defined as assays with the capacity for one or more of the following: To detect (1) pathogens, (2) genotypic or phenotypic antimicrobial susceptibility, or (3) pathogen-specific host responses, with an enhanced range of target detection, sensitivity, specificity, speed and/or simplicity of use, relative to conventional methods. Assay categories that met the above definition and for which some data on clinical performance/utility was available were included in this consensus conference.

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Section: Multiplex Molecular Assaysmentioning

confidence: 99%

Section: Consensus Conference Findingsmentioning

confidence: 99%

A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients

Azar

Turbett

Gaston

et al. 2022

American Journal of Transplantation

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“…The importance of microsporidia in humans came into focus with the emergence of the acquired immune deficiency syndrome (AIDS). In humans severe infection has been seen in patients with AIDS, patients following organ transplantation, and in patients taking immune suppressive drugs or immune modulatory antibodies ( Han and Weiss, 2017 ; Dumond et al, 2021 ; Dumortier et al, 2021 ). Most commonly infection results in a diarrheal syndrome; however, patients may also suffer from encephalitis, ocular infection, sinusitis, myositis, or disseminated infection ( Weber et al, 1994 ; Weiss and Keohane, 2010 ; Ziad et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Current Therapy and Therapeutic Targets for Microsporidiosis

et al. 2022

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Microsporidia are obligate intracellular, spore-forming parasitic fungi which are grouped with the Cryptomycota. They are both opportunistic pathogens in humans and emerging veterinary pathogens. In humans, they cause chronic diarrhea in immune-compromised patients and infection is associated with increased mortality. Besides their role in pébrine in sericulture, which was described in 1865, the prevalence and severity of microsporidiosis in beekeeping and aquaculture has increased markedly in recent decades. Therapy for these pathogens in medicine, veterinary, and agriculture has become a recent focus of attention. Currently, there are only a few commercially available antimicrosporidial drugs. New therapeutic agents are needed for these infections and this is an active area of investigation. In this article we provide a comprehensive summary of the current as well as several promising new agents for the treatment of microsporidiosis including: albendazole, fumagillin, nikkomycin, orlistat, synthetic polyamines, and quinolones. Therapeutic targets which could be utilized for the design of new drugs are also discussed including: tubulin, type 2 methionine aminopeptidase, polyamines, chitin synthases, topoisomerase IV, triosephosphate isomerase, and lipase. We also summarize reports on the utility of complementary and alternative medicine strategies including herbal extracts, propolis, and probiotics. This review should help facilitate drug development for combating microsporidiosis.

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“…Intestinal microsporidiosis cases are associated with severe and chronic diarrhea in immunocompromized patients [13]. They were first reported as opportunistic infections in HIVinfected patients in the 1980s and 1990s, but nowadays they are mostly diagnosed in other immunocompromized populations, such as patients with solid organ transplantation [3,5,6,8,11,15]. Enterocytozoon bieneusi accounts for more than 90% of intestinal microsporidiosis cases; the remaining cases involve Encephalitozoon intestinalis, Encephalitozoon hellem and Encephalitozoon cuniculi [13].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Bio-Evolution Microsporidia generic and typing real-time PCR assays for the diagnosis of intestinal microsporidiosis

et al. 2022

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Cases of intestinal microsporidiosis infection are underestimated and affect both immunocompromized and immunocompetent patients. Real-time PCR is superseding microscopic examination for its diagnosis in medical analysis laboratories. However, few manufacturers include microsporidia in their PCR panel for the diagnosis of infectious gastroenteritis. Here, we evaluated the performances of the real-time PCR assays microsporidia generic and microsporidia typing (Bio-Evolution, France) on the Rotor-Gene Q real-time PCR cycler (Qiagen, France). We included 45 negative and 44 positive stool samples for Enterocytozoon bieneusi (n = 34, with various genotypes), Encephalitozoon intestinalis (n = 4), Encephalitozoon hellem (n = 4), and Encephalitozoon cuniculi (n = 2). We also studied a four-year survey of an inter-laboratory quality control program including 9 centers that used this commercial assay. Sensitivity and specificity of the microsporidia generic assay were 86.4% and 93.3%, respectively. Encephalitozoon hellem and Encephalitozoon cuniculi were detected by the microsporidia generic PCR assay but not by the microsporidia typing PCR assay. These results were consistent with the results of the inter-laboratory quality control program. In conclusion, Bio-Evolution Real-time PCR assays are useful tools for intestinal microsporidiosis, but negative results for microsporidia typing assays require supplementary analyses to confirm E. hellem or E. cuniculi infections.

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Epidemiological and clinical study of microsporidiosis in French kidney transplant recipients from 2005 to 2019: TRANS‐SPORE registry

Abstract: Introduction:Microsporidiosis is an emerging opportunistic infection in renal transplantation (RT) recipients. We aimed to describe its clinical presentation and treatment.

Cited by 5 publications

References 52 publications

A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients

A consensus conference to define the utility of advanced infectious disease diagnostics in solid organ transplant recipients

Current Therapy and Therapeutic Targets for Microsporidiosis

Evaluation of the Bio-Evolution Microsporidia generic and typing real-time PCR assays for the diagnosis of intestinal microsporidiosis

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