Related Experiment Video
Updated: Aug 26, 2025
Methods to Increase the Sensitivity of High Resolution Melting Single Nucleotide Polymorphism Genotyping in Malaria
Published on: November 10, 2015
Nosocomial Malaria Transmissions Resolved by Genomic Analyses-A Retrospective Case Report Study in France: 2007-2021
Romain Coppée1, Véronique Sarrasin2,3, Rizwana Zaffaroulah2
1Université Paris Cité and Sorbonne Paris Nord, Inserm, IAME, F-75018 Paris, France.
Background:
Exposure of blood to malaria parasites can lead to infection even in the absence of the mosquito vector. During a stay in a healthcare facility, accidental inoculation of the skin with blood from a malaria patient might occur, referred to as nosocomial malaria.
Methods:
Between 2007 and 2021, we identified 6 autochthonous malaria cases that occurred in different French hospitals, originating from nosocomial transmission and imported malaria cases being the infection source. Four cases were observed during the coronavirus disease 2019 pandemic. The genetic relatedness between source and nosocomial infections was evaluated by genome-wide short tandem repeats (STRs) and single-nucleotide polymorphisms (SNPs).
Results:
None of the patients with autochthonous malaria had travel history to an endemic area nor had been transfused. For each case, both the source and recipient patients stayed a few hours in the same ward. After diagnosis, autochthonous cases were treated with antimalarials and all recovered except 1. Genetically, each pair of matched source/nosocomial parasite infections showed <1% of different STRs and <6.9% (<1.5% for monoclonal infections) of different SNPs. Similar levels of genetic differences were obtained for parasite DNA samples that were independently sequenced twice as references of identical infections. Parasite phylogenomics were consistent with travel information reported by the source patients.
Conclusions:
Our study demonstrates that genomics analyses may resolve nosocomial malaria transmissions, despite the uncertainty regarding the modes of contamination. Nosocomial transmission of potentially life-threatening parasites should be taken into consideration in settings or occasions where compliance with universal precautions is not rigorous.
Insights
Genomic analysis confirmed six cases of hospital-acquired malaria in France between 2007-2021. This study highlights the importance of strict universal precautions to prevent nosocomial malaria transmission.
Area of Science:
- Infectious Diseases
- Genomics
- Public Health
Background:
- Malaria transmission can occur without mosquito vectors, through direct blood exposure.
- Nosocomial malaria refers to infections acquired within healthcare facilities.
- Accidental inoculation from malaria patients poses a risk in hospitals.
Observation:
- Six cases of autochthonous malaria were identified in French hospitals between 2007 and 2021.
- These cases resulted from nosocomial transmission, with imported malaria cases as the source.
- Four cases occurred during the coronavirus disease 2019 pandemic.
Findings:
- Genomic analysis using STRs and SNPs confirmed the genetic relatedness between source and nosocomial malaria infections.
- Patients with autochthonous malaria had no travel history or blood transfusions.
- Genetic differences between matched parasite samples were minimal, supporting nosocomial transmission.
Implications:
- Genomics can resolve nosocomial malaria transmission pathways.
- Strict adherence to universal precautions is crucial to prevent potentially life-threatening nosocomial malaria.
- Healthcare facilities must consider the risk of nosocomial parasite transmission, especially when precautions are relaxed.
