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Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study

Robert-Gangneux, Florence ; Sterkers, Yvon ; Yera, Hélène ; Accoceberry, Isabelle ; Menotti, Jean ; Cassaing, Sophie ; Brenier-Pinchart, Marie-Pierre ; Hennequin, Christophe ; Delhaes, Laurence ; Bonhomme, Julie ; Villena, Isabelle ; Scherer, Emeline ; Dalle, Frédéric ; Touafek, Feriel ; Filisetti, Denis ; Varlet-Marie, Emmanuelle ; Pelloux, Hervé ; Bastien, Patrick Fenwick, B. W.

Journal of clinical microbiology, 2015-05, Vol.53 (5), p.1677-1684 [Periódico revisado por pares]

United States: American Society for Microbiology

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Título:
Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study
Autor: Robert-Gangneux, Florence ; Sterkers, Yvon ; Yera, Hélène ; Accoceberry, Isabelle ; Menotti, Jean ; Cassaing, Sophie ; Brenier-Pinchart, Marie-Pierre ; Hennequin, Christophe ; Delhaes, Laurence ; Bonhomme, Julie ; Villena, Isabelle ; Scherer, Emeline ; Dalle, Frédéric ; Touafek, Feriel ; Filisetti, Denis ; Varlet-Marie, Emmanuelle ; Pelloux, Hervé ; Bastien, Patrick
Fenwick, B. W.
Assuntos: France - epidemiology ; Human immunodeficiency virus ; Humans ; Immunocompromised Host ; Microbiological Techniques ; Molecular Diagnostic Techniques ; Parasitology ; Polymerase Chain Reaction ; Prevalence ; Retrospective Studies ; Survival Analysis ; Toxoplasma - genetics ; Toxoplasma - isolation & purification ; Toxoplasma gondii ; Toxoplasmosis - diagnosis ; Toxoplasmosis - epidemiology ; Toxoplasmosis - parasitology ; Toxoplasmosis - pathology
É parte de: Journal of clinical microbiology, 2015-05, Vol.53 (5), p.1677-1684
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Citation Robert-Gangneux F, Sterkers Y, Yera H, Accoceberry I, Menotti J, Cassaing S, Brenier-Pinchart M-P, Hennequin C, Delhaes L, Bonhomme J, Villena I, Scherer E, Dalle F, Touafek F, Filisetti D, Varlet-Marie E, Pelloux H, Bastien P. 2015. Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study. J Clin Microbiol 53:1677–1684. doi:10.1128/JCM.03282-14.
Descrição: 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.
Editor: United States: American Society for Microbiology
Idioma: Inglês

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Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study

United States: American Society for Microbiology

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