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Microsporidia are pathogenic fungi mainly responsible for profuse watery diarrhea, requiring management in immunocompromised patients. The main immunocompromised population affected by these infections consists of solid organ transplant recipients (SOT), mainly kidney (~70% of cases in immunocompromised patients). In this population, the infection is severe, and becomes chronic in the absence of appropriate care, the species Enterocytozoon bieneusi being found in more than 95% of these cases. Reducing immunosuppression (adjustment of immunosuppressive therapy) can sometimes be enough to eliminate the pathogen. However, in some cases, specific treatment is necessary. The only molecule whose efficacy has been proven to date to treat infections caused by E. bieneusi is fumagillin (FLISINT®), however its production has been stopped for almost 2 years. Due to the therapeutic impasse, the use of nitazoxanide (ALINIA®) to treat E. bieneusi microsporidiosis is becoming common, despite the lack of proof of its efficacy. It seems important and urgent to evaluate the relevance of the use of nitazoxanide, particularly in SOT, for the treatment of intestinal microsporidiosis due to E. bieneusi.
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| Measure | Description | Time Frame |
|---|---|---|
| efficiency by symptoms | time to resolution of symptoms | 1 year |
| efficiency by parasitology | parasitological negativation | 1 year |
| efficiency by relapses | number of relapses | 1 year |
| tolerance of treatment | duration of treatment | 1 year |
| tolerance with side effects | side effects during treatment: value of platelets, liver enzymes, occurrence of drug interactions | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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SOT with microsporidiosis
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| Name | Affiliation | Role |
|---|---|---|
| Philippe Poirier | University Hospital, Clermont-Ferrand | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Amiens | Amiens | France | ||||
| CHU Besançon |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39726674 | Derived | Garrouste C, Poirier P, Uro-Coste C, Iriart X, Kamar N, Bonhomme J, Calvar E, Le Gal S, Lanfranco L, Autier B, Rakoff L, Durieux MF, Danthu C, Morio F, Deltombe C, Moreno-Sabater A, Ouali N, Costa D, Bertrand D, Chesnay A, Gatault P, Rabodonirina M, Morelon E, Dumortier J, Sitterle E, Scemla A, Hamane S, Cachera L, Damiani C, Poulain C, L'Ollivier C, Moal V, Delhaes L, Kaminski H, Cateau E, Ecotiere L, Brunet J, Caillard S, Valot S, Tinel C, Argy N, Raimbourg Q, Robert MG, Noble J, Boignard A, Botterel F, Matignon M, Bellanger AP, Crepin T, Leroy J, Lionet A, Debourgogne A, Nicolas M, Claudeon J, Moniot M, Lambert C, Nourrisson C. Fumagillin Shortage: How to Treat Enterocytozoon bieneusi Microsporidiosis in Solid Organ Transplant Recipients in 2024? Transpl Int. 2024 Dec 12;37:13518. doi: 10.3389/ti.2024.13518. eCollection 2024. |
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| Besançon |
| France |
| CHU Bordeaux | Bordeaux | France |
| CHU Brest | Brest | France |
| CHU Caen | Caen | France |
| CHU clermont-ferrand | Clermont-Ferrand | 63000 | France |
| CHU Dijon | Dijon | France |
| CHU Grenoble | Grenoble | France |
| CHU Lille | Lille | France |
| CHU Limoges | Limoges | France |
| Hospices Civils de Lyon | Lyon | France |
| AP-HM | Marseille | France |
| CHU Nancy | Nancy | France |
| AP-HP Hopital Bichat Claude-Bernard | Paris | France |
| AP-HP Hopital Necker-Enfants Malades | Paris | France |
| AP-HP Hopital Saint-Antoine | Paris | France |
| AP-HP Hopitaux Universitaires Henri-Mondor | Paris | France |
| CHU Poitiers | Poitiers | France |
| CHU Rouen | Rouen | France |
| CHU Saint-Etienne | Saint-Etienne | France |
| CHU Strasbourg | Strasbourg | France |
| CHU Toulouse | Toulouse | France |
| CHU Tours | Tours | France |
| CHU Pointe-à-Pitre | Pointe-à-Pitre | Guadeloupe |