Publications by authors named "Linda Feghoul"

Objective: Among immunocompromised patients with acute respiratory failure, identification of those at higher risk for opportunistic infections is crucial to optimize management. The Torque teno virus (TTV) DNA burden in the blood has been identified as a surrogate marker of functional immunity in solid organ transplant recipients. This study investigates the clinical relevance of TTV DNA in nasopharyngeal swabs of immunocompromised patients with acute respiratory failure (ARF).

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We report a rare case of pneumonia caused by human mastadenovirus (HAdV) B55 in France in a patient without recent travel history. HAdV-B55 infection was identified retrospectively after being detected in feces during an investigation for concomitant diarrhea. This case suggests possible silent endemic circulation of HAdV-B55 in France.

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BK polyomavirus (BKPyV) infection remains a major concern after kidney transplantation, increasing the risk of graft loss in the absence of specific antiviral agent now available. Here, we investigated the impact of HLA diversity on the control of posttransplant BKPyV replication. High HLA evolutionary divergence (HED) at the DQ locus in the donor was an independent predictor of BKPyV-free outcome.

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Background: Cytomegalovirus (CMV) induces multi-organ pathogenesis in hematopoietic stem cell transplant (HSCT) and kidney transplant (KT) recipients. Effective management involves systematic monitoring for CMV reactivation by quantitative real-time PCR, allowing timely preemptive intervention. However, the optimal blood compartment for CMV surveillance remains undetermined.

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Article Synopsis
  • Predicting COVID-19 severity is challenging, but Torque teno virus (TTV) may help assess infection outcomes as a marker of immunity, especially in transplant patients.
  • A study at Saint-Louis Hospital in Paris analyzed TTV levels in nasopharyngeal samples from 295 COVID-19 patients and found higher TTV levels in those admitted to the ICU compared to those discharged or in medical wards.
  • Elevated TTV loads, specifically above a threshold of 2.91 log copies/mL, were identified as significant predictors of ICU admission, indicating a potential link between TTV levels and respiratory immune response in infected patients.
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  • The study investigates the clinical and immune characteristics of human parvovirus B19 (B19V) infections in patients who have undergone allogeneic hematopoietic stem cell transplantation (alloHSCT), reporting on cases from 2010 to 2021.* -
  • A total of 35 B19V infections were identified in 33 patients, with a median time from transplant to first positive PCR test being 6.9 months, and the most common symptoms including hematological impairment, rash, and fever.* -
  • The findings highlight that B19V can lead to diverse and atypical clinical manifestations, suggesting that the virus is often under-diagnosed due to its varied presentation; targeted tissue PCR may aid in
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  • The study focused on immunocompromised patients with acute respiratory failure (ARF) to understand the significance of detecting respiratory viruses in nasopharyngeal swabs.
  • It involved analyzing data from 510 patients, with 20.2% testing positive for respiratory viruses, predominantly flu-like viruses, and noted a significant relationship between virus detection and the identified causes of ARF.
  • However, no difference was observed in 28-day mortality or the need for invasive mechanical ventilation based on positive viral assay results, although flu-like virus detection correlated with worse outcomes in patients who had received stem cell transplants.
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  • The Omicron variant of SARS-CoV-2 has over 50 mutations that may increase transmission and evade immune responses from vaccines or prior infections.
  • A study compared viral loads in saliva and nasopharyngeal swabs (NPS) during the Alpha, Delta, and Omicron waves, finding lower Ct values in NPS, but higher viral loads in saliva for Omicron.
  • The results suggest that current diagnostic methods may need updates to better detect new variants like Omicron, highlighting the need for refined screening strategies.*
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  • Inborn errors of immunity (IEI) are complex conditions that often lead to late diagnoses, with a rise in related inflammatory issues alongside infections.
  • A case study of an adult showed that chronic Human Adenovirus C-1 arthritis was diagnosed in a patient with primary agammaglobulinemia, highlighting the challenges in managing these patients.
  • The use of metagenomic next-generation sequencing provided an accurate diagnosis, and high-dose intravenous immunoglobulins led to complete recovery, emphasizing the need for advanced diagnostic techniques in treating immune-compromised individuals.
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VIROLOGICAL ASPECTS, DIAGNOSTIC TOOLS AND VARIANTS OF SARS-COV-2 SARS-CoV-2 is an enveloped non-segmented linear single-stranded positive RNA virus. The envelope carries the protein spike (S) which recognizes the ACE2 receptor on the target cell and allows entry of the virus. The numerous mutations on the S protein are at the origin of a great genetic diversity, involved in the species barrier and the escape from neutralizing antibodies.

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The ID NOW COVID-19 system (IDNOW) is a point-of-care test (POCT) providing results within 15 min. We evaluated the impact of IDNOW use on patient length of stay (LOS) in an emergency department (ED). In the ED of Saint-Louis Hospital, Paris, France, adult patients requiring a rapid diagnosis of SARS-CoV-2 were tested with Cepheid Xpert Xpress SARS-CoV-2 or FilmArray respiratory panel RP2 in the virology laboratory between 18 October and 3 November 2020 (period 1) and with IDNOW between 4 November and 30 November 2020 (period 2).

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Background: Letermovir (LMV) is a human cytomegalovirus (HCMV) terminase inhibitor indicated as prophylaxis for HCMV-positive stem-cell recipients. Its mechanism of action involves at least the viral terminase proteins pUL56, pUL89 and pUL51. Despite its efficiency, resistance mutations were characterized in vitro and in vivo, largely focused on pUL56.

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BK polyomavirus (BKPyV) can cause hemorrhagic cystitis (HC) after allogeneic hematopoietic cell transplantation (allo-HCT). Recent evaluation of BKPyV HC (BKHC) incidence and risk factors are scarce. We conducted a retrospective single-center study on a recent allo-HCT cohort over 3 years in a referral academic hospital for hematological malignancies.

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Article Synopsis
  • The study investigates the interpretation of one target positive (OPT) RT-PCR results for COVID-19 using two different diagnostic tests: Cepheid and Roche.
  • Out of 293 samples classified as OPT, 68% met criteria for "probable COVID-19," indicating those patients are likely at a late stage of infection.
  • The findings suggest that combining serology and imaging tests can be beneficial for confirming COVID-19 diagnoses in patients with OPT results.
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Human parainfluenza virus type 3 (HPIV-3) may cause lower respiratory tract infection disease (LRTI-D) after hematopoietic stem cell transplantation (HSCT). Most previous have studies focused on recipients of HSCT whereas data on characteristics and outcomes in patients with hematological malignancies (HMs) compared to non-hematological patients are limited. The prognostic value of viral load in respiratory specimens remains elusive.

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Human adenoviruses (HAdV) infections are generally mild and resolve spontaneously in immunocompetent individuals. However, HAdV infections can have a major clinical impact in immunocompromised patients. HAdV infections are associated with high morbidity and mortality in recipients of allogeneic stem cell transplants, particularly children.

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Human adenovirus (HAdV) represents a major cause of mortality and morbidity in pediatric recipients of allogeneic hematopoietic stem cell transplants (HSCT). HAdV species F type 41 (HAdV-F41) infections in HSCT patients are scarce, whereas HAdV-F41 circulates commonly in healthy individuals. Between March and July 2018, HAdV-F41 infections were identified in four children (A, B, C, and E) who received allogeneic HSCT and one child before HSCT (D) at Robert Debré Hospital, Paris, France.

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Objectives: Environmental contamination by patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through respiratory droplets suggests that surfaces and equipment could be a medium of transmission. We aimed to assess the surface and equipment contamination by SARS-COV-2 of an emergency department (ED) during the coronavirus infectious disease-2019 (COVID-19) outbreak.

Methods: We performed multiple samples from different sites in ED patients care and non-patient care areas with sterile premoistened swabs and used real-time reverse transcriptase polymerase chain reaction (RT-PCR) to detect the presence of SARS-CoV-2 ribonucleic acid (RNA).

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Article Synopsis
  • RT-PCR testing is essential for diagnosing SARS-CoV-2, and this study compares two PCR assays, Cobas® and RealStar®, used for the testing.
  • The comparison involved testing 170 clinical samples in three Paris hospitals, finding an overall agreement of 76% between the two assays, particularly high (99%) for samples with lower cycle threshold (Ct) values below 35.
  • Results indicated a strong correlation between the assays for positive tests, but discrepancies arose with higher Ct values, likely due to low viral loads near the detection limits of the assays.
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Objectives: Human adenovirus (HAdV) infections are associated with a high morbidity and mortality in transplant patients requiring the use of antiviral treatments. Brincidofovir (BCV), a cytidine analog, inhibits HAdV replication through viral DNA elongation termination and likely through other mechanisms. To elucidate if BCV regulates cellular antiviral pathways, we analyzed its impact on HAdV-infected and non-HAdV-infected lung epithelial cells.

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Post-transplantation lymphoproliferative disease (PTLD) is a serious complication associated with Epstein-Barr virus (EBV) infection after hematopoietic stem cell transplantation (HSCT). Although anti-CD-20 therapy is now used as a preemptive strategy for EBV reactivation, PTLD still occurs in some patients. Here we analyzed outcomes and risk factors associated with PTLD transformation in 208 HSCT recipients who were diagnosed with EBV-DNAemia and received at least 1 course of rituximab.

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Background: Human Adenovirus (HAdV) are responsible for severe infections in hematopoietic stem cells transplant (HSCT) recipient, species C viruses being the most commonly observed in this population. There is no approved antiviral treatment yet. Cidofovir (CDV), a cytidine analog, is the most frequently used and its lipophilic conjugate, brincidofovir (BCV), is under clinical development.

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Prior to transplantation of hematopoietic stem cells or solid organ, donor and recipient EBV serostatus has to be determined to assess risks of post-transplant lymphoproliferative disorders. Sensitivity of EBV Viral capsid antigens (VCA) IgG and EBV nuclear antigen-1 (EBNA-1) is critical to define past infection and a good specificity of VCA IgM is required to avoid any disqualification of cord blood (CB) units. Architect™ EBV antibody panel (Architect assay) providing a high throughput was compared to a semi-automated ELISA (Etimax assays Diasorin) to assess sensitivities and specificities of VCA and EBNA-1 IgG and VCA IgM on 419 sera collected from immunocompromised patients (n = 184) and from pregnant women who agreed to give CB cells (n = 235).

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Background: Accurate quantification of Epstein-Barr virus (EBV) load in blood is essential for the management of post-transplant lymphoproliferative disorders. The automation of DNA extraction and amplification may improve accuracy and reproducibility. We evaluated the EBV PCR Kit V1 with fully automated DNA extraction and amplification on the m2000 system (Abbott assay).

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