%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Fenollar, F.
%A Marth, T.
%A Lagier, J. C.
%A Angelakis, E.
%A Raoult, Didier
%T Sewage workers with low antibody responses may be colonized successively by several Tropheryma whipplei strains
%D 2015
%L PAR00013496
%G ENG
%J International Journal of Infectious Diseases
%@ 1201-9712
%K Tropheryma whipplei ; Sewage workers ; Asymptomatic carriage ; Whipple's ; disease
%K FRANCE
%M ISI:000358004000013
%P 51-55
%R 10.1016/j.ijid.2015.04.009
%U https://www.documentation.ird.fr/hor/PAR00013496
%V 35
%W Horizon (IRD)
%X Objectives: Asymptomatic faecal carriage of Tropheryma whipplei, the agent of Whipple's disease, is reported among sewage workers. However, the potential development of such carriage is unknown. A 7-year follow-up of T. whipplei-carrying sewage workers is reported. Methods: Nineteen sewage workers previously detected as faecal carriers of T. whipplei were followed to ascertain the chronicity of their carriage. Faeces were tested by molecular assays using quantitative real-time PCR specifically targeting T. whipplei. Serological anti-T. whipplei Western blotting was also performed. Results: Seventy-nine percent (15/19) of workers exhibited a strong immune response against T. whipplei. Among these, five were followed for more than 1 year. Four maintained a strong response, with three carrying the same strain and one becoming negative. The fifth exhibited a decreased immune response, a negative faeces result, and subsequent carriage of another strain. Three individuals with low immune responses were also followed. Two never developed a response, with one carrying the same strain and one becoming negative and then positive with another strain; the third developed a strong response and became negative. Conclusions: Chronic T. whipplei carriers appear to be protected against reinfection, but those with low or decreasing antibody levels may be re-colonized by another strain.
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