Tropheryma whipplei Colonization in Adults and Children: A Prospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting of the Study
2.2. Ethics Statement
2.3. Study Population, Data, and Samples Collection
2.4. Laboratory Methods
2.4.1. Sample Collection and DNA Extraction
2.4.2. Real-Time PCR (rt-PCR)
2.5. Definitions
2.6. Statistical Analyses
3. Results
3.1. Description of Study Population
3.2. PCR Analysis for T. whipplei
3.3. PCR Analysis for Parasites in the Fecal Samples
3.4. Association Analysis
4. Discussion
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Dolmans, R.A.; Boel, C.E.; Lacle, M.M.; Kusters, J.G. Clinical manifestations, treatment, and diagnosis of Tropheryma whipplei infections. Clin. Microbiol. Rev. 2017, 30, 529–555. [Google Scholar] [CrossRef] [PubMed]
- Herbay, A.V.; Otto, H.; Stolte, M.; Borchard, F.; Kirchner, T.; Ditton, H.-J.; Maiwald, M. Epidemiology of Whipple’s Disease in Germany: Analysis of 110 Patients Diagnosed in 1965–95. Scand. J. Gastroenterol. 1997, 32, 52–57. [Google Scholar] [CrossRef] [PubMed]
- Fenollar, F.; Laouira, S.; Lepidi, H.; Rolain, J.M.; Raoult, D. Value of Tropheryma whipplei quantitative polymerase chain reaction assay for the diagnosis of Whipple disease: Usefulness of saliva and stool specimens for first-line screening. Clin. Infect. Dis. 2008, 47, 659–667. [Google Scholar] [CrossRef] [PubMed]
- Alice Tison, A.S. Potential Role for Urine Polymerase Chain Reaction in the Diagnosis of Whipple Disease. Clin. Infect. Dis. 2019, 69, 904–905. [Google Scholar] [CrossRef] [PubMed]
- Keita, A.K.; Raoult, D.; Fenollar, F. Tropheryma whipplei as a commensal bacterium. Future Microbiol. 2013, 8, 57–71. [Google Scholar] [CrossRef] [PubMed]
- Beltrame, A.; Ragusa, A.; Perandin, F.; Formenti, F.; Fenollar, F.; Edouard, S.; Laroche, M.; Zavarise, G.; Doro, F.; Giorli, G.; et al. Tropheryma whipplei intestinal colonization in Italian and migrant population: A retrospective observational study. Future Microbiol. 2019, 14, 283–292. [Google Scholar] [CrossRef] [PubMed]
- Moro, L.; Pomari, E.; Leonardi, M.; La Marca, G.; Pajola, B.; Mazzi, C.; Piubelli, C.; Beltrame, A. Tropheryma whipplei, Helicobacter pylori, and intestinal protozoal co-infections in Italian and immigrant populations: A cross-sectional study. Microorganisms 2022, 10, 769. [Google Scholar] [CrossRef] [PubMed]
- Marth, T.; Moos, V.; Müller, C.; Biagi, F.; Schneider, T. Tropheryma whipplei infection and Whipple’s disease. Lancet Infect. Dis. 2016, 16, e13–e22. [Google Scholar] [CrossRef] [PubMed]
- Fenollar, F.; Marth, T.; Lagier, J.-C.; Angelakis, E.; Raoult, D. Sewage workers with low antibody responses may be colonized successively by several Tropheryma whipplei strains. Int. J. Infect. Dis. IJID Off. Publ. Int. Soc. Infect. Dis. 2015, 35, 51–55. [Google Scholar] [CrossRef] [PubMed]
- Niesters, H.G. Clinical virology in real time. J. Clin. Virol. 2002, 25 (Suppl. S3), S3–S12. [Google Scholar] [CrossRef] [PubMed]
- Schöniger-Hekele, M.; Petermann, D.; Weber, B.; Müller, C. Tropheryma whipplei in the environment: Survey of sewage plant influxes and sewage plant workers. Appl. Environ. Microbiol. 2007, 73, 2033–2035. [Google Scholar] [CrossRef] [PubMed]
- Fenollar, F.; Trani, M.; Davoust, B.; Salle, B.; Birg, M.L.; Rolain, J.M.; Raoult, D. Prevalence of asymptomatic Tropheryma whipplei carriage among humans and nonhuman primates. J. Infect. Dis. 2008, 197, 880–887. [Google Scholar] [CrossRef] [PubMed]
- García-Álvarez, L.; Pérez-Matute, P.; Blanco, J.R.; Ibarra, V.; Oteo, J.A. High prevalence of asymptomatic carriers of Tropheryma whipplei in different populations from the North of Spain. Enferm. Infecc. Microbiol. Clin. 2016, 34, 340–345. [Google Scholar] [CrossRef] [PubMed]
- Keita, A.K.; Brouqui, P.; Badiaga, S.; Benkouiten, S.; Ratmanov, P.; Raoult, D.; Fenollar, F. Tropheryma whipplei prevalence strongly suggests human transmission in homeless shelters. Int. J. Infect. Dis. 2013, 17, e67–e68. [Google Scholar] [CrossRef] [PubMed]
- Ramharter, M.; Harrison, N.; Bühler, T.; Herold, B.; Lagler, H.; Lötsch, F.; Mombo-Ngoma, G.; Müller, C.; Adegnika, A.A.; Kremsner, P.G.; et al. Prevalence and risk factor assessment of Tropheryma whipplei in a rural community in Gabon: A community-based cross-sectional study. Clin. Microbiol. Infect. 2014, 20, 1189–1194. [Google Scholar] [CrossRef] [PubMed]
- Keita, A.K.; Bassene, H.; Tall, A.; Sokhna, C.; Ratmanov, P.; Trape, J.F.; Raoult, D.; Fenollar, F. Tropheryma whipplei: A common bacterium in rural Senegal. PLoS Negl. Trop. Dis. 2011, 5, e1403. [Google Scholar] [CrossRef] [PubMed]
- Fenollar, F.; Keita, A.K.; Buffet, S.; Raoult, D. Intrafamilial circulation of Tropheryma whipplei, France. Emerg. Infect. Dis. 2012, 18, 949–955. [Google Scholar] [CrossRef] [PubMed]
- Makka, S.; Papadogiannaki, I.; Voulgari-Kokota, A.; Georgakopoulou, T.; Koutantou, M.; Angelakis, E. Tropheryma whipplei Intestinal Colonization in Migrant Children, Greece. Emerg. Infect. Dis. 2022, 28, 1926–1928. [Google Scholar] [CrossRef]
Variables | Overall Sample | |
---|---|---|
n | % | |
Overall Participants | 33 | 100 |
Age, mean (SD) | 29.6 (21.8) | - |
Age group (years) | ||
<18 | 16 | 48.5 |
≥18 | 17 | 51.5 |
Male | 18 | 54.5 |
Nationality | ||
Italy | 17 | 51.5 |
Africa | 10 | 30.3 |
Central and Southern America | 5 | 15.2 |
Asia | 1 | 3 |
Comorbidity | 16 | 48.5 |
Asthma | 3 | |
Chronic hepatitis B | 2 | |
Gastritis, duodenitis, or GER | 3 | |
Hypertension | 2 | |
Parasitosis | 3 | |
Psoriatic arthritis | 1 | |
Type II diabetes mellitus | 1 | |
Hypothyroidism | 1 | |
Monoclonal lymphocytosis B | 1 | |
Not specific | 1 | |
History of intestinal parasitosis | 6 | 18.2 |
History of immunosuppressive therapy | 2 | 5.9 |
History of systemic steroid | 3 | 8.8 |
History of tropical travel | 17 | 51.5 |
Variables | Baseline | Follow-Up at 12 Months | p-Value | ||
---|---|---|---|---|---|
n | % | n | % | ||
Overall participants | 33 | 100 | 28 | 100 | |
Current treatment | 4 | 12.1 | 1 | 3.6 | 1.000 |
Systemic steroid | 3 | 1 | |||
Immunosuppressive therapy | 1 | 1 | |||
Symptoms or signs | 11 | 33.4 | 11 | 39.3 | 1.000 |
Abdominal pain | 9 | 27.3 | 4 | 14.3 | 0.343 |
Abdominal pain duration * | |||||
1 days | 5 | 1 | |||
2–15 days | 2 | 0 | |||
>30 days | 2 | 0 | |||
NA | 0 | 3 | |||
Abdominal pain temporal distribution * | |||||
Single episode | 2 | 0 | |||
2–4 episodes | 1 | 1 | |||
≥5 episodes | 6 | 1 | |||
NA | 0 | 2 | |||
Diarrheal syndrome | 5 | 15.2 | 4 | 14.3 | 1.000 |
Diarrheal syndrome duration | |||||
<15 days | 4 | 2 | |||
15–30 days | 0 | 0 | |||
>30 days | 1 | 0 | |||
NA | 0 | 2 | |||
Arthralgias | 5 | 15.2 | 4 | 14.3 | 1.000 |
Weight loss | 4 | 12.1 | 0 | - | |
Psychiatric disorders | 3 | 9.0 | 1 | 3.6 | 1.000 |
Myoclonus | 2 | 6.0 | 0 | - | |
Fever longer than 1 week | 0 | 0 | - | ||
Arthritis | 1 | 3.0 | 0 | - | |
Cognitive decline | 1 | 3.0 | 0 | - | |
Eye disorders | 1 | 3.0 | 1 | 3.6 | 1.000 |
Abnormal ocular movements | 1 | 3.0 | 0 | - | |
Microbiological results | |||||
Fecal T. whipplei PCR-positive | 14 | 42.4 | 9 | 32.1 | 0.724 |
Saliva T. whipplei PCR-positive | 5 | 15.2 | 2 | 7.1 | 1.000 |
Blood T. whipplei PCR-positive | 0 | 0 | - | ||
Urine T. whipplei PCR-positive | 0 | 0 | - |
Variables | PCR T. whipplei/ Persistent Positive | PCR T. whipplei Intermittent or Persistent Negative | p-Value | ||
---|---|---|---|---|---|
n | % | n | % | ||
Total participants | 7 | 25 | 21 | 75 | |
Continent of origin | 0.254 | ||||
South/Central America | 1 | 14.3 | 4 | 19.0 | |
Africa | 4 | 57.1 | 5 | 23.8 | |
Europe (Italy) | 2 | 28.6 | 12 | 57.1 | |
Current treatment | |||||
Systemic steroid | 0 | 2 | 9.5 | 1 | |
Immunosuppressive therapy | 0 | 1 | 4.8 | 1 | |
Symptoms or signs | 2 | 28.6 | 8 | 38.1 | 1 |
Abdominal pain | 2 | 28.6 | 6 | 28.6 | 1 |
Arthralgias | 0 | 4 | 19.0 | 0.550 | |
Weight loss | 1 | 14.3 | 2 | 9.5 | 1 |
Psychiatric disorders | 1 | 14.3 | 1 | 4.8 | 1 |
Myoclonus | 0 | 1 | 4.8 | 1 | |
Parasite coinfection at baseline | 1 | 14.3 | 10 | 47.6 | 0.190 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Moro, L.; Zavarise, G.; Castagna, G.; Pomari, E.; Perandin, F.; Piubelli, C.; Mazzi, C.; Beltrame, A. Tropheryma whipplei Colonization in Adults and Children: A Prospective Study. Microorganisms 2024, 12, 1395. https://doi.org/10.3390/microorganisms12071395
Moro L, Zavarise G, Castagna G, Pomari E, Perandin F, Piubelli C, Mazzi C, Beltrame A. Tropheryma whipplei Colonization in Adults and Children: A Prospective Study. Microorganisms. 2024; 12(7):1395. https://doi.org/10.3390/microorganisms12071395
Chicago/Turabian StyleMoro, Lucia, Giorgio Zavarise, Giada Castagna, Elena Pomari, Francesca Perandin, Chiara Piubelli, Cristina Mazzi, and Anna Beltrame. 2024. "Tropheryma whipplei Colonization in Adults and Children: A Prospective Study" Microorganisms 12, no. 7: 1395. https://doi.org/10.3390/microorganisms12071395
APA StyleMoro, L., Zavarise, G., Castagna, G., Pomari, E., Perandin, F., Piubelli, C., Mazzi, C., & Beltrame, A. (2024). Tropheryma whipplei Colonization in Adults and Children: A Prospective Study. Microorganisms, 12(7), 1395. https://doi.org/10.3390/microorganisms12071395