Costa Damien, Razakandrainibe Romy, Sautour Marc, Valot Stéphane, Basmaciyan Louise, Gargala Gilles, Lemeteil Denis, Favennec Loïc, Dalle Frédéric
University Hospital of Rouen, France; University of Medicine Pharmacy Rouen EA ESCAPE 7510, France.
University Hospital of Rouen, France; University of Medicine Pharmacy Rouen EA ESCAPE 7510, France.
Exp Parasitol. 2018 Sep;192:108-112. doi: 10.1016/j.exppara.2018.08.001. Epub 2018 Aug 11.
Cryptosporidiosis is a common disease in children and immunodeficient individuals. In 2006, a national network was set up on the surveillance of human cryptosporidiosis in France. Since January 2015, the 41 tertiary care hospitals and the 3 private laboratories of the French National Network on the surveillance of human cryptosporidiosis have been able to declare confirmed cases of cryptosporidiosis online. Between 2015 and 2017, 210 cases of cryptosporidiosis were declared in immunodeficient patients in France; Cryptosporidium parvum and Cryptosporidium hominis represented 66% and 22% of cases, respectively. A peak was observed in autumn. Cryptosporidiosis occurred mainly in a context of solid organ transplantation (SOT) (49%) and of HIV infection (30%). In SOT recipients, cryptosporidiosis appeared more frequently in the first 6 months post transplantation. Regarding cases declared in SOT recipients, mycophenolate mofetil was used in 68%. A mortality rate of 6% was observed. Present results underline the importance of screening for cryptosporidiosis in immunocompromised patients suffering from diarrhea, especially in the course of major cell mediated immunodeficiency or even systematic screening before SOT. Exclusive Cryptosporidium free water feeding could be suggested during major cell mediated immunodeficiency.
隐孢子虫病是儿童和免疫功能低下者的常见疾病。2006年，法国建立了一个全国性的人类隐孢子虫病监测网络。自2015年1月起，法国国家人类隐孢子虫病监测网络的41家三级护理医院和3家私人实验室能够在线申报确诊的隐孢子虫病病例。2015年至2017年期间，法国免疫功能低下患者中申报了210例隐孢子虫病病例；微小隐孢子虫和人隐孢子虫分别占病例的66%和22%。秋季出现了一个高峰。隐孢子虫病主要发生在实体器官移植（SOT）（49%）和艾滋病毒感染（30%）的背景下。在SOT受者中，隐孢子虫病在移植后的前6个月更频繁出现。关于在SOT受者中申报的病例，68%使用了霉酚酸酯。观察到死亡率为6%。目前的结果强调了对腹泻的免疫功能低下患者进行隐孢子虫病筛查的重要性，特别是在主要细胞介导免疫缺陷的过程中，甚至在SOT前进行系统筛查。在主要细胞介导免疫缺陷期间，可建议仅使用无隐孢子虫的水喂养。
