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Dornelles G, Araújo GRDS, Rodrigues M, Alves V, Almeida-Paes R, Frases S. Comparative Analysis of Capsular and Secreted Polysaccharides Produced by Rhodotorula mucilaginosa and Cryptococcus neoformans. J Fungi (Basel) 2023; 9:1124. [PMID: 37998929 PMCID: PMC10672113 DOI: 10.3390/jof9111124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
Fungal infections are a global public health challenge, especially among immunocompromised patients. Basidiomycetous yeasts, such as Rhodotorula mucilaginosa, have emerged as opportunistic pathogens, but have received less attention than Cryptococcus neoformans. This study aimed to characterize the polysaccharides of R. mucilaginosa and compare them with those of C. neoformans, analyzing their clinical implications. Comprehensive physicochemical, mechanical, and ultrastructural analyses of polysaccharides from both species were performed, revealing correlations with virulence and pathogenicity. R. mucilaginosa cells are surrounded by a capsule smaller than that produced by C. neoformans, but with similar polysaccharides. Those polysaccharides are also secreted by R. mucilaginosa. Cross-reactivity with R. mucilaginosa was observed in a diagnostic C. neoformans antigen test, using both in vitro and in vivo samples, highlighting the need for more reliable tests. Some R. mucilaginosa strains exhibited virulence comparable to that of C. neoformans in an invertebrate experimental model (Tenebrio molitor). This study contributes to a deeper understanding of yeast pathogenicity and virulence, highlighting the need for more accurate diagnostic tests to improve the differential diagnosis of infections caused by basidiomycetous yeasts.
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Affiliation(s)
- Gustavo Dornelles
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
| | - Glauber R. de S. Araújo
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
| | - Marcus Rodrigues
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
| | - Vinicius Alves
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil;
- Rede Micologia RJ, Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Rio de Janeiro 21040-360, Brazil
| | - Susana Frases
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
- Rede Micologia RJ, Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Rio de Janeiro 21040-360, Brazil
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2
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Thompson GR, Jenks JD, Baddley JW, Lewis JS, Egger M, Schwartz IS, Boyer J, Patterson TF, Chen SCA, Pappas PG, Hoenigl M. Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management. Clin Microbiol Rev 2023; 36:e0001923. [PMID: 37439685 PMCID: PMC10512793 DOI: 10.1128/cmr.00019-23] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
Fungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (>70%), and presents numerous challenges during clinical care. Candida spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by Aspergillus and Histoplasma spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use. The signs and symptoms of fungal endocarditis are nonspecific, and a high degree of clinical suspicion coupled with the judicious use of diagnostic tests is required for diagnosis. In addition to microbiological diagnostics (e.g., blood culture for Candida spp. or galactomannan testing and PCR for Aspergillus spp.), echocardiography remains critical for evaluation of potential infective endocarditis, although radionuclide imaging modalities such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography are increasingly being used. A multimodal treatment approach is necessary: surgery is usually required and should be accompanied by long-term systemic antifungal therapy, such as echinocandin therapy for Candida endocarditis or voriconazole therapy for Aspergillus endocarditis.
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Affiliation(s)
- George R. Thompson
- Department of Internal Medicine, Division of Infectious Diseases, University of California-Davis Medical Center, Sacramento, California, USA
- Department of Medical Microbiology and Immunology, University of California-Davis, Davis, California, USA
| | - Jeffrey D. Jenks
- Durham County Department of Public Health, Durham, North Carolina, USA
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina, USA
| | - John W. Baddley
- Department of Medicine, Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - James S. Lewis
- Department of Pharmacy, Oregon Health & Science University, Portland, Oregon, USA
| | - Matthias Egger
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Ilan S. Schwartz
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Johannes Boyer
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Thomas F. Patterson
- Department of Medicine, Division of Infectious Diseases, The University of Texas Health Science Center, San Antonio, Texas, USA
| | - Sharon C.-A. Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, New South Wales, Australia
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter G. Pappas
- Department of Medicine Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Martin Hoenigl
- Division of Infectious Diseases, ECMM Excellence Center for Medical Mycology, Department of Medicine, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
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3
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Morovati H, Kord M, Ahmadikia K, Eslami S, Hemmatzadeh M, Kurdestani KM, Khademi M, Darabian S. A Comprehensive Review of Identification Methods for Pathogenic Yeasts: Challenges and Approaches. Adv Biomed Res 2023; 12:187. [PMID: 37694259 PMCID: PMC10492613 DOI: 10.4103/abr.abr_375_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/04/2023] [Accepted: 03/06/2023] [Indexed: 09/12/2023] Open
Abstract
Given the increasing incidence of yeast infections and the presence of drug-resistant isolates, accurate identification of the pathogenic yeasts is essential for the management of yeast infections. In this review, we tried to introduce the routine and novel techniques applied for yeast identification. Laboratory identification methods of pathogenic yeast are classified into three categories; I. conventional methods, including microscopical and culture-base methods II. biochemical/physiological-processes methods III. molecular methods. While conventional and biochemical methods require more precautions and are not specific in some cases, molecular diagnostic methods are the optimum tools for diagnosing pathogenic yeasts in a short time with high accuracy and specificity, and having various methods that cover different purposes, and affordable costs for researchers. Nucleotide sequencing is a reference or gold standard for identifying pathogenic yeasts. Since it is an expensive method, it is not widely used in developing countries. However, novel identification techniques are constantly updated, and we recommend further studies in this field. The results of this study will guide researchers in finding more accurate diagnostic method(s) for their studies in a short period of time.
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Affiliation(s)
- Hamid Morovati
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Kord
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Ahmadikia
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Eslami
- Central Research Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Hemmatzadeh
- Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Kian M. Kurdestani
- Department of Microbiology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | | | - Sima Darabian
- Department of Medical Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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4
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Vu K, Buckley BJ, Bujaroski RS, Blumwald E, Kelso MJ, Gelli A. Antifungal activity of 6-substituted amiloride and hexamethylene amiloride (HMA) analogs. Front Cell Infect Microbiol 2023; 13:1101568. [PMID: 36923593 PMCID: PMC10009331 DOI: 10.3389/fcimb.2023.1101568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/20/2023] [Indexed: 02/19/2023] Open
Abstract
Fungal infections have become an increasing threat as a result of growing numbers of susceptible hosts and diminishing effectiveness of antifungal drugs due to multi-drug resistance. This reality underscores the need to develop novel drugs with unique mechanisms of action. We recently identified 5-(N,N-hexamethylene)amiloride (HMA), an inhibitor of human Na+/H+ exchanger isoform 1, as a promising scaffold for antifungal drug development. In this work, we carried out susceptibility testing of 45 6-substituted HMA and amiloride analogs against a panel of pathogenic fungi. A series of 6-(2-benzofuran)amiloride and HMA analogs that showed up to a 16-fold increase in activity against Cryptococcus neoformans were identified. Hits from these series showed broad-spectrum activity against both basidiomycete and ascomycete fungal pathogens, including multidrug-resistant clinical isolates.
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Affiliation(s)
- Kiem Vu
- Department of Pharmacology, School of Medicine, University of California, Genome and Biomedical Sciences Facility, Davis, CA, United States
| | - Benjamin J. Buckley
- Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Richard S. Bujaroski
- Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
- Monash Institute of Pharmaceutical Science (ATMCF), Monash University, Parkville, VIC, Australia
| | - Eduardo Blumwald
- Department of Plant Sciences, PRB Building, University of California, Davis, CA, Australia
| | - Michael J. Kelso
- Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Angie Gelli
- Department of Pharmacology, School of Medicine, University of California, Genome and Biomedical Sciences Facility, Davis, CA, United States
- *Correspondence: Angie Gelli,
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5
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Synergic Effect of Honey with Other Natural Agents in Developing Efficient Wound Dressings. Antioxidants (Basel) 2022; 12:antiox12010034. [PMID: 36670896 PMCID: PMC9854511 DOI: 10.3390/antiox12010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/18/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Honey has been used for therapeutic and nutritional purposes since ancient times. It was considered one of the essential medical assets in wound healing. According to research, honeybees have significant antibacterial, antioxidant, anti-inflammatory, antitumor, and wound-healing properties. Lately, scientific researchers have focused on apitherapy, using bee products to protect and strengthen the immune system. Since honey is the most important natural product rich in minerals, proteins, and vitamins, it has been intensively used in such therapies. Honey has gained significant consideration because of the beneficial role of its antioxidant compounds, such as enzymes, proteins, amino and organic acids, polyphenols, and carotenoids, but mainly due to flavonoids and phenolic acids. It has been proven that phenolic compounds are responsible for honey's biological activity and that its physicochemical properties, antioxidants, and antimicrobial potential are significant for human health. The review also presents some mechanisms of action and the medical applications of honey, such as wound healing dressings, skin grafts, honey-based nanofibers, and cochlear implants, as the most promising wound healing tools. This extensive review has been written to highlight honey's applications in medicine; its composition with the most important bioactive compounds also illustrates its synergistic effect with other natural products having remarkable therapeutic properties in wound healing.
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Huang JJ, Chen XF, Tsui CKM, Pang CJ, Hu ZD, Shi Y, Wang WP, Cui LY, Xiao YL, Gong J, Fan X, Li YX, Zhang G, Xiao M, Xu YC. Persistence of an epidemic cluster of Rhodotorula mucilaginosa in multiple geographic regions in China and the emergence of a 5-flucytosine resistant clone. Emerg Microbes Infect 2022; 11:1079-1089. [PMID: 35343400 PMCID: PMC9009924 DOI: 10.1080/22221751.2022.2059402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Rhodotorula mucilaginosa, an environmental yeast widely used in industry and agriculture, is also an opportunistic pathogen resistant to multi-antifungals. During the national surveillance in China, R. mucilaginosa has been documented from various hospitals and regions. At present, the molecular epidemiology of invasive infections caused by R. mucilaginosa and their resistance profiles to antifungals were unknown. Here we collected 49 strains from four hospitals located in different geographic regions from 2009 to 2019 in China, determined their genotypes using different molecular markers and quantified susceptibilities to various antifungals. Sequencing of ITS and D1/D2 regions in rDNA indicated that 73.5% (36/49) of clinical strains belong to same sequence type (rDNA type 2). Microsatellite (MT) genotyping with 15 (recently developed) tandem repeat loci identified 5 epidemic MT types, which accounted for 44.9% (22/49) of clinical strains, as well as 27 sporadic MT types. Microsatellite data indicated that the presence of an epidemic cluster including 35 strains (71.4%) repeatedly isolated in four hospitals for eight years. Single nucleotide variants (SNVs) from the whole genome sequence data also supported the clustering of these epidemic strains due to low pairwise distance. In addition, phylogenetic analysis of SNVs from these clinical strains, together with environmental and animal strains showed that the closely related epidemic cluster strains may be opportunistic, zoonotic pathogens. Also, molecular data indicated a possible clonal transmission of pan echinocandins-azoles-5-flucytosine resistant R. mucilaginosa strains in hospital H01. Our study demonstrated that R. mucilaginosa is a multi-drug resistant pathogen with the ability to cause nosocomial infection.
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Affiliation(s)
- Jing-Jing Huang
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, People's Republic of China
| | - Xin-Fei Chen
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Graduate School, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, People's Republic of China
| | - Clement K M Tsui
- Department of Pathology, Sidra Medicine, Education City, Al Rayyan Municipality, Qatar.,Department of Pathology and Laboratory Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar.,Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Chong-Jie Pang
- Department of Infection Diseases, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Zhi-Dong Hu
- Department of Clinical Laboratories, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Yi Shi
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Wei-Ping Wang
- Department of Clinical Laboratory, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Lan-Ying Cui
- Department of Laboratory Diagnosis, the first Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China
| | - Yu-Ling Xiao
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jie Gong
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Xin Fan
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ying-Xing Li
- Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, People's Republic of China.,Department of Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People's Republic of China
| | - Ge Zhang
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, People's Republic of China
| | - Meng Xiao
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, People's Republic of China
| | - Ying-Chun Xu
- Department of Laboratory Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, People's Republic of China
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7
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Endogenous Endophthalmitis-The Clinical Significance of the Primary Source of Infection. J Clin Med 2022; 11:jcm11051183. [PMID: 35268274 PMCID: PMC8911070 DOI: 10.3390/jcm11051183] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/05/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
Endophthalmitis is a severe form of ocular inflammation. The source of pathogens in endogenous endophthalmitis is located inside the body, and infection spreads hematogenously. Although rare, endogenous endophthalmitis is a very serious condition, as this type of inflammation is very devastating for ocular tissues. Prognosis is very poor, and the patients are often in a serious general condition, so they require special care and an individual approach in the treatment process. Thanks to the knowledge of the risks associated with infections of individual tissues and organs as well as potential pathogens and the clinical picture, it is possible to make a correct diagnosis faster and implement the correct treatment. In the case of endogenous endophthalmitis, reaction time is absolutely crucial for prognosis. In this review, we focus primarily on the importance of the primary source of infection for the course of the disease and prognosis.
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Garcia-Gutiérrez CA, Cuétara-García MS, Moragues MD, Ligero J, Quevedo SM, Buitrago MJ. Low sensitivity of conventional fungal agars in fungemia by Rhodotorula mucilaginosa: description of two cases. Ann Clin Microbiol Antimicrob 2021; 20:21. [PMID: 33773588 PMCID: PMC8005224 DOI: 10.1186/s12941-021-00427-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 11/16/2022] Open
Abstract
Background Although most bloodstream yeast infections are caused by Candida spp., infections by rare or less common species have increased in recent years. Diagnosis of infections caused by these species is difficult due to the lack of specific symptoms and adequate diagnostic tools. Cases presentation We describe two cases of fungemia by Rhodotorula mucilaginosa within a few months of each other, in a secondary Spanish hospital. In both cases, diagnosis was challenging. Blood subcultures in conventional fungal media were persistently negatives and the use of non-conventional fungal media was essential for isolating the yeasts and achieving a correct diagnosis. 1–3 beta-d-glucan detection and a panfungal PCR assay were helpful techniques to confirm the diagnosis Conclusion It is highly important to establish an early diagnosis for fungemia. The process is challenging because often non-specific symptoms are presents. When yeasts grow in blood cultures other genera than Candida spp. could be the cause of infection. Patient risk factors should be assessed to incorporate alternative culture media and the available rapid diagnostic test, in order to provide an early recognition of the pathogen. Supplementary Information The online version contains supplementary material available at 10.1186/s12941-021-00427-w.
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Affiliation(s)
| | | | - María Dolores Moragues
- Department of Nursing, School of Medicine and Nursing, University of the Basque Country UPV/EHU, Bilbao, Spain
| | - Jorge Ligero
- Department of Microbiology, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Sara María Quevedo
- Department of Microbiology, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - María José Buitrago
- Mycology Reference Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Ctra Majadahonda-Pozuelo Km2, 28220, Majadahonda, Madrid, Spain.
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9
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Huang Z, Chen H, Liu Z. The 100 top-cited systematic reviews/meta-analyses in central venous catheter research: A PRISMA-compliant systematic literature review and bibliometric analysis. Intensive Crit Care Nurs 2020; 57:102803. [PMID: 32035805 DOI: 10.1016/j.iccn.2020.102803] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The central venous catheter is used extensively worldwide. The purpose of this bibliometric analysis was to identify the 100 top-cited systematic reviews/meta-analyses in the literature on central venous catheters and to capture the most important trends in this area of research. RESEARCH METHODOLOGY A search was performed in the Web of Science Core Collection on studies published prior to November 12th, 2019. The search terms included central venous catheter, systematic review and meta-analysis. Retrieved studies were ranked by citation number and selected by two of the authors. Information such as citation number, author, institution, country and year of publication was collected. RESULTS The 100 top-cited studies published between 1992 and 2017 were reviewed, with the largest proportion published in 2008 (n = 17). The number of citations ranged from 14 to 660. The country with the largest number of studies was the United States of America (n = 36). Critical Care Medicine published the greatest number of these studies (n = 13). The largest number of these studies were focused on central venous catheter-related infection (n = 56) and thrombosis (n = 19). CONCLUSION Developed countries were the most productive in the field of central venous catheters. Most meta-analyses focused on complications associated with central-venous catheters such as infection and thrombosis.
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Affiliation(s)
- Zhaojing Huang
- Center of Gerontology and Geriatrics, and National Clinical Research Center of Geriatrics, West China Hospital Sichuan University, PO Box 610041, No.37 Guo Xue Street, Chengdu, Sichuan Province, PR China
| | - Hongxiu Chen
- West China School of Nursing, West China Hospital, Sichuan University, PO Box 610041, No.37 Guo Xue Street, Chengdu, Sichuan Province, PR China.
| | - Zuoyan Liu
- Department of Rehabilitation Medical Center, West China Hospital, Sichuan University, PO Box 610041, No.37 Guo Xue Street, Chengdu, Sichuan Province, PR China.
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10
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Syakalima M, Ramatla T, Lubanza N. Opportunistic pathogenic fungi isolated from feces of feral pigeons in Mafikeng, North West Province of South Africa. Vet World 2019; 12:1066-1069. [PMID: 31528034 PMCID: PMC6702576 DOI: 10.14202/vetworld.2019.1066-1069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/07/2019] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Pigeon feces are increasingly being implicated in the spread of bacterial pathogens such as Escherichia coli, Campylobacter, Salmonella, Listeria, and Chlamydia. Fungi are rarely investigated except for Cryptococcus that has emerged as an important pathogen in old people and immunosuppressed patients. This study investigated fungi in pigeon feces collected from Mafikeng, the North West Province of South Africa. Materials and Methods: Freshly dropped feces were collected and enriched in phosphate-buffered saline overnight at 48°C and then subcultured on Sabouraud’s dextrose agar and incubated at 48°C for 2 weeks observing any fungal growth from day 2. The growths were picked up, DNA extracted, and polymerase chain reaction was done using the internal transcribed spacer primers. Results: Fungi isolated included: Aspergillus (Aspergillus tubingensis), Cryptococcus (Cryptococcus albidus and Cryptococcus randhawai), Fusarium spp., and Rhodotorula (Rhodotorula mucilaginosa and Rhodotorula kratochvilovae). Most of these isolates are known opportunistic pathogens and have been isolated in clinical conditions elsewhere. Other isolates such as Graphium dubautiae, Myrmecridium schulzeri, Naganishia albida, Paecilomyces lilacinus, and Zygopleurage zygospora were not found to be of any human health significance. Conclusion: We, therefore, concluded that the presence of these opportunistic pathogens is a significant human health risk, especially in the face of the HIV/AIDS pandemic that results in immunosuppression.
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Affiliation(s)
- Michelo Syakalima
- Department of Animal Health, School of Agriculture, Faculty of Natural and Agricultural Sciences, Mafikeng Campus, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Tsepo Ramatla
- Department of Animal Health, School of Agriculture, Faculty of Natural and Agricultural Sciences, Mafikeng Campus, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
| | - Ngoma Lubanza
- Department of Animal Health, School of Agriculture, Faculty of Natural and Agricultural Sciences, Mafikeng Campus, North-West University, Private Bag X2046, Mmabatho 2735, South Africa
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11
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Potenza L, Chitasombat MN, Klimko N, Bettelli F, Dragonetti G, Del Principe MI, Nucci M, Busca A, Fracchiolla N, Sciumè M, Spolzino A, Delia M, Mancini V, Nadali GP, Dargenio M, Shadrivova O, Banchelli F, Aversa F, Sanguinetti M, Luppi M, Kontoyiannis DP, Pagano L. Rhodotorula infection in haematological patient: Risk factors and outcome. Mycoses 2018; 62:223-229. [DOI: 10.1111/myc.12875] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/07/2018] [Accepted: 11/30/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Leonardo Potenza
- Section of HematologyDepartment of Surgical and Medical SciencesAOU PoliclinicoUniversity of Modena and Reggio Emilia Modena Italy
| | - Maria N. Chitasombat
- Division of Infectious DiseasesDepartment of MedicineFaculty of Medicine Ramathibodi HospitalMahidol University Bangkok Thailand
| | - Nikolay Klimko
- Department of Clinical Mycology, Allergy and ImmunologyNorth Western State Medical University Saint Petersburg Russia
| | - Francesca Bettelli
- Section of HematologyDepartment of Surgical and Medical SciencesAOU PoliclinicoUniversity of Modena and Reggio Emilia Modena Italy
| | - Giulia Dragonetti
- Institute of HematologyFondazione Policlinico A. Gemelli ‐ IRCCS–Università Cattolica del Sacro Cuore Rome Italy
| | | | - Marcio Nucci
- University HospitalFederal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Alessandro Busca
- Stem Cell Transplant CenterAOU Citta’ della Salute e Della Scienza Turin Italy
| | - Nicola Fracchiolla
- Department of HematologyFoundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Mariarita Sciumè
- Department of HematologyFoundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | | | - Mario Delia
- Hematology and Bone Marrow Transplantation UnitDepartment of Emergency and Organ TransplantationUniversity of Bari Bari Italy
| | | | | | - Michela Dargenio
- Hematology and Stem Cell Transplantation Unit‘Vito Fazzi’ Hospital Lecce Italy
| | - Olga Shadrivova
- Department of Clinical Mycology, Allergy and ImmunologyNorth Western State Medical University Saint Petersburg Russia
| | - Federico Banchelli
- Statistics UnitDepartment of Surgical and Medical SciencesUniversity of Modena and Reggio Emilia Modena Italy
| | | | - Maurizio Sanguinetti
- Institute of MicrobiologyFondazione Policlinico A. Gemelli ‐ IRCCS–Università Cattolica del Sacro Cuore Rome Italy
| | - Mario Luppi
- Section of HematologyDepartment of Surgical and Medical SciencesAOU PoliclinicoUniversity of Modena and Reggio Emilia Modena Italy
| | - Dimitrios P. Kontoyiannis
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer Center Houston Texas
| | - Livio Pagano
- Institute of HematologyFondazione Policlinico A. Gemelli ‐ IRCCS–Università Cattolica del Sacro Cuore Rome Italy
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12
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Wang CH, Hsueh PR, Chen FL, Lee WS. Breakthrough fungemia caused by Rhodotorula mucilaginosa during anidulafungin therapy. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 52:674-675. [PMID: 29429866 DOI: 10.1016/j.jmii.2018.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 10/18/2022]
Affiliation(s)
- Cheng-Hui Wang
- Department of Laboratory Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan
| | - Fu-Lun Chen
- Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wen-Sen Lee
- Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Medical Center, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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13
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Suzuki Y, Togano T, Ohto H, Kume H. Visceral Mycoses in Autopsied Cases in Japan from 1989 to 2013. Med Mycol J 2018; 59:E53-E62. [DOI: 10.3314/mmj.18-00003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Yuhko Suzuki
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University
| | - Hikaru Kume
- Department of Pathology, Kitasato University School of Medicine
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14
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Abstract
In the expanding population of immunocompromised patients and those treated in intensive care units, rare fungal infectious agents have emerged as important pathogens, causing invasive infections associated with high morbidity and mortality. These infections may present either as de novo or as breakthrough invasive infections in high-risk patients with hematologic malignancies receiving prophylactic or empirical antifungal therapy or in patients with central venous catheters. Diagnosis and treatment are challenging. Physicians should have a high index of suspicion because early diagnosis is of paramount importance. Conventional diagnostic methods such as cultures and histopathology are still essential, but rapid and more specific molecular techniques for both detection and identification of the infecting pathogens are being developed and hopefully will lead to early targeted treatment. The management of invasive fungal infections is multimodal. Reversal of risk factors, if feasible, should be attempted. Surgical debridement is recommended in localized mold infections. The efficacy of various antifungal drugs is not uniform. Amphotericin B is active against most yeasts, except Trichosporon, as well as against Mucorales, Fusarium, and some species of Paecilomyces and dimorphic fungi. The use of voriconazole is suggested for the treatment of trichosporonosis and scedosporiosis. Combination treatment, though recommended as salvage therapy in some infections, is controversial in most cases. Despite the use of available antifungals, mortality remains high. The optimization of molecular-based techniques, with expansion of reference libraries and the possibility for direct detection of resistance mechanisms, is awaited with great interest in the near future. Further research is necessary, however, in order to find the best ways to confront and destroy these lurking enemies.
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Affiliation(s)
- Anna Skiada
- 1st Department of Medicine, Laiko Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Maria Drogari-Apiranthitou
- Infectious Diseases Research Laboratory, 4th Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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15
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Falces-Romero I, Cendejas-Bueno E, Romero-Gómez MP, García-Rodríguez J. Isolation of Rhodotorula mucilaginosa
from blood cultures in a tertiary care hospital. Mycoses 2017; 61:35-39. [DOI: 10.1111/myc.12703] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 08/28/2017] [Accepted: 09/01/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Iker Falces-Romero
- Clinical Microbiology Department; Hospital Universitario La Paz; Madrid Spain
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16
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Byrne DD, Reboli AC. Rare Yeast Infections: Risk Factors, Clinical Manifestations, Treatment, and Special Considerations. CURRENT CLINICAL MICROBIOLOGY REPORTS 2017. [DOI: 10.1007/s40588-017-0073-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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17
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Yeasts. Microbiol Spectr 2017; 4. [PMID: 27726781 DOI: 10.1128/microbiolspec.dmih2-0030-2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Yeasts are unicellular organisms that reproduce mostly by budding and less often by fission. Most medically important yeasts originate from Ascomycota or Basidiomycota. Here, we review taxonomy, epidemiology, disease spectrum, antifungal drug susceptibility patterns of medically important yeast, laboratory diagnosis, and diagnostic strategies.
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18
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Guidara R, Trabelsi H, Neji S, Cheikhrouhou F, Sellami H, Makni F, Ayadi A. Rhodotorula fungemia : Report of two cases in Sfax (Tunisia). J Mycol Med 2016; 26:178-181. [DOI: 10.1016/j.mycmed.2016.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 02/17/2016] [Accepted: 02/21/2016] [Indexed: 11/29/2022]
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19
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Pereira C, Ribeiro S, Lopes V, Mendonça T. Rhodotorula mucilaginosa Fungemia and Pleural Tuberculosis in an Immunocompetent Patient: An Uncommon Association. Mycopathologia 2015; 181:145-9. [DOI: 10.1007/s11046-015-9942-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 09/05/2015] [Indexed: 10/23/2022]
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20
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Carrilho PEM, Santos MBMD, Piasecki L, Jorge AC. Marchiafava-Bignami disease: a rare entity with a poor outcome. Rev Bras Ter Intensiva 2015; 25:68-72. [PMID: 23887763 PMCID: PMC4031867 DOI: 10.1590/s0103-507x2013000100013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 02/21/2013] [Indexed: 11/22/2022] Open
Abstract
Marchiafava-Bignami disease is a rare affliction characterized by primary degeneration of the corpus callosum associated with chronic consumption of ethanol. The disease may occasionally occur in patients who are not alcoholics but are chronically malnourished. A complex deficiency of group B vitamins is the main etiopathogenic hypothesis, and many patients improve after the administration of these compounds. However, a good response is not always observed. The definitive diagnosis of Marchiafava-Bignami disease can be problematic and is based on features of neuroimaging studies, especially magnetic resonance imaging. Its treatment is still controversial and shows variable results. Because nutritional factors are implicated, as in Wernicke's encephalopathy, some authors claim that replacement of B vitamins is beneficial. The present article is a case report of a severe acute form of Marchiafava-Bignami disease in an alcohol-dependent male patient who improved after the administration of parenteral B vitamins. As a consequence of his neurological and immunologic conditions, he developed multiple pulmonary infections and had a protracted course in the intensive care unit. He eventually died of sepsis associated with an uncommon fungus, Rhodotorula mucilaginosa. The present article reports the clinical and neuroimaging data from this patient and contains a review of Marchiafava-Bignami disease and Rhodotorula infections in the intensive care unit.
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21
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Moussa A, Noureddine D, Saad A, Abdelmelek M, Abdelkader B. Antifungal activity of four honeys of different types from Algeria against pathogenic yeast: Candida albicans and Rhodotorula sp. Asian Pac J Trop Biomed 2015; 2:554-7. [PMID: 23569970 DOI: 10.1016/s2221-1691(12)60096-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 01/25/2012] [Accepted: 03/18/2012] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To evaluate the antifungal activity of four honeys of different types from Algeria against pathogenic yeast i.e. Candida albicans (C. albicans) and Rhodotorula sp. METHODS Four Algeria honeys of different botanical origin were analyzed to test antifungal effect against C. albicans, and Rhodotorula sp. Different concentrations (undiluted, 10%, 30%, 50% and 70% w/v) of honey were studied in vitro for their antifugal activity using C. albicans and Rhodotorula sp. as fungal strains. RESULTS The range of the diameter of zone of inhibition of various concentrations of tested honeys was (7-23 mm) for Rhodotorula sp., while C. albicans showed clearly resistance towards all concentrations used. The MICs of tested honey concentrations against C. albicans and Rhodotorula sp. were (70.09-93.48)% and (4.90-99.70)% v/v, respectively. CONCLUSIONS This study demonstrates that, in vitro, these natural products have clearly an antifungal activity against Rhodotorula sp. and C. albicans.
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Affiliation(s)
- Ahmed Moussa
- Institute of Veterinary Sciences University, Ibn-khaldoun Tiaret (14000), Algeria
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22
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Capoor MR, Aggarwal S, Raghvan C, Gupta DK, Jain AK, Chaudhary R. Clinical and microbiological characteristics of Rhodotorula mucilaginosa infections in a tertiary-Care facility. Indian J Med Microbiol 2014; 32:304-9. [DOI: 10.4103/0255-0857.136576] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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23
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Arendrup M, Boekhout T, Akova M, Meis J, Cornely O, Lortholary O. ESCMID† and ECMM‡ joint clinical guidelines for the diagnosis and management of rare invasive yeast infections. Clin Microbiol Infect 2014; 20 Suppl 3:76-98. [DOI: 10.1111/1469-0691.12360] [Citation(s) in RCA: 350] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 08/16/2013] [Accepted: 08/16/2013] [Indexed: 12/27/2022]
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24
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Caira M, Trecarichi EM, Tumbarello M, Leone G, Pagano L. Uncommon yeast infections in hematological patients: from diagnosis to treatment. Expert Rev Anti Infect Ther 2014; 9:1067-75. [DOI: 10.1586/eri.11.124] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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25
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Abstract
Rhodotorula is an emerging opportunistic fungal pathogen that is rarely reported to cause endocarditis. We describe a case involving a patient who developed endocarditis due to Rhodotorula mucilaginosa and Staphylococcus epidermidis, proven by culture and histopathology. The case illustrates the unique diagnostic and therapeutic challenges relevant to Rhodotorula spp.
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26
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Zhou J, Chen M, Chen H, Pan W, Liao W. Rhodotorula minutaas onychomycosis agent in a Chinese patient: first report and literature review. Mycoses 2013; 57:191-5. [PMID: 24118107 DOI: 10.1111/myc.12143] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 08/10/2013] [Accepted: 09/03/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Jie Zhou
- Shanghai Key Laboratory of Medical Molecular Mycology & PLA Key Laboratory of Fungal Disease, ChangZheng Hospital; Second Military Medical University; Shanghai China
| | - Min Chen
- Shanghai Key Laboratory of Medical Molecular Mycology & PLA Key Laboratory of Fungal Disease, ChangZheng Hospital; Second Military Medical University; Shanghai China
| | - Hongduo Chen
- Department of Dermatology; No.1 Hospital of China Medical University; Shenyang China
| | - Weihua Pan
- Shanghai Key Laboratory of Medical Molecular Mycology & PLA Key Laboratory of Fungal Disease, ChangZheng Hospital; Second Military Medical University; Shanghai China
| | - Wanqing Liao
- Shanghai Key Laboratory of Medical Molecular Mycology & PLA Key Laboratory of Fungal Disease, ChangZheng Hospital; Second Military Medical University; Shanghai China
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27
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Kim HA, Hyun M, Ryu SY. Catheter-Associated Rhodotorula mucilaginosa Fungemia in an Immunocompetent Host. Infect Chemother 2013; 45:339-42. [PMID: 24396637 PMCID: PMC3848517 DOI: 10.3947/ic.2013.45.3.339] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 05/27/2013] [Accepted: 05/29/2013] [Indexed: 11/24/2022] Open
Abstract
Rhodotorula species live in the environment, but can also colonize human epithelium, as well as respiratory, and gastrointestinal tracts. Reports of infection, especially in the past 2 decades, have noted increasing numbers of Rhodotorula infections, particularly in immunocompromised hosts, leading it to be considered emerging opportunistic pathogen. The major risk factors for infection were prolonged use of central venous catheters in patients with hematological and solid malignancies who are taking corticosteroids or cytotoxic drugs. Herein, we report a case of catheter-associated fungemia due to R. mucilaginosa in an immunocompetent host. The patient was admitted to the intensive care unit with mechanical ventilation for treatment of community-acquired pneumonia. After 10 days, the patient developed new-onset fever confirmed to be a result of catheter-associated blood-stream infection by R. mucilaginosa. It was successfully treated by catheter removal and intravenous amphotericin B.
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Affiliation(s)
- Hyun Ah Kim
- Department of Infectious Disease, Dongsan Medical Center, Keimyung University School of Medicine, Daegue, Korea
| | - Miri Hyun
- Department of Infectious Disease, Dongsan Medical Center, Keimyung University School of Medicine, Daegue, Korea
| | - Seong-Yeol Ryu
- Department of Infectious Disease, Dongsan Medical Center, Keimyung University School of Medicine, Daegue, Korea
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28
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Kikuchi K. Rare systemic mycosis. Med Mycol J 2013; 54:11-8. [DOI: 10.3314/mmj.54.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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29
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Molecular identification, antifungal susceptibility profile, and biofilm formation of clinical and environmental Rhodotorula species isolates. Antimicrob Agents Chemother 2012; 57:382-9. [PMID: 23114761 DOI: 10.1128/aac.01647-12] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Rhodotorula species are emergent fungal pathogens capable of causing invasive infections, primarily fungemia. They are particularly problematic in immunosuppressed patients when using a central venous catheter. In this study, we evaluated the species distribution of 51 clinical and 8 environmental Rhodotorula species isolates using the ID32C system and internal transcribed spacer (ITS) sequencing. Antifungal susceptibility testing and biofilm formation capability using a crystal violet staining assay were performed. Using ITS sequencing as the gold standard, the clinical isolates were identified as follows: 44 R. mucilaginosa isolates, 2 R. glutinis isolates, 2 R. minuta isolates, 2 R. dairenensis isolates, and 1 Rhodosporidium fluviale isolate. The environmental isolates included 7 R. mucilaginosa isolates and 1 R. slooffiae isolate. Using the ID32C system, along with a nitrate assimilation test, only 90.3% of the isolates tested were correctly identified. In the biofilm formation assay, R. mucilaginosa and R. minuta exhibited greater biofilm formation ability compared to the other Rhodotorula species; the clinical isolates of R. mucilaginosa showed greater biofilm formation compared to the environmental isolates (P = 0.04). Amphotericin B showed good in vitro activity (MIC ≤ 1 μg/ml) against planktonic cells, whereas voriconazole and posaconazole showed poor activity (MIC(50)/MIC(90), 2/4 μg/ml). Caspofungin and fluconazole MICs were consistently high for all isolates tested (≥64 μg/ml and ≥ 4 μg/ml, respectively). In this study, we emphasized the importance of molecular methods to correctly identify Rhodotorula species isolates and non-R. mucilaginosa species in particular. The antifungal susceptibility profile reinforces amphotericin B as the antifungal drug of choice for the treatment of Rhodotorula infections. To our knowledge, this is the first study evaluating putative differences in the ability of biofilm formation among different Rhodotorula species.
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30
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Epidemiology of Rhodotorula: an emerging pathogen. Interdiscip Perspect Infect Dis 2012; 2012:465717. [PMID: 23091485 PMCID: PMC3469092 DOI: 10.1155/2012/465717] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 09/07/2012] [Indexed: 11/17/2022] Open
Abstract
This is an updated paper focusing on the general epidemiological aspects of Rhodotorula in humans, animals, and the environment. Previously considered nonpathogenic, Rhodotorula species have emerged as opportunistic pathogens that have the ability to colonise and infect susceptible patients. Rhodotorula species are ubiquitous saprophytic yeasts that can be recovered from many environmental sources. Several authors describe the isolation of this fungus from different ecosystems, including sites with unfavourable conditions. Compared to R. mucilaginosa, R. glutinis and R. minuta are less frequently isolated from natural environments. Among the few references to the pathogenicity of Rhodotorula spp. in animals, there are several reports of an outbreak of skin infections in chickens and sea animals and lung infections and otitis in sheep and cattle. Most of the cases of infection due to Rhodotorula in humans were fungemia associated with central venous catheter (CVC) use. The most common underlying diseases included solid and haematologic malignancies in patients who were receiving corticosteroids and cytotoxic drugs, the presence of CVC, and the use of broad-spectrum antibiotics. Unlike fungemia, some of the other localised infections caused by Rhodotorula, including meningeal, skin, ocular, peritoneal, and prosthetic joint infections, are not necessarily linked to the use of CVCs or immunosuppression.
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31
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Spiliopoulou A, Anastassiou ED, Christofidou M. Rhodotorula fungemia of an intensive care unit patient and review of published cases. Mycopathologia 2012; 174:301-9. [PMID: 22576941 DOI: 10.1007/s11046-012-9552-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 04/23/2012] [Indexed: 11/26/2022]
Abstract
Rhodotorula species are commensal yeasts that have emerged as a cause of life-threatening fungemia in severely immunocompromised patients. A case of Rhodotorula mucilaginosa fungemia in a 48-year-old woman that had undergone consecutive abdominal surgeries due to ovarian cancer and bowel necrosis while she was receiving fluconazole prophylaxis is presented. Several risk factors were identified such as presence of central venous catheters, solid organ neoplasm, abdominal surgery and administration of antibiotics. Identification was performed using commercial systems. The yeast was resistant to fluconazole, posaconazole and voriconazole and to echinocandins, whereas MIC to amphotericin B was 1.5 mg/L. Furthermore, published cases of Rhodotorula spp fungemia during the last decade are reviewed. In conclusion, Rhodotorula spp must be considered a potential pathogen in patients with immunosupression and central venous catheters. Correct identification is mandatory for appropriate management, as Rhodotorula spp are resistant to antifungal agents, such as fluconazole and echinocandins.
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Affiliation(s)
- Anastasia Spiliopoulou
- Department of Microbiology, School of Medicine, University of Patras, 26500 Patras, Greece
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32
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Chitasombat MN, Kofteridis DP, Jiang Y, Tarrand J, Lewis RE, Kontoyiannis DP. Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections in patients with cancer. J Infect 2012; 64:68-75. [PMID: 22101079 PMCID: PMC3855381 DOI: 10.1016/j.jinf.2011.11.002] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 11/02/2011] [Accepted: 11/04/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections (ROYBSIs) are rare, even in cancer patients. METHODS We retrospectively reviewed all episodes of ROYBSIs occurring from 1998 to 2010 in our cancer center. RESULTS Of 2984 blood cultures positive for Candida and non-Candida yeasts, 94 (3.1%) were positive for non-Candida yeasts, representing 41 ROYBSIs (incidence, 2.1 cases/100,000 patient-days). Catheter-associated fungemia occurred in 21 (51%) patients. Breakthrough ROYBSIs occurred in 20 (49%) patients. The yeast species distribution was Rhodotorula in 21 (51%) patients, Trichosporon in 8 (20%) patients, Saccharomyces cerevisiae in 8 (20%) patients, Geotrichum in 2 (5%) patients, Pichia anomala, and Malassezia furfur in 1 patient each. All tested Trichosporon, Geotrichum, and Pichia isolates were azole-susceptible, whereas the Rhodotorula isolates were mostly azole-resistant. We noted echinocandin nonsusceptibility (minimal inhibitory concentration ≥ 2 mg/L) in all but the S. cerevisiae isolates. Most of the isolates (28/33 [85%]) were susceptible to amphotericin B. The mortality rate in all patients at 30 days after ROYBSIs diagnosis was 34%. Multivariate survival analysis revealed increased risk of death in patients with S. cerevisiae infections (hazard ratio, 3.7), Geotrichum infections (hazard ratio, 111.3), or disseminated infections (hazard ratio, 33.4) and reduced risk in patients who had catheter removal (hazard ratio, 0.1). CONCLUSIONS ROYBSIs are uncommon in patients with cancer, and catheters are common sources of them. Half of the ROYBSIs occurred as breakthrough infections, and in vitro species-specific resistance to echinocandins and azoles was common. Disseminated infections resulted in the high mortality rate.
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Affiliation(s)
- Maria N. Chitasombat
- Department of Infectious Diseases, Infection Control and Employee Health, Houston, Texas
| | | | - Ying Jiang
- Department of Infectious Diseases, Infection Control and Employee Health, Houston, Texas
| | - Jeffrey Tarrand
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Russell E. Lewis
- Department of Infectious Diseases, Infection Control and Employee Health, Houston, Texas
- Department of College of Pharmacy, University of Houston, Houston, Texas
| | - Dimitrios P. Kontoyiannis
- Department of Infectious Diseases, Infection Control and Employee Health, Houston, Texas
- Department of College of Pharmacy, University of Houston, Houston, Texas
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33
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Al-Obaid I, Khan Z, Ahmad S, Emara M, Burhama M, Purohit P, Joseph L. Persistent catheter-related Rhodotorula mucilaginosa fungemia in a leukemic child. J Mycol Med 2011. [DOI: 10.1016/j.mycmed.2011.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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34
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Mori T, Nakamura Y, Kato J, Sugita K, Murata M, Kamei K, Okamoto S. Fungemia due to Rhodotorula mucilaginosa after allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2011; 14:91-4. [PMID: 21535337 DOI: 10.1111/j.1399-3062.2011.00647.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Rhodotorula species have been increasingly recognized as emerging pathogens, particularly in immunocompromised patients. We herein report on a patient with myelodysplastic syndrome who developed fungemia due to Rhodotorula mucilaginosa after allogeneic hematopoietic stem cell transplantation (HSCT) from an unrelated donor. He developed severe acute graft-versus-host disease requiring high-dose steroids, and had serially been administered fluconazole and micafungin for the prophylaxis of fungal infection. Although several cases of Rhodotorula infection after HSCT have been reported, all of them were recipients of autologous HSCT, not allogeneic HSCT. A review of all the reported cases of Rhodotorula infection after HSCT revealed that all patients had received fluconazole or echinocandins before the onset of infection. The findings suggest that Rhodotorula species could be causative yeasts, particularly in patients receiving fluconazole or echinocandins, both of which are inactive against the species.
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Affiliation(s)
- T Mori
- Department of Medicine, Division of Hematology, Keio University School of Medicine, Tokyo, Japan.
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Yang YL, Cheng MF, Wang CW, Wang AH, Cheng WT, Lo HJ, Hospitals T. The distribution of species and susceptibility of amphotericin B and fluconazole of yeast pathogens isolated from sterile sites in Taiwan. Med Mycol 2010; 48:328-34. [PMID: 20141372 DOI: 10.3109/13693780903154070] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To study the demographic changes of yeasts causing invasive infections in Taiwan, especially with respect to species distribution and antifungal susceptibility, we analyzed isolates obtained from four sterile sites of patients in 19 hospitals in 2002 (155 strains) and again from the same hospitals in 2006 (208 strains). Blood was the most common source of the yeasts, accounting for 73.8% of the total isolates, followed by ascites (21.5%), cerebrospinal fluid (3%), and synovia (1.7%). Candida albicans was the most frequently recovered species (50.1% of the total), followed by Candida tropicalis (20.7%), Candida glabrata (11.6%), Candida parapsilosis (8.5%), Cryptococcus neoformans (3.9%), Candida krusei (0.8%), and nine other species (4.3%). There were one (0.3%) and seven (1.9%) isolates with minimum inhibitory concentrations (MICs) of amphotericin B > or =2 mg/l after 24 h and 48 h incubation, respectively. In addition, there were 15 (4.3%) and 31 (8.6%) isolates with MICs of fluconazole > or =64 mg/l under the same conditions. The MIC(90) value of amphotericin B was 1 mg/l. The MIC(90) values of fluconazole were 4 mg/l after 24 h incubation and 32 mg/l after 48 h incubation. Interestingly, MICs for fluconazole > or =64 mg/l after 24 h were significantly higher for isolates obtained in 2006 than those in 2002 after 24 h (7.1% vs. 0.7%, p =0.009) and 48 h (13.5% vs. 2%, p =0.0003) incubations. The demographic difference between these two surveys is mainly due to one species, C. tropicalis.
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Affiliation(s)
- Y L Yang
- Department of Biological Science and Technology, Institute of Molecular Medicine and Bioengineering, National Chiao Tung University, Hsinchu, Taiwan
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Baradkar VP, Kumar S. Meningitis caused by Rhodotorula mucilaginosa in human immunodeficiency virus seropositive patient. Ann Indian Acad Neurol 2010; 11:245-7. [PMID: 19893682 PMCID: PMC2771990 DOI: 10.4103/0972-2327.44561] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2008] [Revised: 05/01/2008] [Accepted: 05/16/2008] [Indexed: 11/04/2022] Open
Abstract
Rhodotorula species may be responsible for systemic infection in immunocompromised patients. Meningitis by Rhodotorula species in human immunodeficiency virus (HIV) infected persons has been reported previously. We report a case of meningitis caused by Rhodotorula mucilaginosa in a 36-year-old HIV seropositive male patient who presented with fever, altered sensorium and features of meningeal irritation i.e. neck rigidity. The Cerebrospinal fluid (CSF) cell counts were high, showing 150 cells/mm(3), with 60% lymphocytes and 40% polymorphs, and protein content of 100 mg%; glucose was 60 mg%. The diagnosis was confirmed by culture on Sabouraud's Dextrose agar. The patient was treated successfully with intensive Amphotericin B (1 mg/kg), for two weeks, followed by oral Itraconazole (400 mg daily), for a period of two months. The patient was started on anti retroviral therapy. He did not show any relapse of the symptoms when the last follow up was done six months after the date of discharge.
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Affiliation(s)
- V P Baradkar
- Department of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India.
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García-Suárez J, Gómez-Herruz P, Cuadros JA, Burgaleta C. Epidemiology and outcome of Rhodotorula infection in haematological patients. Mycoses 2010; 54:318-24. [PMID: 20337934 DOI: 10.1111/j.1439-0507.2010.01868.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Rhodotorula spp. are emergent opportunistic pathogens, particularly in haematological patients. However, no systematic review of this infection has been undertaken in this high-risk patient group. The aim of this study was to review all reported cases of Rhodotorula infection to determine the epidemiology and outcome of this infection in this high-risk population. The 29 reported cases were fungaemias. The most common underlying haematological disorder was the presence of acute leukaemia (65.5%). Rhodotorula mucilaginosa was the species found more frequently (79.3%). Most cases (58.6%) had several risk factors (≥ 3) simultaneously. The most common predisposing factors were the presence of central venous catheter (CVC, 100%) and neutropenia (62.1%). A substantial number of patients (81.5%) received antifungal treatment with amphotericin B. The overall mortality was higher (13.8%) than that described in non-haematological patients (5.8% in solid-organ neoplasms and 9% in AIDS or other chronic diseases). Patients with acute leukaemia had a higher mortality rate (15.7%) than patients with non-Hodgkin's lymphoma (0%). Our data suggest that patients with acute leukaemia might be managed as high-risk patients and intensive measures might be taken. In addition, it appears that the subgroup of patients without acute leukaemia have a good outcome and might be managed as low-risk patients with a less intensive approach.
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Affiliation(s)
- J García-Suárez
- Haematology Department, Príncipe Asturias Teaching Hospital, Medical Department, University of Alcalá, Alcalá de Henares, Madrid, Spain.
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Sabino R, Veríssimo C, Brandão J, Alves C, Parada H, Rosado L, Paixão E, Videira Z, Tendeiro T, Sampaio P, Pais C. Epidemiology of candidemia in oncology patients: a 6-year survey in a Portuguese central hospital. Med Mycol 2010. [DOI: 10.3109/13693780903161216] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Neves Junior MAD, Melo RC, Goes Junior AMDO, Protta TR, Almeida CCD, Fernandes AR, Petnys A, Raboni E. Infecções em cateteres venosos centrais de longa permanência: revisão da literatura. J Vasc Bras 2010. [DOI: 10.1590/s1677-54492010000100008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cateteres venosos de longa permanência são amplamente utilizados em pacientes com necessidade de acesso venoso por período prolongado. A infecção relacionada a esses cateteres permanece um desafio na prática clínica. Revisamos a literatura acerca da epidemiologia e tratamento das infecções relacionadas a cateteres. Staphylococcus aureus é a bactéria mais comumente isolada. Os cateteres semi-implantáveis apresentam taxas de infecção maiores que os totalmente implantáveis. O tratamento pode ser feito com locks, antibioticoterapia sistêmica e até mesmo com retirada do cateter, dependendo do tipo de infecção, do microrganismo isolado e das condições clínicas do paciente. O salvamento do cateter deve ser tentado sempre que possível.
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Affiliation(s)
| | | | | | | | | | | | | | - Edgar Raboni
- Hospital do Servidor Público Municipal de São Paulo
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Bloodstream infections due to Trichosporon spp.: species distribution, Trichosporon asahii genotypes determined on the basis of ribosomal DNA intergenic spacer 1 sequencing, and antifungal susceptibility testing. J Clin Microbiol 2009; 47:1074-81. [PMID: 19225102 DOI: 10.1128/jcm.01614-08] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The reevaluation of the genus Trichosporon has led to the replacement of the old taxon Trichosporon beigelii by six new species. Sequencing of the ribosomal DNA (rDNA) intergenic spacer 1 (IGS1) is currently mandatory for accurate Trichosporon identification, but it is not usually performed in routine laboratories. Here we describe Trichosporon species distribution and prevalence of Trichosporon asahii genotypes based on rDNA IGS1 sequencing as well as antifungal susceptibility profiles of 22 isolates recovered from blood cultures. The clinical isolates were identified as follows: 15 T. asahii isolates, five Trichosporon asteroides isolates, one Trichosporon coremiiforme isolate, and one Trichosporon dermatis isolate. We found a great diversity of different species causing trichosporonemia, including a high frequency of isolation of T. asteroides from blood cultures that is lower than that of T. asahii only. Regarding T. asahii genotyping, we found that the majority of our isolates belonged to genotype 1 (86.7%). We report the first T. asahii isolate belonging to genotype 4 in South America. Almost 50% of all T. asahii isolates exhibited amphotericin B MICs of >or=2 microg/ml. Caspofungin MICs obtained for all the Trichosporon sp. isolates tested were consistently high (MICs >or= 2 microg/ml). Most isolates (87%) had high MICs for 5-flucytosine, but all of them were susceptible to triazoles, markedly to voriconazole (all MICs <or= 0.06 microg/ml).
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Abstract
This case report is a case history of a femoral prosthesis infection caused by Rhodotorula mucilaginosa in a human immunodeficiency virus patient. Though the pathogenicity of this organism for bone tissue has been previously reported, this is the first reported case of an orthopedic prosthesis infection by this species of the genus Rhodotorula.
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Update on the Genus Trichosporon. Mycopathologia 2008; 166:121-32. [DOI: 10.1007/s11046-008-9136-x] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Accepted: 05/21/2008] [Indexed: 10/21/2022]
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Richardson M, Lass-Flörl C. Changing epidemiology of systemic fungal infections. Clin Microbiol Infect 2008; 14 Suppl 4:5-24. [DOI: 10.1111/j.1469-0691.2008.01978.x] [Citation(s) in RCA: 341] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Isolation, Identification and Susceptibility Profile of Rhodotorula Species Isolated From Two Educational Hospitals in Ahvaz. Jundishapur J Microbiol 1970. [DOI: 10.5812/jjm.8935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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