Infectiology
We specialise in the study and detection of infectious diseases and our laboratories are dedicated to 4 different sectors. We have a Class 3 mycobacteriology laboratory, a microbiology lab for the study of bacterial and viral cultures as well as parasitology, and 2 labs dedicated to the study of molecular biology for the diagnosis of infectious diseases as well as general serology.
- Bacteriology-Parasitology/Viral Culture Mycology
- Mycobacteriology
- Infectious Disease Molecular biology
- Serology
State-of-the-art technologies are essential to this department and enable us to quickly adapt to the latest, ever-changing methods for the diagnosis of infectious diseases, epidemics, emergence of new pathogenic agents, and resistance to drugs used to fight various infectious diseases.
Bacteriology-Parasitology/Viral Culture Mycology
The Bacteriology-Parasitology Laboratory is staffed with experienced technologists, and managed by 2 microbiologists. The analyses performed
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therein play important roles in the overall care of patients’ health and well-
being including diagnosis, therapeutic monitoring, detection of multi-resistant bacteria, production of sterility-monitoring devices implanted in immuno-compromised patients, detection of microorganisms in transfusion blood bags, and the performance of analyses subject to prefectural approval.
With regards to Clostridium difficile, our bacteriology sector is capable of performing the entire range of analyses recommended by companies who specialise in the latest, biological-diagnostic algorithms. In addition to the more traditional techniques based on cultures and susceptibility tests, we also use PCR techniques for the detection and identification of resistance genes in bacteria that are difficult to cultivate (Helicobacter pylori). In addition, we can perform respiratory tests, in conjunction with 13C-marked urine, to diagnose the in vivo presence of Helicobacter pylori infections. This technique is widely-used today, especially to monitor and ensure eradication of various diseases.
Thanks to molecular biology, the detection of multi-resistant enterobacteria, which can carry carbapenemases, can be completed within a few hours, as opposed to the many days required by the more traditional techniques.
Other bacteriology and mycology analyses (considered to be “reference techniques”) are subcontracted to St-Etienne Public Hospital and are performed with the care and quality expected of hospital centres.
In parallel, our laboratory has recognised experience in the production of cellular cultures which we use to employ traditional virology techniques such as virus isolation and identification, and seroneutralisation. These tests are still considered to be the standard reference, especially for the diagnosis of herpes.
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Mycobacteriology
In terms of volume and expertise, our mycobacteria laboratory is the top private laboratory in France. For the diagnosis of tuberculosis, we use the most-sensitive, direct-PCR techniques available, whereby we can directly detect the presence of the mycobacteria tuberculous complex in less than 2 hours. We use molecular biology techniques for the identification of mycobacteria, identification via DNA-DNA hybridisation, as well as for the detection of mutations that modify the effectiveness of rifampicin and isoniazid. For cultures, antibiograms and CMIs, we use the latest, state-of-the-art techniques (cultures in liquid media with automatic, growth-detection, and antibiograms in a liquid media).
We can also perform the QuantiFERON-TB Gold Plus® test (a test used to evaluate the production of interferon-gamma or Interferon-Gamma Release Assay (IGRA)), for the diagnosis of latent tuberculosis as recommended in 2011 by the Haut Conseil de la Santé publique.
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Infectious Disease Molecular biology
A large part of our activity involves the detection, quantification and, classification of viruses with DNA or RNA that are difficult, or currently impossible, to cultivate (HIV, hepatitis B and C viruses, papillomavirus, CMV, EBV, parvovirus, etc.). Real-time PCR methods are used because they are highly effective but also because they reduce turn-around time. The use of automation and electronic-processing, from the extraction of samples through to the final results, improves the reproducibility and accuracy of those results.
We also perform extremely specialised PCRs which greatly helps in the detection of micro-organisms that are hard, or currently impossible, to cultivate: Treponema pallidum, Mycoplasma genitalium, Haemophilus ducreyi, Kingella kingae, Tropheryma whiplei, Bartonella spp and slow-growth cultures such as Legionella pneumophila.
In order to make up for the lack of sensitivity of the more traditional diagnosis techniques, we developed Pnemocystis jirovecii and Clostridium difficile PCRs.
For epidemics, we developed an A H1N1 influenza PCR, and, more recently, PCRs for chikungunya and dengue.
In addition, we have developed PCRs used to diagnose less-common viral infections seen in immuno-compromised patients, including JC, BK, Human Herpes virus 6, HHV 7, and HHV8 PCRs.
We also have 2 certified pathologists who contribute their expertise to the diagnosis of prenatal infections.
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Serology
Our serology lab employs a full set of analysis methods for the detection and quantification of antibodies as well as for the specific antigens of infectious-disease agents which can indicate contact with such organisms. In this way it is possible to diagnose viral, bacterial, parasitic and fungal infections (detection of IgM-type antigens and anti-bodies, as well as seroconversion), which can be used to measure the impact on a given population (epidemiology), to determine the degree of post-vaccination protection and to evaluate a patient’s immunological status which is especially important for pregnant women and immuno-compromised individuals.
We follow the traditional approach consisting of detection, then confirmation and identification in positive cases. The tests are selected based on their effectiveness, for a particular sector or infectious agent, in the characterisation of various immunoglobulin isotypes (IgM, IgG, and IgA). They are employed for viral serology (HIV, HCV, HBV, EBV, CMV, etc.), bacterial diseases (Lyme disease, whooping cough, etc.), parasitic diseases (hydatidosis, toxocariasis, amibiasis, bilharziosis, etc.), as well as fungal diseases (Candida albicans, Aspergillus fumigatus).
Some of these analyses are performed in collaboration with renowned infectology centres such as Hôpital Paul Brousse for various tests including rubella avidity, West-Nile arbovirosis CNR, Japanese encephalitis, and hepatitis CNRs for example, for the PCR confirmation and geno-typing of indigenous hepatitis E, etc.
Some of our pathologists are also members of the American Society for Microbiology (ASM) and ANSM consultants.
Resources
Bacteriology-Parasitology/Viral Culture Mycology
Focus 35 – Staphylococcus Aureus
Focus 32 – Parasitic Lung Diseases
Focus 15 – Faecal culture
Focus on – Tick Borne Diseases
Mycobacteriology
Focus 5 – Mycobacterial
Focus on – Diagnosis of Mycobacterial Infections
Infectious Disease Molecular biology
Focus 52 – HPV infection in 2014
Focus 46 – Sexually transmitted diseases
Focus 27 – Measles
Focus 24 – Dengue fever
Focus 18 – 16S RNA PCR
Focus 3 – Influenza
Focus 2 – Avian influenza
Focus on – Human papillomavirus and cervical cancer screening
Serology
Focus 53 – Arboviral diseases
Focus 46 – Sexually transmitted diseases
Focus 27 – Measles
Focus 17 – Biological diagnosis of syphilis in 2009