References of "Hayette, Marie-Pierre"
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See detailA clinical lab experience with an automated HIV Antigen/Antibody (Ag/Ab) combined assay
HUYNEN, Pascale ULg; TOUSSAINT, Françoise ULg; GERARD, Christiane ULg et al

Poster (2014, May 11)

OBJECTIVES: To describe the diagnostic performance of a new fourth-generation HIV Ag/Ab chemiluminescent immunoassay, available on the new LIAISON® XL analyser, in a clinical setting. METHODS: Through ... [more ▼]

OBJECTIVES: To describe the diagnostic performance of a new fourth-generation HIV Ag/Ab chemiluminescent immunoassay, available on the new LIAISON® XL analyser, in a clinical setting. METHODS: Through February 2012-October 2013, 12,438 samples of serum, received at our laboratory for screening for HIV infection were routinely tested with LIAISON® XL Murex HIV Ab/Ag assay (HIV-XL), which employs HIV-1, HIV-1 group O, and HIV-2 antigens and anti-p24 monoclonal antibodies in two coupled reagent cartridges, providing information of the overall Ab/Ag reactivity and detail of the specific reactivity for anti-HIV/HIV p24 antigen. Each serum with positive result or with negative result displaying a value close to the cut-off were sent to the regional AIDS-Reference Laboratory (RefLab) to perform confirmatory assays (PCR, Immunoblot). A previous verification of the HIV-XL demonstrated 100% sensitivity with a challenge panel of hundred positive sera provided by the RefLab. Performed external quality control was from United-Kingdom National External Quality Assessment Service (NEQAS). RESULTS: Out of the clinical samples, 12,312 non-reactive samples (including 6 negative results displaying a value close to the cut-off further confirmed true HIV negative), 64 Ab HIV reactive samples (all confirmed HIV-1 positive by immunoblot), including 4 samples reactive also for Ag HIV (confirmed positive by Ag assay/PCR), 42 Ab HIV reactive samples tested negative by immunoblot, and 20 Ag HIV reactive samples tested negative by the kit used for the Ag p24 detection in our HIV Reference Lab, have been found. All the 43 NEQAS specimens tested, 16 reactive and 27 non-reactive, were correctly classified. These results, considered all together, provide a calculated positive predictive value of 57.5% with an estimated specificity of 99.5% (with 95% confidence interval of 99.36-99.62%), and a calculated negative predictive value of 100% with an estimated sensitivity of 100.0% (with 95% confidence interval of 95.49-100%). CONCLUSIONS: In our experience HIV-XL showed excellent performance associated to all the advantages of a fully automated/random access instrument. [less ▲]

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See detailEVALUATION OF THE RAPID DETECTION OF ST-17 AND ST-1 GROUP B STREPTOCOCCI USING A MICROFLEX MALDI-TOF MS (BRUKER)
MEEX, Cécile ULg; SACHELI, Rosalie ULg; DESCY, Julie ULg et al

Poster (2014, May)

Objectives Clearly associated to neonatal meningitis, Group B streptococci (GBS) classified as sequence type-17 (ST-17) are defined as the “highly virulent” clone amongst GBS. The aim of this study was to ... [more ▼]

Objectives Clearly associated to neonatal meningitis, Group B streptococci (GBS) classified as sequence type-17 (ST-17) are defined as the “highly virulent” clone amongst GBS. The aim of this study was to evaluate an easy and rapid method, recently described to detect ST-17 and ST-1 GBS, based on distinguishing peak-shifts present on the protein spectrum of these 2 sequence types, using a Microflex (Bruker) matrix-assisted laser desorption/ionization time of flight mass spectrometer (MALDI-TOF MS). Methods This study was performed on 67 multi locus sequence typed (MLST) GBS originated from the Belgian and Czech National Reference Centers, including 18 ST-17 and 16 ST-1. After culture on blood agar, an ethanol/formic acid extraction was performed on each strain. Each extract was spotted once on a target plate, overlaid with 1 µl alpha-cyano-4-hydroxycinnamic acid matrix and further analysed by a Microflex MALDI-TOF MS. One spectrum per isolate was recorded, 240 laser shots being recorded for each spectrum. The spectra were further analysed using a Bruker prototype software, and 2 logarithmic values, one for ST-17 and one for ST-1, calculated from the intensities of the present and absent peaks, were obtained for each strain. If >0, this value indicated the presence of the specific sequence type. In a second step, the test was repeated on each strain with discordant result when compared with MLST. Results Compared with MLST method, the first analysis of the strains gave poor results, leading to very low sensitivities (77.8% for ST-17 and 50% for ST-1) but rather good specificities (85.7% for ST-17 and 98.0% for ST-1). After repeating the analysis on the strains with discordant result, sensitivity, 100% and 93.8%, and specificity, 87.8% and 98.0%, for ST-17 and ST-1 respectively were highly improved. Conclusion Since ST-17 and ST-1 GBS both show distinguishing peak-shifts on their protein spectrum, as described by Lartigue et al., the distinction of these 2 sequence types is now possible by MALDI-TOF MS. To our knowledge, this study is the first describing this application on a Microflex MS using a software to classify the strains. The observed results are promising but, given to the variability of the logarithmic value given by the software, the need to perform several measures on a same strain seems to be essential. After optimization of the analysis procedure, this rapid, easy and cheap method could be used to precociously detect ST-17 among GBS isolated from prenatal screenings, allowing a better follow up of the colonized mothers and a closer monitoring of their newborns. We would like to thank the Bruker Company which allowed us to evaluate the prototype software they have developed. [less ▲]

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See detailNo simian Plasmodium detected in populations living in the equatorial rainy forest of the Democratic Republic of Congo
Mvumbi makaba, Dieudonné; Bobanga Lengu, Thierry; Kayembe Ntumba, Jean-Marie et al

Poster (2014, April 03)

Background Malaria remains the most deadly parasitic disease to date, especially in sub-Saharan Africa, which comprises the majority of cases collected per year. It has long been accepted that four ... [more ▼]

Background Malaria remains the most deadly parasitic disease to date, especially in sub-Saharan Africa, which comprises the majority of cases collected per year. It has long been accepted that four species of Plasmodium (P. falciparum, P. vivax, P. malariae and P. ovale) were responsible for the disease in humans. But quite recently, a fifth species, Plasmodium Knowlesi, has been identified as naturally infecting humans. Indeed, known for decades as naturally parasitizing the monkey Macaca fascicularis, P. knowlesi has long been confused, in terms of its evolutionary stage, with P. malariae or P. falciparum, which it resembles morphologically and it was not possible to properly differentiate them until the advent of molecular biology. To date, P. Knowlesi has only been identified in Southeast Asia and a similar phenomenon of natural transmission of simian plasmodium to humans has not been reported elsewhere. We therefore conducted this study to investigate the possible transmission of simian plasmodium to humans in populations living near the rainforest of the Democratic Republic of Congo (DRC) where several species of primates lives. Methods & Materials Three villages (Wenji-Secli, Bongonde, and Bolenge) in the Province of Ecuador (North-eastern DRC) were selected because of their geographical location. Blood samples spotted on filter paper were collected from 100 people randomly taken in each village. Two successive RT- PCR were performed. A first one using a single probe able to diagnose all plasmodium spp. and a second using four species-specific probes for the diagnosis of the four conventional human plasmodium species. Positivity in the first RT- PCR with negativity in the second RT- PCR would suggest the presence of plasmodium species other than the four conventional. Results P. falciparum was correctly identified in 44.6 % of samples. No other species of human plasmodium or not has been identified. Conclusion This preliminary study did not detect the presence of simian plasmodium in human populations living in the rainforest of the DRC. Studies with larger samples and with more advanced techniques should still be conducted. Keywords: Malaria, simian plasmodium, DR Congo [less ▲]

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See detailMortierella wolfii-Associated Invasive Disease.
LAYIOS, Nathalie ULg; Canivet, Jean-Luc; Baron, Frédéric ULg et al

in Emerging infectious diseases (2014), 20(9), 1591-2

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See detailAssessment of pfcrt 72-76 haplotypes eight years after chloroquine withdrawal in Kinshasa, Democratic Republic of Congo
Mvumbi, Dieudonné; BOREUX, Raphaël ULg; SACHELI, Rosalie ULg et al

in Malaria Journal (2013), 12

BACKGROUND: In 2001, the World Health Organization (WHO) has recommended the use of artemisinin-based combination therapy (ACT) as the first-line treatment of uncomplicated malaria cases, as monotherapies ... [more ▼]

BACKGROUND: In 2001, the World Health Organization (WHO) has recommended the use of artemisinin-based combination therapy (ACT) as the first-line treatment of uncomplicated malaria cases, as monotherapies had become ineffective in many parts of the world. As a result, the Democratic Republic of Congo (DRC) withdrew chloroquine (CQ) from its malaria treatment policy in 2002 and an artesunate (AS)-amodiaquine (AQ) combination became the ACT of choice in DRC in 2005. AQ-resistance (AQR) has been reported in several parts of the world and mutations in codons 72-76 of the Plasmodium falciparum chloroquine-resistance transporter (pfcrt) gene have been strongly correlated with resistance, especially mutations encoding the SVMNT haplotype. This haplotype was first identified in Southeast Asia and South America but was recently reported in two African countries neighbouring DRC. These facts raised two questions: the first about the evolution of CQ resistance (CQR) in DRC and the second about the presence of the SVMNT haplotype, which would compromise the use of AQ as a partner drug for ACT. METHODS: A total of 213 thick blood films were randomly collected in 2010 from a paediatric clinic in Kinshasa, DRC. Microscopy controls and real-time polymerase chain reaction (RT-PCR) were performed for Plasmodium species identification. Haplotypes of the pfcrt gene were determined by sequencing. RESULTS: The K76T mutation was detected in 145 out of 198 P. falciparum-positive samples (73.2%).In these 145 resistant strains, only the CVIET haplotype was detected. CONCLUSIONS: This study is the first to assess the molecular markers of resistance to CQ and AQ after the introduction of ACT in DRC. The results suggest first that CQR is decreasing, as wild-type pfcrt haplotypes were found in only 26.8% of the samples and secondly that the SVMNT haplotype is not yet present in Kinshasa, suggesting that AQ remains valid as a partner drug for ACT in this region. [less ▲]

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See detailFilamentous fungi in water distribution systems: what is the risk?
Hayette, Marie-Pierre ULg

Conference (2013, November 14)

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See detailA case of hemolytic anemia after severe malaria successfully treated with artesunate
ROUYA, Laura ULg; LEONARD, Philippe ULg; Hayette, Marie-Pierre ULg

Poster (2013, October 24)

Intravenous artesunate is the treatment of choice for severe and complicated malaria according to the WHO 2010 guidelines. Seventeencases of delayed hemolysis after parenteral treatment with artesunate ... [more ▼]

Intravenous artesunate is the treatment of choice for severe and complicated malaria according to the WHO 2010 guidelines. Seventeencases of delayed hemolysis after parenteral treatment with artesunate have been recently reported in European travellers with imported Plasmodium falciparummalaria1. We report the case of a 40-years-old Belgian man who contracted severe falciparum malaria after a four-weeks stay in Central and Eastern Africa without taking any antimalarial chemoprophylaxis. He presented on admission with fever, headache, jaundice andabdominal syndrome.Thereafter hisbiological and clinical conditionrapidly worsened withconsciousness disorders, severe thrombocytopenia,acute hepatitis and pancreatitis, and renal failure. Parasitemia reached a peak of 37 % on the second day of admission. Since this patient fulfilled WHO 2010 criteria for severe malaria,intravenous artesunatetreatment dosed at 2,4 mg/kg was started. Parasite clearancewas obtained after 48 hours and the patient’s clinical status improved significantly.Five doses of intravenous artesunate were administered, followed by oral artemeter/lumefantrine treatment during 60 hours. Tendays after the first dose of artesunate the patient developed a severe hemolyticanemia(hemoglobin4,9 g/dL) associated with impaired renal function. Thick blood film was negative. Blood transfusion and high doses of corticosteroids were successfully administrated and hemodialysis was not necessary. Until now, no clear explanation has been given to this complication. This case highlights the usefulness of extended follow-up including haematological parametersforpatients treated with artesunate, at least one monthafter the malaria episode. 1Published reports of delayed hemolyticanemia after treatment with artesunate for severe malaria--worldwide, 2010-2012. Centers for Disease Control and Prevention (CDC). [less ▲]

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See detailDNA fingerprinting using Diversilab system for genotyping characterization of Microsporum audouinii and Trichophyton violaceum
SACHELI, Rosalie ULg; DIMO, Lauryl; GRAIDE, Hélène ULg et al

in Mycoses (2013, October 01), 56(Supplement S3), 99

Objectives: To investigate the epidemiological determinants responsible for the high number of anthropophilic dermatophytes received by the National Reference Center for Mycosis of Liege (NRCL) during the ... [more ▼]

Objectives: To investigate the epidemiological determinants responsible for the high number of anthropophilic dermatophytes received by the National Reference Center for Mycosis of Liege (NRCL) during the year 2012. To perform a genotypic characterization by the Diversilab® system focusing on the two main isolated species, Microsporum audouinii and Trichophyton violaceum. To present a preliminary study preceding the national survey launched in 2013. Methods: A total of 51 strains of M. audouinii (50 clinical + 1 reference (ref.) strains) and 15 strains of T. violaceum (14 clinical + 1 ref. strain) originating from different locations through Belgium were included in the study. The fungal strains were first cultivated on Malt agar, then sub-cultured in Sabouraud liquid medium (Fluka). The grown mycelium was processed for DNA extraction following recommendations of the manufacturer (Ultra Clean® DNA Microbial isolation kit, MoBio laboratories). Genotypic analysis was performed using the DiversiLab® system (BioMérieux) for DNA fingerprinting and analysis. Results: Regarding M. audouinii, four different genotypic groups of strains were separated. Group 1 includes 11 strains and is only found in the Liège surroundings. Group 2 includes only one strain with little differences compared to group 1 and collected from the Liège area. These two groups may be related to each other. Group 3 contains 36 strains and the reference strain. This genotype is distributed in different Belgium locations. The last group, group 4, contains only 3 isolates sharing low similarities in comparison with the 3 other groups. Concerning T. violaceum, 6 different genotypic groups with a mixed geographical distribution were determined. Group 1 includes 8 clinical isolates and the ref. strain. The other five isolates are all different and seem not to be related to each other. Conclusion: The automated typing DiversiLab® system proved to be an easy and efficient method to investigate the molecular epidemiology of dermatophytes infections. Preliminary results of the study show that, through Belgium, several groups of isolates co-exist for M. audouinii and T. violaceum providing evidence of genetic heterogeneity. This variation can be related to acquired mutations due to environmental adaptation. Further investigations are necessary to better understand the impact of this genotypic variation. [less ▲]

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See detailFirst report of Mortierella wolfii causing human disease
LAYIOS, Nathalie ULg; HAYETTE, Marie-Pierre ULg; HUWART, Aline ULg et al

Conference (2013, September)

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See detailSurveillance of serotypes and antimicrobial susceptibility profile in group B streptococcus (GBS) in Belgium
Melin, Pierrette ULg; SACHELI, Rosalie ULg; Sarlet, Gilles ULg et al

in Program and Abstract of the 53rd Intersciences Conference on Antimicrobial Agents and Chemotherapy. Washington, USA: ASM. (2013, September)

BACKGROUND Today GBS vaccines for prevention of severe neonatal disease through transplacental delivery of antibodies directly from immunized mothers are in advanced stage of development. For the ... [more ▼]

BACKGROUND Today GBS vaccines for prevention of severe neonatal disease through transplacental delivery of antibodies directly from immunized mothers are in advanced stage of development. For the introduction of any GBS vaccine there are urgent needs for pre and post vaccine enhanced surveillance studies of strains isolated from both neonatal diseases and vagino-rectal colonization of pregnant women. In Belgium, surveillance of invasive isolates is regularly done by the NRC. We report in this study a surveillance of colonizing isolates of GBS. METHODS In 2012, 344 GBS isolates were obtained from a Belgian surveillance for vagino-rectal colonization among pregnant women (max. 5 isolates/lab). Capsular types were determined by agglutination (Strep-B-latex, SSI, Denmark) and MICs by using a microdilution method (Sensititre) and Etest® (EUCAST interpretive criteria). Furthermore, for the erythromycin (E) resistant (R) isolates, the inducible (iMLS), constitutive (cMLS) and M phenotypes were assessed by a double-disk diffusion test. RESULTS Serotype III was the more common (27.6%) followed by V, II, Ia, Ib, IV, IX, VII and VI (18.1%, 16.4%, 13.4%, 7%, 4.7%, 2.5%, 0.8%, 0.5%) and 8.9% were non typable. All isolates were susceptible to penicillin ; 29% were R to E with a higher rate among serotypes IV and V (p<0.05). Among these E-R isolates, 93% exhibited the MLS phenotype (R to E and CC): 66% were cMLS with E MIC50>256 mg/L and 27% iMLS with E MIC50/MIC90 2/>8 mg/L. The M phenotype (R to E and S to C) was expressed by 7% of E-R isolates with E MIC50/MIC90 2/4 mg/L. CONCLUSION Compared with Belgian data relating to neonatal invasive strains (NRC reports) 1) Serotype V and II are more frequent and III less frequent among colonizing isolates 2) Prevalence of E-R is similar in percentage and phenotypes with the MLS R phenotype as major mechanism. Extended surveillance of both invasive and colonizing isolates is needed currently to prepare the follow-up in the future vaccine era. [less ▲]

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See detailImprovement of transport condition of swabs for group B streptococcal (GBS) screening
MELIN, Pierrette ULg; Dodémont, Magali; Sarlet, Gilles ULg et al

in Program and Abstract of the 53rd Intersciences Conference on Antimicrobial Agents and Chemotherapy. Washington, USA: ASM. (2013, September)

BACKGROUND For the screening-based strategy for prevention of perinatal GBS disease, CDC Guidelines as many others recommend use of appropriate transport media (Amies, Stuart, e.g.) and processing of ... [more ▼]

BACKGROUND For the screening-based strategy for prevention of perinatal GBS disease, CDC Guidelines as many others recommend use of appropriate transport media (Amies, Stuart, e.g.) and processing of specimen as soon as possible within 1 to 4 days. False negative cultures occur for several causes including lost of GBS viability during transport. Could Lim broth, recommended for the selective enrichment, and Granada tubes be used as transport media for swab? Simulating conditions of routine practice, Lim broth and Granada tubes, were evaluated in vitro as transport media. METHODS Tubes of 3 brands of Lim broth (Becton Dickinson, bioMérieux, Copan) and Granada tubes (bioMérieux) were inoculated with low inocula of 10-100 CFU of GBS. Each type of tubes was incubated at 4°C, room T° (RT) and 35°C. GBS were enumerated from each tube by subculture on blood agar after 1, 2, 3 and 4 days of storage at the different T°. All tests were processed in triplicates with 3 strains of GBS belonging to serotype Ia, III and V. RESULTS No difference of survival was observed between the 3 strains. T° had significant impact on GBS recovery for each type of tubes. At 4°C the viability was hardly sustained along the 4 days. At RT and 35°C, an increase >6 log of the inocula was observed. The increase of GBS density was sustained at least 4 days for the 3 brands of Lim broth. For the Granada broth, such increase was also observed but at day 3 for tubes incubated at 35°C, viability decreased and for some tubes, GBS subcultures were negative at day 3 or 4. CONCLUSION To improve sensitivity of GBS screening cultures, Lim broth could be recommended as a strong transport media and the advisable storage condition would be RT to 35°C up to 4 days. In this way, initiating selective enrichment culture at the time of collection of specimen would provide higher sensitivity even for low density of colonization. Transport at 4°C should be avoided in favour with RT to 35°C. Studies in clinical setting are expected. For Granada tubes, storage at RT was fine but improvement seemed restricted in time at 35°C as there was a loss of viability after 3 days. For Granada tubes, extended evaluation and delimitation of use are needed. [less ▲]

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See detailEvaluation of a new rapid test for the detection of norovirus antigen in comparison with Real Time RT-PCR
HUYNEN, Pascale ULg; Mauroy, Axel ULg; Gérard, Catherine ULg et al

Poster (2013, September)

Diagnosis of NoV infection mainly relies on molecular methods. A detection of viral antigens can also be performed by immunochromatographic assays, and may be useful in outbreak settings. The aim of this ... [more ▼]

Diagnosis of NoV infection mainly relies on molecular methods. A detection of viral antigens can also be performed by immunochromatographic assays, and may be useful in outbreak settings. The aim of this study was to compare the performances of the new RDT ImmunoCardSTAT!®Norovirus (Meridian Bioscience®, Europe) with a real time RT-PCR. [less ▲]

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See detailComparison of Real-Time Aspergillus PCR with Platelia™AspergillusEIA in broncho-alveolar lavage fluids for the diagnosis of invasive aspergillosis in neutropenic and non-neutropenic patients
RUZICKA, NADIA; BOREUX, Raphaël ULg; LEVAUX, Laetitia ULg et al

Poster (2013, April 27)

Objectives. Because of low sensitivity of fungal cultures and lack of standardization of Aspergillus PCR, laboratory diagnosis of invasive aspergillosis still relies on galactomannan (GM) detection in ... [more ▼]

Objectives. Because of low sensitivity of fungal cultures and lack of standardization of Aspergillus PCR, laboratory diagnosis of invasive aspergillosis still relies on galactomannan (GM) detection in broncho-alveolar lavage (BAL) fluids and serum. The aim of this study was double: first, to assess the place of a 18S rRNA Aspergillus real-time PCR test performed in BAL fluid for the diagnosis of invasive aspergillosis (IA) in neutro- and non-neutropenic patients in comparison with GM detection; secondly, to evaluate the use of three different GM cut-off values. Materials and methods. A total of 111 neutropenic and non-neutropenic patients hospitalized at the University hospital of Liège from March to October 2012 with suspicion of IA were included in the study. A total of 138 broncho-alveolar lavage fluids were evaluated by three laboratory diagnostic methods: 1/ culture on Sabouraud agar slants with antibiotics (bioMérieux, France) incubated at 28°C for 28 days; 2/ GM detection (Platelia ™Aspergillus EIA, Biorad) using GM index cut-off values at 0.5, 0.8 and 1, performed three times a week; 3/ a real-time Aspergillus PCR assay performed daily and targeting the 18S rRNA genes by using an in-house method. Clinical, radiological and microbiological data were reviewed for classification of patients. Results. Nine patients developed probable or possible IA. The sensitivity/specificity/positive (VPP) and negative (NPV) predictive values (%) for culture, PCR, and GM using 0,5 as cut-off value were respectively 41/100/100/94, 58/97/70/96, and 91/83/34/99. The use of 0,8 and 1 as GM index cut-off values increased the specificity to 89 and 92% respectively, and the VPP to 44 and 54%. PCR had a better turn-around time and allowed the detection of Aspergillus colonisation. Conclusion: GM detection in BAL fluids using a cut-off value of 1 was the most efficient laboratory test for the diagnosis of IA in neutropenic and non-neutropenic patients. Despite a lower sensitivity, PCR had a better VPP, and allowed the detection of culture-negative Aspergillus colonisations. A shorter turnaround time (TAT) due to daily practice of PCR tests may reduce the time-to-treatment up to 24 hours. [less ▲]

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See detailFATAL ALVEOLAR ECHINOCOCCOSIS OF THE LUMBAR SPINE
KEUTGENS, Aurore ULg; SIMONI, Paolo ULg; DETREMBLEUR, Nancy ULg et al

in Journal of Clinical Microbiology (2013), 51(2), 688-91

For the last ten years, the southern part of Belgium has been recognized as a low-risk endemic area for alveolar echinococcosis. This infection, caused by Echinococcus multilocularis, usually induces a ... [more ▼]

For the last ten years, the southern part of Belgium has been recognized as a low-risk endemic area for alveolar echinococcosis. This infection, caused by Echinococcus multilocularis, usually induces a severe liver condition, and can sometimes spread to other organs. However, alveolar echinococcosis involving bones has been described only very rarely. Here, a fatal case of spondylodiscitis due to E. multilocularis contracted in southern Belgium is reported. [less ▲]

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See detailCOMMENTEZ CE CAS CLINIQUE
HUWART, Aline ULg; RADERMACHER, Jean; CAPRASSE, Philippe et al

in Journal de Mycologie Médicale (2013)

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See detailAbcès hépatique amibien contracté en Inde avec confirmation du diagnostic par PCR
Ho, Giang; Arenas Sanchez, Maria Mara ULg; LEONARD, Philippe ULg et al

in Revue Médicale de Liège (2013), 68(7-8), 428-432

Amoebiasis is a disease of parasitic origin responsible for dysentery and extraintestinal complications. It is due to the infection by Entamoebe histolytica an amoeba whose geographical distribution is ... [more ▼]

Amoebiasis is a disease of parasitic origin responsible for dysentery and extraintestinal complications. It is due to the infection by Entamoebe histolytica an amoeba whose geographical distribution is cosmopolitan but that is more prevalent in tropical areas. Only a few infections are symptomatic and some of them may cause extraintestinal complications. Hepatic amoebiasis is the most frequently observed. We report the case of a Belgian woman who developed amoebic liver abscess after returning from a trip to India. The diagnosis was confirmed by PCR detection of E. histolytica DNA performed on the abscess fluid. The epidemiological, diagnosis and treatment aspects are discussed. [less ▲]

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See detailCerebral aspergillosis in immunocompromised patient successfully treated with voriconazole
HUWART, Aline ULg; RADERMACHER, Jean; HENROTEAUX, Adrienne ULg et al

Poster (2012, November 08)

Cerebral aspergillosis is a severe invasive mycosis occurring in immunocompromised patients. This pathology is associated with a high rate of mortality and is a current complication of pulmonary invasive ... [more ▼]

Cerebral aspergillosis is a severe invasive mycosis occurring in immunocompromised patients. This pathology is associated with a high rate of mortality and is a current complication of pulmonary invasive aspergillosis. We report the case of a 44-year-old immunocompromised male with a recent history of oropharyngeal carcinoma. At his admission the patient presented with fever and confusion. Imaging revealed the presence of a cerebral abscess combined with lung infiltrates. During hospitalization and despite a broad-spectrum antibiotic regimen his condition worsened. A thin needle aspiration of the abscess was performed for diagnosis purpose. Histological examination of the tissue showed septate and branched hyphae with 45° angles suggestive of Aspergillus. A real-time PCR specific for the detection of Aspergillus sp. was carried out and confirmed the fungal etiology of the abscess. Rare colonies of A. fumigatus were isolated a few days later. The diagnosis of invasive pulmonary aspergillosis complicated by a cerebral dissemination was confirmed. Antifungal treatment based on voriconazole 4 mg/kg q12h was introduced and the dosage was successfully increased up to 5 mg/kg q12h by drug monitoring. This case highlights the usefulness of the Aspergillus PCR for the rapid identification of hyphae in tissue biopsies (or in the event of negative culture), and the importance of therapeutic drug monitoring in treatment by voriconazole. [less ▲]

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See detailDirect identification of bacteria from BacT/ALERT anaerobic positive blood cultures by MALDI-TOF MS: MALDI Sepsityper kit versus an in-house saponin method for bacterial extraction.
MEEX, Cécile ULg; Neuville, Florence; DESCY, Julie ULg et al

in Journal of Medical Microbiology (2012), 61

In cases of bacteraemia, a rapid species identification of the causal agent directly from positive blood culture broths could assist clinicians in the timely targeting of empirical antimicrobial therapy ... [more ▼]

In cases of bacteraemia, a rapid species identification of the causal agent directly from positive blood culture broths could assist clinicians in the timely targeting of empirical antimicrobial therapy. For this purpose, we evaluated the direct identification of micro-organisms from BacT/ALERT (bioMérieux) anaerobic positive blood cultures without charcoal using the Microflex matrix-assisted laser desorption/ionization (MALDI) time of flight MS (Bruker), after bacterial extraction by using two different methods: the MALDI Sepsityper kit (Bruker) and an in-house saponin lysis method. Bruker's recommended criteria for identification were expanded in this study, with acceptance of the species identification when the first three results with the best matches with the MALDI Biotyper database were identical, whatever the scores were. In total, 107 monobacterial cultures and six polymicrobial cultures from 77 different patients were included in this study. Among monomicrobial cultures, we identified up to the species level 67 and 66 % of bacteria with the MALDI Sepsityper kit and the saponin method, respectively. There was no significant difference between the two extraction methods. The direct species identification was particularly inconclusive for Gram-positive bacteria, as only 58 and 52 % of them were identified to the species level with the MALDI Sepsityper kit and the saponin method, respectively. Results for Gram-negative bacilli were better, with 82.5 and 90 % of correct identification to the species level with the MALDI Sepsityper kit and the saponin method, respectively. No misidentifications were given by the direct procedures when compared with identifications provided by the conventional method. Concerning the six polymicrobial blood cultures, whatever the extraction method used, a correct direct identification was only provided for one of the isolated bacteria on solid medium in all cases. The analysis of the time-to-result demonstrated a reduction in the turnaround time for identification ranging from 1 h 06 min to 24 h 44 min, when performing the blood culture direct identification in comparison with the conventional method, whatever the extraction method. [less ▲]

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