Genotype of 88 Toxoplasma gondii Isolates Associated with Toxoplasmosis in Immunocompromised Patients and Correlation with Clinical Findings

J Infect Dis. 2009 Mar 5. [Epub ahead of print]

Genotype of 88 Toxoplasma gondii Isolates Associated with Toxoplasmosis in Immunocompromised Patients and Correlation with Clinical Findings

Ajzenberg D, Yera H, Marty P, Paris L, Dalle F, Menotti J, Aubert D, Franck J, Bessières MH, Quinio D, Pelloux H, Delhaes L, Desbois N, Thulliez P, Robert-Gangneux F, Kauffmann-Lacroix C, Pujol S, Rabodonirina M, Bougnoux ME, Cuisenier B, Duhamel C, Duong TH, Filisetti D, Flori P, Gay-Andrieu F, Pratlong F, Nevez G, Totet A, Carme B, Bonnabau H, Dardé ML, Villena I.

Centre Hospitalier Universitaire, Amiens, 2Centre Hospitalier Universitaire, Bordeaux, 3Centre Hospitalier Universitaire, Brest, 4Centre Hospitalier Universitaire, Caen, 5Centre Hospitalier Universitaire, Dijon, 6Centre Hospitalier Universitaire, Grenoble, 7Centre Hospitalier Universitaire, Lille, 8Laboratoire de Parasitologie-Mycologie, EA 3174, Faculté de Médecine, Université de Limoges, and 9Centre National de Référence Toxoplasmose, Centre Hospitalier Universitaire, and 10Unité Fonctionnelle de Recherche Clinique et Biostatistique UFRCB, Centre Hospitalier Universitaire, Limoges, Université de Limoges, Limoges, 11Hospices civils de Lyon, Hôpital de la Croix-Rousse, Lyon, 12Centre Hospitalier Universitaire, Marseille, 13Centre Hospitalier Universitaire, Montpellier, 14Centre Hospitalier Universitaire, Nantes, 15Centre Hospitalier Universitaire, Nice, 16Institut de Puériculture, 17Hôpital Cochin and 18Hôpital Necker-Enfants Malades, 19Hôpital Pitié-Salpêtrière, and 20Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, 21Centre Hospitalier Universitaire, Poitiers, 22Centre Hospitalier Universitaire, Reims, 23Centre Hospitalier Universitaire, Rennes, 24Centre Hospitalier Universitaire, Saint-Etienne, 25Hôpitaux Universitaires de Strasbourg, Strasbourg, 26Centre Hospitalier Universitaire, Toulouse, 27Centre Hospitalier Universitaire, Tours, France; 28Centre Hospitalier Général, Cayenne, French Guiana; 29Centre Hospitalier Universitaire, Fort de France, Martinique.

We report the genotyping analysis of Toxoplasma gondii isolates in samples collected from 88 immunocompromised patients, along with clinical and epidemiological data. Most of these samples were collected in France during the current decade by the Toxoplasma Biological Resource Center. Lack of specific anti-Toxoplasma treatment, pulmonary toxoplasmosis, and involvement of multiple organs were the 3 main risk factors associated with death for this patient group. Genotyping results with 6 microsatellite markers showed that type II isolates were predominant among patients who acquired toxoplasmic infection in Europe. Non-type II isolates included 13 different genotypes and were mainly collected from patients who acquired toxoplasmosis outside Europe. Type III was the second most common genotype recovered from patients, whereas type I was rare in our population. Three nonarchetypal genotypes were repeatedly recovered from different patients who acquired the infection in sub-Saharan Africa (genotypes Africa 1 and Africa 2) and in the French West Indies (genotype Caribbean 1). The distribution of genotypes (type II vs. non-type II) was not significantly different when patients were stratified by underlying cause of immunosuppression, site of infection, or outcome. We conclude that in immunocompromised patients, host factors are much more involved than parasite factors in patients' resistance or susceptibility to toxoplasmosis.

PMID: 19265484 [PubMed - as supplied by publisher]