Bronchopulmonary aspergillosis are in the news. Invasive pulmonary aspergillosis raise early diagnostic problems and prevention problems in immunocompromised patients. These infections are no unusual in chronic obstructive pulmonary disease. The diagnosis between aspergilloma and chronic necrotizing pulmonary aspergillosis can be difficult. In allergic bronchopulmonary aspergillosis, epidemiology and therapy are questionable. Real progress has been made due to thoracic computed tomographic scan and mycological methods. Better use of amphotericin B, of amphotericin B lipid formulations and of azole antifungal agents, combined with surgical resection if necessary should improve aspergillosis prognosis.

[Bronchopulmonary aspergillosis: new developments].

Intérêt et limites du diagnostic sérologique des mycoses

Génotypage d'Aspergillus fumigatus : principes des méthodes et applications

Summary. A new immunoelectrophoresis system, the Paragon@ system, was evaluated in three different hospital centres with the aim of improving standardization of the serodiagnosis of human aspergillosis. To select the most efficient antigen, various commercial and home-made antigens were first tested on 19 sera from 19 patients with highly probable aspergillosis. The value measured using the Paragon@ anti-Aspergillus antibody detection system was then compared with the results obtained by conventional serological diagnostic methods (conventional immunoelectrophoresis, enzyme linked-immunosorbent assay, indirect immunofluorescence): this step was performed using the first 19 sera as well as 16 other sera from 13 patients with suspected aspergillosis. Concordant results were obtained in 28 cases. The discrepancies observed with seven sera were probably related to differences in the nature of

Specific antibody detection in human aspergillosis: a GEMO* multicentre evaluation of a rapid immunoelectrophoresis method (Paragon@) S pezifisc her An tiko rp e r- Nac hweis bei Aspe rgillo se : Mu1 tizen trisc he Bewertun einer schnellen Immunelektrophorese-Methode (Paragon 8 ) durch die GEMO-Arbeitsgruppe

But. Afin de mieux connaitre l'epidemiologie des infections a Aspergillus fumigatus et d'apporter des precisions quant a l'origine de la contamination, trois procedures de typage moleculaire ont ete employees pour caracteriser des souches isolees dans un cas de colonisation bronchique observe a l'hopital (CHU de Lyon). Materiel et technique. La methode d'amplification au hasard d'ADN polymorphes (Random Amplified Polymorphic DNA ou RAPD), l'analyse du polymorphisme de taille des fragments de restriction (Restriction Fragment Length Polymorphisms ou RFLP), et l'hybridation selon Southern avec une sonde ADN mitochondrial (ADNmt) ont ete employees. Resultats-Conclusion. Au total, 27 isolats ont ete caracterises. Ils comprenaient 12 souches independantes d'A. fumigatus qui servaient de temoins externes, la souche colonisatrice isolee lors du suivi d'un patient transplante pulmonaire, BG, a Lyon, les souches presentes au domicile de ce patient (13 isolats) et une souche isolee a posteriori dans le service ou fut hospitalise ce patient. Les profils RAPD, avec les amorces (octamers), appelees primer 2 et primer 5, ont permis de reveler la biodiversite genetique des differents isolats d'A. fumigatus avec une reproductibilite satisfaisante. Ainsi, pour les 12 souches temoins, le primer 2 permettait de differencier 10 types et le primer 5, 12 types. L'hybridation avec la sonde ADNmt des fragments de restriction obtenus avec HinfI permettait de discriminer 6 types parmi ces 12 souches independantes. La souche clinique du patient BG (LBA) presentait un profil RAPD-primer 5 different de celui des souches domiciliaires, mais identique a celui de la souche isolee a l'hopital. Cependant, les profils obtenus avec le primer 2 pour ces 2 souches s'averaient differents. Les resultats des hybridations avec la sonde ADNmt et de l'analyse des profils RFLP obtenus avec l'enzyme de restriction HaeIII ont confirme cette differenciation. Les resultats de differentes methodes de typage sont donc a prendre en consideration pour conclure sur l'identite ou la non-identite des souches d'A. fumigatus.

Différenciation par typages moléculaires d'une souche colonisatrice d'Aspergillus fumigatus isolée chez un patient et de souches isolées à son domicile et à l'hôpital

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Différenciation par typages moléculaires d'une souche colonisatrice d'Aspergillus fumigatus isolée chez un patient et de souches isolées à son domicile et à l'hôpital