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Benamu E, Yu ATH, Xie L, Fernandez-Pol S, Liu AY, Ho DY. Scedosporium apiospermum infection of the urinary system with a review of treatment options and cases in the literature. Transpl Infect Dis 2017; 20. [PMID: 29111602 DOI: 10.1111/tid.12804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 08/31/2017] [Accepted: 08/31/2017] [Indexed: 11/26/2022]
Abstract
Infection with Scedosporium species is associated with a significant morbidity and mortality and is becoming increasingly common, especially in immunocompromised patients. We describe the presentation and successful management of an immunocompromised patient with Scedosporium apiospermum infection of the upper urinary tract system, a rare disease manifestation. The current literature on urinary tract scedosporiosis is further reviewed with emphasis on treatment options and limitations of current antifungal therapy.
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Affiliation(s)
- Esther Benamu
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Alexander Tin-Han Yu
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Lijia Xie
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Anne Y Liu
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Dora Y Ho
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
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52
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Abela IA, Murer C, Schuurmans MM, Schmitt JW, Muller F, Imkamp F, Mueller NJ, Benden C. A cluster of scedosporiosis in lung transplant candidates and recipients: The Zurich experience and review of the literature. Transpl Infect Dis 2017; 20. [PMID: 29044831 DOI: 10.1111/tid.12792] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 06/25/2017] [Accepted: 06/26/2017] [Indexed: 12/19/2022]
Abstract
Scedosporium species are fungal pathogens increasingly recognized in cystic fibrosis (CF). They can cause multiresistant, life-threatening infections that are of particular concern in CF patients undergoing lung transplantation, as optimal treatment remains unclear. Here, we describe our Zurich experience of CF patients with Scedosporium infection. Disseminated infection occurred in one patient after transplantation and was successfully treated. We propose a step-by-step approach to treat candidates with colonization, and discuss our cases in the context of the current literature.
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Affiliation(s)
- Irene A Abela
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Christian Murer
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Macé M Schuurmans
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Juergen W Schmitt
- Division of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Frabci Muller
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Frank Imkamp
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Christian Benden
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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53
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Quaesaet L, Stindel E, Lanternier F, Williams T, Jaffuel S, Moalic E, Garcia Hermoso D, Lortholary O, Ansart S. Miltefosine-based regimen as salvage therapy in Lomentospora prolificans bone and joint infection. Med Mal Infect 2017; 48:63-65. [PMID: 29153288 DOI: 10.1016/j.medmal.2017.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/12/2017] [Accepted: 10/13/2017] [Indexed: 12/25/2022]
Affiliation(s)
- L Quaesaet
- Service des maladies infectieuses et tropicales, CHRU de Brest, 29609 Brest, France.
| | - E Stindel
- Service d'orthopédie, CHRU de Brest, 29609 Brest, France
| | - F Lanternier
- Service des maladies infectieuses et tropicales, hôpital Necker-Enfants-Malades, Institut Pasteur, IHU imagine, université Paris-Descartes, 75015 Paris, France; Unité de mycologie moléculaire, CNRS URA 3012, centre national de référence des mycoses invasives et antifongiques, Institut Pasteur, 75724 Paris, France
| | - T Williams
- Service d'orthopédie, CHRU de Brest, 29609 Brest, France
| | - S Jaffuel
- Service des maladies infectieuses et tropicales, CHRU de Brest, 29609 Brest, France
| | - E Moalic
- Laboratoire de parasitologie et mycologie, EA 3142 GEIHP, CHRU de Brest, 29609 Brest, France
| | - D Garcia Hermoso
- Unité de mycologie moléculaire, CNRS URA 3012, centre national de référence des mycoses invasives et antifongiques, Institut Pasteur, 75724 Paris, France
| | - O Lortholary
- Service des maladies infectieuses et tropicales, hôpital Necker-Enfants-Malades, Institut Pasteur, IHU imagine, université Paris-Descartes, 75015 Paris, France
| | - S Ansart
- Service des maladies infectieuses et tropicales, CHRU de Brest, 29609 Brest, France
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Repurposing antipsychotic drugs into antifungal agents: Synergistic combinations of azoles and bromperidol derivatives in the treatment of various fungal infections. Eur J Med Chem 2017; 139:12-21. [DOI: 10.1016/j.ejmech.2017.07.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/16/2017] [Accepted: 07/17/2017] [Indexed: 01/02/2023]
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Lu M, Yu C, Cui X, Shi J, Yuan L, Sun S. Gentamicin synergises with azoles against drug-resistant Candida albicans. Int J Antimicrob Agents 2017; 51:107-114. [PMID: 28943366 DOI: 10.1016/j.ijantimicag.2017.09.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 11/29/2022]
Abstract
Candida spp. are the primary opportunistic pathogens of nosocomial fungal infections, causing both superficial and life-threatening systemic infections. Combination therapy for fungal infections has attracted considerable attention, especially for those caused by drug-resistant fungi. Gentamicin (GM), an aminoglycoside antibiotic, has weak antifungal activity against Fusarium spp. The aim of this study was to investigate the interactions of GM with azoles against Candida spp. and the underlying mechanisms. In a chequerboard assay, GM was found not only to work synergistically with azoles against planktonic cells of drug-resistant Candida albicans with a fractional inhibitory concentration index (FICI) of 0.13-0.14, but also synergised with fluconazole (FLC) against C. albicans biofilms pre-formed in <12 h. Synergism of GM with FLC was also confirmed in vivo in a Galleria mellonella infection model. In addition, mechanism studies showed that GM not only suppressed the efflux pump of resistant C. albicans in a dose-dependent manner but also inhibited extracellular phospholipase activity of resistant C. albicans when combined with FLC. These findings suggest that GM enhances the efficacy of azoles against resistant C. albicans via efflux inhibition and decreased activity of extracellular phospholipase.
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Affiliation(s)
- Mengjiao Lu
- School of Pharmaceutical Sciences, Shandong University, Ji'nan 250012, Shandong Province, China
| | - Cuixiang Yu
- Respiration Medicine, Qianfoshan Hospital Affiliated to Shandong University, Ji'nan, Shandong Province, China
| | - Xueyan Cui
- Department of Pharmacy, Qianfoshan Hospital Affiliated to Shandong University, Ji'nan, 250014, Shandong Province, China
| | - Jinyi Shi
- Department of Pharmacy, Qianfoshan Hospital Affiliated to Shandong University, Ji'nan, 250014, Shandong Province, China
| | - Lei Yuan
- Department of Pharmacy, Baodi People's Hospital, Baodi 301800, Tianjin, China
| | - Shujuan Sun
- Department of Pharmacy, Qianfoshan Hospital Affiliated to Shandong University, Ji'nan, 250014, Shandong Province, China.
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56
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Sakata Y, Taga F, Ushigami T, Takeda K, Anzawa K, Nishibu A, Mochizuki T. A Case of Cutaneous Mycosis Caused by Scedosporium dehoogii on an Immunocompromised Patient. Mycopathologia 2017; 183:465-470. [PMID: 28864936 DOI: 10.1007/s11046-017-0198-5] [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: 07/01/2017] [Accepted: 08/23/2017] [Indexed: 01/26/2023]
Abstract
This report describes a 77-year-old man with cutaneous mycosis caused by Scedosporium dehoogii while taking oral betamethasone and tacrolimus for the treatment of rheumatoid arthritis. At examination in our clinic, the patient had multiple cystic lesions and nodules with slight tenderness, varying in size up to 4 cm, on his left knee and shin. He had not noticed any traumatic injury at the site of the lesions. Fungal cultures of samples taken from the abscesses, scales, and crusts of the lesions yielded white, later grayish brown, fluffy surfaced colonies. Partial sequencing of the β-tubulin gene confirmed the species of the isolate. The patient was initially treated with oral voriconazole and local hyperthermia, but experienced hepatic injury 2 weeks later. His treatment was changed to itraconazole (ITC) and local hyperthermia, followed by a combination of ITC and terbinafine. The patient recovered completely during the 12-month course of treatment.
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Affiliation(s)
- Yuichi Sakata
- Department of Dermatology, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa, 920-0293, Japan
| | - Fumiaki Taga
- Department of Dermatology, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa, 920-0293, Japan
| | - Tsuyoshi Ushigami
- Department of Dermatology, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa, 920-0293, Japan
| | - Kiminobu Takeda
- Department of Dermatology, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa, 920-0293, Japan
| | - Kazushi Anzawa
- Department of Dermatology, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa, 920-0293, Japan
| | - Akiko Nishibu
- Department of Dermatology, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa, 920-0293, Japan
| | - Takashi Mochizuki
- Department of Dermatology, Kanazawa Medical University, Daigaku 1-1, Uchinada, Ishikawa, 920-0293, Japan.
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57
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Progress in Definition, Prevention and Treatment of Fungal Infections in Cystic Fibrosis. Mycopathologia 2017; 183:21-32. [DOI: 10.1007/s11046-017-0182-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 07/19/2017] [Indexed: 12/21/2022]
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58
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Pellon A, Ramirez-Garcia A, Buldain I, Antoran A, Martin-Souto L, Rementeria A, Hernando FL. Pathobiology of Lomentospora prolificans: could this species serve as a model of primary antifungal resistance? Int J Antimicrob Agents 2017; 51:10-15. [PMID: 28669833 DOI: 10.1016/j.ijantimicag.2017.06.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 06/06/2017] [Accepted: 06/17/2017] [Indexed: 01/13/2023]
Abstract
The number of fungal isolates resistant to antifungal drugs has increased dramatically over the last few years and has become an important concern for clinicians. Among these isolates, fungi showing multidrug resistance are particularly worrying because of the difficulties associated with their treatment. These factors hamper the successful recovery of patients and drastically raise mortality rates. Antifungal resistance is multifactorial and several mechanisms in different fungi have been described. There is a need to study these mechanisms in depth; however, the study of antifungal drug resistance separately for each individual species makes progress in the field very slow and tedious. The selection of a multiresistant microorganism as a model for understanding resistance mechanisms and extrapolating the results to other species could help in the search for a solution. In this mini-review, we describe the pathobiology of Lomentospora (Scedosporium) prolificans, paying special attention to its intrinsic resistance to all currently available antifungal agents. The characteristics of L. prolificans offer several advantages: the possibility of using a single microorganism for the study of resistance to different drugs, even cases of double and triple resistance; it is biologically safe for society in general as no new genetically-modified strains are needed for the experiments; it is homologous with other fungal species, and there is repetitiveness between different strains. In conclusion, we propose L. prolificans as a candidate for consideration as a fungal model for the study of resistance mechanisms against antifungal agents.
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Affiliation(s)
- Aize Pellon
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
| | - Andoni Ramirez-Garcia
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain.
| | - Idoia Buldain
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
| | - Aitziber Antoran
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
| | - Leire Martin-Souto
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
| | - Aitor Rementeria
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
| | - Fernando L Hernando
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
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Abstract
Immunocompromised patients are at high risk for invasive fungal infections (IFIs); although Aspergillus remains the most common IFI caused by molds, other fungi, such as Mucorales, dematiaceous molds, and Fusarium spp, are being seen with increasing frequency. Presentations can vary, but sinopulmonary and disseminated infections are common. Our understanding of the pathogenesis of these infections is rudimentary. Fungal cultures and histopathology remain the backbone of diagnostics, as no good serologic markers are available. Polymerase chain reaction tests are being developed but currently remain investigational. Management of these infections is usually multidisciplinary, requiring surgical debridement along with antifungal therapy.
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60
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Xia J, Qian F, Xu W, Zhang Z, Wei X. In vitro inhibitory effects of farnesol and interactions between farnesol and antifungals against biofilms of Candida albicans resistant strains. BIOFOULING 2017; 33:283-293. [PMID: 28317391 DOI: 10.1080/08927014.2017.1295304] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/08/2017] [Indexed: 06/06/2023]
Abstract
Antifungal resistance is a serious problem in clinical infections. Farnesol, which is a potential antifungal agent against biofilms formed by Candida albicans resistant strains (a fluconazole-resistant isolate derived from SC5314 and two clinical Candida resistant isolates), was investigated in this study. The inhibitory effects of farnesol on biofilms were examined by XTT assay. The morphological changes and biofilm thicknesses were analyzed by scanning electron microscopy and confocal laser scanning microscopy, respectively. Additionally, the checkerboard microdilution method was used to investigate the interactions between farnesol and antifungals (fluconazole, amphotericin B, caspofungin, itraconazole, terbinafine and 5-flurocytosine) against biofilms. The results showed decreased SMICs of farnesol and thinner biofilms in the farnesol-treated groups, indicating that farnesol inhibited the development of biofilms formed by the resistant strain. Furthermore, there were synergistic effects between farnesol and fluconazole/5-flurocytosine, while there were antagonistic effects between farnesol and terbinafine/itraconazole, respectively, on the biofilms formed by the resistant strains.
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Affiliation(s)
- Jinping Xia
- a Jiangsu Key Laboratory of Oral Diseases , School of Stomatology, Nanjing Medical University , Nanjing , PR China
| | - Fang Qian
- a Jiangsu Key Laboratory of Oral Diseases , School of Stomatology, Nanjing Medical University , Nanjing , PR China
| | - Wenqian Xu
- a Jiangsu Key Laboratory of Oral Diseases , School of Stomatology, Nanjing Medical University , Nanjing , PR China
| | - Zhenzhen Zhang
- a Jiangsu Key Laboratory of Oral Diseases , School of Stomatology, Nanjing Medical University , Nanjing , PR China
| | - Xin Wei
- a Jiangsu Key Laboratory of Oral Diseases , School of Stomatology, Nanjing Medical University , Nanjing , PR China
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61
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Pellon A, Ramirez-Garcia A, Buldain I, Antoran A, Rementeria A, Hernando FL. Molecular and cellular responses of the pathogenic fungus Lomentospora prolificans to the antifungal drug voriconazole. PLoS One 2017; 12:e0174885. [PMID: 28362854 PMCID: PMC5376303 DOI: 10.1371/journal.pone.0174885] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/16/2017] [Indexed: 11/18/2022] Open
Abstract
The filamentous fungus Lomentospora (Scedosporium) prolificans is an emerging opportunistic pathogen associated with fatal infections in patients with disturbed immune function. Unfortunately, conventional therapies are hardly of any use against this fungus due to its intrinsic resistance. Therefore, we performed an integrated study of the L. prolificans responses to the first option to treat these mycoses, namely voriconazole, with the aim of unveiling mechanisms involved in the resistance to this compound. To do that, we used a wide range of techniques, including fluorescence and electron microscopy to study morphological alterations, ion chromatography to measure changes in cell-wall carbohydrate composition, and proteomics-based techniques to identify the proteins differentially expressed under the presence of the drug. Significantly, we showed drastic changes occurring in cell shape after voriconazole exposure, L. prolificans hyphae being shorter and wider than under control conditions. Interestingly, we proved that the architecture and carbohydrate composition of the cell wall had been modified in the presence of the drug. Specifically, L. prolificans constructed a more complex organelle with a higher presence of glucans and mannans. In addition to this, we identified several differentially expressed proteins, including Srp1 and heat shock protein 70 (Hsp70), as the most overexpressed under voriconazole-induced stress conditions. The mechanisms described in this study, which may be directly related to L. prolificans antifungal resistance or tolerance, could be used as targets to improve existing therapies or to develop new ones in order to successfully eliminate these mycoses.
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Affiliation(s)
- Aize Pellon
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Andoni Ramirez-Garcia
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
- * E-mail:
| | - Idoia Buldain
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Aitziber Antoran
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Aitor Rementeria
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Fernando L. Hernando
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
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62
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Screening the Pathogen Box for Identification of Candida albicans Biofilm Inhibitors. Antimicrob Agents Chemother 2016; 61:AAC.02006-16. [PMID: 27795383 DOI: 10.1128/aac.02006-16] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 10/19/2016] [Indexed: 11/20/2022] Open
Abstract
Candida albicans remains the main causative agent of candidiasis, one of the most frequent nosocomial infections, with unacceptably high mortality rates. Biofilm formation is a major risk factor for invasive candidiasis, as Candida biofilms display high-level resistance to most antifungal agents. In this work we have screened the Pathogen Box chemical library (Medicines for Malaria Venture [MMV], Switzerland) in search for inhibitors of C. albicans biofilm formation. Our initial screen identified seven hits, and additional dose-response assays confirmed the biofilm-inhibitory activity of six of these small molecules. Three compounds, MMV688768, MMV687273, and MMV687807, were also able to reduce the metabolic activity of cells within preformed biofilms. Interestingly, the most potent of these, compound MMV688768, displayed increased antibiofilm activity compared to its activity against planktonic cultures, indicating that it may affect processes with a predominant role during the biofilm mode of growth. This compound demonstrated a high selectivity index when its antibiofilm activity was compared with its toxicity in liver hepatocellular cells. In vitro combination assays showed a synergistic interaction between compound MMV688768 and fluconazole against preformed biofilms. Overall, our results indicate that this compound may constitute a potential candidate for further clinical development.
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63
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Abstract
Dematiaceous fungi are the cause of phaeohyphomycosis, a term that encompasses many clinical syndromes, from local infections due to trauma to widely disseminated infection in immunocompromised patients. These fungi are unique owing to the presence of melanin in their cell walls, which imparts the characteristic dark color to their spores and hyphae. Melanin may also be a virulence factor. Local infection may be cured with excision alone, whereas systemic disease is often refractory to therapy. Azoles have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and treatment of these uncommon infections.
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Affiliation(s)
- Eunice H Wong
- Division of Infectious Diseases, Harper University Hospital, Wayne State University, 3990 John R., 5 Hudson, Detroit, MI 48201, USA
| | - Sanjay G Revankar
- Division of Infectious Diseases, Harper University Hospital, Wayne State University, 3990 John R., 5 Hudson, Detroit, MI 48201, USA.
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64
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Meletiadis J, Leth Mortensen K, Verweij PE, Mouton JW, Arendrup MC. Spectrophotometric reading of EUCAST antifungal susceptibility testing of Aspergillus fumigatus. Clin Microbiol Infect 2016; 23:98-103. [PMID: 27793736 DOI: 10.1016/j.cmi.2016.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Given the increasing number of antifungal drugs and the emergence of resistant Aspergillus isolates, objective, automated and high-throughput antifungal susceptibility testing is important. The EUCAST E.Def 9.3 reference method for MIC determination of Aspergillus species relies on visual reading. Spectrophotometric reading was not adopted because of concern that non-uniform filamentous growth might lead to unreliable and non-reproducible results. We therefore evaluated spectrophotometric reading for the determination of MICs of antifungal azoles against Aspergillus fumigatus. METHODS Eighty-eight clinical isolates of A. fumigatus were tested against four medical azoles (posaconazole, voriconazole, itraconazole, isavuconazole) and one agricultural azole (tebuconazole) with EUCAST E.Def 9.3. The visually determined MICs (complete inhibition of growth) were compared with spectrophotometrically determined MICs and essential (±1 twofold dilution) and categorical (susceptible/intermediate/resistant or wild-type/non-wild-type) agreement was calculated. Spectrophotometric data were analysed with regression analysis using the Emax model, and the effective concentration corresponding to 5% (EC5) was estimated. RESULTS Using the 5% cut-off, high essential (92%-97%) and categorical (93%-99%) agreement (<6% errors) was found between spectrophotometric and visual MICs. The EC5 also correlated with the visually determined MICs with an essential agreement of 83%-96% and a categorical agreement of 90%-100% (<5% errors). CONCLUSIONS Spectrophotometric determination of MICs of antifungal drugs may increase objectivity, and allow automation and high-throughput of EUCAST E.Def 9.3 antifungal susceptibility testing of Aspergillus species.
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Affiliation(s)
- J Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, National and Kapodistrian University of Athens, Greece; Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center Rotterdam, Netherlands.
| | - K Leth Mortensen
- Unit of Mycology, Department Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark; Department of Clinical Microbiology, Copenhagen University, Rigshospitalet, Copenhagen, Denmark
| | - P E Verweij
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands; Centre of Expertise in Mycology, Radboudumc/CWZ, Nijmegen, The Netherlands
| | - J W Mouton
- Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center Rotterdam, Netherlands
| | - M C Arendrup
- Unit of Mycology, Department Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark; Department of Clinical Microbiology, Copenhagen University, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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65
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Bugli F, Palmieri V, Torelli R, Papi M, De Spirito M, Cacaci M, Galgano S, Masucci L, Paroni Sterbini F, Vella A, Graffeo R, Posteraro B, Sanguinetti M. In vitro effect of clarithromycin and alginate lyase against helicobacter pylori biofilm. Biotechnol Prog 2016; 32:1584-1591. [PMID: 27535356 DOI: 10.1002/btpr.2339] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/05/2016] [Indexed: 12/31/2022]
Abstract
It is now established that the gastric pathogen Helicobacter pylori has the ability to form biofilms in vitro as well as on the human gastric mucosa. The aim of this study is to evaluate the antimicrobial effects of Clarithromycin on H. pylori biofilm and to enhance the effects of this antibiotic by combining it with Alginate Lyase, an enzyme degrading the polysaccharides present in the extracellular polymeric matrix forming the biofilm. We evaluated the Clarithromycin minimum inhibition concentration (MIC) on in vitro preformed biofilm of a H. pylori. Then the synergic effect of Clarithromycin and Alginate Lyase treatment has been quantified by using the Fractional Inhibitory Concentration index, measured by checkerboard microdilution assay. To clarify the mechanisms behind the effectiveness of this antibiofilm therapeutic combination, we used Atomic Force Microscopy to analyze modifications of bacterial morphology, percentage of bacillary or coccoid shaped bacteria cells and to quantify biofilm properties. © 2016 American Institute of Chemical Engineers Biotechnol. Prog., 32:1584-1591, 2016.
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Affiliation(s)
- F Bugli
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - V Palmieri
- Istituto di Fisica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - R Torelli
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - M Papi
- Istituto di Fisica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - M De Spirito
- Istituto di Fisica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - M Cacaci
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - S Galgano
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - L Masucci
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - F Paroni Sterbini
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - A Vella
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - R Graffeo
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - B Posteraro
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
| | - M Sanguinetti
- Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, 00168, Italy
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Tamaki M, Nozaki K, Onishi M, Yamamoto K, Ujiie H, Sugahara H. Fungal meningitis caused byLomentospora prolificansafter allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2016; 18:601-5. [DOI: 10.1111/tid.12563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/22/2015] [Accepted: 03/16/2016] [Indexed: 11/30/2022]
Affiliation(s)
- M. Tamaki
- Department of Hematology; Sumitomo Hospital; Osaka Japan
| | - K. Nozaki
- Department of Hematology; Sumitomo Hospital; Osaka Japan
| | - M. Onishi
- Department of Hematology; Sumitomo Hospital; Osaka Japan
| | - K. Yamamoto
- Department of Hematology; Sumitomo Hospital; Osaka Japan
| | - H. Ujiie
- Department of Hematology; Sumitomo Hospital; Osaka Japan
| | - H. Sugahara
- Department of Hematology; Sumitomo Hospital; Osaka Japan
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67
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Williams JR, Tenforde MW, Chan JD, Ko A, Graham SM. Safety and clinical response of intraventricular caspofungin for Scedosporium apiospermum complex central nervous system infection. Med Mycol Case Rep 2016; 13:1-4. [PMID: 27656356 PMCID: PMC5021765 DOI: 10.1016/j.mmcr.2016.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 06/25/2016] [Accepted: 07/08/2016] [Indexed: 11/23/2022] Open
Abstract
We present a 71-year old woman treated with 14 days of 5 mg intraventricular caspofungin for Scedosporium apiospermum complex meningoencephalitis diagnosed after spinal fusion and instrumentation. Cerebrospinal fluid studies improved during therapy and intraventricular administration was well tolerated. Within weeks of discontinuation, the patient experienced clinical deterioration with disease progression. There are sparse data on the efficacy and safety of administering intraventricular caspofungin. While apparently safe, intraventricular caspofungin was insufficient for disease control in this case.
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Affiliation(s)
- John R Williams
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Mark W Tenforde
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Jeannie D Chan
- Department of Pharmacy, Harborview Medical Center, Seattle, WA, USA
| | - Andrew Ko
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Susan M Graham
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA; Department of Global Health, University of Washington School of Medicine, Seattle, WA, USA; Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
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68
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Stefanovic A, Wright A, Tang V, Hoang L. Positive blood cultures in a patient recovering from febrile neutropenia. JMM Case Rep 2016; 3:e005038. [PMID: 28348759 PMCID: PMC5330227 DOI: 10.1099/jmmcr.0.005038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/14/2016] [Accepted: 04/16/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Aleksandra Stefanovic
- Division of Medical Microbiology, Department of Pathology and Laboratory Medicine, Vancouver General Hospital , Vancouver, BC , Canada
| | - Alissa Wright
- Division of Infectious Diseases, Department of Internal Medicine, Vancouver General Hospital , Vancouver, BC , Canada
| | - Vincent Tang
- BC Public Health Microbiology and Reference Laboratory , Vancouver, BC , Canada
| | - Linda Hoang
- BC Public Health Microbiology and Reference Laboratory , Vancouver, BC , Canada
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69
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Yang S, Liao Y, Cong L, Lu X, Yang R. In Vitro Interactions between Non-Steroidal Anti-Inflammatory Drugs and Antifungal Agents against Planktonic and Biofilm Forms of Trichosporon asahii. PLoS One 2016; 11:e0157047. [PMID: 27275608 PMCID: PMC4898695 DOI: 10.1371/journal.pone.0157047] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 05/24/2016] [Indexed: 11/29/2022] Open
Abstract
Increasing drug resistance has brought enormous challenges to the management of Trichosporon spp. infections. The in vitro antifungal activities of non-steroidal anti-inflammatory drugs (NSAIDs) against Candida spp. and Cryptococcus spp. were recently discovered. In the present study, the in vitro interactions between three NSAIDs (aspirin, ibuprofen and diclofenac sodium) and commonly used antifungal agents (fluconazole, itraconazole, voriconazole, caspofungin and amphotericin B) against planktonic and biofilm cells of T. asahii were evaluated using the checkerboard microdilution method. The spectrophotometric method and the XTT reduction assay were used to generate data on biofilm cells. The fractional inhibitory concentration index (FICI) and the ΔE model were compared to interpret drug interactions. Using the FICI, the highest percentages of synergistic effects against planktonic cells (86.67%) and biofilm cells (73.33%) were found for amphotericin B/ibuprofen, and caspofungin/ibuprofen showed appreciable percentages (73.33% for planktonic form and 60.00% for biofilm) as well. We did not observe antagonism. The ΔE model gave consistent results with FICI (86.67%). Our findings suggest that amphotericin B/ibuprofen and caspofungin/ibuprofen combinations have potential effects against T. asahii. Further in vivo and animal studies to investigate associated mechanisms need to be conducted.
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Affiliation(s)
- Suteng Yang
- Department of Dermatology, General Hospital of Beijing Military Command, Beijing, China
- The Clinical Medical College in the Beijing Military Region, Second Military Medical University of People’s Liberation Army, Shanghai, China
| | - Yong Liao
- Department of Dermatology, General Hospital of Beijing Military Command, Beijing, China
- The Clinical Medical College in the Beijing Military Region, Second Military Medical University of People’s Liberation Army, Shanghai, China
| | - Lin Cong
- Department of Dermatology, General Hospital of Beijing Military Command, Beijing, China
| | - Xuelian Lu
- Department of Dermatology, General Hospital of Beijing Military Command, Beijing, China
| | - Rongya Yang
- Department of Dermatology, General Hospital of Beijing Military Command, Beijing, China
- * E-mail:
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Reichert-Lima F, Busso-Lopes AF, Lyra L, Peron IH, Taguchi H, Mikami Y, Kamei K, Moretti ML, Schreiber AZ. Evaluation of antifungal combination againstCryptococcusspp. Mycoses 2016; 59:585-93. [DOI: 10.1111/myc.12510] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/03/2016] [Accepted: 04/04/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Franqueline Reichert-Lima
- Clinical Pathology Department; Faculty of Medical Sciences; State University of Campinas; Campinas Sao Paulo Brazil
| | - Ariane F. Busso-Lopes
- Internal Medicine Department; Faculty of Medical Sciences; State University of Campinas; Campinas Sao Paulo Brazil
| | - Luzia Lyra
- Clinical Pathology Department; Faculty of Medical Sciences; State University of Campinas; Campinas Sao Paulo Brazil
| | - Isabela Haddad Peron
- Clinical Pathology Department; Faculty of Medical Sciences; State University of Campinas; Campinas Sao Paulo Brazil
| | - Hideaki Taguchi
- Medical Mycology Research Center; Chiba University; Chiba Japan
| | - Yuzuru Mikami
- Medical Mycology Research Center; Chiba University; Chiba Japan
| | - Katsuiko Kamei
- Medical Mycology Research Center; Chiba University; Chiba Japan
| | - Maria Luiza Moretti
- Internal Medicine Department; Faculty of Medical Sciences; State University of Campinas; Campinas Sao Paulo Brazil
| | - Angelica Z. Schreiber
- Clinical Pathology Department; Faculty of Medical Sciences; State University of Campinas; Campinas Sao Paulo Brazil
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71
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Chen TC, Ho MW, Chien WC, Lin HH. Disseminated Scedosporium apiospermum infection in a near-drowning patient. J Formos Med Assoc 2016; 115:213-4. [DOI: 10.1016/j.jfma.2015.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/03/2015] [Accepted: 02/16/2015] [Indexed: 02/05/2023] Open
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Jover-Saénz A, Altermir-Martínez V, Barcenilla-Gaite F, Garrido-Calvo S. Artritis infecciosa con osteomielitis debida a Scedosporium prolificans en un paciente inmunocompetente. Med Clin (Barc) 2016; 146:e15-6. [DOI: 10.1016/j.medcli.2015.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 08/03/2015] [Accepted: 09/03/2015] [Indexed: 11/29/2022]
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Wakabayashi Y, Okugawa S, Tatsuno K, Ikeda M, Misawa Y, Koyano S, Tsuji E, Yanagimoto S, Hatakeyama S, Moriya K, Yotsuyanagi H. Scedosporium prolificans Endocarditis: Case Report and Literature Review. Intern Med 2016; 55:79-82. [PMID: 26726091 DOI: 10.2169/internalmedicine.55.5592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Scedosporium prolificans, a hyaline filamentous fungus, is widely distributed in the environment and is currently an emerging human pathogen, especially among immunocompromised patients. However, S. prolificans endocarditis is rare. We herein report a case of S. prolificans endocarditis in a 64-year-old patient with breast cancer in complete remission for 30 years after chemotherapy and radiation treatment who was not cured. Susceptibility testing showed resistance to all antifungal drugs, except echinocandin. A review of the literature revealed 10 cases of S. prolificans endocarditis; of these, only one involved an immunocompetent host with no risk factors and only two patients survived. In order to improve the mortality rate, it is necessary to establish rapid diagnostic methods and efficient therapeutic approaches.
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74
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Fosso MY, Shrestha SK, Green KD, Garneau-Tsodikova S. Synthesis and Bioactivities of Kanamycin B-Derived Cationic Amphiphiles. J Med Chem 2015; 58:9124-32. [PMID: 26592740 DOI: 10.1021/acs.jmedchem.5b01375] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cationic amphiphiles derived from aminoglycosides (AGs) have been shown to exhibit enhanced antimicrobial activity. Through the attachment of hydrophobic residues such as linear alkyl chains on the AG backbone, interesting antibacterial and antifungal agents with a novel mechanism of action have been developed. Herein, we report the design and synthesis of seven kanamycin B (KANB) derivatives. Their antibacterial and antifungal activities, along with resistance/enzymatic, hemolytic, and cytotoxicity assays were also studied. Two of these compounds, with a C12 and C14 aliphatic chain attached at the 6″-position of KANB through a thioether linkage, exhibited good antibacterial and antifungal activity, were poorer substrates than KANB for several AG-modifying enzymes, and could delay the development of resistance in bacteria and fungi. Also, they were both relatively less hemolytic than the known membrane targeting antibiotic gramicidin and the known antifungal agent amphotericin B and were not toxic at their antifungal MIC values. Their oxidation to sulfones was also demonstrated to have no effect on their activities. Moreover, they both acted synergistically with posaconazole, an azole currently used in the treatment of human fungal infections.
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Affiliation(s)
- Marina Y Fosso
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky , 789 South Limestone Street, Lexington, Kentucky 40536-0596, United States
| | - Sanjib K Shrestha
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky , 789 South Limestone Street, Lexington, Kentucky 40536-0596, United States
| | - Keith D Green
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky , 789 South Limestone Street, Lexington, Kentucky 40536-0596, United States
| | - Sylvie Garneau-Tsodikova
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky , 789 South Limestone Street, Lexington, Kentucky 40536-0596, United States
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75
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Shrestha SK, Fosso MY, Garneau-Tsodikova S. A combination approach to treating fungal infections. Sci Rep 2015; 5:17070. [PMID: 26594050 PMCID: PMC4655404 DOI: 10.1038/srep17070] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/23/2015] [Indexed: 12/11/2022] Open
Abstract
Azoles are antifungal drugs used to treat fungal infections such as candidiasis in humans. Their extensive use has led to the emergence of drug resistance, complicating antifungal therapy for yeast infections in critically ill patients. Combination therapy has become popular in clinical practice as a potential strategy to fight resistant fungal isolates. Recently, amphiphilic tobramycin analogues, C12 and C14, were shown to display antifungal activities. Herein, the antifungal synergy of C12 and C14 with four azoles, fluconazole (FLC), itraconazole (ITC), posaconazole (POS), and voriconazole (VOR), was examined against seven Candida albicans strains. All tested strains were synergistically inhibited by C12 when combined with azoles, with the exception of C. albicans 64124 and MYA-2876 by FLC and VOR. Likewise, when combined with POS and ITC, C14 exhibited synergistic growth inhibition of all C. albicans strains, except C. albicans MYA-2876 by ITC. The combinations of FLC-C14 and VOR-C14 showed synergistic antifungal effect against three C. albicans and four C. albicans strains, respectively. Finally, synergism between C12/C14 and POS were confirmed by time-kill and disk diffusion assays. These results suggest the possibility of combining C12 or C14 with azoles to treat invasive fungal infections at lower administration doses or with a higher efficiency.
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Affiliation(s)
- Sanjib K Shrestha
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY, 40536-0596, USA
| | - Marina Y Fosso
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY, 40536-0596, USA
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Mora-Navarro C, Caraballo-León J, Torres-Lugo M, Ortiz-Bermúdez P. Synthetic antimicrobial β-peptide in dual-treatment with fluconazole or ketoconazole enhances the in vitro inhibition of planktonic and biofilm Candida albicans. J Pept Sci 2015; 21:853-61. [PMID: 26470850 DOI: 10.1002/psc.2827] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 09/05/2015] [Accepted: 09/09/2015] [Indexed: 11/06/2022]
Abstract
Fungal infections are a pressing concern for human health worldwide, particularly for immunocompromised individuals. Current challenges such as the elevated toxicity of common antifungal drugs and the emerging resistance towards these could be overcome by multidrug therapy. Natural antimicrobial peptides, AMPs, in combination with other antifungal agents are a promising avenue to address the prevailing challenges. However, they possess limited biostability and susceptibility to proteases, which has significantly hampered their development as antifungal therapies. β-peptides are synthetic materials designed to mimic AMPs while allowing high tunability and increased biostability. In this work, we report for the first time the inhibition achieved in Candida albicans when treated with a mixture of a β-peptide model and fluconazole or ketoconazole. This combination treatment enhanced the biological activity of these azoles in planktonic and biofilm Candida, and also in a fluconazole-resistant strain. Furthermore, the in vitro cytotoxicity of the dual treatment was evaluated towards the human hepatoma cell line, HepG2, a widely used model derived from liver tissue, which is primarily affected by azoles. Analyses based on the LA-based method and the mass-action law principle, using a microtiter checkerboard approach, revealed synergism of the combination treatment in the inhibition of planktonic C. albicans. The dual treatment proved to be fungicidal at 48 and 72 h. Interestingly, it was also found that the viability of HepG2 was not significantly affected by the dual treatments. Finally, a remarkable enhancement in the inhibition of the highly azole-resistant biofilms and fluconazole resistant C. albicans strain was obtained.
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Affiliation(s)
- Camilo Mora-Navarro
- Department of Chemical Engineering, University of Puerto Rico, Mayagüez Campus, Mayagüez, 00680, Puerto Rico
| | - Jean Caraballo-León
- Department of Chemical Engineering, University of Puerto Rico, Mayagüez Campus, Mayagüez, 00680, Puerto Rico
| | - Madeline Torres-Lugo
- Department of Chemical Engineering, University of Puerto Rico, Mayagüez Campus, Mayagüez, 00680, Puerto Rico
| | - Patricia Ortiz-Bermúdez
- Department of Chemical Engineering, University of Puerto Rico, Mayagüez Campus, Mayagüez, 00680, Puerto Rico
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77
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Blyth CC, Gilroy NM, Guy SD, Chambers ST, Cheong EY, Gottlieb T, McGuinness SL, Thursky KA. Consensus guidelines for the treatment of invasive mould infections in haematological malignancy and haemopoietic stem cell transplantation, 2014. Intern Med J 2015; 44:1333-49. [PMID: 25482744 DOI: 10.1111/imj.12598] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mould species represent the pathogens most commonly associated with invasive fungal disease in patients with haematological malignancies and patients of haemopoietic stem cell transplants. Invasive mould infections in these patient populations, particularly in the setting of neutropenia, are associated with high morbidity and mortality, and significantly increase the complexity of management. While Aspergillus species remain the most prevalent cause of invasive mould infections, Scedosporium and Fusarium species and the Mucormycetes continue to place a significant burden on the immunocompromised host. Evidence also suggests that infections caused by rare and emerging pathogens are increasing within the setting of broad-spectrum antifungal prophylaxis and improved survival times placing immunosuppressed patients at risk for longer. These guidelines present evidence-based recommendations for the antifungal management of common, rare and emerging mould infections in both adult and paediatric populations. Where relevant, the role of surgery, adjunctive therapy and immunotherapy is also discussed.
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Affiliation(s)
- C C Blyth
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia; Department of General Paediatrics, Princess Margaret Hospital for Children, Subiaco, Western Australia; PathWest Laboratory Medicine WA, Subiaco, Western Australia; Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia
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78
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Shrestha SK, Grilley M, Anderson T, Dhiman C, Oblad J, Chang CWT, Sorensen KN, Takemoto JY. In vitro antifungal synergy between amphiphilic aminoglycoside K20 and azoles against Candida species and Cryptococcus neoformans. Med Mycol 2015; 53:837-44. [PMID: 26260746 DOI: 10.1093/mmy/myv063] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 06/11/2015] [Indexed: 11/13/2022] Open
Abstract
Several azoles are widely used to treat human fungal infections. Increasing resistance to these azoles has prompted exploration of their synergistic antifungal activities when combined with other agents. The amphiphilic aminoglycoside, K20, was recently shown to inhibit filamentous fungi, yeasts and heterokonts, but not bacteria. In this study, in vitro synergistic growth inhibition by combinations of K20 and azoles (fluconazole, itraconazole, voriconazole, clotrimazole, or posaconazole) were examined against Candida species and Cryptococcus neoformans. Checkerboard microbroth dilution, time-kill curve, and disk diffusion assays revealed that K20 has synergistic inhibitory activities with all five azoles against C. albicans including azole-resistant C. albicans strains ATCC 64124 and ATCC 10231. Four (fluconazole, itraconazole, clotrimazole, posaconazole) and three (fluconazole, itraconazole, voriconazole) azoles were synergistically inhibitory with K20 against C. lusitaniae and C. tropicalis, respectively. Only posaconazole showed synergy with K20 against two Cryptococcus neoformans strains (90-26 and VR-54). Time-kill curves with azole-resistant C. albicans 64124 and azole-sensitive C. albicans MYA-2876 confirmed the K20-azole synergistic interactions with a ≥ 2 log10 decrease in colony-forming units (CFU)/ml compared with the corresponding azoles alone. These results suggest that combinations of K20 and azoles offer a possible strategy for developing therapies against candidiasis.
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Affiliation(s)
- Sanjib K Shrestha
- Department of Biology, Utah State University, Logan, Utah, USA Synthetic Bioproducts Center, Utah State University, North Logan, Utah, USA
| | | | - Thomas Anderson
- Department of Biology, Utah State University, Logan, Utah, USA
| | | | - John Oblad
- Synthetic Bioproducts Center, Utah State University, North Logan, Utah, USA
| | - Cheng-Wei T Chang
- Synthetic Bioproducts Center, Utah State University, North Logan, Utah, USA Department of Chemistry and Biochemistry, Utah State University, Logan, Utah, USA
| | | | - Jon Y Takemoto
- Department of Biology, Utah State University, Logan, Utah, USA Synthetic Bioproducts Center, Utah State University, North Logan, Utah, USA
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79
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Calzetta L, Cazzola M, Page CP, Rogliani P, Facciolo F, Matera MG. Pharmacological characterization of the interaction between the dual phosphodiesterase (PDE) 3/4 inhibitor RPL554 and glycopyrronium on human isolated bronchi and small airways. Pulm Pharmacol Ther 2015; 32:15-23. [PMID: 25899618 DOI: 10.1016/j.pupt.2015.03.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/02/2015] [Accepted: 03/03/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The dual PDE3/4 inhibitor RPL 554 causes bronchodilation in patients with asthma or COPD and synergistically interacts with muscarinic receptor antagonists in relaxing human isolated bronchi in acute experimental settings. In the present study we investigated the long-lasting interaction between RPL554 and glycopyrronium by testing these drugs for their ability to relax both medium and small human isolated bronchi. METHODS The relaxant effect and duration of action of RPL554 and glycopyrronium, alone, or in combination, were studied on the contractile tone induced by electrical field stimulation (EFS) or carbachol in medium and small human isolated bronchi. Relaxation was expressed as percentage of maximal response and synergy analyzed by Bliss Independence theory. RESULTS Low concentrations of RPL554 and glycopyrronium induced maximal relaxation of medium bronchi at 160 ± 20 min and 50 ± 10 min, respectively, an effect detectable for at least 4 h. Maximal synergy was observed at ≃ 2 hrs (-71.4 ± 5.1%), and the combination extended the relaxation to at least 6 hrs, when the contractile tone was -41.2 ± 8.5% of the control responses. The combination induced the greatest effectiveness for EFS at 3 Hz and low-to-middle concentrations also produced significant synergism on small airways (21.1 ± 4.0%,P < 0.05), compared with the additive response. The combination induced lumen area enhancement of 69.1 ± 2.4% (P < 0.05), compared with the additive response (51.0 ± 5.4%). CONCLUSIONS RPL554 and glycopyrronium demonstrated a synergistic interaction in relaxing both human medium and small isolated bronchi, in terms of peak relaxation and an extended duration of action, suggesting that this combination may have a beneficial role in the treatment of asthma or COPD.
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Affiliation(s)
- Luigino Calzetta
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy.
| | - Mario Cazzola
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Clive P Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK
| | - Paola Rogliani
- Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
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80
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Compain F, Botterel F, Sitterlé E, Paugam A, Bougnoux ME, Dannaoui E. In vitro activity of miltefosine in combination with voriconazole or amphotericin B against clinical isolates of Scedosporium spp. J Med Microbiol 2015; 64:309-311. [DOI: 10.1099/jmm.0.000019] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Fabrice Compain
- Université Paris-Descartes, Faculté de Médecine, APHP, Hôpital Européen Georges Pompidou, Unité de Parasitologie-Mycologie, Service de Microbiologie, Paris, France
| | - Françoise Botterel
- Dynamyc Research Group, Université Paris-Est Créteil, Faculté de Médecine, Créteil, France
- APHP, Hôpital Henri Mondor, Unité de Parasitologie–Mycologie, Service de Microbiologie, Créteil, France
| | - Emilie Sitterlé
- Dynamyc Research Group, Université Paris-Est Créteil, Faculté de Médecine, Créteil, France
- APHP, Hôpital Henri Mondor, Unité de Parasitologie–Mycologie, Service de Microbiologie, Créteil, France
| | - André Paugam
- Université Paris-Descartes, Faculté de Médecine, APHP, Hôpital Cochin, Service de Parasitologie–Mycologie, Paris, France
| | - Marie-Elisabeth Bougnoux
- Université Paris-Descartes, Faculté de Médecine, APHP, Hôpital Necker Enfants-Malades, Unité de Parasitologie–Mycologie, Service de Microbiologie, Paris, France
| | - Eric Dannaoui
- Dynamyc Research Group, Université Paris-Est Créteil, Faculté de Médecine, Créteil, France
- Université Paris-Descartes, Faculté de Médecine, APHP, Hôpital Européen Georges Pompidou, Unité de Parasitologie-Mycologie, Service de Microbiologie, Paris, France
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81
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Pharmacodynamic and response surface analysis of linezolid or vancomycin combined with meropenem against Staphylococcus aureus. Pharm Res 2015; 32:2410-8. [DOI: 10.1007/s11095-015-1632-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 01/16/2015] [Indexed: 10/24/2022]
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82
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Ochi Y, Hiramoto N, Takegawa H, Yonetani N, Doi A, Ichikawa C, Imai Y, Ishikawa T. Infective endocarditis caused by Scedosporium prolificans infection in a patient with acute myeloid leukemia undergoing induction chemotherapy. Int J Hematol 2015; 101:620-5. [DOI: 10.1007/s12185-015-1752-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 01/19/2015] [Accepted: 01/21/2015] [Indexed: 10/24/2022]
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83
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Cazzola M, Calzetta L, Page CP, Rogliani P, Facciolo F, Gavaldà A, Matera MG. Pharmacological characterization of the interaction between aclidinium bromide and formoterol fumarate on human isolated bronchi. Eur J Pharmacol 2014; 745:135-43. [DOI: 10.1016/j.ejphar.2014.10.025] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/13/2014] [Accepted: 10/15/2014] [Indexed: 02/04/2023]
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84
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Taylor A, Talbot J, Bennett P, Martin P, Makara M, Barrs VR. Disseminated Scedosporium prolificans infection in a Labrador retriever with immune mediated haemolytic anaemia. Med Mycol Case Rep 2014; 6:66-9. [PMID: 25473599 PMCID: PMC4246399 DOI: 10.1016/j.mmcr.2014.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 09/28/2014] [Accepted: 10/27/2014] [Indexed: 12/04/2022] Open
Abstract
Disseminated scedosporiosis is rare in dogs and is usually reported in German Shepherds with suspected heritable immunodeficiency. This is the first report of disseminated scedosporiosis due to Scedosporium prolificans in a Labrador retriever dog that was receiving immunosuppressive drug therapy for treatment of immune-mediated haemolytic anaemia. Despite cessation of immunosuppressive medications and an initial response to aggressive treatment with voriconazole and terbinafine the dog developed progressive disease with neurological signs necessitating euthanasia six months from diagnosis. Disseminated scedosporiosis due to Scedosporium prolificans is described in a dog. Chronic prednisolone and cyclosporine therapy preceded disseminated scedosporiosis. Combination therapy with oral voriconazole and terbinafine was prescribed. Despite an initial response progressive disease occurred.
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Affiliation(s)
| | | | | | | | | | - Vanessa R. Barrs
- Corresponding author. Tel.: +61 2 9351 3437; fax: +61 2 9351 7436.
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85
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Tortorano AM, Richardson M, Roilides E, van Diepeningen A, Caira M, Munoz P, Johnson E, Meletiadis J, Pana ZD, Lackner M, Verweij P, Freiberger T, Cornely OA, Arikan-Akdagli S, Dannaoui E, Groll AH, Lagrou K, Chakrabarti A, Lanternier F, Pagano L, Skiada A, Akova M, Arendrup MC, Boekhout T, Chowdhary A, Cuenca-Estrella M, Guinea J, Guarro J, de Hoog S, Hope W, Kathuria S, Lortholary O, Meis JF, Ullmann AJ, Petrikkos G, Lass-Flörl C. ESCMID and ECMM joint guidelines on diagnosis and management of hyalohyphomycosis: Fusarium spp., Scedosporium spp. and others. Clin Microbiol Infect 2014; 20 Suppl 3:27-46. [PMID: 24548001 DOI: 10.1111/1469-0691.12465] [Citation(s) in RCA: 324] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 11/18/2013] [Accepted: 11/18/2013] [Indexed: 01/03/2023]
Abstract
Mycoses summarized in the hyalohyphomycosis group are heterogeneous, defined by the presence of hyaline (non-dematiaceous) hyphae. The number of organisms implicated in hyalohyphomycosis is increasing and the most clinically important species belong to the genera Fusarium, Scedosporium, Acremonium, Scopulariopsis, Purpureocillium and Paecilomyces. Severely immunocompromised patients are particularly vulnerable to infection, and clinical manifestations range from colonization to chronic localized lesions to acute invasive and/or disseminated diseases. Diagnosis usually requires isolation and identification of the infecting pathogen. A poor prognosis is associated with fusariosis and early therapy of localized disease is important to prevent progression to a more aggressive or disseminated infection. Therapy should include voriconazole and surgical debridement where possible or posaconazole as salvage treatment. Voriconazole represents the first-line treatment of infections due to members of the genus Scedosporium. For Acremonium spp., Scopulariopsis spp., Purpureocillium spp. and Paecilomyces spp. the optimal antifungal treatment has not been established. Management usually consists of surgery and antifungal treatment, depending on the clinical presentation.
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Affiliation(s)
- A M Tortorano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
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86
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Katragkou A, McCarthy M, Alexander EL, Antachopoulos C, Meletiadis J, Jabra-Rizk MA, Petraitis V, Roilides E, Walsh TJ. In vitro interactions between farnesol and fluconazole, amphotericin B or micafungin against Candida albicans biofilms. J Antimicrob Chemother 2014; 70:470-8. [PMID: 25288679 DOI: 10.1093/jac/dku374] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Biofilm formation by Candida albicans poses an important therapeutic challenge in human diseases. Typically, conventional antifungal agents encounter difficulty in treating and fully eradicating biofilm-related infections. Novel therapeutic approaches are needed to treat recalcitrant Candida biofilms. Farnesol is a quorum-sensing molecule, which induces apoptosis, inhibits Ras protein pathways and profoundly affects the morphogenesis of C. albicans. We therefore investigated the interactions between farnesol and different classes of antifungal agents. METHODS The combined antifungal effects of triazoles (fluconazole), polyenes (amphotericin B) and echinocandins (micafungin) with farnesol against C. albicans biofilms were assessed in vitro. Antifungal activity was determined by the XTT metabolic assay and confocal microscopy. The nature and the intensity of the interactions were assessed using the Loewe additivity model [fractional inhibitory concentration (FIC) index] and the Bliss independence (BI) model. RESULTS Significant synergy was found between each of the three antifungal agents and farnesol, while antagonism was not observed for any of the combinations tested. The greatest synergistic effect was found with the farnesol/micafungin combination, for which the BI-based model showed the observed effects as being 39%-52% higher than expected if the drugs had been acting independently. The FIC indices ranged from 0.49 to 0.79, indicating synergism for farnesol/micafungin and farnesol/fluconazole and no interaction for farnesol/amphotericin B. Structural changes in the biofilm correlated well with the efficacies of these combinations. The maximum combined effect was dependent on the farnesol concentration for micafungin and amphotericin B. CONCLUSIONS Farnesol exerts a synergistic or additive interaction with micafungin, fluconazole and amphotericin B against C. albicans biofilms, thus warranting further in vivo study.
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Affiliation(s)
- Aspasia Katragkou
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Weill Cornell Medical Center of Cornell University, New York, NY, USA Infectious Disease Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece
| | - Matthew McCarthy
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Weill Cornell Medical Center of Cornell University, New York, NY, USA
| | | | - Charalampos Antachopoulos
- Infectious Disease Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Mary Ann Jabra-Rizk
- Department of Oncology and Diagnostic Sciences, University of Maryland, Baltimore, MD, USA Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Vidmantas Petraitis
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Weill Cornell Medical Center of Cornell University, New York, NY, USA
| | - Emmanuel Roilides
- Infectious Disease Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece
| | - Thomas J Walsh
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Weill Cornell Medical Center of Cornell University, New York, NY, USA Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA Department of Microbiology and Immunology, Weill Cornell Medical College, New York, NY, USA
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87
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In vitro combination of isavuconazole with micafungin or amphotericin B deoxycholate against medically important molds. Antimicrob Agents Chemother 2014; 58:6934-7. [PMID: 25136021 DOI: 10.1128/aac.03261-14] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Whether isavuconazole, an extended-spectrum triazole, possesses synergistic activity in combination therapy with echinocandins or amphotericin B for the treatment of invasive molds infections has not been studied. Our in vitro combination studies showed that isavuconazole and micafungin are synergistically active against Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, and Cunninghamella bertholletiae. These results suggest that isavuconazole, in combination with micafungin, may have a role in the treatment of invasive aspergillosis and warrants further investigation.
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88
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Johnson L, Shields R, Clancy C. Epidemiology, clinical manifestations, and outcomes ofScedosporiuminfections among solid organ transplant recipients. Transpl Infect Dis 2014; 16:578-87. [DOI: 10.1111/tid.12244] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 01/02/2014] [Accepted: 03/01/2014] [Indexed: 01/30/2023]
Affiliation(s)
- L.S. Johnson
- Department of Medicine; University of Pittsburgh; Pittsburgh Pennsylvania USA
| | - R.K. Shields
- Department of Medicine; University of Pittsburgh; Pittsburgh Pennsylvania USA
- Infectious Diseases; Department of Medicine; University of Pittsburgh; Pittsburgh Pennsylvania USA
| | - C.J. Clancy
- Infectious Diseases; Department of Medicine; University of Pittsburgh; Pittsburgh Pennsylvania USA
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89
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Bhagavatula S, Vale L, Evans J, Carpenter C, Barnes RA. Scedosporium prolificans osteomyelitis following penetrating injury: A case report. Med Mycol Case Rep 2014; 4:26-9. [PMID: 24855598 PMCID: PMC4024514 DOI: 10.1016/j.mmcr.2014.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 03/07/2014] [Accepted: 03/12/2014] [Indexed: 11/30/2022] Open
Abstract
Scedosporium prolificans are opportunistic moulds that can cause mycetoma following penetrating injuries. This fungus is more virulent than other species and treatment options are limited. Here we describe the first known case in the UK of S. prolificans osteomyelitis, in a 4 year old following penetrating injury. Successful outcome with limb salvage and foot function is achieved after repeated surgical debridement, and combination chemotherapy with voriconazole/terbinafine.
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Affiliation(s)
- S Bhagavatula
- Department of Microbiology, University Hospital of Wales, Cardiff, United Kingdom
| | - L Vale
- Department of Microbiology, University Hospital of Wales, Cardiff, United Kingdom
| | - J Evans
- Department of Paediatrics and Child Health, University Hospital of Wales, Cardiff, United Kingdom
| | - C Carpenter
- Department of Paediatric Orthopedics, University Hospital of Wales, Cardiff, United Kingdom
| | - R A Barnes
- Department of Microbiology, University Hospital of Wales, Cardiff, United Kingdom
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90
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Scedosporium Infections at a Cancer Center Over a 10-Year Period (2001–2010). INFECTIOUS DISEASES IN CLINICAL PRACTICE 2014. [DOI: 10.1097/ipc.0b013e318297d5bf] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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91
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Abstract
Dematiaceous fungi are responsible for a wide variety of clinical syndromes, from local infections due to trauma, to disseminated infection in immunocompromised patients. These fungi are unique owing to the presence of melanin in their cell walls, which imparts the characteristic dark color to their spores and hyphae. Melanin may also be a virulence factor in these fungi. Therapy depends upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Azoles such as itraconazole and voriconazole have the most consistent in vitro activity, although newer agents may also play a role in therapy in the future.
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Affiliation(s)
- Sanjay G Revankar
- Dallas VA Medical Center, 4500 S. Lancaster Road, Dallas, TX 75216, USA.
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92
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Abstract
Scedosporium species are now increasingly isolated from immunocompromised and immunocompetent patients. Unfortunately, Scedosporium species infections are generally resistant to amphotericin B, and S. prolificans strains are particularly resistant to presently-available antifungal agents. Here we review the microbiology, expanding epidemiology, numerous clinical presentations, and diagnostic tools available for Scedosporium species infections. Finally, we detail the available in vitro, animal model, and clinical data on the treatment of Scedosporium species infections with special emphasis on the role of newer antifungal therapies for these recalcitrant infections.
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Affiliation(s)
- W J Steinbach
- Department of Pediatrics, Duke University, Durham, NC 27710, USA.
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93
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Post-tsunami primary Scedosporium apiospermum osteomyelitis of the knee in an immunocompetent patient. Int J Infect Dis 2013; 17:e646-9. [DOI: 10.1016/j.ijid.2013.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 01/28/2013] [Accepted: 02/05/2013] [Indexed: 11/17/2022] Open
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94
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Synergysm of voriconazole or itraconazole with other antifungal agents against species of Fusarium. Rev Iberoam Micol 2013; 30:200-4. [DOI: 10.1016/j.riam.2013.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 11/30/2012] [Accepted: 01/08/2013] [Indexed: 11/20/2022] Open
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95
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Calzetta L, Page CP, Spina D, Cazzola M, Rogliani P, Facciolo F, Matera MG. Effect of the Mixed Phosphodiesterase 3/4 Inhibitor RPL554 on Human Isolated Bronchial Smooth Muscle Tone. J Pharmacol Exp Ther 2013; 346:414-23. [DOI: 10.1124/jpet.113.204644] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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96
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Rogliani P, Calzetta L, Rendina EA, Massullo D, Dauri M, Rinaldi B, Capuano A, Matera MG. The influence of propofol, remifentanil and lidocaine on the tone of human bronchial smooth muscle. Pulm Pharmacol Ther 2013; 26:325-31. [DOI: 10.1016/j.pupt.2013.01.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 12/31/2012] [Accepted: 01/03/2013] [Indexed: 01/08/2023]
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97
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Gao Y, Zhang C, Lu C, Liu P, Li Y, Li H, Sun S. Synergistic effect of doxycycline and fluconazole againstCandida albicansbiofilms and the impact of calcium channel blockers. FEMS Yeast Res 2013; 13:453-62. [PMID: 23577622 DOI: 10.1111/1567-1364.12048] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 03/25/2013] [Accepted: 04/05/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yuan Gao
- School of Pharmaceutical Sciences; Shandong University; Jinan; Shandong Province; China
| | - Caiqing Zhang
- Department of Respiratory Medicine; Shandong Provincial Qianfoshan Hospital; Jinan; Shandong Province; China
| | - Chunyan Lu
- Department of Pharmacy; Shandong Provincial Qianfoshan Hospital; Jinan; Shandong Province; China
| | - Ping Liu
- School of Pharmaceutical Sciences; Shandong University; Jinan; Shandong Province; China
| | - Yan Li
- Department of Oncology; Shandong Provincial Qianfoshan Hospital; Jinan; Shandong Province; China
| | - Hui Li
- School of Pharmaceutical Sciences; Shandong University; Jinan; Shandong Province; China
| | - Shujuan Sun
- Department of Pharmacy; Shandong Provincial Qianfoshan Hospital; Jinan; Shandong Province; China
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98
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Combination Antifungal Therapy in the Treatment of Scedosporium apiospermum Central Nervous System Infections. Case Rep Infect Dis 2013; 2013:589490. [PMID: 23738164 PMCID: PMC3657419 DOI: 10.1155/2013/589490] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 04/08/2013] [Indexed: 11/17/2022] Open
Abstract
Treatment of Scedosporium apiospermum central nervous system (CNS) infection typically consists of an azole in combination with surgical debridement. This approach requires prolonged treatment and carries a high associated mortality. We present two cases of the successful treatment of S. apiospermum CNS infections with the combination of voriconazole and terbinafine.
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99
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Holmes NE, Trevillyan JM, Kidd SE, Leong TYM. Locally extensive angio-invasive Scedosporium prolificans infection following resection for squamous cell lung carcinoma. Med Mycol Case Rep 2013; 2:98-102. [PMID: 24432228 DOI: 10.1016/j.mmcr.2013.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 04/03/2013] [Accepted: 04/05/2013] [Indexed: 11/25/2022] Open
Abstract
We report a case of Scedosporium prolificans infection in a patient following surgery for squamous cell lung carcinoma. Combination therapy with voriconazole and terbinafine was commenced for intrathoracic infection and mycotic vasculitis. In spite of antifungal treatment, he developed culture-positive sternal and rib osteomyelitis four months later. Scedosporiosis is not commonly reported in patients with solid organ malignancies, and this case highlights its aggressive nature and propensity for direct local invasion.
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Affiliation(s)
- Natasha E Holmes
- Austin Centre for Infection Research, Austin Health, Heidelberg, VIC 3084, Australia ; Department of Medicine, University of Melbourne, Parkville, VIC 3052, Australia
| | - Janine M Trevillyan
- Austin Centre for Infection Research, Austin Health, Heidelberg, VIC 3084, Australia
| | - Sarah E Kidd
- Mycology Unit, SA Pathology, Women's and Children's Hospital, North Adelaide, SA 5006, Australia
| | - Trishe Y-M Leong
- Department of Anatomical Pathology, Austin Pathology, Heidelberg, VIC 3084, Australia
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100
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Impact of multidrug-resistant organisms on patients considered for lung transplantation. Infect Dis Clin North Am 2013; 27:343-58. [PMID: 23714344 DOI: 10.1016/j.idc.2013.02.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Infections with multidrug-resistant organisms are a growing problem in lung transplant recipients. Carriage of drug-resistant bacteria and fungi before transplantation is an important risk factor for such infections. In that regard Pseudomonas aeruginosa and species of Burkholderia, Acinetobacter, non-tuberculous mycobacteria and Scedosporium are particularly important. An understanding of the impact of these organisms is essential to the evaluation of lung transplant candidates. The microbiology, epidemiology, clinical manifestations, and approach to these pathogens before transplant are reviewed in this article.
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