Human cryptosporidiosis in immunodeficient patients in France (2015-2017)

Area of Science:

• Infectious Diseases
• Parasitology
• Public Health Surveillance

Background:

• Cryptosporidiosis is a significant opportunistic infection in immunocompromised individuals.
• France established a national surveillance network for human cryptosporidiosis in 2006.
• Since 2015, online case reporting has been implemented by the French National Network.

Purpose of the Study:

• To analyze cryptosporidiosis epidemiology in immunocompromised patients in France.
• To identify risk factors and clinical contexts associated with cryptosporidiosis.
• To inform public health strategies for cryptosporidiosis prevention and management.

Main Methods:

• Analysis of cryptosporidiosis cases declared through the French National Network between 2015 and 2017.
• Data collection from 41 tertiary care hospitals and 3 private laboratories.
• Epidemiological analysis focusing on patient demographics, underlying conditions, and outcomes.

Main Results:

• 210 cases of cryptosporidiosis were reported in immunocompromised patients.
• Cryptosporidium parvum (66%) and Cryptosporidium hominis (22%) were the predominant species.
• A seasonal peak was observed in autumn, with solid organ transplantation (49%) and HIV infection (30%) as primary contexts.
• In solid organ transplant recipients, infection often occurred within 6 months post-transplant, with mycophenolate mofetil use in 68% of cases.
• A 6% mortality rate was recorded.

Conclusions:

• Screening for cryptosporidiosis is vital in immunocompromised patients with diarrhea, especially those with severe cell-mediated immunodeficiency or awaiting solid organ transplantation.
• Exclusive consumption of Cryptosporidium-free water should be considered during periods of severe cell-mediated immunodeficiency.