Pathogens (Jun 2022)
Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France
- Laurène Tardieu,
- Gillian Divard,
- Olivier Lortholary,
- Anne Scemla,
- Éric Rondeau,
- Isabelle Accoceberry,
- Rémi Agbonon,
- Alexandre Alanio,
- Adela Angoulvant,
- Laetitia Albano,
- Philippe Attias,
- Anne Pauline Bellanger,
- Dominique Bertrand,
- Julie Bonhomme,
- Françoise Botterel,
- Nicolas Bouvier,
- Matthias Buchler,
- Taieb Chouaki,
- Thomas Crépin,
- Marie-Fleur Durieux,
- Guillaume Desoubeaux,
- Gary Doppelt,
- Loïc Favennec,
- Arnaud Fekkar,
- Ophélie Fourdinier,
- Marie Frimat,
- Jean-Pierre Gangneux,
- Claire Garandeau,
- Lilia Hasseine,
- Christophe Hennequin,
- Xavier Iriart,
- Nassim Kamar,
- Hannah Kaminski,
- Raphael Kormann,
- Laurence Lachaud,
- Christophe Legendre,
- Moglie Le Quintrec Donnette,
- Jordan Leroy,
- Charlène Levi,
- Marie Machouart,
- David Marx,
- Jean Menotti,
- Valérie Moal,
- Florent Morio,
- Natacha Mrozek,
- Muriel Nicolas,
- Philippe Poirier,
- Marie-Noelle Peraldi,
- Benjamin Poussot,
- Stéphane Ranque,
- Jean-Philippe Rerolle,
- Boualem Sendid,
- Renaud Snanoudj,
- Jérôme Tourret,
- Marc Vasse,
- Cécile Vigneau,
- Odile Villard,
- Laurent Mesnard,
- Fanny Lanternier,
- Cédric Rafat
Affiliations
- Laurène Tardieu
- Service de Soins Intensifs Néphrologiques et Rein Aigu, French Intensive Renal Network, Hôpital Tenon, 75020 Paris, France
- Gillian Divard
- Paris Translational Research Centre for Organ Transplantation, PARCC, INSERM U970, Université de Paris, 75015 Paris, France
- Olivier Lortholary
- Centre d’Infectiologie Necker-Pasteur, Université de Paris Cité, Hôpital Necker-Enfant Malades, AP-HP, 75015 Paris, France
- Anne Scemla
- Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, 75015 Paris, France
- Éric Rondeau
- Service de Soins Intensifs Néphrologiques et Rein Aigu, French Intensive Renal Network, Hôpital Tenon, 75020 Paris, France
- Isabelle Accoceberry
- Laboratory of Parasitology-Mycology, Pellegrin University Hospital, 33000 Bordeaux, France
- Rémi Agbonon
- Department of Radiology, Tenon Hospital, 75020 Paris, France
- Alexandre Alanio
- Laboratory of Parasitology-Mycology, Saint-Louis Hospital, AP-HP, 75010 Paris, France
- Adela Angoulvant
- Service de Maladies infectieuses et Tropicale, APHP-Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France
- Laetitia Albano
- Department of Nephrology and Transplantation, 06000 CHU Nice, France
- Philippe Attias
- Nephrology and Renal Transplantation Department, APHP, Groupe Hospitalier Henri-Mondor, 94010 Créteil, France
- Anne Pauline Bellanger
- Parasitology Mycology Department, University Hospital, 25000 Besancon, France
- Dominique Bertrand
- Department of Nephrology and Transplantation, University of Rouen, 76000 Rouen, France
- Julie Bonhomme
- Laboratory of Parasitology-Mycology, CHU Caen, 14033 Caen, France
- Françoise Botterel
- Laboratory of Mycology, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, 94010 Créteil, France
- Nicolas Bouvier
- Department of Nephrology and Transplantation, University of Caen, 14033 Caen, France
- Matthias Buchler
- Service de Néphrologie-Hypertension, Dialyses, Transplantation Rénale, Hôpital Bretonneau et Hôpital Clocheville, 37000 Tours, France
- Taieb Chouaki
- Service de Parasitologie et Mycologie Médicales, CHU d’Amiens, 80000 Amiens, France
- Thomas Crépin
- Department of Nephrology, Dialysis, and Renal Transplantation, CHU Besançon, 25000 Besançon, France
- Marie-Fleur Durieux
- Laboratoire de Parasitologie—Mycologie, CHU de Limoges, 87000 Limoges, France
- Guillaume Desoubeaux
- Department of Parasitology-Mycology Service, Tropical Medicine Program, University Hospital of Tours, 37000 Tours, France
- Gary Doppelt
- Department of Radiology, André Rosemon, Hôpital de Cayenne, Université des Antilles et de la Guyane Française, 97139 Pointe à Pitre, France
- Loïc Favennec
- Department of Parasitology/Mycology, Rouen University Hospital, 76000 Rouen, France
- Arnaud Fekkar
- Service de Parasitologie Mycologie, Assistance Publique—Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France
- Ophélie Fourdinier
- Department of Nephrology, Dialysis and Transplantation, CHU Amiens, 80000 Amiens, France
- Marie Frimat
- Nephrology Department, University Lille, CHU Lille, 59000 Lille, France
- Jean-Pierre Gangneux
- Centre Hospitalier Universitaire de Rennes, Laboratoire de Parasitologie-Mycologie, Rennes, France INSERM U1085, IRSET (Institut de Recherche en Santé Environnement Travail), Université Rennes 1, 35000 Rennes, France
- Claire Garandeau
- Department of Nephrology and Immunology, Institut de Transplantation Urologie Néphrologie (ITUN), 44000 Nantes, France
- Lilia Hasseine
- Centre Méditerranéen de Médecine Moléculaire, Université de Nice-Sophia Antipolis, 06000 Nice, France
- Christophe Hennequin
- Centre de Recherche Saint-Antoine, CRSA, Inserm, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Sorbonne Université, 75012 Paris, France
- Xavier Iriart
- Department of Parasitology-Mycology, Toulouse University Hospital Toulouse, 31400 Toulouse, France
- Nassim Kamar
- Department of Nephrology and Organs Transplantation, Toulouse Rangueil University Hospital, INSERM UMR 1291, Toulouse Institute for Infectious and Inflammatory Disease (Infinity), Paul Sabatier University, 31400 Toulouse, France
- Hannah Kaminski
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Pellegrin University Hospital, 33000 Bordeaux, France
- Raphael Kormann
- Department of Nephrology, University of Lorrain, CHRU-Nancy, 54511 Vandoeuvre, France
- Laurence Lachaud
- CHU Montpellier, Laboratoire de parasitologie-mycologie, Centre national de référence Leishmaniose, Université de Montpellier, UMR MiVEGEC, 34090 Montpellier, France
- Christophe Legendre
- Service de Néphrologie et Transplantation Rénale, Hôpital Kremlin Bicêtre, 94270 Le Kremlin-Bicêtre, France
- Moglie Le Quintrec Donnette
- Department of Nephrology, Université de Montpellier, CHU de Montpellier, 34090 Montpellier, France
- Jordan Leroy
- INSERM U1285, CNRS UMR 8576, Glycobiology in Fungal Pathogenesis and Clinical Applications, Université de Lille, 59000 Lille, France
- Charlène Levi
- Department of Transplantation, Nephrology and Clinical Immunology, Edouard Herriot University Hospital, 69003 Lyon, France
- Marie Machouart
- Laboratory of Parasitology-Mycology, University of Lorrain, 54511 Nancy, France
- David Marx
- Department of Nephrology and Transplantation, Strasbourg University Hospital, 67000 Strasbourg, France
- Jean Menotti
- Hospices Civils de Lyon, Institut des Agents Infectieux, Service de Parasitologie et Mycologie Médicale, Hôpital de la Croix-Rousse, 69004 Lyon, France
- Valérie Moal
- Institut pour la Recherche et pour le Développement, Microbes, Evolution, Phylogénie et Infection, Institut Hospitalo Universitaire-Méditerranée Infection, Hôpital Conception, Centre de Néphrologie et Transplantation Rénale, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, 13005 Marseille, France
- Florent Morio
- Cibles et Médicaments des Infections et de L’immunité, IICiMed, UR1155, CHU de Nantes, Nantes Université, 44000 Nantes, France
- Natacha Mrozek
- Service de Néphrologie Réanimation Médicale, Pole REUNNIRH, 63000 Clermont-Ferrand, France
- Muriel Nicolas
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire de Pointe-à-Pitre, Pointe-à-Pitre, 97189 Guadeloupe, France
- Philippe Poirier
- Service de Parasitologie-Mycologie, CHU Clermont-Ferrand, 3iHP, INSERM, Université Clermont Auvergne, 63000 Clermont Ferrand, France
- Marie-Noelle Peraldi
- Department of Nephrology, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, 75010 Paris, France
- Benjamin Poussot
- Centre Hospitalier Bordeaux, Department of Radiology, 33400 Bordeaux, France
- Stéphane Ranque
- Assistance Publique-Hôpitaux de Marseille, Institut Hospitalo-Universitaire Méditerranée Infection, Institut de Recherche Pour le Développement, Aix-Marseille Université, Service de Santé des Armées, VITROME, 19-21 Boulevard Jean-Moulin, 13005 Marseille, France
- Jean-Philippe Rerolle
- Department of Nephrology and Kidney Transplantation, CHU de Limoges, 87000 Limoges, France
- Boualem Sendid
- INSERM U1285, CNRS UMR 8576, Glycobiology in Fungal Pathogenesis and Clinical Applications, Université de Lille, 59000 Lille, France
- Renaud Snanoudj
- Service de Néphrologie—Transplantation Rénale, Hôpital Foch, 92150 Suresnes, France
- Jérôme Tourret
- AP-HP, Service de Néphrologie, Groupe Hospitalier Pitié Salpétrière Charles Foix, 75013 Paris, France
- Marc Vasse
- Service de Biologie Clinique and UMR-S 1176, Hôpital Foch, 92150 Suresnes, France
- Cécile Vigneau
- Department of Nephrology, Centre Hospitalier Universitaire Pontchaillou, 35000 Rennes, France
- Odile Villard
- CHU Strasbourg, Laboratoire de Parasitologie-Mycologie, 67000 Strasbourg, France
- Laurent Mesnard
- Service de Soins Intensifs Néphrologiques et Rein Aigu, French Intensive Renal Network, Hôpital Tenon, 75020 Paris, France
- Fanny Lanternier
- Centre d’Infectiologie Necker-Pasteur, Université de Paris Cité, Hôpital Necker-Enfant Malades, AP-HP, 75015 Paris, France
- Cédric Rafat
- Service de Soins Intensifs Néphrologiques et Rein Aigu, French Intensive Renal Network, Hôpital Tenon, 75020 Paris, France
- DOI
- https://doi.org/10.3390/pathogens11060699
- Journal volume & issue
-
Vol. 11,
no. 6
p. 699
Abstract
Cryptococcosis is the third most common cause of invasive fungal infection in solid organ transplant recipients and cryptococcal meningitis (CM) its main clinical presentation. CM outcomes, as well as its clinical features and radiological characteristics, have not yet been considered on a large scale in the context of kidney transplantation (KT). We performed a nationwide retrospective study of adult patients diagnosed with cryptococcosis after KT between 2002 and 2020 across 30 clinical centers in France. We sought to describe overall and graft survival based on whether KT patients with cryptococcosis developed CM or not. Clinical indicators of CNS involvement and brain radiological characteristics were assessed. Eighty-eight cases of cryptococcosis were diagnosed during the study period, with 61 (69.3%) cases of CM. Mortality was high (32.8%) at 12 months (M12) but not significantly different whether or not patients presented with CM. Baseline hyponatremia and at least one neurological symptom were independently associated with CM (p p < 0.001). On magnetic resonance imaging (MRI), three patterns of brain injury were identified: parenchymal, meningeal, and vascular lesions. Although CM does not affect graft function directly, it entails a grim prognosis.
Keywords
- cryptococcosis
- opportunistic infection
- transplant associated diseases
- renal transplantation
- cryptococcal meningitis
- graft outcome
