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Giacobbe DR, Del Bono V, Viscoli C, Mikulska M. Use of 1,3-β-D-glucan in invasive fungal diseases in hematology patients. Expert Rev Anti Infect Ther 2017; 15:1101-1112. [PMID: 29125373 DOI: 10.1080/14787210.2017.1401467] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Invasive fungal diseases (IFD) remain a leading cause of morbidity and mortality in hematology patients. Within a diagnostic-driven approach, the use of the serum (1,3)-ß-D-glucan (BDG) test represents a valid tool for the early diagnosis and treatment of IFD. Areas covered: The available literature on the use of BDG in hematology patients was systematically retrieved. Then, it was reviewed and discussed, to identify key issues pertaining to a clinically-oriented narrative presentation of the topic. Expert commentary: The use of BDG in hematology patients at risk for invasive aspergillosis (IA) is secondary to the use of galactomannan. However, since BDG is not specific for IA, it offers an advantage of diagnosing also other IFD, such as candidiasis and pneumocystosis. The limitations of BDG include high costs and lower sensitivity in hematology patients compared to other cohorts. The risk of false positive results is possibly lower in real life than in theory, since glucan-free equipment is available and modern dialysis membranes and blood products usually do not release BDG. Thus, in experienced hands and selected clinical situations, BDG is a useful diagnostic tool, particularly due to short turnover time to results and versatility in diagnosing different IFD.
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Affiliation(s)
- Daniele Roberto Giacobbe
- a Infectious Diseases Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, DISSAL , Genoa , Italy
| | - Valerio Del Bono
- a Infectious Diseases Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, DISSAL , Genoa , Italy
| | - Claudio Viscoli
- a Infectious Diseases Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, DISSAL , Genoa , Italy
| | - Malgorzata Mikulska
- a Infectious Diseases Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, DISSAL , Genoa , Italy
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Abstract
In the expanding population of immunocompromised patients and those treated in intensive care units, rare fungal infectious agents have emerged as important pathogens, causing invasive infections associated with high morbidity and mortality. These infections may present either as de novo or as breakthrough invasive infections in high-risk patients with hematologic malignancies receiving prophylactic or empirical antifungal therapy or in patients with central venous catheters. Diagnosis and treatment are challenging. Physicians should have a high index of suspicion because early diagnosis is of paramount importance. Conventional diagnostic methods such as cultures and histopathology are still essential, but rapid and more specific molecular techniques for both detection and identification of the infecting pathogens are being developed and hopefully will lead to early targeted treatment. The management of invasive fungal infections is multimodal. Reversal of risk factors, if feasible, should be attempted. Surgical debridement is recommended in localized mold infections. The efficacy of various antifungal drugs is not uniform. Amphotericin B is active against most yeasts, except Trichosporon, as well as against Mucorales, Fusarium, and some species of Paecilomyces and dimorphic fungi. The use of voriconazole is suggested for the treatment of trichosporonosis and scedosporiosis. Combination treatment, though recommended as salvage therapy in some infections, is controversial in most cases. Despite the use of available antifungals, mortality remains high. The optimization of molecular-based techniques, with expansion of reference libraries and the possibility for direct detection of resistance mechanisms, is awaited with great interest in the near future. Further research is necessary, however, in order to find the best ways to confront and destroy these lurking enemies.
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Affiliation(s)
- Anna Skiada
- 1st Department of Medicine, Laiko Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Maria Drogari-Apiranthitou
- Infectious Diseases Research Laboratory, 4th Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Pfliegler WP, Boros E, Pázmándi K, Jakab Á, Zsuga I, Kovács R, Urbán E, Antunovics Z, Bácsi A, Sipiczki M, Majoros L, Pócsi I. Commercial strain-derived clinicalSaccharomyces cerevisiaecan evolve new phenotypes without higher pathogenicity. Mol Nutr Food Res 2017; 61. [DOI: 10.1002/mnfr.201601099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 06/08/2017] [Accepted: 06/28/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Walter P. Pfliegler
- Department of Biotechnology and Microbiology; University of Debrecen; Debrecen Hungary
- Postdoctoral Fellowship Programme of the Hungarian Academy of Sciences (MTA); Budapest Hungary
| | - Enikő Boros
- Department of Biotechnology and Microbiology; University of Debrecen; Debrecen Hungary
| | - Kitti Pázmándi
- Department of Immunology; University of Debrecen; Debrecen Hungary
| | - Ágnes Jakab
- Department of Biotechnology and Microbiology; University of Debrecen; Debrecen Hungary
| | - Imre Zsuga
- Department of Biotechnology and Microbiology; University of Debrecen; Debrecen Hungary
| | - Renátó Kovács
- Department of Medical Microbiology; University of Debrecen; Debrecen Hungary
- Faculty of Pharmacy; University of Debrecen; Debrecen Hungary
| | - Edit Urbán
- Institute of Clinical Microbiology; University of Szeged; Szeged Hungary
| | - Zsuzsa Antunovics
- Department of Genetics and Applied Microbiology; University of Debrecen; Debrecen Hungary
| | - Attila Bácsi
- Department of Immunology; University of Debrecen; Debrecen Hungary
| | - Matthias Sipiczki
- Department of Genetics and Applied Microbiology; University of Debrecen; Debrecen Hungary
| | - László Majoros
- Department of Medical Microbiology; University of Debrecen; Debrecen Hungary
| | - István Pócsi
- Department of Biotechnology and Microbiology; University of Debrecen; Debrecen Hungary
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Byrne DD, Reboli AC. Rare Yeast Infections: Risk Factors, Clinical Manifestations, Treatment, and Special Considerations. CURRENT CLINICAL MICROBIOLOGY REPORTS 2017. [DOI: 10.1007/s40588-017-0073-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Colombo AL, de Almeida Júnior JN, Slavin MA, Chen SCA, Sorrell TC. Candida and invasive mould diseases in non-neutropenic critically ill patients and patients with haematological cancer. THE LANCET. INFECTIOUS DISEASES 2017; 17:e344-e356. [PMID: 28774702 DOI: 10.1016/s1473-3099(17)30304-3] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 01/06/2017] [Accepted: 03/07/2017] [Indexed: 12/11/2022]
Abstract
Critically ill patients and patients with haematological cancer are HIV-negative populations at high risk of invasive fungal infections. In intensive-care units, candidaemia and intra-abdominal candidiasis predominate, but aspergillosis has emerged as a lethal, under-recognised cause of pneumonia. In patients with haematological malignancies or who have undergone stem-cell transplantations, pulmonary disease due to aspergillus and other mould diseases predominate. In this Series paper, we provide an update on risk assessment, new diagnostic strategies, and therapeutic approaches. New concepts have emerged for use of risk prediction rules and an evidence base now exists for inclusion of biomarkers (eg, galactomannan, 1,3-β-D-glucan, and PCR assays for Aspergillus spp) into early diagnostic and therapeutic strategies. Imaging techniques remain helpful for early diagnosis of pulmonary mould diseases, with PET techniques offering potential improvements in diagnostic specificity and evaluation of clinical response. Echinocandins and triazoles have been validated extensively for prophylaxis, empirical therapy, and targeted therapy, but an increase in intrinsically resistant fungi and emergence of secondary resistance as a result of drug-induced selection pressure are of major concern. Echinocandins remain a major component of treatment of invasive candidiasis and new triazoles are the best alternative for prophylaxis and therapy of invasive aspergillosis.
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Affiliation(s)
- A L Colombo
- Department of Medicine, Division of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
| | - J N de Almeida Júnior
- Central Laboratory Division (LIM03) and Laboratory of Medical Mycology (LIM53), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Monica A Slavin
- Department of Infectious Diseases, Peter MacCallum Cancer Center, Melbourne, VIC, Australia; Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute, Melbourne, VIC, Australia
| | - Sharon C-A Chen
- The Center for Infectious Diseases and Microbiology Laboratory Services, ICPMR Pathology West, New South Wales Health Pathology, Westmead and Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, Australia
| | - Tania C Sorrell
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney and Westmead Institute for Medical Research, Westmead, NSW, Australia
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56
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Yeasts. Microbiol Spectr 2017; 4. [PMID: 27726781 DOI: 10.1128/microbiolspec.dmih2-0030-2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Yeasts are unicellular organisms that reproduce mostly by budding and less often by fission. Most medically important yeasts originate from Ascomycota or Basidiomycota. Here, we review taxonomy, epidemiology, disease spectrum, antifungal drug susceptibility patterns of medically important yeast, laboratory diagnosis, and diagnostic strategies.
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57
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Liver Abscess in Patients With Leukemia and Prolonged Neutropenia. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2017. [DOI: 10.1097/ipc.0000000000000478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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58
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Epidemiology of antifungal resistance in human pathogenic yeasts: current viewpoint and practical recommendations for management. Int J Antimicrob Agents 2017; 50:318-324. [PMID: 28669831 DOI: 10.1016/j.ijantimicag.2017.05.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/11/2017] [Accepted: 05/17/2017] [Indexed: 11/23/2022]
Abstract
In this review, we describe the epidemiology and clinical significance of resistance in Candida spp. and other non-Cryptococcus yeasts. The rise in echinocandin resistance, azole resistance and cross-resistance to two or more antifungal classes [multidrug resistance (MDR)] has been a worrisome trend, mainly in US large tertiary and oncology centres, particularly as it relates to Candida glabrata. Candida kefyr is also a concern as it can be resistant to echinocandins and polyenes, especially in patients with haematological malignancies. Lately, Candida auris has drawn a lot of attention: this uncommon Candida spp. is the first globally emerging fungal pathogen that exhibits MDR and strong potential for nosocomial transmission. Its almost simultaneous spread in four continents could be indicative of increasing selection pressures from the use of antifungal agents. Echinocandin non-susceptibility is also common among non-Candida, non-Cryptococcus yeasts. As Candida resistance patterns reflect, in part, institutional practices of antifungal administration, the benefits of antifungal stewardship protocols are increasingly recognised and endorsed in recent guidelines. Development of rapid diagnostic methods for detecting or ruling out the presence of candidaemia and antifungal resistance, as well as discovery of novel antifungals, are key priorities in medical mycology research.
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59
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Evaluating and Improving Vitek MS for Identification of Clinically Relevant Species of Trichosporon and the Closely Related Genera Cutaneotrichosporon and Apiotrichum. J Clin Microbiol 2017; 55:2439-2444. [PMID: 28539340 DOI: 10.1128/jcm.00461-17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 05/16/2017] [Indexed: 12/27/2022] Open
Abstract
Trichosporon species are relevant etiologic agents of hospital-acquired infections. High mortality rates are attributed to Trichosporon deep-seated infections in immunocompromised individuals, making fast and accurate species identification relevant for hastening the discovery of best-targeted therapy. Recently, Trichosporon taxonomy has been reassessed, and three genera have been proposed for the pathogenic species: Trichosporon, Cutaneotrichosporon, and Apiotrichum Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has replaced old phenotypic methods for microorganism identification in clinical laboratories, but spectral profile databases have to be evaluated and improved for optimal species identification performance. Vitek MS (bioMérieux) is one of the commercially available MALDI-TOF MS platforms for pathogen identification, and its spectral profile databases remain poorly evaluated for Trichosporon, Cutaneotrichosporon, and Apiotrichum species identification. We herein evaluated and improved Vitek MS for the identification of the main clinical relevant species of Trichosporon, Cutaneotrichosporon, and Apiotrichum using a large set of strains and isolates belonging to different yeast collections in Brazil and France.
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60
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Hazirolan G, Aypak A, Aksu N. An unusual case of urinary tract infection caused by Saprochaete capitata under anidulafungin treatment. J Mycol Med 2017; 27:387-390. [PMID: 28478968 DOI: 10.1016/j.mycmed.2017.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 03/09/2017] [Accepted: 04/04/2017] [Indexed: 11/28/2022]
Abstract
Saprochaete capitata may cause uncommon severe infections, especially in immunocompromised patients. Here, we describe a rare case of urinary tract infection by S. capitata in a chronic kidney disease and diabetes mellitus patient, which occur during anidulafungin therapy. Mycological examinations of urine were positive to S. capitata identified by mass spectrometry and confirmed by ITS sequencing. Minimum inhibitory concentration (MIC) of the isolate for amphotericin B, fluconazole, itraconazole, voriconazole and, anidulafungin were 2, 16, 1, 1, and 8μg/mL, respectively. Presence of S. capitata infection was not known. Clinicians should be aware about these rare opportunistic fungal pathogens, particularly those with intrinsic or variable resistance to antifungals including echinocandins.
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Affiliation(s)
- G Hazirolan
- Medical microbiology, Ankara Numune training and research hospital, Ulku Mahallesi Talatpasa Bulvari No. 5 Altindag, 06100 Ankara, Turkey.
| | - A Aypak
- Clinical microbiology and infectious disease department, Ankara Numune training and research hospital, Ulku Mahallesi Talatpasa Bulvari, No. 5 Altindag, 06100 Ankara, Turkey
| | - N Aksu
- Medical microbiology, Ankara Numune training and research hospital, Ulku Mahallesi Talatpasa Bulvari No. 5 Altindag, 06100 Ankara, Turkey
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61
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Duarte-Oliveira C, Rodrigues F, Gonçalves SM, Goldman GH, Carvalho A, Cunha C. The Cell Biology of the Trichosporon-Host Interaction. Front Cell Infect Microbiol 2017; 7:118. [PMID: 28439501 PMCID: PMC5383668 DOI: 10.3389/fcimb.2017.00118] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 03/23/2017] [Indexed: 11/13/2022] Open
Abstract
Fungi of the genus Trichosporon are increasingly recognized as causative agents of superficial and invasive fungal disease in humans. Although most species are considered commensals of the human skin and gastrointestinal tract, these basidiomycetes are an increasing cause of fungal disease among immunocompromised hosts, such as hematological patients and solid organ transplant recipients. The initiation of commensal or pathogenic programs by Trichosporon spp. involves the adaptation to the host microenvironment and its immune system. However, the exact virulence factors activated upon the transition to a pathogenic lifestyle, including the intricate biology of the cell wall, and how these interact with and subvert the host immune responses remain largely unknown. Here, we revisit our current understanding of the virulence attributes of Trichosporon spp., particularly T. asahii, and their interaction with the host immune system, and accommodate this knowledge within novel perspectives on fungal diagnostics and therapeutics.
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Affiliation(s)
- Cláudio Duarte-Oliveira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
| | - Fernando Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
| | - Samuel M Gonçalves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
| | - Gustavo H Goldman
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São PauloSão Paulo, Brazil
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
| | - Cristina Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of MinhoBraga, Portugal.,ICVS/3B's - PT Government Associate LaboratoryBraga/Guimarães, Portugal
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Vaezi A, Fakhim H, Khodavaisy S, Alizadeh A, Nazeri M, Soleimani A, Boekhout T, Badali H. Epidemiological and mycological characteristics of candidemia in Iran: A systematic review and meta-analysis. J Mycol Med 2017; 27:146-152. [PMID: 28318900 DOI: 10.1016/j.mycmed.2017.02.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 01/30/2017] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
Abstract
To date, there has been no comprehensive review of the epidemiology, risk factors, species distribution, and outcomes of candidemia in Iran. This study aimed to perform a systematic review and meta-analysis of all reported candidemia cases in Iran until December 2015. The review process occurred in three steps, namely a literature search, data extraction and statistical analyses. After a comprehensive literature search, we identified 55 cases. The mean age of patients was 46.80±24.30 years (range 1-81 years). The main risk factors for candidemia were surgery and burns (23.6%), followed by malignancies (20%), use of broad-spectrum antibiotics (18.2%), and diabetes (7.3%). Candida parapsilosis (n=17, 30.8%) was the leading agent, followed by Candida albicans (n=15, 27.3%), Candida glabrata (n=10, 18.2%), and Candida tropicalis (n=8, 14.5%). The frequencies of candidemia cases due to C. glabrata, C. parapsilosis, and C. albicans were significantly higher among patients aged>60, 21-40, and 41-60 years, respectively. Comparison of risk factors for candidemia by multiple logistic regression showed that one of the most important risk factors was surgery (OR: 4.245; 95% CI: 1.141-15.789; P=0.031). The outcome was recorded in only 19 cases and 13 of those patients (68.4%) expired. This study confirms that knowledge of the local epidemiology is important when conducting surveillance studies to prevent and control candidemia and will be of interest for antifungal stewardship.
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Affiliation(s)
- A Vaezi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran; Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - H Fakhim
- Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - S Khodavaisy
- Department of Medical Mycology and Parasitology, Tehran University of Medical Sciences, Tehran, Iran
| | - A Alizadeh
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - M Nazeri
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - A Soleimani
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - T Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands; Institute of Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, The Netherlands
| | - H Badali
- Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Invasive Fungi Research Center (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
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63
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Pande A, Non LR, Romee R, Santos CAQ. Pseudozyma and other non-Candida opportunistic yeast bloodstream infections in a large stem cell transplant center. Transpl Infect Dis 2017; 19. [PMID: 28099778 DOI: 10.1111/tid.12664] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/22/2016] [Accepted: 10/08/2016] [Indexed: 11/28/2022]
Abstract
Non-Candida opportunistic yeasts are emerging causes of bloodstream infection (BSI) in immunocompromised hosts. However, their clinical presentation, management, and outcomes in stem cell transplant (SCT) recipients are not well described. We report the first case to our knowledge of Pseudozyma BSI in a SCT recipient. He had evidence of cutaneous involvement, which has not been previously described in the literature. He became infected while neutropenic and receiving empiric micafungin, which is notable because Pseudozyma is reported to be resistant to echinocandins. He was successfully treated with the sequential use of liposomal amphotericin B and voriconazole. A review of the literature revealed nine reported instances of Pseudozyma fungemia. We performed a retrospective review of 3557 SCT recipients at our institution from January 2000 to June 2015 and identified four additional cases of non-Candida yeast BSIs. These include two with Cryptococcus, one with Trichosporon, and one with Saccharomyces. Pseudozyma and other non-Candida yeasts are emerging pathogens that can cause severe and disseminated infections in SCT recipients and other immunocompromised hosts. Clinicians should have a high degree of suspicion for echinocandin-resistant yeasts, if patients develop breakthrough yeast BSIs while receiving echinocandin therapy.
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Affiliation(s)
- Anupam Pande
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Lemuel R Non
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Rizwan Romee
- Bone Marrow Transplantation and Leukemia Section, Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carlos A Q Santos
- Division of Infectious Diseases, Rush University Medical Center, Chicago, IL, USA
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64
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Gonia S, Archambault L, Shevik M, Altendahl M, Fellows E, Bliss JM, Wheeler RT, Gale CA. Candida parapsilosis Protects Premature Intestinal Epithelial Cells from Invasion and Damage by Candida albicans. Front Pediatr 2017; 5:54. [PMID: 28382297 PMCID: PMC5360698 DOI: 10.3389/fped.2017.00054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 03/03/2017] [Indexed: 11/13/2022] Open
Abstract
Candida is a leading cause of late-onset sepsis in premature infants and is thought to invade the host via immature or damaged epithelial barriers. We previously showed that the hyphal form of Candida albicans invades and causes damage to premature intestinal epithelial cells (pIECs), whereas the non-hyphal Candida parapsilosis, also a fungal pathogen of neonates, has less invasion and damage abilities. In this study, we investigated the potential for C. parapsilosis to modulate pathogenic interactions of C. albicans with the premature intestine. While a mixed infection with two fungal pathogens may be expected to result in additive or synergistic damage to pIECs, we instead found that C. parapsilosis was able to protect pIECs from invasion and damage by C. albicans. C. albicans-induced pIEC damage was reduced to a similar extent by multiple different C. parapsilosis strains, but strains differed in their ability to inhibit C. albicans invasion of pIECs, with the inhibitory activity correlating with their adhesiveness for C. albicans and epithelial cells. C. parapsilosis cell-free culture fractions were also able to significantly reduce C. albicans adhesion and damage to pIECs. Furthermore, coadministration of C. parapsilosis cell-free fractions with C. albicans was associated with decreased infection and mortality in zebrafish. These results indicate that C. parapsilosis is able to reduce invasion, damage, and virulence functions of C. albicans. Additionally, the results with cellular and cell-free fractions of yeast cultures suggest that inhibition of pathogenic interactions between C. albicans and host cells by C. parapsilosis occurs via secreted molecules as well as by physical contact with the C. parapsilosis cell surface. We propose that non-invasive commensals can be used to inhibit virulence features of pathogens and deserve further study as a non-pharmacological strategy to protect the fragile epithelial barriers of premature infants.
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Affiliation(s)
- Sara Gonia
- Department of Pediatrics, University of Minnesota , Minneapolis, MN , USA
| | - Linda Archambault
- Department of Molecular and Biomedical Sciences, University of Maine , Orono, ME , USA
| | - Margaret Shevik
- Department of Pediatrics, University of Minnesota , Minneapolis, MN , USA
| | - Marie Altendahl
- Department of Pediatrics, University of Minnesota , Minneapolis, MN , USA
| | - Emily Fellows
- Department of Pediatrics, University of Minnesota , Minneapolis, MN , USA
| | - Joseph M Bliss
- Department of Pediatrics, Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University , Providence, RI , USA
| | - Robert T Wheeler
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, ME, USA; Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, ME, USA
| | - Cheryl A Gale
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Department of Genetics, Cell Biology and Development, University of Minnesota, Minneapolis, MN, USA
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65
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de Almeida Júnior JN, Hennequin C. Invasive Trichosporon Infection: a Systematic Review on a Re-emerging Fungal Pathogen. Front Microbiol 2016; 7:1629. [PMID: 27799926 PMCID: PMC5065970 DOI: 10.3389/fmicb.2016.01629] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 09/29/2016] [Indexed: 12/11/2022] Open
Abstract
Objectives: This review aimed to better depict the clinical features and address the issue of therapeutic management of Trichosporon deep-seated infections. Methods: We comprehensively reviewed the cases of invasive Trichosporon infection reported in the literature from 1994 (date of taxonomic modification) to 2015. Data from antifungal susceptibility testing (AST) studies were also analyzed. Results: Two hundred and three cases were retained and split into four groups: homeopathy (n = 79), other immunodeficiency conditions (n = 41), miscellaneous (n = 58) and newborns (n = 25). Trichosporon asahii was the main causative species (46.7%) and may exhibit cross-resistance to different antifungal classes. The unfavorable outcome rate was at 44.3%. By multivariate analysis, breakthrough infection (OR 2.45) was associated with unfavorable outcome, whilst the use of an azole-based therapy improved the prognosis (OR 0.16). Voriconazole-based treatment was associated with favorable outcome in hematological patients (73.6 vs. 41.8%; p = 0.016). Compiled data from AST demonstrated that (i) T. asahii exhibits the highest MICs to amphotericin B and (ii) voriconazole has the best in vitro efficacy against clinical isolates of Trichosporon spp. Conclusions:Trichosporon infection is not only restricted to hematological patients. Analysis of compiled data from AST and clinical outcome support the use of voriconazole as first line therapy.
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Affiliation(s)
- João N de Almeida Júnior
- Central Laboratory Division-LIM03, Faculdade de Medicina da Universidade de São PauloSão Paulo, Brazil; Laboratory of Medical Mycology-LIM53, Instituto de Medicina Tropical da Universidade de São PauloSão Paulo, Brazil
| | - Christophe Hennequin
- Service de Parasitologie-Mycologie-AP-HP, Hôpital St AntoineParis, France; Institut National de la Santé et de la Recherche Médicale UMR 1135, Centre National de la Recherche Scientifique ERL 8255, Sorbonne Universités, University Pierre and Marie Curie (UPMC)Paris, France; Centre d'Immunologie et des Maladies Infectieuses, Bd de l'hôpitalParis, France
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66
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Sanguinetti M, Posteraro B. Mass spectrometry applications in microbiology beyond microbe identification: progress and potential. Expert Rev Proteomics 2016; 13:965-977. [DOI: 10.1080/14789450.2016.1231578] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Brunella Posteraro
- Institute of Public Health (Section of Hygiene), Università Cattolica del Sacro Cuore, Rome, Italy
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67
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Fernández-Ruiz M, Guinea J, Puig-Asensio M, Zaragoza Ó, Almirante B, Cuenca-Estrella M, Aguado JM. Fungemia due to rare opportunistic yeasts: data from a population-based surveillance in Spain. Med Mycol 2016; 55:125-136. [DOI: 10.1093/mmy/myw055] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 02/22/2016] [Accepted: 05/15/2016] [Indexed: 12/18/2022] Open
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68
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Enfermedades invasoras por hongos levaduriformes en pacientes neutropénicos. Rev Iberoam Micol 2016; 33:170-5. [DOI: 10.1016/j.riam.2015.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/15/2015] [Accepted: 11/19/2015] [Indexed: 11/18/2022] Open
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69
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de Almeida JN, Sztajnbok J, da Silva AR, Vieira VA, Galastri AL, Bissoli L, Litvinov N, Del Negro GMB, Motta AL, Rossi F, Benard G. Rapid identification of moulds and arthroconidial yeasts from positive blood cultures by MALDI-TOF mass spectrometry. Med Mycol 2016; 54:885-9. [PMID: 27317582 DOI: 10.1093/mmy/myw044] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 04/18/2016] [Indexed: 12/14/2022] Open
Abstract
Moulds and arthroconidial yeasts are potential life-threatening agents of fungemia in immunocompromised patients. Fast and accurate identification (ID) of these pathogens hastens initiation of targeted antifungal therapy, thereby improving the patients' prognosis. We describe a new strategy that enabled the identification of moulds and arthroconidial yeasts directly from positive blood cultures by MALDI-TOF mass spectrometry (MS). Positive blood cultures (BCs) with Gram staining showing hyphae and/or arthroconidia were prospectively selected and submitted to an in-house protein extraction protocol. Mass spectra were obtained by Vitek MS™ system, and identifications were carried out with in the research use only (RUO) mode with an extended database (SARAMIS™ [v.4.12] plus in-house database). Fusarium solani, Fusarium verticillioides, Exophiala dermatitidis, Saprochaete clavata, and Trichosporon asahii had correct species ID by MALDI-TOF MS analysis of positive BCs. All cases were related to critically ill patients with high mortality fungemia and direct ID from positive BCs was helpful for rapid administration of targeted antifungal therapy.
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Affiliation(s)
- João N de Almeida
- Central Laboratory Division-LIM03, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas da FMUSP and Instituto de Medicina Tropical, Universidade de São Paulo, Brazil
| | - Jaques Sztajnbok
- Children's Institute, Hospital das Clínicas Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Afonso Rafael da Silva
- Central Laboratory Division-LIM03, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Vinicius Adriano Vieira
- Children's Institute, Hospital das Clínicas Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Anne Layze Galastri
- Children's Institute, Hospital das Clínicas Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Leandro Bissoli
- Laboratory of Bacteriology-LIM54, Instituto de Medicina Tropical, Universidade de São Paulo, Brazil
| | - Nadia Litvinov
- Children's Institute, Hospital das Clínicas Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Gilda Maria Barbaro Del Negro
- Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas da FMUSP and Instituto de Medicina Tropical, Universidade de São Paulo, Brazil
| | - Adriana Lopes Motta
- Central Laboratory Division-LIM03, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Flávia Rossi
- Central Laboratory Division-LIM03, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Gil Benard
- Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas da FMUSP and Instituto de Medicina Tropical, Universidade de São Paulo, Brazil
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70
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Low Utility of Pediatric Isolator Blood Culture System for Detection of Fungemia in Children: a 10-Year Review. J Clin Microbiol 2016; 54:2284-7. [PMID: 27307462 DOI: 10.1128/jcm.00578-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/13/2016] [Indexed: 11/20/2022] Open
Abstract
The use of the Wampole Isolator 1.5-ml pediatric blood culture tube for the detection of fungemia in children was assessed by a 10-year retrospective review at two pediatric hospitals, The Hospital for Sick Children in Toronto, Canada, and the Children's Medical Center of Dallas, Texas. Over this period, a total of 9,442 pediatric Isolator specimens were processed, with yeast or yeast-like organisms recovered in 297 (3.1%) of the specimens (151 [1.6%] unique clinical episodes) and filamentous or dimorphic fungi recovered in 31 (0.3%) of the specimens (25 unique clinical episodes). Only 18 of the 151 clinical episodes of fungemia attributable to yeast were not detected by automated blood culture systems. The majority of isolated yeast were Candida spp., which were usually detected by automated systems, whereas the most common non-Candida yeast was Malassezia furfur, which the automated system failed to detect. Filamentous or dimorphic fungi were detected in 25 episodes, of which only 9 (36%) episodes were deemed clinically significant after chart review, indicating that in the majority of cases (16/25, 64%) fungal isolation represented contamination. In five of the nine clinically significant episodes, the isolated fungus (Histoplasma capsulatum, Coccidioides immitis/posadasii, Fusarium oxysporum, Aspergillus spp., and Bipolaris spp.) was also identified in other clinical specimens. Over the 10-year study period, the use of the pediatric Isolator system, at the discretion of the treating physician, only rarely provided useful clinical information for the diagnosis of fungemia in children, with the exception of M. furfur and possibly endemic mycoses.
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Abstract
In humans, microbial cells (including bacteria, archaea, and fungi) greatly outnumber host cells. Candida albicans is the most prevalent fungal species of the human microbiota; this species asymptomatically colonizes many areas of the body, particularly the gastrointestinal and genitourinary tracts of healthy individuals. Alterations in host immunity, stress, resident microbiota, and other factors can lead to C. albicans overgrowth, causing a wide range of infections, from superficial mucosal to hematogenously disseminated candidiasis. To date, most studies of C. albicans have been carried out in suspension cultures; however, the medical impact of C. albicans (like that of many other microorganisms) depends on its ability to thrive as a biofilm, a closely packed community of cells. Biofilms are notorious for forming on implanted medical devices, including catheters, pacemakers, dentures, and prosthetic joints, which provide a surface and sanctuary for biofilm growth. C. albicans biofilms are intrinsically resistant to conventional antifungal therapeutics, the host immune system, and other environmental perturbations, making biofilm-based infections a significant clinical challenge. Here, we review our current knowledge of biofilms formed by C. albicans and closely related fungal species.
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Affiliation(s)
- Clarissa J Nobile
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, California 95343;
| | - Alexander D Johnson
- Department of Microbiology and Immunology, University of California, San Francisco, California 94143;
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72
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Alby-Laurent F, Dollfus C, Ait-Oufella H, Rambaud J, Legrand O, Tabone MD, Hennequin C. Trichosporon
: another yeast-like organism responsible for immune reconstitution inflammatory syndrome in patients with hematological malignancy. Hematol Oncol 2016; 35:900-904. [DOI: 10.1002/hon.2309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 04/08/2016] [Accepted: 04/27/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Fanny Alby-Laurent
- Service d'Hémato-Oncologie Pédiatrique; AP-HP, Hôpital A. Trousseau; Paris France
- Service de Réanimation Pédiatrique; AP-HP, Hôpital A. Trousseau; Paris France
| | - Catherine Dollfus
- Service d'Hémato-Oncologie Pédiatrique; AP-HP, Hôpital A. Trousseau; Paris France
| | - Hafid Ait-Oufella
- Service de Réanimation Médicale; AP-HP, Hôpital St Antoine; Paris France
| | - Jerome Rambaud
- Service de Réanimation Pédiatrique; AP-HP, Hôpital A. Trousseau; Paris France
| | - Ollivier Legrand
- Service d'hématologie clinique et de thérapie cellulaire; AP-HP, Hôpital St Antoine; Paris France
| | | | - Christophe Hennequin
- Assistance Publique-Hôpitaux de Paris; Hôpital St Antoine, Service de Parasitologie-Mycologie; Paris France
- Inserm; U1135, CIMI-Paris; Paris France
- CNRS; ERL 8255, CIMI-Paris; Paris France
- Sorbonne Universités; UPMC Univ Paris 06, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris); Paris France
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73
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Laboratory Diagnosis of Infections in Cancer Patients: Challenges and Opportunities. J Clin Microbiol 2016; 54:2635-2646. [PMID: 27280421 DOI: 10.1128/jcm.00604-16] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Infections remain a significant cause of morbidity and mortality in cancer patients. The differential diagnosis for these patients is often wide, and the timely selection of the right clinical tests can have a significant impact on their survival. However, laboratory findings with current methodologies are often negative, challenging clinicians and laboratorians to continue the search for the responsible pathogen. Novel methodologies are providing increased sensitivity and rapid turnaround time to results but also challenging our interpretation of what is a clinically significant pathogen in cancer patients. This minireview provides an overview of the most common infections in cancer patients and discusses some of the challenges and opportunities for the clinical microbiologist supporting the care of cancer patients.
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74
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Guidara R, Trabelsi H, Neji S, Cheikhrouhou F, Sellami H, Makni F, Ayadi A. Rhodotorula fungemia : Report of two cases in Sfax (Tunisia). J Mycol Med 2016; 26:178-181. [DOI: 10.1016/j.mycmed.2016.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 02/17/2016] [Accepted: 02/21/2016] [Indexed: 11/29/2022]
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75
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Hou X, Xiao M, Chen SCA, Wang H, Zhang L, Fan X, Xu ZP, Cheng JW, Kong F, Zhao YP, Xu YC. Sequencer-Based Capillary Gel Electrophoresis (SCGE) Targeting the rDNA Internal Transcribed Spacer (ITS) Regions for Accurate Identification of Clinically Important Yeast Species. PLoS One 2016; 11:e0154385. [PMID: 27105313 PMCID: PMC4841527 DOI: 10.1371/journal.pone.0154385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/12/2016] [Indexed: 12/30/2022] Open
Abstract
Accurate species identification of Candida, Cryptococcus, Trichosporon and other yeast pathogens is important for clinical management. In the present study, we developed and evaluated a yeast species identification scheme by determining the rDNA internal transcribed spacer (ITS) region length types (LTs) using a sequencer-based capillary gel electrophoresis (SCGE) approach. A total of 156 yeast isolates encompassing 32 species were first used to establish a reference SCGE ITS LT database. Evaluation of the ITS LT database was then performed on (i) a separate set of (n = 97) clinical isolates by SCGE, and (ii) 41 isolates of 41 additional yeast species from GenBank by in silico analysis. Of 156 isolates used to build the reference database, 41 ITS LTs were identified, which correctly identified 29 of the 32 (90.6%) species, with the exception of Trichosporon asahii, Trichosporon japonicum and Trichosporon asteroides. In addition, eight of the 32 species revealed different electropherograms and were subtyped into 2–3 different ITS LTs each. Of the 97 test isolates used to evaluate the ITS LT scheme, 96 (99.0%) were correctly identified to species level, with the remaining isolate having a novel ITS LT. Of the additional 41 isolates for in silico analysis, none was misidentified by the ITS LT database except for Trichosporon mucoides whose ITS LT profile was identical to that of Trichosporon dermatis. In conclusion, yeast identification by the present SCGE ITS LT assay is a fast, reproducible and accurate alternative for the identification of clinically important yeasts with the exception of Trichosporon species.
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Affiliation(s)
- Xin Hou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Meng Xiao
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Sharon C.-A. Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR– Pathology West, Westmead Hospital, University of Sydney, Darcy Road, Westmead, New South Wales, Australia
| | - He Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Li Zhang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Fan
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhi-Peng Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing-Wei Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Fanrong Kong
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR– Pathology West, Westmead Hospital, University of Sydney, Darcy Road, Westmead, New South Wales, Australia
| | - Yu-Pei Zhao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying-Chun Xu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- * E-mail:
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76
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Cassagne C, Normand AC, Bonzon L, L'Ollivier C, Gautier M, Jeddi F, Ranque S, Piarroux R. Routine identification and mixed species detection in 6,192 clinical yeast isolates. Med Mycol 2015; 54:256-65. [DOI: 10.1093/mmy/myv095] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/04/2015] [Indexed: 11/14/2022] Open
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77
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Liao Y, Lu X, Yang S, Luo Y, Chen Q, Yang R. Epidemiology and Outcome of Trichosporon Fungemia: A Review of 185 Reported Cases From 1975 to 2014. Open Forum Infect Dis 2015; 2:ofv141. [PMID: 26566536 PMCID: PMC4630454 DOI: 10.1093/ofid/ofv141] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 09/16/2015] [Indexed: 12/20/2022] Open
Abstract
We first reviewed the English-language literature for reported cases of Trichosporon fungemia over the past four decades, and did comprehensive analysis in order to guide our understanding of epidemiology and outcome-related aspects, especially the antifungal treatment and CVC management. Background. Trichosporon species have emerged as an important non-Candida spp yeast pathogen in immunocompromised patients in recent decades; however, the systemic analysis of Trichosporon epidemiology has seldom been reported. Methods. We reviewed 185 reported cases of Trichosporon fungemia from 1975 to 2014 in the English-language literature, and the epidemiology and prognostic factors of the included cases are described. Results. The number of cases reported has increased with time, especially over the past decade. During the 3 decades from 1975 to 2004, the most commonly used antifungal compounds were amphotericin B/liposomal amphotericin B; however, in recent decades (2005–2014), triazoles (especially voriconazole) have become the most widely used agents, significantly improving outcome in the reported cases. Correlation analysis revealed that negative outcome is associated with several prognostic factors, including a history of antimicrobial use, bacterial bloodstream coinfection, prophylactic/empirical antifungal therapy, Trichosporon beigelii infection, and receiving the antifungal regimen of amphotericin B/liposomal amphotericin B. In addition, a significantly greater proportion of patients with a positive outcome had fungemia without invasive tissue infection and received a voriconazole regimen or an AmB-triazole combined regimen. Significant positive outcome was also associated with patients who had recovered from neutropenia or after central venous catheter removal. Conclusions. Voriconazole can be recommended as a first-line antifungal compound to treat Trichosporon fungemia; the immune status of the host plays a crucial role in the outcome of this infection, and the removal of vascular catheters should be considered if feasible.
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Affiliation(s)
- Yong Liao
- Department of Dermatology , General Hospital of Beijing Military Command ; The Clinical Medical College in the Beijing Military Region of Second Military Medical University of People's Liberation Army
| | - Xuelian Lu
- Department of Dermatology , General Hospital of Beijing Military Command
| | - Suteng Yang
- Department of Dermatology , General Hospital of Beijing Military Command ; The Clinical Medical College in the Beijing Military Region of Second Military Medical University of People's Liberation Army
| | - Yi Luo
- Medical Clinic, General Political Department of People's Liberation Army, Beijing
| | - Qi Chen
- Department of Statistics , Second Military Medical University , Shanghai , China
| | - Rongya Yang
- Department of Dermatology , General Hospital of Beijing Military Command
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78
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Prodhan T, Yacoub AT, Jones L, Mai J, Greene J. Non-Candida Yeasts Fungemia in Cancer Patients. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2015. [DOI: 10.1097/ipc.0000000000000271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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79
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Hsu PH, Chiang PC, Liu CH, Chang YW. Characterization of Cell Wall Proteins in Saccharomyces cerevisiae Clinical Isolates Elucidates Hsp150p in Virulence. PLoS One 2015; 10:e0135174. [PMID: 26270963 PMCID: PMC4535956 DOI: 10.1371/journal.pone.0135174] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 07/17/2015] [Indexed: 11/25/2022] Open
Abstract
The budding yeast Saccharomyces cerevisiae has recently been described as an emerging opportunistic fungal pathogen. Fungal cell wall mannoproteins have been demonstrated to be involved in adhesion to inert surfaces and might be engaged in virulence. In this study, we observed four clinical isolates of S. cerevisiae with relatively hydrophobic cell surfaces. Yeast cell wall subproteome was evaluated quantitatively by liquid chromatography/tandem mass spectrometry. We identified totally 25 cell wall proteins (CWPs) from log-phase cells, within which 15 CWPs were quantified. The abundance of Scw10p, Pst1p, and Hsp150p/Pir2p were at least 2 folds higher in the clinical isolates than in S288c lab strain. Hsp150p is one of the members in Pir family conserved in pathogenic fungi Candida glabrata and Candida albicans. Overexpression of Hsp150p in lab strain increased cell wall integrity and potentially enhanced the virulence of yeast. Altogether, these results demonstrated that quantitative cell wall subproteome was analyzed in clinical isolates of S. cerevisiae, and several CWPs, especially Hsp150p, were found to be expressed at higher levels which presumably contribute to strain virulence and fungal pathogenicity.
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Affiliation(s)
- Pang-Hung Hsu
- Department of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan
- * E-mail: (YC); (PH)
| | - Pei-Chi Chiang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University, Taipei, Taiwan
| | - Chia-Hsun Liu
- Department of Bioscience and Biotechnology, National Taiwan Ocean University, Keelung, Taiwan
| | - Ya-Wen Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University, Taipei, Taiwan
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: (YC); (PH)
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80
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Perfect JR, Hachem R, Wingard JR. Update on epidemiology of and preventive strategies for invasive fungal infections in cancer patients. Clin Infect Dis 2015; 59 Suppl 5:S352-5. [PMID: 25352630 DOI: 10.1093/cid/ciu639] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Changes in antineoplastic treatments and transplant practices are driving shifts in the epidemiology of invasive fungal diseases (IFDs). Patients with acute myelogenous leukemia (AML) and those undergoing bone marrow transplant (BMT) are at greatest risk for contracting IFDs. Unfortunately, there are few large population studies that can be used to track trends and help us to better understand why certain individuals within recognized high-risk groups are at greater risks than others for contracting IFDs. The growing use of antifungals in prophylaxis and treatment influences which species will cause an IFD as well as the resistance patterns of these fungi. On the one hand, antifungal prophylaxis has mitigated, but not eliminated, the threat of candidiasis. Furthermore, prophylaxis trials have shown trends of reduced aspergillosis in BMT patients; however, no survival benefits were seen, and 1 trial indicated a lower rate of aspergillosis and survival benefits in patients with AML. Future prophylaxis trials should reduce the heterogeneity of risk in study participants in order to better assess benefit; these trials should also incorporate fungal biomarkers into their design. The threat of emerging fungal resistance in prophylaxis strategies is real and must be monitored.
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Affiliation(s)
- John R Perfect
- Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina
| | - Ray Hachem
- Department of Infectious Diseases, Division of Internal Medicine, University of Texas MD Anderson Cancer Center, Houston
| | - John R Wingard
- Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville
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81
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Devadas SK, Bhat V, Khattry N. Subcutaneous infection caused by Blastoschizomyces capitatus post allogeneic hematopoietic transplant and its successful treatment with voriconazole. Transpl Infect Dis 2015; 17:588-92. [PMID: 26012493 DOI: 10.1111/tid.12404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/24/2015] [Accepted: 05/05/2015] [Indexed: 11/30/2022]
Abstract
We describe a 33-year-old man with relapsed acute myelogenous leukemia who developed subcutaneous nodules >6 months after allogeneic hematopoietic stem cell transplant. These nodules were caused by Blastoschizomyces capitatus. The lesions progressed after treatment with a posaconazole suspension. The lesions resolved after switching to voriconazole, which was given for 21 weeks. B. capitatus is a rare infection affecting immunocompromised patients, which responds to azoles.
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Affiliation(s)
- S K Devadas
- Medical Oncology, Tata Memorial Center, Mumbai, India
| | - V Bhat
- Medical Oncology, Tata Memorial Center, Mumbai, India
| | - N Khattry
- Medical Oncology, Tata Memorial Center, Mumbai, India
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82
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Galán F, García-Agudo L, Guerrero I, Marín P, García-Tapia A, García-Martos P, Rodríguez-Iglesias M. Evaluación de la espectrometría de masas en la identificación de levaduras de interés clínico. Enferm Infecc Microbiol Clin 2015; 33:372-8. [DOI: 10.1016/j.eimc.2014.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/29/2014] [Accepted: 10/01/2014] [Indexed: 10/24/2022]
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83
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Strope PK, Skelly DA, Kozmin SG, Mahadevan G, Stone EA, Magwene PM, Dietrich FS, McCusker JH. The 100-genomes strains, an S. cerevisiae resource that illuminates its natural phenotypic and genotypic variation and emergence as an opportunistic pathogen. Genome Res 2015; 25:762-74. [PMID: 25840857 PMCID: PMC4417123 DOI: 10.1101/gr.185538.114] [Citation(s) in RCA: 247] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/18/2015] [Indexed: 12/18/2022]
Abstract
Saccharomyces cerevisiae, a well-established model for species as diverse as humans and pathogenic fungi, is more recently a model for population and quantitative genetics. S. cerevisiae is found in multiple environments—one of which is the human body—as an opportunistic pathogen. To aid in the understanding of the S. cerevisiae population and quantitative genetics, as well as its emergence as an opportunistic pathogen, we sequenced, de novo assembled, and extensively manually edited and annotated the genomes of 93 S. cerevisiae strains from multiple geographic and environmental origins, including many clinical origin strains. These 93 S. cerevisiae strains, the genomes of which are near-reference quality, together with seven previously sequenced strains, constitute a novel genetic resource, the “100-genomes” strains. Our sequencing coverage, high-quality assemblies, and annotation provide unprecedented opportunities for detailed interrogation of complex genomic loci, examples of which we demonstrate. We found most phenotypic variation to be quantitative and identified population, genotype, and phenotype associations. Importantly, we identified clinical origin associations. For example, we found that an introgressed PDR5 was present exclusively in clinical origin mosaic group strains; that the mosaic group was significantly enriched for clinical origin strains; and that clinical origin strains were much more copper resistant, suggesting that copper resistance contributes to fitness in the human host. The 100-genomes strains are a novel, multipurpose resource to advance the study of S. cerevisiae population genetics, quantitative genetics, and the emergence of an opportunistic pathogen.
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Affiliation(s)
- Pooja K Strope
- Duke University Medical Center, Department of Molecular Genetics and Microbiology, Durham, North Carolina 27710, USA
| | - Daniel A Skelly
- Department of Biology, Duke University, Durham, North Carolina 27710, USA
| | - Stanislav G Kozmin
- Duke University Medical Center, Department of Molecular Genetics and Microbiology, Durham, North Carolina 27710, USA
| | - Gayathri Mahadevan
- Duke University Medical Center, Department of Molecular Genetics and Microbiology, Durham, North Carolina 27710, USA
| | - Eric A Stone
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - Paul M Magwene
- Department of Biology, Duke University, Durham, North Carolina 27710, USA
| | - Fred S Dietrich
- Duke University Medical Center, Department of Molecular Genetics and Microbiology, Durham, North Carolina 27710, USA
| | - John H McCusker
- Duke University Medical Center, Department of Molecular Genetics and Microbiology, Durham, North Carolina 27710, USA
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84
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Herb A, Sabou M, Delhorme JB, Pessaux P, Mutter D, Candolfi E, Letscher-Bru V. Pseudozyma aphidis fungemia after abdominal surgery: First adult case. Med Mycol Case Rep 2015; 8:37-9. [PMID: 25870786 PMCID: PMC4389203 DOI: 10.1016/j.mmcr.2015.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 02/24/2015] [Accepted: 03/05/2015] [Indexed: 11/17/2022] Open
Abstract
Pseudozyma aphidis is an environmental Basidiomycete yeast, and has been involved in the ten past years in rare cases of invasive infection. Pseudozyma species are naturally resistant to caspofungin and often present decreased susceptibility or resistance to fluconazole. This fungus may be difficult to recognize and misidentifications are reported with conventional phenotypical methods. We report a case of P. aphidis invasive infection in an adult with a metastatic ampulloma who had gone through digestive surgery. Pseudozyma aphidis invasive infection after abdominal surgery. Identification of Pseudozyma aphidis: mass spectrometry could be promising if databanks include more spectra, whereas conventional phenotypical methods fail. Resistance to echinocandins and flucytosine and decreased susceptibility to fluconazole.
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Affiliation(s)
- Agathe Herb
- Laboratoire de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg, France
| | - Marcela Sabou
- Laboratoire de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg, France ; Institut de Parasitologie et de Pathologie Tropicale, EA7292, Fédération de Médecine Translationnelle, Université de Strasbourg, 3 rue Koeberlé, 67000 Strasbourg, France
| | - Jean-Baptiste Delhorme
- Service de Chirurgie Digestive, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg, France
| | - Patrick Pessaux
- Service de Chirurgie Digestive, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg, France
| | - Didier Mutter
- Service de Chirurgie Digestive, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg, France
| | - Ermanno Candolfi
- Laboratoire de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg, France ; Institut de Parasitologie et de Pathologie Tropicale, EA7292, Fédération de Médecine Translationnelle, Université de Strasbourg, 3 rue Koeberlé, 67000 Strasbourg, France
| | - Valérie Letscher-Bru
- Laboratoire de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg, France ; Institut de Parasitologie et de Pathologie Tropicale, EA7292, Fédération de Médecine Translationnelle, Université de Strasbourg, 3 rue Koeberlé, 67000 Strasbourg, France
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85
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Karimi L, Mirhendi H, Khodadadi H, Mohammadi R. Molecular identification of uncommon clinical yeast species in Iran. Curr Med Mycol 2015; 1:1-6. [PMID: 28680981 PMCID: PMC5490306 DOI: 10.18869/acadpub.cmm.1.2.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Purpose: By using advanced detection/identification methods, the list of emerging uncommon opportunistic yeast infections is rapidly expanding worldwide. Our aim in the present study was sequence-based species delineation of previously unidentified yeasts obtained from a clinically yeast collection. Materials and Methods: A total of twenty three out of the 855 (5.7%) yeast isolates which formerly remained unidentified by PCR-RFLP method, were subjected to sequence analysis of the entire internal transcribed spacers (ITS) regions of rDNA. The precise species recognition was performed by the comparison of the sequences with the reliable GenBank database. Results: Sequencing analysis of the ITS region of the strains revealed several uncommon yeasts that were not reported previously in Iran. The species include Hanseniaspora uvarum, Saccharomyces cerevisiae, Sporidiobolus salmonicolor, Pichia fabianii, Pichia fermentans, Candida famata, Candida inconspicua, Candida maqnoliae, Candida guilliermondii, Candida kefyr, Candida rugosa, Candida lusitaniae, Candida orthopsilosis, and Candida viswanathii. Conclusion: We identified several rare clinical isolates selected from a big collection at the species level by ITS-sequencing. As the list of yeast species as opportunistic human fungal infections is increasing dramatically, and many isolates remain unidentified using conventional methods, more sensitive and specific advanced approaches help us to clarify the aspects of microbial epidemiology of the yeast infections.
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Affiliation(s)
- L Karimi
- Dr. Beheshti Hospital, Social Security Organization, Shiraz, Iran
| | - H Mirhendi
- Department of Medical Parasitology and Mycology, School of Public Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - H Khodadadi
- Department of Medical Parasitology and Mycology, School of Medicine; Shiraz University of Medical Sciences, Shiraz, Iran
| | - R Mohammadi
- Department of Medical Parasitology and Mycology, School of Medicine; Isfahan University of Medical Sciences
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86
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Iatta R, Immediato D, Montagna MT, Otranto D, Cafarchia C. In vitro
activity of two amphotericin B formulations against
Malassezia furfur
strains recovered from patients with bloodstream infections. Med Mycol 2015; 53:269-74. [DOI: 10.1093/mmy/myu089] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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87
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Pemmaraju N, Shetty AV, Prieto VG, Jain N, Kontoyiannis DP, Borthakur G. Disseminated Saprochaete capitata (formerly known as Geotrichum capitatum and Blastoschizomyces capitatus) in a patient with acute myeloid leukemia. Eur J Haematol 2014; 93:543-4. [PMID: 24592915 DOI: 10.1111/ejh.12303] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Naveen Pemmaraju
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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88
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Ikeda R, Ichikawa T, Miyazaki Y, Shimizu N, Ryoke T, Haru K, Sugita T, Takashima M. Detection and characterization of plasminogen receptors on clinical isolates of Trichosporon asahii. FEMS Yeast Res 2014; 14:1186-95. [PMID: 25263492 DOI: 10.1111/1567-1364.12215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 09/17/2014] [Accepted: 09/17/2014] [Indexed: 11/28/2022] Open
Abstract
Trichosporon asahii is the major causative agent of deep-seated trichosporonosis. The virulence factors of this yeast pathogen remain uncharacterized. To investigate the pathogenicity of T. asahii, we focused on the interactions between surface molecules of the yeast and host biomolecules. We examined the ability of surface molecules to bind human plasminogen using clinical isolates of T. asahii. Living T. asahii cells accelerated the conversion of plasminogen to plasmin in a dose-dependent manner in the presence of tissue plasminogen activator. Extracts from cells using lithium chloride contained plasminogen-binding molecules based on surface plasmon resonance (SPR) analyses. In all strains tested, several of the fractions obtained using DEAE column chromatography bound and accelerated the conversion of plasminogen to plasmin. Based on far-Western blotting analyses, a common protein was identified within the four strains, which was identified as a hypothetical protein from genome analyses of T. asahii. blast searches suggested the protein might be heparinase, and heparinase activity was detected in the T. asahii extract. Furthermore, affinity chromatography using plasminogen as a ligand detected one protein band by SDS-PAGE, which was identified as thioredoxin-dependent peroxide reductase.SPR analyses suggested the presence of molecules on T. asahii cells that could bind plasminogen with differing affinities.
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Affiliation(s)
- Reiko Ikeda
- Department of Microbial Science and Host Defense, Meiji Pharmaceutical University, Tokyo, Japan
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89
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Minea B, Nastasa V, Moraru RF, Kolecka A, Flonta MM, Marincu I, Man A, Toma F, Lupse M, Doroftei B, Marangoci N, Pinteala M, Boekhout T, Mares M. Species distribution and susceptibility profile to fluconazole, voriconazole and MXP-4509 of 551 clinical yeast isolates from a Romanian multi-centre study. Eur J Clin Microbiol Infect Dis 2014; 34:367-83. [PMID: 25224578 DOI: 10.1007/s10096-014-2240-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/27/2014] [Indexed: 01/22/2023]
Abstract
This is the first multi-centre study regarding yeast infections in Romania. The aim was to determine the aetiological spectrum and susceptibility pattern to fluconazole, voriconazole and the novel compound MXP-4509. The 551 isolates were identified using routine laboratory methods, matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and DNA sequence analysis. Susceptibility testing was performed using the European Committee for Antimicrobial Susceptibility Testing (EUCAST) method and breakpoints. The yeasts originated from superficial infections (SUP, 51.5 %), bloodstream infections (BSI, 31.6 %) and deep-seated infections (DEEP, 16.9 %), from patients of all ages. Nine genera and 30 species were identified. The 20 Candida species accounted for 94.6 % of all isolates. C. albicans was the overall leading pathogen (50.5 %). Lodderomyces elongisporus is reported for the first time as a fungaemia cause in Europe. C. glabrata and Saccharomyces cerevisiae, as well as the non-Candida spp. and non-albicans Candida spp. groups, showed decreased fluconazole susceptibility (<75 %). The overall fluconazole resistance was 10.2 %. C. krusei accounted for 27 of the 56 fluconazole-resistant isolates. The overall voriconazole resistance was 2.5 % and was due mainly to C. glabrata and C. tropicalis isolates. Fluconazole resistance rates for the three categories of infection were similar to the overall value; voriconazole resistance rates differed: 4 % for BSI, 3.2 % for DEEP and 1.4 % for SUP. The antifungal activity of MXP-4509 was superior to voriconazole against C. glabrata and many fluconazole-resistant isolates. There was a large percentage of non-albicans Candida isolates. A large part of the high fluconazole resistance was not acquired but intrinsic, resulting from the high percentage of C. krusei.
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Affiliation(s)
- B Minea
- Advanced Research Centre for Bionanoconjugates and Biopolymers, Institute of Macromolecular Chemistry "Petru Poni", 700487, Iasi, Romania
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90
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Immunoproteomic profiling of Saccharomyces cerevisiae systemic infection in a murine model. J Proteomics 2014; 112:14-26. [PMID: 25173100 DOI: 10.1016/j.jprot.2014.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 08/01/2014] [Accepted: 08/06/2014] [Indexed: 02/01/2023]
Abstract
UNLABELLED Saccharomyces cerevisiae is considered a safe microorganism widely used as a dietary supplement. However, in the latest decades several cases of S. cerevisiae infections have been reported. Recent studies in a murine model of systemic infection have also revealed the virulence of some S. cerevisiae dietary strains. Here we use an immunoproteomic approach based on protein separation by 2D-PAGE followed by Western-blotting to compare the serological response against a virulent dietary and a non-virulent laboratory strains leading to the identification of highly different patterns of antigenic proteins. Thirty-six proteins that elicit a serological response in mice have been identified. Most of them are involved in stress responses and metabolic pathways. Their selectivity as putative biomarkers for S. cerevisiae infections was assessed by testing sera from S. cerevisiae-infected mice against Candida albicans and C. glabrata proteins. Some chaperones and metabolic proteins showed cross-reactivity. We also compare the S. cerevisiae immunodetected proteins with previously described C. albicans antigens. The results point to the stress-related proteins Ahp1, Yhb1 and Oye2, as well as the glutamine synthetase Gln1 and the oxysosterol binding protein Kes1 as putative candidates for being evaluated as biomarkers for diagnostic assays of S. cerevisiae infections. BIOLOGICAL SIGNIFICANCE S. cerevisiae can cause opportunistic infections, and therefore, a precise diagnosis of fungal infections is necessary. This immunoproteomic analysis of sera from a model murine infection with a virulent dietary S. cerevisiae strain has been shown to be a source of candidate proteins for being evaluated as biomarkers to develop assays for diagnosis of S. cerevisiae infections. To our knowledge, this is the first study devoted to the identification of S. cerevisiae immunogenic proteins and the results allowed the proposal of five antigens to be further investigated.
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91
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Malassezia infections: A medical conundrum. J Am Acad Dermatol 2014; 71:170-6. [DOI: 10.1016/j.jaad.2013.12.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 12/14/2013] [Accepted: 12/17/2013] [Indexed: 11/21/2022]
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92
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Purohit P, Al‐Obaid I, Al‐Oneizi E, Al‐Hindi O, Joseph L, Ahmad S, Khan Z. Breakthrough disseminated Saprochaete capitata infection in a child with acute myeloid leukaemia receiving caspofungin therapy. JMM Case Rep 2014. [DOI: 10.1099/jmmcr.0.001750] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | - Inam Al‐Obaid
- Unit of Microbiology, Al‐Sabah Hospital, Shuwaikh, Kuwait
| | | | - Osama Al‐Hindi
- Unit of Pediatric Intensive Care, Al‐Sabah Hospital, Shuwaikh, Kuwait
| | - Leena Joseph
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriyah, Kuwait
| | - Suhail Ahmad
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriyah, Kuwait
| | - Ziauddin Khan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriyah, Kuwait
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93
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Camus V, Thibault ML, David M, Gargala G, Compagnon P, Lamoureux F, Girault C, Michot JB, Stamatoullas A, Lanic H, Jardin F, Lenain P, Tilly H, Leprêtre S. Invasive Geotrichum clavatum fungal infection in an acute myeloid leukaemia patient: a case report and review. Mycopathologia 2014; 177:319-24. [PMID: 24748454 DOI: 10.1007/s11046-014-9746-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 04/08/2014] [Indexed: 10/25/2022]
Abstract
Invasive Geotrichum clavatum fungal infections are extremely rare and unusual, occurring nearly exclusively in patients experiencing prolonged neutropenia during the treatment for acute myeloid leukaemia. Several groups of cases of fatal G. clavatum infection were reported in France between 2011 and 2012, but the ecological niche has not yet been identified. We report a case of a 32-year-old patient with acute myeloid leukaemia who developed G. clavatum sepsis with primary peritonitis, hepatic nodular lesions, and multivisceral failure during aplasia after induction followed by salvage chemotherapy. He was treated with voriconazole and is still alive 1 year after with controlled disease. We then discuss the epidemiological, clinical, and therapeutic features of these serious fungal infections compared to the published data.
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Affiliation(s)
- Vincent Camus
- Department of Hematology, Centre Henri Becquerel, rue d'Amiens, 76038, Rouen, France
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94
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Arendrup M, Boekhout T, Akova M, Meis J, Cornely O, Lortholary O. ESCMID† and ECMM‡ joint clinical guidelines for the diagnosis and management of rare invasive yeast infections. Clin Microbiol Infect 2014; 20 Suppl 3:76-98. [DOI: 10.1111/1469-0691.12360] [Citation(s) in RCA: 350] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 08/16/2013] [Accepted: 08/16/2013] [Indexed: 12/27/2022]
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95
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de Almeida Júnior JN, Figueiredo DSY, Toubas D, Del Negro GMB, Motta AL, Rossi F, Guitard J, Morio F, Bailly E, Angoulvant A, Mazier D, Benard G, Hennequin C. Usefulness of matrix-assisted laser desorption ionisation-time-of-flight mass spectrometry for identifying clinical Trichosporon isolates. Clin Microbiol Infect 2014; 20:784-90. [PMID: 24355037 DOI: 10.1111/1469-0691.12502] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 11/12/2013] [Accepted: 12/10/2013] [Indexed: 11/27/2022]
Abstract
Trichosporon spp. have recently emerged as significant human pathogens. Identification of these species is important, both for epidemiological purposes and for therapeutic management, but conventional identification based on biochemical traits is hindered by the lack of updates to the species databases provided by the different commercial systems. In this study, 93 strains, or isolates, belonging to 16 Trichosporon species were subjected to both molecular identification using IGS1 gene sequencing and matrix-assisted laser desorption ionisation-time-of-flight (MALDI-TOF) analysis. Our results confirmed the limits of biochemical systems for identifying Trichosporon species, because only 27 (36%) of the isolates were correctly identified using them. Different protein extraction procedures were evaluated, revealing that incubation for 30 min with 70% formic acid yields the spectra with the highest scores. Among the six different reference spectra databases that were tested, a specific one composed of 18 reference strains plus seven clinical isolates allowed the correct identification of 67 of the 68 clinical isolates (98.5%). Although until recently it has been less widely applied to the basidiomycetous fungi, MALDI-TOF appears to be a valuable tool for identifying clinical Trichosporon isolates at the species level.
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Affiliation(s)
- J N de Almeida Júnior
- Central Laboratory Division-LIM03, Hospital das Clínicas da FMUSP, São Paulo, Brazil; INSERM, U945, Paris, France; Mycology Laboratory-LIM-53, Instituto de Medicina Tropical, FMUSP, São Paulo, Brazil
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96
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Almeida Júnior JN, Song ATW, Campos SV, Strabelli TMV, Del Negro GM, Figueiredo DSY, Motta AL, Rossi F, Guitard J, Benard G, Hennequin C. Invasive Trichosporon infection in solid organ transplant patients: a report of two cases identified using IGS1 ribosomal DNA sequencing and a review of the literature. Transpl Infect Dis 2014; 16:135-40. [PMID: 24383613 DOI: 10.1111/tid.12179] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 06/26/2013] [Accepted: 10/06/2013] [Indexed: 01/16/2023]
Abstract
Trichosporon species are rare etiologic agents of invasive fungal infection in solid organ transplant (SOT) recipients. We report 2 well-documented cases of Trichosporon inkin invasive infection in SOT patients. We also conducted a detailed literature review of Trichosporon species infections in this susceptible population. We gathered a total of 13 cases of Trichosporon species infections. Any type of organ transplantation can be complicated by Trichosporon infection. Bloodstream infections and disseminated infections were the most common clinical presentations. Liver recipients with bloodstream or disseminated infections had poor prognoses. Although the most common species was formerly called Trichosporon beigelii, this species name should no longer be used because of the changes in the taxonomy of this genus resulting from the advent of molecular approaches, which were also used to identify the strains isolated from our patients. Antifungal susceptibility testing highlights the possibility of multidrug resistance. Indeed, Trichosporon has to be considered in cases of breakthrough infection or treatment failure under echinocandins or amphotericin therapy. Voriconazole seems to be the best treatment option.
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Affiliation(s)
- J N Almeida Júnior
- Divisão de Laboratório Central - LIM03, Hospital das Clínicas da FMUSP, São Paulo, Brazil; INSERM, UMRS945, Paris, France
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97
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Taj-Aldeen SJ, Kolecka A, Boesten R, Alolaqi A, Almaslamani M, Chandra P, Meis JF, Boekhout T. Epidemiology of candidemia in Qatar, the Middle East: performance of MALDI-TOF MS for the identification of Candida species, species distribution, outcome, and susceptibility pattern. Infection 2013; 42:393-404. [PMID: 24352810 DOI: 10.1007/s15010-013-0570-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 12/02/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Bloodstream infections (BSIs) due to Candida spp. constitute the predominant group of hospital-based fungal infections worldwide. A retrospective study evaluated the performance of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for the identification of BSI Candida isolates. The epidemiology, risk factors, demographic features, species distribution, and clinical outcome associated with candidemia in patients admitted to a single tertiary-care hospital in Qatar, were analyzed. METHODS A single-center, retrospective analysis covering the period from January 1, 2004 to December 31, 2010 was performed. Molecular identification used sequence analysis of the D1/D2 domains of the large subunit ribosomal DNA (LSU rDNA) and the ITS1/2 regions of the rDNA. MALDI-TOF MS-based identification of all yeast isolates was performed with the ethanol/formic acid extraction protocol according to Bruker Daltonics (Bremen, Germany). The susceptibility profiles of 201 isolates to amphotericin B, itraconazole, fluconazole, voriconazole, anidulafungin, caspofungin, posaconazole, and isavuconazole were tested using CLSI standard broth microdilution method (M27-A3 and M27 S4) guidelines. Statistical analyses were performed with the statistical package SPSS 19.0. RESULTS A total of 187 patients with 201 episodes of candidemia were identified. Candida albicans was the most common species isolated (33.8 %; n = 68), whereas non-albicans Candida species represented 66.2 % (n = 133) of the episodes. The species distribution and outcome of candidemia showed a difference in the crude mortality between patients infected with C. albicans (n = 30; 45.5 %) and non-albicans Candida species. For example, C. parapsilosis candidemia was associated with the lowest mortality rate (40.6 %), and patients with other non-albicans species had the highest mortality rate (68-71.4 %). High mortality rates were observed among pediatric (<1 year of age) and elderly patients (>60 years of age). All strains showed low minimum inhibitory concentrations (MICs) (MIC90 of 0.063 μg/ml) to isavuconazole. The overall resistance to voriconazole in vitro antifungal activity was 2.5 %. C. glabrata (n = 38) had an MIC90 of 8 μg/ml for fluconazole. Most yeast isolates were susceptible to anidulafungin (>99.5 %) and 81.1 % to caspofungin. Resistance to anidulafungin was detected in 1/8 (12.5 %) isolates of C. orthopsilosis. According to new Clinical and Laboratory Standards Institute (CLSI) breakpoints, C. glabrata (n = 38) showed 100 % resistance, and 37/68 (54.4 %) C. albicans isolates were susceptible dose dependent (SDD) to caspofungin. Identification by MALDI-TOF MS was in 100 % concordance with molecular identification. CONCLUSION The Middle East epidemiology of candidemia has a unique species distribution pattern distinct from other parts of the globe. High mortality rates were observed among pediatric (<1 year of age) and elderly patients (>60 years of age). All strains were susceptible to isavuconazole. All isolates of C.glabrata were resistant to caspofungin based on M27 S4. MALDI-TOF MS is a highly useful method for the routine identification of yeast isolates in clinical setting to achieve successful therapeutic treatment.
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Affiliation(s)
- S J Taj-Aldeen
- Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar,
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98
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Deshpande A, Gaur S, Bal A. Candidaemia in the non-neutropenic patient: A critique of the guidelines. Int J Antimicrob Agents 2013; 42:294-300. [DOI: 10.1016/j.ijantimicag.2013.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 06/11/2013] [Indexed: 10/26/2022]
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99
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de Aguiar Cordeiro R, Pereira de Alencar L, Nogueira Brilhante RS, de Souza Collares Maia Castelo-Branco D, Cordeiro Teixeira CE, de Brito Macedo R, Teixeira Lima D, Paiva de Araújo Neto M, Jalles Monteiro A, Dutra Alves N, Franco de Oliveira M, Costa Sidrim JJ, Rocha Gadelha MF. Antifungal susceptibility of emerging opportunistic yeasts and yeast-like fungi from Rhea americana. Can J Microbiol 2013; 59:577-80. [PMID: 23899001 DOI: 10.1139/cjm-2013-0176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Opportunistic yeasts and yeast-like fungi have been recognized as important pathogens in high-risk patients. This study aimed to evaluate the presence of these microorganisms in the microbiota of captive rheas and to investigate the antifungal susceptibility of the isolated strains. Isolates representing Magnusiomyces capitatus (Geotrichum capitatum, n = 11), Trichosporon mucoides (n = 11), Trichosporon asteroides (n = 5), Rhodotorula mucilaginosa (n = 4), Trichosporon asahii (n = 3), Trichosporon cutaneum (n = 3), and Trichosporon ovoides (n = 3) were obtained from the oropharynx, cloaca, and feces of 58 animals. Most of the isolates were susceptible to antifungals in vitro; however, resistance against fluconazole (n = 1) and itraconazole (n = 2) was detected among T. mucoides. This study indicates that healthy rheas can be reservoirs of opportunistic pathogens. Primary resistance to azoles in T. mucoides obtained from these animals demonstrates the potential risk to humans.
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Affiliation(s)
- Rossana de Aguiar Cordeiro
- Department of Pathology and Legal Medicine, School of Medicine, Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 CEP: 60430-270 Fortaleza, CE, Brazil.
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Chan AW, Cartwright EJ, Reddy SC, Kraft CS, Wang YF. Pichia anomala (Candida pelliculosa) fungemia in a patient with sickle cell disease. Mycopathologia 2013; 176:273-7. [PMID: 23884540 DOI: 10.1007/s11046-013-9677-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 06/28/2013] [Indexed: 11/26/2022]
Abstract
This case report discusses a patient with sickle cell disease who presented with fungemia from Pichia anomala (teleomorph: Candida pelliculosa). The organism was identified as P. anomala by MALDI-TOF VITEK mass spectrometry and VITEK 2 yeast identification card. Pichia anomala should be considered in sickle cell patients with recurrent fungemia.
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Affiliation(s)
- Austin W Chan
- Department of Medicine, Emory University, Atlanta, GA, USA
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