Publications by authors named "Delhaes L"

Background: The airways of patients with cystic fibrosis (pwCF) harbour complex fungal and bacterial microbiota involved in pulmonary exacerbations (PEx) and requiring antimicrobial treatment. Descriptive studies analysing bacterial and fungal microbiota concomitantly are scarce, especially using both culture and high-throughput-sequencing (HTS).

Objectives: We analysed bacterial-fungal microbiota and inter-kingdom correlations in two French CF centres according to clinical parameters and antimicrobial choices.

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Unlabelled: Intestinal microsporidiosis caused by is an opportunistic infection that especially affects solid organ transplant (SOT) recipients. Management revolves around tapering the immunosuppressive regimen and/or using a specific anti-microsporidia treatment, but only fumagillin has demonstrated efficacy for treatment of this infection. Since fumagillin has been commercially discontinued, nitazoxanide is increasingly being used in this indication.

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Article Synopsis
  • Fungal lung disease includes various infections caused by fungi, particularly from the Aspergillus species, leading to conditions like allergic bronchopulmonary aspergillosis and chronic pulmonary aspergillosis, influenced by the patient's immune response and the type of fungi.
  • The diagnosis of these diseases is complicated by geographic and environmental factors as well as coexisting health issues, with new techniques developing but still facing challenges in speed and accuracy, especially in less developed areas.
  • Treatments mainly use antifungal drugs, but drug resistance is becoming a significant problem; however, new antifungal medications and better understanding of the lung mycobiome could pave the way for improved diagnosis and therapy.
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  • Many microorganisms, including bacteria, fungi, and plants, have a protective cell wall that offers strength and protection, especially important for pathogens during host interaction.
  • Solid-state NMR has gained attention as a technique to analyze the molecular structure of these cell walls, focusing on the composition of polysaccharides.
  • This study explores a method called DREAM to enhance NMR analysis, showcasing its effectiveness in identifying polysaccharide signals in intact fungal cells, and discussing its potential for studying more complex cell surfaces.
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  • The study investigates allergic bronchopulmonary mycoses (ABPM) in patients with cystic fibrosis, focusing on specific IgE responses to five non-Aspergillus molds.
  • Researchers analyzed serum samples from 238 patients across several European countries, finding higher levels of specific IgE in these patients compared to healthy controls.
  • The findings highlight the need for improved diagnostic tools for ABPM, as several cases were identified using a new scoring system, emphasizing the importance of non-A. fumigatus molds in these conditions.
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Background: The resistance of Aspergillus flavus to the azole antifungal drugs is an emerging problem. Mutations in the molecular targets of the azole antifungals - CYP 51 A, B and C - are possible mechanisms of resistance, but data to confirm this hypothesis are scarce. In addition, the behaviour of resistant strains in vitro and in vivo is not yet understood.

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Scedosporium spp. and Lomentospora prolificans are emerging non-Aspergillus filamentous fungi. The Scedosporiosis/lomentosporiosis Observational Study we previously conducted reported frequent fungal vascular involvement, including aortitis and peripheral arteritis.

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Background: Acute respiratory distress syndrome (ARDS) is responsible for 400,000 deaths annually worldwide. Few improvements have been made despite five decades of research, partially because ARDS is a highly heterogeneous syndrome including various types of aetiologies. Lower airway microbiota is involved in chronic inflammatory diseases and recent data suggest that it could also play a role in ARDS.

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We report a severe case of kerion Celsi of the scalp in a previously healthy 13-year-old girl due to Trichophyton quinckeanum, an emerging dermatophyte species in Europe. The species was definitely identified by DNA sequencing and the patient was successfully treated by oral terbinafine for 6 weeks. Kerion Celsi is a severe inflammatory form of tinea capitis, which is characterised by a purulent discharge and alopecia [1].

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Article Synopsis
  • The study focuses on a group of fungal isolates, which require molecular identification due to their similarity to other species, and assesses their antifungal susceptibility and clinical context from patient sources.
  • A total of 140 clinical isolates were analyzed over 15 years, using gene sequencing and susceptibility tests to evaluate resistance to antifungal medications like itraconazole and voriconazole.
  • The results showed that most isolates were identified as a specific species, with a small percentage exhibiting resistance to isavuconazole and itraconazole, highlighting the need for reliable identification and treatment strategies in clinical settings.
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  • * Understanding how these modulators affect the microbiomes in the lungs and digestive tract is crucial for predicting disease outcomes and mechanisms.
  • * This review discusses the current knowledge of CFTR modulators' effects on microbial communities and highlights the connection between lung and gut health in cystic fibrosis.
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  • Ventilator-associated pneumonia (VAP) is a common infection in patients on mechanical ventilation, and this study looks into the gut microbiota's role in its development, compared to oropharyngeal and lung microbiota.
  • Researchers analyzed the gut microbiota of 42 ICU patients, finding that while the overall diversity of bacteria (α-diversity) was similar, the specific composition (β-diversity) differed between those who developed VAP and those who did not.
  • The study suggests that certain gut fungal species may influence the likelihood of developing VAP and encourages further research on how gut microbiota might impact lung infections in critically ill patients.
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  • - Malnutrition is a significant issue in cystic fibrosis (CF) that increases health problems, making proper nutritional management crucial for patients.
  • - A study at the University Hospital of Bordeaux analyzed dietary intake from 130 CF patients aged 2-18 years, revealing that only 53% met total energy intake goals, and 28% met protein intake recommendations.
  • - Despite normal vitamin and micronutrient levels in 80% of patients, vitamin K levels were low in 58%, highlighting the ongoing challenges in meeting nutritional targets for effective CF management.
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Background: Nutritional status is a major prognostic factor for breathing and the survival of patients with cystic fibrosis (CF). Since 2012, the development of CFTR modulators has considerably transformed the outcome of this disease. Indeed, both lung function and body mass index are improved by CFTR modulators, such as Lumacaftor/Ivacaftor.

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Background: The worldwide dissemination of extended spectrum beta-lactamase producing Enterobacteriales (ESBL-E) is of major concern. Microbiota may play a role in the host resistance to colonization with ESBL-E, but the underlying mechanisms remain unknown. We aimed to compare the gut microbiota composition between ESBL-producing E.

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Chronic obstructive pulmonary disease (COPD) affects more than 200 million people worldwide. The chronic course of COPD is frequently worsened by acute exacerbations (AECOPD). Mortality in patients hospitalized for severe AECOPD remains dramatically high, and the underlying mechanisms are poorly understood.

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Article Synopsis
  • Lumacaftor-ivacaftor is a CFTR modulator combination effective for cystic fibrosis patients with the F508del allele, showing improvement in clinical outcomes like body mass index and fewer antibiotic courses.
  • A study involving 75 patients analyzed changes in airway microbiota, mycobiota, and inflammation markers before and after 6 months of treatment; overall, no significant changes in microbial diversity or inflammation were found.
  • However, patients not chronically colonized with Pseudomonas aeruginosa showed decreased inflammation and increased bacterial diversity, suggesting individual patient characteristics influence treatment outcomes.
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Little is known about localized osteoarticular Scedosporiosis (LOS). Most data come from case reports and small case series. Here we present an ancillary study of the nationwide French Scedosporiosis Observational Study (SOS), describing 15 consecutive cases of LOS diagnosed between January 2005 and March 2017.

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Article Synopsis
  • - This study evaluated the MycoGENIE® Pj qPCR kit's effectiveness in distinguishing between Pneumocystis jirovecii pneumonia (PCP) and Pj colonization in patients at Bordeaux University Hospital from May 2019 to December 2020.
  • - Results showed significant differences in Pj loads, with higher fungal loads indicating probable PCP; specific thresholds for diagnosis were identified for both bronchoalveolar lavage (BAL) and upper respiratory tract (URT) samples.
  • - The study concluded that while high fungal loads can help diagnose PCP, low loads should be interpreted with caution alongside clinical and radiological findings.
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There has been significant increase in the use of molecular tools for the diagnosis of invasive aspergillosis (IA) and mucormycosis. However, their range of detection may be too limited as species diversity and coinfections are increasing. Here, we aimed to evaluate a molecular workflow based on a new multiplex PCR assay detecting the whole Aspergillus genus and the Mucorales order followed by a species-specific PCR or a DNA-sequencing approach for IA and/or mucormycosis diagnosis and species identification on serum.

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Objectives: To determine the epidemiological cut-off values (ECVs) of ten antifungal agents in a wide range of yeasts and Aspergillus spp. using gradient concentration strips.

Methods: The minimum inhibitory concentrations for amphotericin B, anidulafungin, caspofungin, micafungin, flucytosine, fluconazole, itraconazole, isavuconazole, posaconazole, and voriconazole, determined with gradient concentration strips at 35 French microbiology laboratories between 2002 and 2020, were retrospectively collected.

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Article Synopsis
  • A decrease in gut microbiome diversity is known to correlate with health issues, but the relationship between respiratory microbiome diversity and chronic lung diseases like asthma, COPD, CF, and bronchiectasis is still debated.
  • Researchers conducted a systematic review and meta-analysis on studies evaluating lung microbiota diversity in these conditions, with a focus on comparing patients to healthy controls.
  • The findings suggest that cystic fibrosis patients have lower respiratory microbiota diversity compared to healthy individuals, but due to significant variability in the data, more research is needed to clarify the connections between respiratory microbiota and health outcomes, especially beyond cystic fibrosis.
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