FATAL ALVEOLAR ECHINOCOCCOSIS OF THE LUMBAR SPINE

in Journal of Clinical Microbiology (2012)

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 ▲]

Direct 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.

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 ▲]

Echinoccose alvéolaire : l'expérience liégeoise

Conference (2012, June 09)

Filamentous fungi recovered from the water distribution system of a Belgian university hospital

in Medical Mycology (2010), 48(7), 969-974

A study was carried out over a 4-month winter period in order to assess the presence of filamentous fungi in the water distribution system of the University Hospital of Liège. A total of 197 hot and cold ... [more ▼]

A study was carried out over a 4-month winter period in order to assess the presence of filamentous fungi in the water distribution system of the University Hospital of Liège. A total of 197 hot and cold water samples were collected from the main water supply lines and from the taps at three different hospital sites. Overall, filamentous fungi were recovered from 55% and 50% of the main water distribution system and tap water samples, respectively, with a mean of 3.5 ± 1.5 colony forming units per 500 ml water. Nine different genera were identified, all belonging to the Hyphomycetes class. Aspergillus spp. were recovered from 6% of the samples of the water distribution system and A. fumigatus was the most frequently recovered species (66.6%). However, this species was not isolated from water taps. Fusarium spp. was predominant at one site, where it was found in 28% of tap water samples. No Aspergillus spp. but some Fusarium spp. isolates were identified in samples collected from high-risk units. Filters were introduced at the point-of-use in the haematology unit after completion of the study. The findings of the present study confirm the need for further documented studies to evaluate the safety of the hospital water system and to define new preventive measures. [less ▲]

Comparative studies for the serodiagnosis of Chlamydophila and Mycoplasma pneumoniae infections

in ESCMID (Ed.) Abstract book of the 20th ECCMID (2010, April)

Spectrométrie de masse MALDI-TOF en bactériologie clinique ou comment identifier une bactérie en une minute

in Revue Médicale de Liège (2010), 65(Suppl. Synthèse 2010), 29-34

The major application of MALDI-TOTOF mass spectrometry in clinical microbiology is the bacterial identification based on the analysis of all their proteins (ribosomal and membrane-associated proteins ... [more ▼]

The major application of MALDI-TOTOF mass spectrometry in clinical microbiology is the bacterial identification based on the analysis of all their proteins (ribosomal and membrane-associated proteins). This technology allows the identification of most of bacteria within a few minutes. The method is fast, accurate, reliable and cost-effective by comparison to conventional phenotypic techniques. Other applications of MALDI-TOF mass spectrometry are still under development, as the detection of bacterial toxins or resistance mechanisms to antimicrobial agents. [less ▲]

A Patient with Hiv Infection, Cough, Asthenia, and Fever

in Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America (2007), 45(5), 662-3559-600

Evaluation of a new commercial real time PCR for the detection of Aspergillus spp. in serum and respiratory samples

Poster (2007, April)

Objectives. Diagnosis of invasive aspergillosis is still disappointing and often delayed because of the lack of sensitivity of diagnostic tools. DNA detection based-methods have been developed, but differ ... [more ▼]

Objectives. Diagnosis of invasive aspergillosis is still disappointing and often delayed because of the lack of sensitivity of diagnostic tools. DNA detection based-methods have been developed, but differ widely and comparisons are difficult to assess. The objective of the study is to compare a new commercial real-time PCR kit, affigene® Aspergillus tracer assay, with an in house nested PCR targeting 18S rRNA Aspergillus sp. gene. Methods. Twelve patients at risk for invasive aspergillosis were included in the study. They were classified to have possible (5 cases), probable (1 case) or proven (6 cases) invasive aspergillosis following E.O.R.T.C. criteria. Fifteen serum and respiratory paired samples were collected. The DNA extraction was performed by using the QIAmp DNA mini kit® (Qiagen, Germany). All samples were tested by both PCR assays and respiratory samples were cultured. Results. Respiratory samples. A. fumigatus, A. niger and A. flavus were isolated from 10/15 samples; both PCR methods were positive for these samples except one that was positive for affigene® and equivocal for the nested PCR. The real-time PCR assay reported cycle thresholds ranging from 25 to 38. Three of the five culture-negative samples were negative by both PCR methods; one of three was negative in affigene® assay and equivocal by nested PCR; the last sample was positive in affigene® assay and negative by nested PCR. Serum. Thirteen of fifteen blood samples were negative by both PCR methods. One sample was equivocal by nested PCR and was inhibited in affigene® assay despite a culture-positive paired respiratory sample. The last case was inhibited by the real-time PCR assay and negative by nested PCR. Nor the nested PCR, nor affigene® assay could detect any Aspergillus DNA in serum. In total, there was 93% of agreement between the two PCR assays. Conclusion. Both methods are in good agreement and can detect at least three different species of Aspergillus. However, the sensitivity of both assays does not permit the detection of Aspergillus DNA in serum. affigene® assay can easy replace the “in house” assay: it allows a fast and standardized detection of Aspergillus sp. DNA in respiratory samples without inconvenient due to the handling of PCR products. [less ▲]

Disseminated Penicillium marneffei infection contrated in China

Poster (2007)

Penicillium marneffei infection is a rare fungal disease that cause significant disease in immunosuppressed patients. The geographical distribution of this dimorphic fungus is restricted to Asia ... [more ▼]

Penicillium marneffei infection is a rare fungal disease that cause significant disease in immunosuppressed patients. The geographical distribution of this dimorphic fungus is restricted to Asia, Southeast and Far East, where the disease is considered as an indicator of acquired immunodeficiency syndrome (AIDS). Case report. A 42-year old Congolese woman living in Lubumbashi was admitted at the university hospital of Liège for exploration of a general status impairment. She experienced for three months spiking fever, weight loss, productive cough with bloody expectorations and progressive dyspnoea. She reported also to have non-bloody mild diarrhoea with abdominal pain. The HIV antibody status was positive with a low CD4 T lymphocytes count (28/µl). Pulmonary infiltrates were visualized on chest radiography and the computed tomography revealed the presence of a severe pneumopathy characterised by bilateral micronodular lesions. Mediastinal polyadenopathies associated with hepato- and splenomegaly were also highlighted. Bronchoscopy was performed and bronchial aspirations revealed the presence of numerous leucocytes with the presence of intracellular Gram positive organisms suggestive of yeasts. Ziehl, Giemsa and Gomori-Grocott staining were also performed. Ziehl staining was negative. The morphological aspect given by Giemsa staining excluded infection and the PCR specific for T. gondii B1 gene was negative. However, Gomori-Grocott staining revealed the presence of intracellular oval, elongated, sausage-shaped cells with a single transverse septum (3 to 5 µm). Penicillium marneffei was isolated from blood culture and respiratory samples. Intraveinous amphotericin B treatment was administrated during 15 days followed by itraconazole oral administration (200 mg/j). The antimycotic treatment improved the patient condition and despite other clinical troubles she was prematurely discharged because of financial problems. Conclusion. Opportunistic agents involved in HIV-infected patients differ in Africa and Asia and it is important to be able to make a rapid diagnosis with the aid of an experienced laboratory. [less ▲]

Molecular epidemiology of extended-spectrum beta-lactamase-producing Enterobacteriaceae colonizing the digestive tract of patients admitted to intensive care units in a Belgian university hospital

in American Society of Microbiology (Ed.) Program and Abstracts of the 46th Intersciences Conference on Antimicrobial Agents and Chemotherapy (2006, September)