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Sainte-Foy-lès-Lyon, France

Daumas A.,Service de Nephrologie | El-Mekaoui F.,Service de Nephrologie | Bataille S.,Service de Nephrologie | Daniel L.,Service danatomopathologie | And 7 more authors.
Journal of Medical Case Reports | Year: 2012

Introduction. Legionnaires' disease is recognized as a multi-systemic illness. Afflicted patients may have pulmonary, renal, gastrointestinal tract and central nervous system complications. However, renal insufficiency is uncommon. The spectrum of renal involvement may range from a mild and transient elevation of serum creatinine levels to anuric renal failure requiring dialysis and may be linked to several causes. In our present case report, we would like to draw attention to the importance of the pathological documentation of acute renal failure by reporting a case of a patient with acute tubulointerstitial nephritis complicating Legionnaires' disease. Case presentation. A 55-year-old Caucasian man was admitted to our hospital for community-acquired pneumonia complicated by acute renal failure. Legionella pneumophila serogroup type 1 was diagnosed. Although the patient's respiratory illness responded to intravenous erythromycin and ofloxacin therapy, his renal failure worsened, he became anuric, and hemodialysis was started. A renal biopsy was performed, which revealed severe tubulointerstitial nephritis. After initiation of steroid therapy, his renal function improved dramatically. Conclusions: This case highlights the importance of kidney biopsies in cases where acute renal failure is a complicating factor in Legionnaires' disease. If the presence of acute tubulointerstitial nephritis can be confirmed, it will likely respond favorably to steroidal treatment and thus irreversible renal damage and chronic renal failure will be avoided. © 2012 Daumas et al; licensee BioMed Central Ltd.

Al Masalma M.,Federation de Microbiologie Clinique | Al Masalma M.,French National Center for Scientific Research | Lonjon M.,Nice University Hospital Center | Richet H.,Federation de Microbiologie Clinique | And 9 more authors.
Clinical Infectious Diseases | Year: 2012

Background. The bacterial flora involved in brain abscess is often complex. In a previous study, using a metagenomic approach based on 16S ribosomal DNA (rDNA) amplification, we demonstrated that the diversity of the microbial flora involved in these infections was underestimated.Methods.We performed a 16S rDNA-based metagenomic analysis of cerebral abscesses from patients diagnosed from 2006 through 2010. All bacteria present in brain abscess specimens were identified, in view of the clinical and epidemiological characteristics of the patients. Results. Fifty-one patients were included in our study. By detecting polymicrobial infections in 19 patients, our strategy was significantly more discriminatory and enabled the identification of a greater number of bacterial taxa than did culture and conventional 16S rDNA polymerase chain reaction (PCR) and sequencing, respectively (P < 10-2). Data mining discriminated 2 distinct bacterial populations in brain abscess from dental and sinusal origin. In addition, of the 80 detected bacterial species, we identified 44 bacteria that had never been found in brain abscess specimens, including 22 uncultured bacteria. These uncultured agents mostly originated from the buccal or sinusal floras (P < 10-2) and were found in polymicrobial specimens (P < 10-2).Conclusions.Cloning and sequencing of PCR-amplified 16S rDNA is a highly valuable method to identify bacterial agents of brain abscesses. © 2011 The Author.

Moliner C.,IRD Montpellier | Ginevra C.,University of Lyon | Ginevra C.,French Institute of Health and Medical Research | Jarraud S.,University of Lyon | And 7 more authors.
Journal of Medical Microbiology | Year: 2010

Legionella species are facultative, intracellular bacteria that infect macrophages and protozoa, with the latter acting as transmission vectors to humans. These fastidious bacteria mostly cause pulmonary tract infections and are routinely identified by various molecular methods, mainly PCR targeting the mip gene and sequencing, which are expensive and time-consuming. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) has emerged as a rapid and inexpensive method for identification of bacterial species. This study evaluated the use of MALDI-TOF-MS for rapid species and serogroup identification of 21 Legionella species recognized as human pathogens. To this end, a reference MS database was developed including 59 Legionella type strains, and a blind test was performed using 237 strains from various species. Two hundred and twenty-three of the 237 strains (94.1 %) were correctly identified at the species level, although ten (4.2 %) were identified with a score lower than 2.0. Fourteen strains (5.9 %) from eight species were misidentified at the species level, including seven (3.0 %) with a significant score, suggesting an intraspecific variability of protein profiles within some species. MALDI-TOF-MS was reproducible but could not identify Legionella strains at the serogroup level. When compared with mip gene sequencing, MALDI-TOF-MS exhibited a sensitivity of 99.2 and 89.9% for the identification of Legionella strains at the genus and species level, respectively. This study demonstrated that MALDI-TOF-MS is a reliable tool for the rapid identification of Legionella strains at the species level. © 2010 SGM.

Ninove L.,Federation de Microbiologie Clinique | Ninove L.,Institut Universitaire de France | Daniel L.,Laboratoire dAnatomie Pathologique | Gallou J.,Federation de Microbiologie Clinique | And 10 more authors.
Clinical Microbiology and Infection | Year: 2011

We describe a fatal case of Reye's syndrome in a 12-year-old male patient during an influenza A (H3N2) infection for which he received salicylates. In the current situation of the novel A/H1N1 virus pandemic, we believe that it is of high importance to emphasize the risks associated with salicylate intake to avoid the reappearance of Reye's syndrome. © 2010 European Society of Clinical Microbiology and Infectious Diseases. No claim to original US government works.

Belhocine W.,Federation de Microbiologie Clinique | Purgus R.,Service de Nephrologie | Almasalma M.,Federation de Microbiologie Clinique | Moal V.,Service de Nephrologie | And 4 more authors.
Transplantation Proceedings | Year: 2010

We report an unusual case of Nocardia carnea brain and lung abscesses in a 54-year-old kidney transplant recipient. Our case was confirmed by molecular detection despite negative cultures. The patient recovered using prolonged cotrimoxazole treatment. © 2010 Elsevier Inc. All rights reserved.

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