1
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Chronic rapamycin pretreatment modulates arginase/inducible nitric oxide synthase balance attenuating aging-dependent susceptibility to Trypanosoma cruzi infection and acute myocarditis. Exp Gerontol 2022; 159:111676. [DOI: 10.1016/j.exger.2021.111676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 11/22/2022]
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2
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Nathan CL, Emmert BE, Nelson E, Berger JR. CNS fungal infections: A review. J Neurol Sci 2021; 422:117325. [PMID: 33516057 DOI: 10.1016/j.jns.2021.117325] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/23/2020] [Accepted: 01/19/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Cody L Nathan
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brian E Emmert
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ernest Nelson
- Departments of Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph R Berger
- Departments of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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3
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Therapeutic failure with itraconazole in sporotrichosis due to bariatric surgery. An Bras Dermatol 2020; 95:241-243. [PMID: 32165024 PMCID: PMC7175040 DOI: 10.1016/j.abd.2019.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/19/2019] [Indexed: 11/23/2022] Open
Abstract
Sporotrichosis is a deep mycosis of subacute or chronic evolution, caused by the dimorphic fungus of the genus Sporothrix. The treatment is carried out with antifungal orally or intravenously. Therapeutic success can be affected by several factors, such as altered gastrointestinal physiology by surgery. More and more patients are submitted to bariatric surgeries and the literature for the alterations of the absorption of medications in this context is very scarce. We intend to contribute to a better understanding with this case report of cutaneous-lymphatic sporotrichosis in a patient after bariatric surgery without response to itraconazole treatment, even at high doses.
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4
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Tannou T, Koeberle S, Manckoundia P, Aubry R. Multifactorial immunodeficiency in frail elderly patients: Contributing factors and management. Med Mal Infect 2019; 49:167-172. [DOI: 10.1016/j.medmal.2019.01.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 01/25/2019] [Indexed: 12/31/2022]
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5
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Coelho RA, Brito-Santos F, Figueiredo-Carvalho MHG, Silva JVDS, Gutierrez-Galhardo MC, do Valle ACF, Zancopé-Oliveira RM, Trilles L, Meyer W, Freitas DFS, Almeida-Paes R. Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. PLoS Negl Trop Dis 2018; 12:e0006675. [PMID: 30048450 PMCID: PMC6080783 DOI: 10.1371/journal.pntd.0006675] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/07/2018] [Accepted: 07/09/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Chromoblastomycosis (CBM) is a difficult-to-treat chronic subcutaneous mycosis. In Brazil, the main agent of this disease is Fonsecaea pedrosoi, which is phenotypically very similar to other Fonsecaea species, differing only genetically. The correct species identification is relevant since different species may differ in their epidemiologic aspects, clinical presentation, and treatment response. METHODOLOGY/PRINCIPAL FINDINGS Partial sequencing of the internal transcribed spacer (ITS) was used to identify twenty clinical isolates of Fonsecaea spp. Their in vitro antifungal susceptibility was determined using the broth microdilution method, according to the M38-A2 protocol. Amphotericin B (AMB), flucytosine (5FC), terbinafine (TRB), fluconazole (FLC), itraconazole (ITC), ketoconazole (KTC), posaconazole (POS), voriconazole (VRC), ravuconazole (RVC), caspofungin (CAS), and micafungin (MFG) were tested. The association between ITC/TRB, AMB/5FC, and ITC/CAS was studied by the checkerboard method to check synergism. The available patients' data were correlated with the obtained laboratory results. Fonsecaea monophora (n = 10), F. pedrosoi (n = 5), and F. nubica (n = 5) were identified as CBM' agents in the study. TRB and VRC were the drugs with the best in vitro activity with minimal inhibitory concentrations (MIC) lower than 0.25 mg/L. On the other hand, FLC, 5FC, AMB, and MFG showed high MICs. The AMB/5FC combination was synergistic for three F. monophora strains while the others were indifferent. Patients had moderate or severe CBM, and ITC therapy was not sufficient for complete cure in most of the cases, requiring adjuvant surgical approaches. CONCLUSIONS/SIGNIFICANCE F. monophora, the second most frequent Fonsecaea species in South America, predominated in patients raised and born in Rio de Janeiro, Brazil, without cerebral involvement in these cases. TRB, VRC, and the AMB/5FC combination should be further investigated as a treatment option for CBM.
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Affiliation(s)
- Rowena Alves Coelho
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Fábio Brito-Santos
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Juliana Vitoria dos Santos Silva
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Antonio Carlos Francesconi do Valle
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Luciana Trilles
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School-Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead Institute for Medical Research, Sydney, Australia
| | - Dayvison Francis Saraiva Freitas
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rodrigo Almeida-Paes
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
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6
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Veiga FF, Gadelha MC, da Silva MRT, Costa MI, Kischkel B, de Castro-Hoshino LV, Sato F, Baesso ML, Voidaleski MF, Vasconcellos-Pontello V, Vicente VA, Bruschi ML, Negri M, Svidzinski TIE. Propolis Extract for Onychomycosis Topical Treatment: From Bench to Clinic. Front Microbiol 2018; 9:779. [PMID: 29922236 PMCID: PMC5996904 DOI: 10.3389/fmicb.2018.00779] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/05/2018] [Indexed: 12/28/2022] Open
Abstract
Onychomycosis is a chronic fungal infection of nails, commonly caused by dermatophyte fungi, primarily species of Trichophyton. Because of the limited drug arsenal available to treat general fungal infections and the frequent failure of onychomycosis treatment, the search for new therapeutic sources is essential, and topical treatment with natural products for onychomycosis has been encouraged. Propolis, an adhesive resinous compound produced by honeybees (Apis mellifera), has shown multiple biological properties including significant antifungal and anti-biofilm activities in vitro. In spite of promising in vitro results, in vivo results have not been reported so far. This study assessed an ethanol propolis extract (PE) as a topical therapeutic option for onychomycosis, including its characterization in vitro and its applicability as a treatment for onychomycosis (from bench to clinic). The in vitro evaluation included analysis of the cytotoxicity and the antifungal activity against the planktonic cells and biofilm formed by Trichophyton spp. We also evaluated the capacity of PE to penetrate human nails. Patients with onychomycosis received topical PE treatments, with a 6-month follow-up period. The results of the in vitro assays showed that PE was non-toxic to the cell lines tested, and efficient against both the planktonic cells and the biofilm formed by Trichophyton spp. The results also showed that PE is able to penetrate the human nail. The results for PE applied topically to treat onychomycosis were promising, with complete mycological and clinical cure of onychomycosis in 56.25% of the patients. PE is an inexpensive commercially available option, easy to obtain and monitor. Our results indicated that PE is a promising natural compound for onychomycosis treatment, due to its ability to penetrate the nail without cytotoxicity, and its good antifungal performance against species such as Trichophyton spp. that are resistant to conventional antifungals, both in vitro and in patients.
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Affiliation(s)
- Flavia F. Veiga
- Laboratório de Micologia Médica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
| | - Marina C. Gadelha
- Laboratório de Micologia Médica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
| | - Marielen R. T. da Silva
- Laboratório de Micologia Médica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
| | - Maiara I. Costa
- Laboratório de Micologia Médica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
| | - Brenda Kischkel
- Laboratório de Micologia Médica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
| | | | - Francielle Sato
- Programa de Pós-Graduação em Física, Departamento de Física, Universidade Estadual de Maringá, Maringá, Brazil
| | - Mauro L. Baesso
- Programa de Pós-Graduação em Física, Departamento de Física, Universidade Estadual de Maringá, Maringá, Brazil
| | - Morgana F. Voidaleski
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Vanessa Vasconcellos-Pontello
- Laboratório de Micologia Médica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
| | - Vânia A. Vicente
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Marcos L. Bruschi
- Laboratory of Research and Development of Drug Delivery Systems, Department of Pharmacy, Universidade Estadual de Maringá, Maringá, Brazil
| | - Melyssa Negri
- Laboratório de Micologia Médica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
| | - Terezinha I. E. Svidzinski
- Laboratório de Micologia Médica, Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
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7
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Abstract
Vulvovaginal conditions are common in mature women. This reflects age-related changes in immunity and skin barrier function of vulvovaginal tissues. Vaginal atrophy is commonly complicated by dryness and inflammation, which makes postmenopausal atrophic vaginitis a virtually ubiquitous condition. The differential of vaginitis includes inflammatory, infectious, and malignant diseases, plus drug hypersensitivity. Atrophic vaginitis is treated with estrogen replacement therapy. Vulvovaginal malignant melanoma occurs predominantly in postmenopausal women and carries a poor prognosis. Similarly, the incidence of vulvovaginal malignancies, such as squamous cell carcinoma and extramammary Paget disease, rises exponentially after 65 years of age. Early diagnosis of these malignancies is of utmost importance. Lichen sclerosus et atrophicus and vulvovaginal candidosis are among the most common postmenopausal vulvovaginal conditions. Lichen sclerosus et atrophicus is associated with significant morbidity, and its management can be challenging. The incidence of vulvovaginal candidosis increases in patients on estrogen replacement therapy.
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Affiliation(s)
- Natalie Matthews
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI
| | - Vivian Wong
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI
| | | | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI; Department of Dermatology, Medical School of Jundiaí, São Paulo, Brazil.
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8
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Benedetti VP, Savi DC, Aluizio R, Adamoski D, Kava-Cordeiro V, Galli-Terasawa LV, Glienke C. Analysis of the genetic diversity of Candida isolates obtained from diabetic patients and kidney transplant recipients. Mem Inst Oswaldo Cruz 2017; 0:0. [PMID: 27276363 PMCID: PMC4957493 DOI: 10.1590/0074-02760160042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/16/2016] [Indexed: 11/22/2022] Open
Abstract
Yeasts of the genus Candida have high genetic variability and are the most common opportunistic pathogenic fungi in humans. In this study, we evaluated the genetic diversity among 120 isolates of Candida spp. obtained from diabetic patients, kidney transplant recipients and patients without any immune deficiencies from Paraná state, Brazil. The analysis was performed using the ITS1-5.8S-ITS2 region and a partial sequence of 28S rDNA. In the phylogenetic analysis, we observed a consistent separation of the species C. albicans, C. dubliniensis, C. glabrata, C. tropicalis, C. parapsilosis, C. metapsilosis and C. orthopsilosis, however with low intraspecific variability. In the analysis of the C. albicans species, two clades were formed. Clade A included the largest number of isolates (91.2%) and the majority of isolates from GenBank (71.4%). The phylogenetic analysis showed low intraspecific genetic diversity, and the genetic polymorphisms between C. albicans isolates were similar to genetic divergence found in other studies performed with isolates from Brazil. This low genetic diversity of isolates can be explained by the geographic proximity of the patients evaluated. It was observed that yeast colonisation was highest in renal transplant recipients and diabetic patients and that C. albicans was the species most frequently isolated.
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Affiliation(s)
- Volmir Pitt Benedetti
- Universidade Paranaense, Universidade Paranaense, Departamento de Microbiologia, Francisco Beltrão PR , Brasil, Universidade Paranaense, Departamento de Microbiologia, Francisco Beltrão, PR, Brasil.,Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Patologia Básica, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Patologia Básica, Curitiba, PR, Brasil
| | - Daiani Cristina Savi
- Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Patologia Básica, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Patologia Básica, Curitiba, PR, Brasil.,Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Genética, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Genética, Curitiba, PR, Brasil
| | - Rodrigo Aluizio
- Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Genética, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Genética, Curitiba, PR, Brasil
| | - Douglas Adamoski
- Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Genética, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Genética, Curitiba, PR, Brasil
| | - Vanessa Kava-Cordeiro
- Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Genética, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Genética, Curitiba, PR, Brasil
| | - Lygia V Galli-Terasawa
- Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Genética, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Genética, Curitiba, PR, Brasil
| | - Chirlei Glienke
- Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Patologia Básica, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Patologia Básica, Curitiba, PR, Brasil.,Universidade Federal do Paraná, Universidade Federal do Paraná, Departamento de Genética, Curitiba PR , Brasil, Universidade Federal do Paraná, Departamento de Genética, Curitiba, PR, Brasil
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9
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Zilli DMW, Lopes RG, Alves SL, Barros LM, Miletti LC, Stambuk BU. Secretion of the acid trehalase encoded by the CgATH1 gene allows trehalose fermentation by Candida glabrata. Microbiol Res 2015; 179:12-9. [PMID: 26411890 DOI: 10.1016/j.micres.2015.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 06/26/2015] [Accepted: 06/27/2015] [Indexed: 01/10/2023]
Abstract
The emergent pathogen Candida glabrata differs from other yeasts because it assimilates only two sugars, glucose and the disaccharide trehalose. Since rapid identification tests are based on the ability of this yeast to rapidly hydrolyze trehalose, in this work a biochemical and molecular characterization of trehalose catabolism by this yeast was performed. Our results show that C. glabrata consumes and ferments trehalose, with parameters similar to those observed during glucose fermentation. The presence of glucose in the medium during exponential growth on trehalose revealed extracellular hydrolysis of the sugar by a cell surface acid trehalase with a pH optimum of 4.4. Approximately ∼30% of the total enzymatic activity is secreted into the medium during growth on trehalose or glycerol. The secreted enzyme shows an apparent molecular mass of 275 kDa in its native form, but denaturant gel electrophoresis revealed a protein with ∼130 kDa, which due to its migration pattern and strong binding to concanavalin A, indicates that it is probably a dimeric glycoprotein. The secreted acid trehalase shows high affinity and activity for trehalose, with Km and Vmax values of 3.4 mM and 80 U (mg protein)(-1), respectively. Cloning of the CgATH1 gene (CAGLOK05137g) from de C. glabrata genome, a gene showing high homology to fungal acid trehalases, allowed trehalose fermentation after heterologous expression in Saccharomyces cerevisiae.
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Affiliation(s)
- D M W Zilli
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Trindade, Florianópolis, SC 88040-900, Brazil
| | - R G Lopes
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Trindade, Florianópolis, SC 88040-900, Brazil
| | - S L Alves
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Trindade, Florianópolis, SC 88040-900, Brazil
| | - L M Barros
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Trindade, Florianópolis, SC 88040-900, Brazil
| | - L C Miletti
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Trindade, Florianópolis, SC 88040-900, Brazil
| | - B U Stambuk
- Departamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina, Campus Trindade, Florianópolis, SC 88040-900, Brazil.
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10
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Affiliation(s)
- Erika Shor
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
| | - Neeraj Chauhan
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
- Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
- * E-mail:
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11
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Abstract
Candida infections of the skin, mucous membranes as well as of internal organs may be more frequent and more serious in the elderly. There are several biological reasons for this, for example, alterations in the immune system. Whereas Candida albicans remains the major pathogen, there has been a relative increase of Candida glabrata infections. This species is associated with higher mortality. Furthermore, C. glabrata is in general less susceptible to fluconazole, so that this drug does not represent the agent of first choice for the treatment of yeast infections. The choice of the antimycotic agent must take into consideration their inherent side effects and interaction profiles; echinocandins play a particular role in the treatment of yeast infections in the elderly. These drugs have low toxicities, low potential for interactions with co-medications, as well as broad and good activities against yeasts.
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Affiliation(s)
- H Hof
- Labor Limbach, Heidelberg.
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12
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Daboit TC, Magagnin CM, Heidrich D, Castrillón MR, Mendes SDC, Vettorato G, Valente P, Scroferneker ML. A case of relapsed chromoblastomycosis due to Fonsecaea monophora: antifungal susceptibility and phylogenetic analysis. Mycopathologia 2013; 176:139-44. [PMID: 23645135 DOI: 10.1007/s11046-013-9660-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 04/19/2013] [Indexed: 11/25/2022]
Abstract
Chromoblastomycosis is a chronic cutaneous and subcutaneous mycosis. The management of this infection continues to be challenging because there is no consensus on the therapeutic regimen. We report here a case of a 69-year-old male patient with cauliflower-like lesions on his left leg and foot. He had already been treated with itraconazole at a dose of 200 mg/day for 5 months, with mycological cure for all the affected areas. However, the lesions relapsed at both sites, and treatment with itraconazole was resumed at the dose previously used. Initially, direct mycological examination, cultural, and microculture slide observation were performed. Afterward, sequencing of the ITS1-5.8S rDNA-ITS2 region of the fungal DNA and evaluation of its susceptibility to antifungal agents alone and in combination were performed. In direct mycological examination, the presence of sclerotic cells was verified, and the fungus was identified as Fonsecaea based on cultural and microscopic examinations. Identification as Fonsecaea monophora was confirmed after sequencing of the ITS region and phylogenetic analysis. The isolate was susceptible to itraconazole and terbinafine. The combinations of amphotericin B and terbinafine and terbinafine and voriconazole were synergistic. The use of drugs for which the causative agent is susceptible to singly or in combination may be an alternative for the treatment of mycosis. Furthermore, the identification of the agent by molecular techniques is important for epidemiological purposes. To the best of our knowledge, this is the first case of relapsed chromoblastomycosis caused by F. monophora in Brazil.
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Affiliation(s)
- Tatiane Caroline Daboit
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400-2º andar, Porto Alegre, Rio Grande do Sul, CEP 90035-003, Brazil,
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13
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Dimopoulos G, Paiva JA, Meersseman W, Pachl J, Grigoras I, Sganga G, Montravers P, Auzinger G, Sá MB, Miller PJ, Marček T, Kantecki M, Ruhnke M. Efficacy and safety of anidulafungin in elderly, critically ill patients with invasive Candida infections: a post hoc analysis. Int J Antimicrob Agents 2012; 40:521-6. [PMID: 22998997 DOI: 10.1016/j.ijantimicag.2012.07.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 06/14/2012] [Accepted: 07/30/2012] [Indexed: 11/17/2022]
Abstract
Post hoc analysis of a non-comparative, prospective, multicentre, phase IIIb study was performed to compare efficacy and safety of anidulafungin in elderly (≥65 years) versus non-elderly (<65 years) Intensive Care Unit (ICU) patients with candidaemia/invasive candidiasis (C/IC). Adult ICU patients with confirmed C/IC meeting ≥1 of the following criteria were enrolled: post-abdominal surgery; solid tumour; renal/hepatic insufficiency; solid organ transplantation; neutropenia; age ≥65 years. Patients received anidulafungin (200 mg on Day 1, 100 mg/day thereafter) for ≥10 days followed by optional azole step-down therapy for a total treatment duration of 14-56 days. The primary efficacy endpoint was global (clinical and microbiological) response at the end of all therapy (EOT). Primary efficacy analysis was performed in the modified intent-to-treat (mITT) population (n=170), excluding unknown and missing responses. In total, 80 patients (47.1%) were aged ≥65 years and 90 (52.9%) were aged <65 years; the mean age difference between the two groups was 21.9 years. Global success at EOT in mITT patients was similar in elderly (68.1%) and non-elderly (70.7%) patients (P=0.719). However, global success rates were significantly lower in elderly versus non-elderly patients at 2 and 6 weeks after EOT (P=0.045 and P=0.016, respectively). Ninety-day survival was significantly lower (P=0.006) for elderly (42.8%) versus non-elderly patients (63.3%). The incidence and profile of adverse events were similar in elderly and non-elderly patients. Anidulafungin was effective and safe for treatment of C/IC in elderly ICU patients, despite higher baseline severity of illness scores.
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14
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Daboit TC, Duquia RP, Magagnin CM, Mendes SDC, Castrillón MR, Steglich R, Dos Santos IS, Vettorato G, Valente P, Scroferneker ML. A case of Exophiala spinifera infection in Southern Brazil: Molecular identification and antifungal susceptibility. Med Mycol Case Rep 2012; 1:72-5. [PMID: 24371743 DOI: 10.1016/j.mmcr.2012.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 08/30/2012] [Indexed: 11/28/2022] Open
Abstract
We report a case of an 80-year-old Brazilian man, farmer, with lesions on the dorsum of the hand. A direct mycological examination, cultivation and microculture slide observation was performed. The sequencing of ITS1-5.8S rDNA-ITS2 region was carried out and the etiological agent confirmed as Exophiala spinifera. The in vitro susceptibility of this isolate to antifungal agents alone and in combination was evaluated. This is the third case of phaeohyphomycosis caused by Exophiala spinifera in Brazil.
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Affiliation(s)
- Tatiane Caroline Daboit
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - 2 floor, Porto Alegre, CEP: 90035-003, Brazil ; Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500, Sala 210, Porto Alegre, CEP: 90050-170, Brazil
| | - Rodrigo Pereira Duquia
- Dermatology Service, Santa Casa de Misericórdia de Porto Alegre Hospital Complex. Rua Prof. Annes Dias, 285, Porto Alegre, CEP: 90020-090, Brazil
| | - Cibele Massotti Magagnin
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - 2 floor, Porto Alegre, CEP: 90035-003, Brazil ; Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500, Sala 210, Porto Alegre, CEP: 90050-170, Brazil
| | - Sandra Denise Camargo Mendes
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500, Sala 210, Porto Alegre, CEP: 90050-170, Brazil
| | - Mauricio Ramírez Castrillón
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500, Sala 210, Porto Alegre, CEP: 90050-170, Brazil
| | - Raquel Steglich
- Dermatology Service, Santa Casa de Misericórdia de Porto Alegre Hospital Complex. Rua Prof. Annes Dias, 285, Porto Alegre, CEP: 90020-090, Brazil
| | - Inajara Silveira Dos Santos
- Dermatology Service, Santa Casa de Misericórdia de Porto Alegre Hospital Complex. Rua Prof. Annes Dias, 285, Porto Alegre, CEP: 90020-090, Brazil
| | - Gerson Vettorato
- Dermatology Service, Santa Casa de Misericórdia de Porto Alegre Hospital Complex. Rua Prof. Annes Dias, 285, Porto Alegre, CEP: 90020-090, Brazil
| | - Patrícia Valente
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500, Sala 210, Porto Alegre, CEP: 90050-170, Brazil
| | - Maria Lúcia Scroferneker
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 - 2 floor, Porto Alegre, CEP: 90035-003, Brazil ; Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500, Sala 210, Porto Alegre, CEP: 90050-170, Brazil
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15
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Heidrich D, Stopiglia CDO, Senter L, Vetoratto G, Valente P, Scroferneker ML. Successful treatment of terbinafine in a case of sporotrichosis. An Bras Dermatol 2012; 86:S182-5. [PMID: 22068805 DOI: 10.1590/s0365-05962011000700047] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 01/22/2011] [Indexed: 02/04/2023] Open
Abstract
Sporotrichosis is a chronic subacute infection caused by fungi belonging to the Sporothrix Complex. In the present clinical case, nasal sporotrichosis was treated with potassium iodide. This was unsuccessful, and the treatment was restarted with a combination of potassium iodide and itraconazole. This however resulted in a further recurrence of the infection. The mycological cultures were tested in vitro for antifungal activity to assist in treatment. Terbinafine, an antifungal drug, produced the best results and was therefore used for the rest of the treatment course, with no recurrence after two years of its completion. In addition, both cultures were compared using RAPD and different fragment patterns were observed. This indicated that the isolates were either different or indicated a microevolutionary process of this microorganism.
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Affiliation(s)
- Daiane Heidrich
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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16
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Ledtke C, Tomford JW, Jain A, Isada CM, Duin D. Clinical Presentation and Management of Histoplasmosis in Older Adults. J Am Geriatr Soc 2012; 60:265-70. [DOI: 10.1111/j.1532-5415.2011.03825.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - J. Walton Tomford
- Department of Infectious Diseases; Cleveland Clinic; Cleveland; Ohio
| | | | - Carlos M. Isada
- Department of Infectious Diseases; Cleveland Clinic; Cleveland; Ohio
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17
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Ataides FS, Chaul MH, El Essal FE, Costa CR, Souza LKH, Fernandes OFL, Silva MRR. Antifungal susceptibility patterns of yeasts and filamentous fungi isolated from nail infection. J Eur Acad Dermatol Venereol 2011; 26:1479-85. [PMID: 22049990 DOI: 10.1111/j.1468-3083.2011.04315.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Onychomycosis is the nail infection caused by a wide spectrum of fungi species, including yeasts, dermatophytes and filamentous fungi non-dermatophytes (FFND). This fungal infection represents an important medical problem because it involves the patient's life quality. OBJECTIVE The aim was to isolate and identify the fungal agents of onychomycosis, and to determine the in vitro susceptibility to antifungal agents. METHODS During the period of March 2008 to March 2009, 114 patients clinically suspected of having onychomycosis were examined. Demographic data, mainly age and gender were obtained from each patient. The nail samples collected (136) were submitted to direct examination with potassium hydroxide 20% and grown on Sabouraud dextrose agar. The in vitro antifungal susceptibility testing was performed according to the method of broth microdilution, recommended by the Clinical Laboratory Standards Institute (CLSI). RESULTS Onychomycosis was observed in 95 (83.3%) patients, including 16 men (16.8%) and 79 women (83.2%), with mean age of 48.1 years. Candida parapsilosis, Trichophyton rubrum and Fusarium spp were the fungi most frequently isolated. The most of the isolated yeasts showed susceptibility to antifungal agents studied. Among filamentous fungi, high MIC values to itraconazole were found for T. rubrum and T. mentagrophytes, while Fusarium spp showed decreased susceptibility to itraconazole and voriconazole. CONCLUSION C. parapsilosis was the most common fungal species isolated from patients with onychomycosis. The different response obtained by in vitro susceptibility testing to drugs shows the importance of these methods to assist clinicians in choosing the best therapeutic option.
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Affiliation(s)
- F S Ataides
- Institute of Tropical Diseases and Public Health, Federal University of Goiás, Goiânia-Goias, Brazil
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18
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Böhme A, Atta J, Mousset S, Ehlken B, Shlaen M, Bug G, Serve H, Hoelzer D. Antifungal management and resource use in patients with acute myeloid leukaemia after chemotherapy--retrospective analysis of changes over 3 yr in a German hospital. Eur J Haematol 2011; 88:68-77. [PMID: 21883484 PMCID: PMC3267047 DOI: 10.1111/j.1600-0609.2011.01704.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To describe changes in costs of managing hospitalised patients with acute myeloid leukaemia (AML) after chemotherapy in Germany over 3 yr, with a special focus on prophylaxis and treatment patterns as well as resource use related to invasive fungal infections (IFI). METHODS The study was conducted as a retrospective, single-centre chart review in patients with AML hospitalised for chemotherapy, neutropenia and infections after myelosuppressive chemotherapy from January 2004 to December 2006 in Germany. The following resource utilisation data were collected: inpatient stay, mechanical ventilation, parenteral feeding, diagnostics, systemic antifungal medication and cost-intensive concomitant medication. Direct medical costs were calculated from hospital provider perspective. RESULTS A total of 471 episodes in 212 patients were included in the analysis. Occurrence of IFI decreased from 5.9% in 2004 to 1.9% in 2006. Mean (± standard deviation) hospital stay decreased from 28.7 ± 17.9 d in 2004 to 22.4 ± 11.8 d in 2006. From 2004 to 2006, the use of a single antifungal drug increased from 30.4% to 46.9%, whereas the use of multiple antifungal drugs decreased from 24.4% to 13.1%. The use of liposomal amphotericin B declined between 2004 and 2006 (21.4% vs. 3.8%) and caspofungin between 2005 and 2006 (19.3% vs. 8.1%). Total costs per episode declined from €19051 ± 19024 in 2004 to €13531 ± 9260 in 2006; major reductions were observed in the use of antimycotics and blood products as well as length of hospital stay. CONCLUSION Analysis of real-life data from one single centre in Germany demonstrated a change in antifungal management of patients with AML between 2004/2005 and 2006, accompanied by a decline in total costs.
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Affiliation(s)
- Angelika Böhme
- Department of Medicine, Hematology/Oncology, Goethe-University, Frankfurt/Main, Germany.
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Roetzer A, Gabaldón T, Schüller C. From Saccharomyces cerevisiae to Candida glabratain a few easy steps: important adaptations for an opportunistic pathogen. FEMS Microbiol Lett 2010; 314:1-9. [PMID: 20846362 PMCID: PMC3015064 DOI: 10.1111/j.1574-6968.2010.02102.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The opportunistic human fungal pathogen Candida glabrata is closely related to Saccharomyces cerevisiae, yet it has evolved to survive within mammalian hosts. Which traits help C. glabrata to adapt to this different environment? Which specific responses are crucial for its survival in the host? The main differences seem to include an extended repertoire of adhesin genes, high drug resistance, an enhanced ability to sustain prolonged starvation and adaptations of the transcriptional wiring of key stress response genes. Here, we discuss the properties of C. glabrata with a focus on the differences to related fungi.
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Affiliation(s)
- Andreas Roetzer
- Max F. Perutz Laboratories, Department of Biochemistry and Cell Biology, University of Vienna, Vienna, Austria
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