Dataset Information

Ruling out nosocomial transmission of Cryptosporidium in a renal transplantation unit: case report.

ABSTRACT: Cryptosporidium spp. is a ubiquitous parasite affecting humans as well as domestic and wild vertebrates, causing diarrhea in both immunocompetent and immunocompromised hosts worldwide. Its transmission occurs primarily by the fecal-oral route. In humans, C. parvum and C. hominis are the most prevalent species, whereas immunocompetent and immunocompromised individuals can also be infected by other zoonotic species. Renal transplant patients are prone to develop cryptosporidiosis, which can induce severe and life-threatening diarrhea.We report here a series of nearly concomitant cases of acute symptomatic cryptosporidiosis in three renal transplant patients attending the Strasbourg University Hospital Nephrology Unit. The clinical presentation was persistent diarrhea and acute renal failure. The diagnosis was confirmed by microscopic stool examination using a modified Ziehl-Neelsen staining method and species identification by molecular tools. All patients were treated with nitazoxanide and recovered from diarrhea after 14 days of therapy.Genotypic species identification was not consistent with an epidemic context, thus underlining the need for genotyping to monitor at risk patients.

SUBMITTER: Brunet J

PROVIDER: S-EPMC4969980 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Ruling out nosocomial transmission of Cryptosporidium in a renal transplantation unit: case report.

Brunet J J Lemoine J P JP Pesson B B Valot S S Sautour M M Dalle F F Muller C C Borni-Duval C C Caillard S S Moulin B B Pfaff A W AW Razakandrainibe R R Abou-Bacar A A Favennec L L Candolfi E E

BMC infectious diseases 20160802

<h4>Background</h4>Cryptosporidium spp. is a ubiquitous parasite affecting humans as well as domestic and wild vertebrates, causing diarrhea in both immunocompetent and immunocompromised hosts worldwide. Its transmission occurs primarily by the fecal-oral route. In humans, C. parvum and C. hominis are the most prevalent species, whereas immunocompetent and immunocompromised individuals can also be infected by other zoonotic species. Renal transplant patients are prone to develop cryptosporidiosi ...[more]

PMID: 27484187

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Project description:BackgroundLarge-scale deworming programs have, to date, mostly targeted preschool- and school-age children. As community-based deworming programs become more common, deworming will be offered to women of reproductive age. The World Health Organization recommends preventive chemotherapy be administered to pregnant women only after the first trimester. It is therefore important for deworming programs to be able to identify women in early pregnancy. Our objective was to validate a short questionnaire which could be used by deworming program managers to identify and screen out women in early pregnancy.Methodology/principal findingsIn May and June 2018, interviewers administered a questionnaire, followed by a pregnancy test, to 1,203 adult women living in the Peruvian Amazon. Regression analyses were performed to identify questions with high predictive properties (using the pregnancy test as the gold standard). Test parameters were computed at different decision tree nodes (where nodes represented questions). With 106 women confirmed to be pregnant, the positive predictive value of asking the single question 'Are you pregnant?' was 100%, at a 'cost' of a false negative rate of 1.9% (i.e. 21 women were incorrectly identified as not pregnant when they were truly pregnant). Additional questions reduced the false negative rate, but increased the false positive rate. Rates were dependent on both the combination and the order of questions.Conclusions/significanceTo identify women in early pregnancy when deworming programs are community-based, both the number and order of questions are important. The local context and cultural acceptability of different questions should inform this decision. When numbers are manageable and resources are available, pregnancy tests can be considered at different decision tree nodes to confirm pregnancy status. Trade-offs in terms of efficiency and misclassification rates will need to be considered to optimize deworming coverage in women of reproductive age.

Dataset Information

Ruling out nosocomial transmission of Cryptosporidium in a renal transplantation unit: case report.

Publications

Ruling out nosocomial transmission of Cryptosporidium in a renal transplantation unit: case report.

Similar Datasets

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