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Rodrigues KF, Heidrich D, Fensterseifer F, Roso MT, Bruxel F, Ethur EM, Hoehne L, de Freitas EM. Chemical characterization and antimicrobial activity of Baccharis vulneraria Baker essential oil against strains of microorganisms that cause cutaneous infections. Nat Prod Res 2024; 38:1647-1651. [PMID: 37203185 DOI: 10.1080/14786419.2023.2214840] [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: 10/19/2022] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
Baccharis vulneraria Baker is used popularly for the treatment of skin infections. So, this study aimed investigate the antimicrobial activity and chemical characterization of the essential oil (EO) against microorganisms that cause cutaneous infections. The EO was analyzed by GC-MS. The antimicrobial test was performed using the serial microdilution method, and the antimicrobial activity was determined by the minimum inhibitory concentration against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, Trichophyton interdigitale, Trichophyton rubrum, Fusarium solani and Fusarium oxysporum within the 32-0.0625 mg/mL concentration range. Were identified 31 EO compounds. Its major compounds are bicyclogermacrene, trans-cadin-1,4-diene, β-caryophyllene, and germacrene A. EO showed antifungal action against T. rubrum and T. interdigitale (2 and 4 mg/mL MIC, respectively). The growth of C. albicans, at 4 mg/mL, decreased by 50% compared to control. The oil had no significant potential for other microorganisms at the selected concentrations.
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Affiliation(s)
| | | | | | | | | | | | - Lucélia Hoehne
- Universidade do Vale do Taquari - Univates, Lajeado, Brazil
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2
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Jimbo-Zapata A, Sevillano G, Rodríguez P, Ramírez-Iglesias JR, Navarro JC. First report of fatal fungemia due Fusarium oxysporum in a patient with COVID-19 in Ecuador. Med Mycol Case Rep 2024; 43:100622. [PMID: 38225951 PMCID: PMC10788292 DOI: 10.1016/j.mmcr.2023.100622] [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] [Received: 08/26/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
Filamentous fungal infections are an important cause of systemic infections in immunocompromised patients. Fusarium genus members potentially cause disseminated infections, especially in patients with catheters, due to the ability to adhere to these devices. We describe a case of fatal fungemia due to Fusarium oxysporum in a patient with COVID-19 in Ecuador. The genus identification was carried out with conventional techniques and species identification by molecular and phylogenetic techniques through sequencing of the ITS region.
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Affiliation(s)
- Alexander Jimbo-Zapata
- Universidad Internacional SEK, Facultad de Ciencias de la Salud, Grupo de Investigación en Enfermedades Emergentes, Desatendidas, Ecoepidemiología y Biodiversidad, Quito, Ecuador
- Universidad Internacional SEK, Maestría en Biomedicina, Facultad de Ciencias de la Salud, Quito, Ecuador
- Área de Micología y Tuberculosis, Unidad Técnica de Patología Clínica, Hospital de Especialidades Carlos Andrade Marín, Quito, Ecuador
| | - Gabriela Sevillano
- Universidad Internacional SEK, Facultad de Ciencias de la Salud, Grupo de Investigación en Enfermedades Emergentes, Desatendidas, Ecoepidemiología y Biodiversidad, Quito, Ecuador
- Universidad Internacional SEK, Maestría en Biomedicina, Facultad de Ciencias de la Salud, Quito, Ecuador
- Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios, Quito, Ecuador
| | - Pilar Rodríguez
- Área de Micología y Tuberculosis, Unidad Técnica de Patología Clínica, Hospital de Especialidades Carlos Andrade Marín, Quito, Ecuador
| | - José Rubén Ramírez-Iglesias
- Universidad Internacional SEK, Facultad de Ciencias de la Salud, Grupo de Investigación en Enfermedades Emergentes, Desatendidas, Ecoepidemiología y Biodiversidad, Quito, Ecuador
| | - Juan-Carlos Navarro
- Universidad Internacional SEK, Facultad de Ciencias de la Salud, Grupo de Investigación en Enfermedades Emergentes, Desatendidas, Ecoepidemiología y Biodiversidad, Quito, Ecuador
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3
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Siddig EE, Ahmed A, Eltigani HF, Bakhiet SM, van de Sande WWJ, Fahal AH. The First Case of Fusarium falciforme Eumycetoma in Sudan and an Extensive Literature Review about Treatment Worldwide. J Fungi (Basel) 2023; 9:730. [PMID: 37504719 PMCID: PMC10381130 DOI: 10.3390/jof9070730] [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: 04/07/2023] [Revised: 04/21/2023] [Accepted: 05/17/2023] [Indexed: 07/29/2023] Open
Abstract
Eumycetoma is an infectious disease caused by various fungal pathogens. The disease is characterised by black and pale-yellowish grain discharge. In this communication, we report a case of eumycetoma with a pale grain foot-eumycetoma caused by Fusarium falciforme. The patient presented at the outpatient clinic of the Mycetoma Research Centre in Sudan. The causative agent was initially misidentified as Aspergillus nidulans based on its seemingly similar histopathological appearance. However, sequencing the internally transcribed spacer region of the extracted grain confirmed infection with Fusarium falciforme. Although the patient received Itraconazole and underwent surgical excision, the disease was recurrent. To our knowledge, this is the first report on Fusarium falciforme causing eumycetoma in Sudan, indicating the expansion of the geographical distribution of this pathogen. This calls for raising the awareness of healthcare providers and improving the diagnostic and surveillance systems in at-risk areas to improve the case management and reduce the threat of further spread. Considering the potential impacts of F. falciforme infection including threatening the global health, food security, and ecosystem balance, as well as loss of biodiversity and negative socioeconomic changes in endemic countries, we recommend the implementation of an integrated transdisciplinary One Health strategy for the prevention and control of emerging infectious diseases including F. falciforme.
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Affiliation(s)
- Emmanuel Edwar Siddig
- The Mycetoma Research Center, University of Khartoum, Khartoum 11111, Sudan
- ErasmusMC, Department of Medical Microbiology and Infectious Diseases, University Medical Center Rotterdam, 3000 Rotterdam, The Netherlands
- Unit of Applied Medical Sciences, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum 11115, Sudan
| | - Ayman Ahmed
- Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, CH-4123 Basel, Switzerland
- Faculty of Sciences, University of Basel, CH-4003 Basel, Switzerland
- Institute of Endemic Diseases, Faculty of Medicine, University of Khartoum, Khartoum 11111, Sudan
| | | | | | - Wendy W J van de Sande
- ErasmusMC, Department of Medical Microbiology and Infectious Diseases, University Medical Center Rotterdam, 3000 Rotterdam, The Netherlands
| | - Ahmed Hassan Fahal
- The Mycetoma Research Center, University of Khartoum, Khartoum 11111, Sudan
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4
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Skóra M, Obłoza M, Tymecka M, Kalaska B, Gurgul M, Kamiński K. Studies on Antifungal Properties of Methacrylamido Propyl Trimethyl Ammonium Chloride Polycations and Their Toxicity In Vitro. Microbiol Spectr 2023; 11:e0084423. [PMID: 37166300 PMCID: PMC10269872 DOI: 10.1128/spectrum.00844-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/20/2023] [Indexed: 05/12/2023] Open
Abstract
The biological activity of polycations is usually associated with their biocidal properties. Their antibacterial features are well known, but in this work, observations on the antifungal properties of macromolecules obtained by methacrylamido propyl trimethyl ammonium chloride (MAPTAC) polymerization are presented. The results, not previously reported, make it possible to correlate antifungal properties directly with the structure of the macromolecule, in particular the molecular mass. The polymers described here have antifungal activity against some filamentous fungi. The strongest effect occurs for polymers with a mass of about 0.5 mDa which have confirmed activity against the multidrug-resistant species Scopulariopsis brevicaulis, Fusarium oxysporum, and Fusarium solani, as well as the dermatophytes Trichophyton mentagrophytes, Trichophyton rubrum, Trichophyton interdigitale, and Trichophyton tonsurans. In addition, this publication describes the effects of these macromolecular systems on serum and blood components and provides a preliminary assessment of toxicity on cell lines of skin-forming cells, i.e., fibroblasts and keratinocytes. Additionally, using a Franz diffusion chamber, a negligibly low transport of the active polymer through the skin was demonstrated, which is a desirable effect for externally applied antifungal drugs. IMPORTANCE Infectious diseases are a very big medical, social, and economic problem. Even before the COVID-19 pandemic, certain infections were among of the most common causes of death. The difficulties in the treatment of infectious diseases concern in particular fungal diseases, against which we have only a few classes of drugs represented by a few substances. The publication presents the preliminary results of the in vitro antifungal activity studies of four MAPTAC polymers on different fungal species and their cytotoxicity to human cells (fibroblasts and keratinocytes). The paper also compares these properties with analogous ones of two commonly used antifungal drugs, ciclopirox and terbinafine.
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Affiliation(s)
- Magdalena Skóra
- Department of Infections Control and Mycology, Chair of Microbiology, Jagiellonian University Medical College, Cracow, Poland
| | | | - Małgorzata Tymecka
- Doctoral School of Exact and Natural Sciences, Faculty of Chemistry, Jagiellonian University, Cracow, Poland
| | - Bartlomiej Kalaska
- Department of Pharmacodynamics, Medical University of Białystok, Białystok, Poland
| | | | - Kamil Kamiński
- Faculty of Chemistry, Jagiellonian University, Cracow, Poland
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Arrieta AC, Lee A, Tran MT. Invasive Mold Infections in Children: Navigating Troubled Waters with a Broken Compass. Infect Dis Ther 2023:10.1007/s40121-023-00819-9. [PMID: 37209297 DOI: 10.1007/s40121-023-00819-9] [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: 02/22/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023] Open
Abstract
Incidence of invasive mold infections in children, while rare, is increasing as the population of high-risk patients expands, including premature infants, pediatric patients undergoing treatment for hematological malignancies, or recipients of allogeneic hematologic stem cell transplants. The infectious agents, including Aspergillus spp., Mucorales, and other molds, are especially difficult to treat and have serious morbidity and high mortality. Clinicians must maintain a high index of suspicion for invasive mold infections in at-risk patients. Diagnosis of invasive mold infections is complicated by difficulties isolating pathogens on culture, but progress is being made in immunological and molecular diagnostic technologies. Treatment in children is challenging; no randomized controlled trials exist. There is a growing body of data on treatment, specifically on safer antifungal agents, including indications for treatment, spectrum of coverage, pharmacokinetics for different ages, and pharmacodynamic targets associated with therapeutic success. However, pediatricians must often extrapolate from adult data. In this review, we aim to harmonize the existing body of literature on invasive mold infections in children, covering epidemiology, clinical presentations, diagnostic methods, and principles of management.
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Affiliation(s)
- Antonio C Arrieta
- Department of Infectious Diseases, Children's Hospital of Orange County, Orange, CA, USA
- Department of Pediatrics, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Adam Lee
- Department of Infectious Diseases, Children's Hospital of Orange County, Orange, CA, USA.
| | - M Tuan Tran
- Department of Pharmacy, Children's Hospital of Orange County, Orange, CA, USA
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Salvador A, Veiga FF, Svidzinski TIE, Negri M. In vitro ability of Fusarium keratoplasticum to form biofilms in venous catheter. Microb Pathog 2022; 173:105868. [DOI: 10.1016/j.micpath.2022.105868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/10/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
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7
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Guo P, Chen J, Tan Y, Xia L, Zhang W, Li X, Jiang Y, Li R, Chen C, Liao K, Peng Y. Comparison of molecular and MALDI-TOF MS identification and antifungal susceptibility of clinical Fusarium isolates in Southern China. Front Microbiol 2022; 13:992582. [PMID: 36386677 PMCID: PMC9664484 DOI: 10.3389/fmicb.2022.992582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/22/2022] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Fusarium species are opportunistic causative agents of superficial and disseminated human infections. Fast and accurate identification and targeted antifungal therapy give help to improve the patients' prognosis. OBJECTIVES This study aimed to evaluate the effectiveness of matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI-TOF MS) for Fusarium identification, and investigate the epidemiology and antifungal susceptibility profiles of clinical Fusarium isolates in Southern China. METHODS There were 95 clinical Fusarium isolates identified by DNA sequencing of translation elongation factor 1-alpha (TEF1α) and MALDI-TOF MS, respectively. Antifungal susceptibility testing of isolates was performed by broth microdilution according to the CLSI approved standard M38-A3 document. RESULTS Seven species complexes (SC) with 17 Fusarium species were identified. The most prevalent SC was the F. solani SC (70.5%, 67/95), followed by the F. fujikuroi SC (16.8%, 16/95). F. keratoplasticum within the F. solani SC was the most prevalent species (32.6%, 31/95). There were 91.6% (87/95) of isolates identified by MALDI-TOF MS at the SC level. In most of species, amphotericin B and voriconazole showed lower MICs compared to itraconazole and terbinafine. The F. solani SC showed higher MICs to these antifungal agents compared to the other SCs. There were 10.5% (10/95) of strains with high MICs for amphotericin B (≥8 μg/ml), terbinafine (≥32 μg/ml) and itraconazole (≥32 μg/ml) simultaneously, mostly focusing on F. keratoplasticum (9/10). CONCLUSION MALDI-TOF MS exhibited good performance on the identification of Fusarium strains at the SC level. The F. solani SC was the most prevalent clinical SC in Southern China. The MICs varied significantly among different species or SCs to different antifungal agents.
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Affiliation(s)
- Penghao Guo
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianlong Chen
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yiwei Tan
- Department of Clinical Laboratory, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Li Xia
- Department of Clinical Laboratory, Jieyang People’s Hospital, Jieyang, China
| | - Weizheng Zhang
- Department of Clinical Laboratory, Guangzhou No.11 People’s Hospital, Guangzhou, China
| | - Xiaojie Li
- Department of Clinical Laboratory, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yujie Jiang
- Department of Clinical Laboratory, Central Hospital of Guangdong Nongken, Zhanjiang, China
| | - Ruiying Li
- Department of Clinical Laboratory, The First Affiliated Hospital, Guangdong Pharmaceutical University, Guangzhou, China
| | - Chunmei Chen
- Department of Clinical Laboratory, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - Kang Liao
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yaqin Peng
- Department of Clinical Laboratory, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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8
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Bupha-Intr O, Butters C, Reynolds G, Kennedy K, Meyer W, Patil S, Bryant P, Morrissey CO. Consensus guidelines for the diagnosis and management of invasive fungal disease due to moulds other than Aspergillus in the haematology/oncology setting, 2021. Intern Med J 2021; 51 Suppl 7:177-219. [PMID: 34937139 DOI: 10.1111/imj.15592] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Invasive fungal disease (IFD) due to moulds other than Aspergillus is a significant cause of mortality in patients with malignancies or post haemopoietic stem cell transplantation. The current guidelines focus on the diagnosis and management of the common non-Aspergillus moulds (NAM), such as Mucorales, Scedosporium species (spp.), Lomentospora prolificans and Fusarium spp. Rare but emerging NAM including Paecilomyces variotii, Purpureocillium lilacinum and Scopulariopsis spp. are also reviewed. Culture and histological examination of tissue biopsy specimens remain the mainstay of diagnosis, but molecular methods are increasingly being used. As NAM frequently disseminate, blood cultures and skin examination with biopsy of any suspicious lesions are critically important. Treatment requires a multidisciplinary approach with surgical debridement as a central component. Other management strategies include control of the underlying disease/predisposing factors, augmentation of the host response and the reduction of immunosuppression. Carefully selected antifungal therapy, guided by susceptibility testing, is critical to cure. We also outline novel antifungal agents still in clinical trial which offer substantial potential for improved outcomes in the future. Paediatric recommendations follow those of adults. Ongoing epidemiological research, improvement in diagnostics and the development of new antifungal agents will continue to improve the poor outcomes that have been traditionally associated with IFD due to NAM.
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Affiliation(s)
- Olivia Bupha-Intr
- Department of Infection Services, Wellington Regional Hospital, Wellington, New Zealand
| | - Coen Butters
- Department of General Paediatric and Adolescent Medicine, John Hunter Children's Hospital, Newcastle, New South Wales, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Gemma Reynolds
- Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia
| | - Karina Kennedy
- Department of Infectious Diseases and Microbiology, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia.,ANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Research and Education Network, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Sushrut Patil
- Malignant Haematology and Stem Cell Transplantation Service, Department of Clinical Haematology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Penelope Bryant
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Infectious Diseases, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine O Morrissey
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.,Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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García-Martín JM, Sarmiento-Ramírez JM, Diéguez-Uribeondo J. Beyond Sea Turtles: Fusarium keratoplasticum in Eggshells of Podocnemis unifilis, a Threatened Amazonian Freshwater Turtle. J Fungi (Basel) 2021; 7:742. [PMID: 34575781 PMCID: PMC8470610 DOI: 10.3390/jof7090742] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/04/2021] [Accepted: 09/07/2021] [Indexed: 12/12/2022] Open
Abstract
The endangered yellow-spotted river turtle (Podocnemis unifilis) has experienced a dramatic population decline in the Ecuadorian Amazonia, mainly due to overexploitation of its eggs. To reverse this trend, the Wildlife Conservation Society has developed a head-start program in Yasuní National Park since 2008, but the potential risk that microbes associated with its eggs might represent for hatching success has not been evaluated yet. Members of the Fusarium solani species complex (FSSC) are involved in egg failure in sea turtles under natural and hatchery conditions, but their role in infecting the eggs of P. unifilis is unknown. In this study, we collected eggshells of P. unifilis and obtained 50 fungal and bacterial isolates. Some potentially pathogenic fungi of the genera Fusarium, Penicillium and Rhizopus were identified based on molecular data. Most importantly, the sea turtle pathogenic species F. keratoplasticum not only was present, but it was the most frequently found. Conversely, we have also isolated other microorganisms, such as Pseudomonas or Phoma-like species, producing a wide spectrum of antifungal compounds that may have a protective role against fungal diseases. Our survey provides useful information on potential pathogens found in P. unifilis eggshells, upon which the success of conservation programs may depend.
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Affiliation(s)
| | | | - Javier Diéguez-Uribeondo
- Departamento de Micología, Real Jardín Botánico-CSIC, 28014 Madrid, Spain; (J.M.G.-M.); (J.M.S.-R.)
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Cerchione C, Peleteiro Raíndo A, Mosquera Orgueira A, Mosquera Torre A, Bao Pérez L, Marconi G, Isidori A, Pérez Encinas MM, Martinelli G. Safety of FLT3 inhibitors in patients with acute myeloid leukemia. Expert Rev Hematol 2021; 14:851-865. [PMID: 34424108 DOI: 10.1080/17474086.2021.1969911] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction: Acute myeloblastic leukemia (AML) is the most frequent type of acute leukemia in adults with an incidence of 4.2 cases per 100,000 inhabitants and poor 5-year survival. Patients with mutations in the FMS-like tyrosine kinase 3 (FLT3) gene have poor survival and higher relapse rates compared with wild-type cases.Areas covered: Several FLT3 inhibitors have been proved in FLT3mut AML patients, with differences in their pharmacokinetics, kinase inhibitory and adverse events profiles. First-generation multi-kinase inhibitors (midostaurin, sorafenib, lestaurtinib) target multiple proteins, whereassecond-generation inhibitors (crenolanib, quizartinib, gilteritinib) are more specific and potent inhibitors of FLT3, so they are associated with less off-target toxic effects. All of these drugs have primary and acquired mechanisms of resistance, and therefore their combinations with other drugs (checkpoint inhibitors, hypomethylating agents, standard chemotherapy) and its application in different clinical settings are under study.Expert opinion: The recent clinical development of various FLT3 inhibitors for the treatment of FLT3mut AML is an effective therapeutic strategy. However, there are unique toxicities and drug-drug interactions that need to be resolved. It is necessary to understand the mechanisms of toxicity in order to recognize and manage them adequately.
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Affiliation(s)
- Claudio Cerchione
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per Lo Studio Dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Andrés Peleteiro Raíndo
- Health Research Institute of Santiago De Compostela (Idis), Santiago De Compostela, Spain.,Division of Hematology, Complejo Hospitalario Universitario De Santiago (Chus), Santiago De Compostela, Spain
| | - Adrián Mosquera Orgueira
- Health Research Institute of Santiago De Compostela (Idis), Santiago De Compostela, Spain.,Division of Hematology, Complejo Hospitalario Universitario De Santiago (Chus), Santiago De Compostela, Spain
| | - Alicia Mosquera Torre
- Health Research Institute of Santiago De Compostela (Idis), Santiago De Compostela, Spain.,Division of Hematology, Complejo Hospitalario Universitario De Santiago (Chus), Santiago De Compostela, Spain
| | - Laura Bao Pérez
- Health Research Institute of Santiago De Compostela (Idis), Santiago De Compostela, Spain.,Division of Hematology, Complejo Hospitalario Universitario De Santiago (Chus), Santiago De Compostela, Spain
| | - Giovanni Marconi
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per Lo Studio Dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Alessandro Isidori
- Hematology and Stem Cell Transplant Center, Aormn Hospital, Pesaro, Italy
| | - Manuel Mateo Pérez Encinas
- Health Research Institute of Santiago De Compostela (Idis), Santiago De Compostela, Spain.,Division of Hematology, Complejo Hospitalario Universitario De Santiago (Chus), Santiago De Compostela, Spain.,University of Santiago De Compostela, Santiago De Compostela, Spain
| | - Giovanni Martinelli
- Hematology Unit, IRCCS Istituto Scientifico Romagnolo per Lo Studio Dei Tumori (IRST) "Dino Amadori", Meldola, Italy
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Yao YF, Feng J, Liu J, Chen CF, Yu B, Hu XP. Disseminated infection by Fusarium solani in acute lymphocytic leukemia: A case report. World J Clin Cases 2021; 9:6443-6449. [PMID: 34435010 PMCID: PMC8362567 DOI: 10.12998/wjcc.v9.i22.6443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/07/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, the rate of immunosuppressed patients has increased rapidly. Invasive fungal infections usually occur in these patients, especially those who have had hematological malignances and received chemotherapy. Fusariosis is a rare pathogenic fungus, it can lead to severely invasive Fusarium infections. Along with the increased rate of immune compromised patients, the incidence of invasive Fusarium infections has also increased from the past few years. Early diagnosis and therapy are important to prevent further development to a more aggressive or disseminated infection.
CASE SUMMARY We report a case of a 19-year-old male acute B-lymphocytic leukemia patient with fungal infection in the skin, eyeball, and knee joint during the course of chemotherapy. We performed skin biopsy, microbial cultivation, and molecular biological identification, and the pathogenic fungus was finally confirmed to be Fusarium solani. The patient was treated with oral 200 mg voriconazole twice daily intravenous administration of 100 mg liposomal amphotericin B once daily, and surgical debridement. Granulocyte colony-stimulating factor was administered to expedite neutrophil recovery. The disseminated Fusarium solani infection eventually resolved, and there was no recurrence at the 3 mo follow-up.
CONCLUSION Our case illustrates the early detection and successful intervention of a systemic invasive Fusarium infection. These are important to prevent progression to a more aggressive infection. Disseminate Fusarium infection requires the systemic use of antifungal agents and immunotherapy. Localized infection likely benefits from surgical debridement and the use of topical antifungal agents.
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Affiliation(s)
- Yu-Fang Yao
- Department of Dermatology & Venereology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Jia Feng
- Department of Hematology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Jie Liu
- Department of Dermatology & Venereology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Chao-Feng Chen
- Department of Dermatology & Venereology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Bo Yu
- Department of Dermatology & Venereology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Xiao-Ping Hu
- Department of Dermatology & Venereology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
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Normand AC, Imbert S, Brun S, Al-Hatmi AMS, Chryssanthou E, Cassaing S, Schuttler C, Hasseine L, Mahinc C, Costa D, Bonnal C, Ranque S, Sautour M, Rubio E, Delhaes L, Riat A, Sendid B, Kristensen L, Brandenberger M, Guitard J, Packeu A, Piarroux R, Fekkar A. Clinical Origin and Species Distribution of Fusarium spp. Isolates Identified by Molecular Sequencing and Mass Spectrometry: A European Multicenter Hospital Prospective Study. J Fungi (Basel) 2021; 7:jof7040246. [PMID: 33806102 PMCID: PMC8064482 DOI: 10.3390/jof7040246] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 01/30/2023] Open
Abstract
Fusarium spp. are widespread environmental fungi as well as pathogens that can affect plants, animals and humans. Yet the epidemiology of human fusariosis is still cloudy due to the rapidly evolving taxonomy. The Mass Spectrometry Identification database (MSI) has been developed since 2017 in order to allow a fast, accurate and free-access identification of fungi by matrix-assisted laser desorption ionization—time of flight (MALDI-TOF) mass spectrometry. Taking advantage of the MSI database user network, we aim to study the species distribution of Fusarium spp. isolates in an international multicenter prospective study. This study also allowed the assessment of the abilities of miscellaneous techniques to identify Fusarium isolates at the species level. The identification was performed by PCR-sequencing and phylogenic-tree approach. Both methods are used as gold standard for the evaluation of mass spectrometry. Identification at the species complex was satisfactory for all the tested methods. However, identification at the species level was more challenging and only 32% of the isolates were correctly identified with the National Center for Biotechnology Information (NCBI) DNA database, 20% with the Bruker MS database and 43% with the two MSI databases. Improvement of the mass spectrometry database is still needed to enable precise identification at the species level of any Fusarium isolates encountered either in human pathology or in the environment.
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Affiliation(s)
- Anne-Cécile Normand
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Correspondence: ; Tel.: +33-142160113
| | - Sébastien Imbert
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6525 Nijmegen, The Netherlands;
| | - Sophie Brun
- AP-HP, Hôpital Avicenne, Service de Parasitologie-Mycologie, 93000 Bobigny, France;
| | - Abdullah M. S. Al-Hatmi
- Centre of Expertise in Mycology Radboud University Medical Centre, Canisius Wilhelmina Hospital, 6525 Nijmegen, The Netherlands;
- Natural & Medical Sciences Research Center, Department of Microbiology, University of Nizwa, Nizwa 616, Oman
| | - Erja Chryssanthou
- Division of Clinical Microbiology, Karolinska Institutet, Department of Laboratory Medicine, 171 77 Stockholm, Sweden;
| | - Sophie Cassaing
- CHU Toulouse, Service de Parasitologie-Mycologie, 31000 Toulouse, France;
| | | | - Lilia Hasseine
- CHU de Nice, Service de Parasitologie Mycologie, 06200 Nice, France;
| | - Caroline Mahinc
- CHU de Saint Etienne, Service de Parasitologie Mycologie, 42000 Saint Etienne, France;
| | - Damien Costa
- Centre Hospitalier Universitaire de Rouen, Service de Parasitologie Mycologie, 76000 Rouen, France;
| | - Christine Bonnal
- AP-HP, Hôpital Bichat-Claude Bernard, Service de Parasitologie Mycologie, 75018 Paris, France;
| | - Stéphane Ranque
- Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, 13005 Marseille, France;
| | - Marc Sautour
- CHU de Dijon, Service de Parasitologie Mycologie, 21079 Dijon, France;
| | - Elisa Rubio
- Department of Microbiology, ISGlobal Barcelona Institute for Global Health, Barcelona, Spain CDB, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
| | - Laurence Delhaes
- CHU de Bordeaux, Groupe Hospitalier Pellegrin, Service de Mycologie, 33404 Bordeaux, France;
| | - Arnaud Riat
- Laboratory of bacteriology, Division of Laboratory Medicine, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland;
| | - Boualem Sendid
- Department Parasitology-Mycology, CHU de Lille, 59000 Lille, France;
| | - Lise Kristensen
- Department of Clinical Microbiology, Aarhus University Hospital, 8200 Aarhus, Denmark;
| | | | - Juliette Guitard
- Centre de Recherche Saint-Antoine, Inserm, CRSA, AP-HP, Hôpital Saint-Antoine, Service de Parasitologie-Mycologie, Sorbonne Université, 75012 Paris, France;
| | - Ann Packeu
- Sciensano, BCCM/IHEM collection, Mycology and Aerobiology Unit, 1000 Brussels, Belgium;
| | - Renaud Piarroux
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Inserm, Institut Pierre Louis d’Epidemiologie et de Santé Publique, Sorbonne Université, 75571 Paris, France
| | - Arnaud Fekkar
- AP-HP, Groupe Hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, 75013 Paris, France; (S.I.); (R.P.); (A.F.)
- Inserm, CNRS, Centre d’Immunologie et des Maladies Infectieuses, Cimi-Paris, Sorbonne Université, 75005 Paris, France
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Das L, Dahiya D, Gupta K, Prakash M, Malhotra B, Rastogi A, Choudhary H, Rudramurthy SM, Dutta P. Eumycetoma of the Foot due to Fusarium solani in a Person with Diabetes Mellitus: Report of a Case and Review of Literature. Mycopathologia 2021; 186:277-288. [PMID: 33687638 DOI: 10.1007/s11046-020-00524-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/21/2020] [Indexed: 10/20/2022]
Abstract
Eumycetomas are chronic suppurative granulomas caused by fungi characterised by invasive tumefactive lesions, sinuses and discharging grains. Herein, we describe a case of pedal eumycetoma due to Fusarium solani sensu stricto in a person with diabetes mellitus. A 45-year-old gentleman presented with an insidious onset swelling over his right foot with nodules and discharging grains. He had received itraconazole and anti-tuberculous therapy elsewhere, without response. Re-evaluation included a biopsy which confirmed eumycetoma and newly diagnosed diabetes. Surgical excision followed by histopathological, microbiological and multigene sequencing analyses [translation elongation factor, calmodulin and internal transcribed spacer region of rDNA] of the mould on culture were performed. Histopathology revealed septate fungal hyphae amidst a dense inflammatory infiltrate (Splendore-Hoeppli) reaction. Oral voriconazole was started and good glycemic control attained. Tissue growth sequences showed > 99% similarity with Fusarium solani sensu stricto. Antifungal susceptibility testing showed lowest MIC to voriconazole (0.5 mg/L). The patient showed excellent response to combined therapeutic modality with a near-complete resolution in size of lesion and obliteration of sinuses following 4 months of therapy and is planned for prolonged voriconazole therapy till complete radiological resolution. Diabetes predisposes to fungal infections of foot but eumycetomas are uncommon. Combined surgery and antifungals can improve morbidity and avoid amputations.
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Affiliation(s)
- Liza Das
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Divya Dahiya
- Department of General Surgery, PGIMER, Chandigarh, India
| | - Kirti Gupta
- Department of Histopathology, PGIMER, Chandigarh, India
| | | | - Bhanu Malhotra
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Ashu Rastogi
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India
| | - Hansraj Choudhary
- Department of Medical Microbiology, PGIMER, Nehru Hospital, Research Block A, Chandigarh, India
| | | | - Pinaki Dutta
- Department of Endocrinology, PGIMER, 1012, Nehru Hospital Extension Block, Chandigarh, 160012, India.
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14
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Advances in Fusarium drug resistance research. J Glob Antimicrob Resist 2021; 24:215-219. [PMID: 33460843 DOI: 10.1016/j.jgar.2020.12.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/19/2020] [Accepted: 12/16/2020] [Indexed: 12/12/2022] Open
Abstract
Fusarium species cause many diseases in plants and humans, which results in a great number of economic losses every year. The management of plant diseases and related human diseases caused by Fusarium is challenging as many kinds of Fusarium may be intrinsically resistant to antifungal drugs, not to mention the fact that they can acquire drug resistance, which is common in clinical practice. To date, the drug resistance of Fusarium is mainly related to target alterations, drug efflux and biofilm formation. This article reviews recent studies related to the mechanism of Fusarium resistance, and summarizes the key molecules affecting resistance.
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Carolus H, Pierson S, Lagrou K, Van Dijck P. Amphotericin B and Other Polyenes-Discovery, Clinical Use, Mode of Action and Drug Resistance. J Fungi (Basel) 2020; 6:E321. [PMID: 33261213 PMCID: PMC7724567 DOI: 10.3390/jof6040321] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 12/21/2022] Open
Abstract
Although polyenes were the first broad spectrum antifungal drugs on the market, after 70 years they are still the gold standard to treat a variety of fungal infections. Polyenes such as amphotericin B have a controversial image. They are the antifungal drug class with the broadest spectrum, resistance development is still relatively rare and fungicidal properties are extensive. Yet, they come with a significant host toxicity that limits their use. Relatively recently, the mode of action of polyenes has been revised, new mechanisms of drug resistance were discovered and emergent polyene resistant species such as Candida auris entered the picture. This review provides a short description of the history and clinical use of polyenes, and focusses on the ongoing debate concerning their mode of action, the diversity of resistance mechanisms discovered to date and the most recent trends in polyene resistance development.
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Affiliation(s)
- Hans Carolus
- VIB-KU Leuven Center for Microbiology, 3001 Leuven, Belgium; (H.C.); (S.P.)
- Laboratory of Molecular Cell Biology, Department of Biology, KU Leuven, 3001 Leuven, Belgium
| | - Siebe Pierson
- VIB-KU Leuven Center for Microbiology, 3001 Leuven, Belgium; (H.C.); (S.P.)
- Laboratory of Molecular Cell Biology, Department of Biology, KU Leuven, 3001 Leuven, Belgium
| | - Katrien Lagrou
- Laboratory of Clinical Bacteriology and Mycology, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3001 Leuven, Belgium;
- Department of Laboratory Medicine and National Reference Center for Mycosis, UZ Leuven, 3001 Leuven, Belgium
| | - Patrick Van Dijck
- VIB-KU Leuven Center for Microbiology, 3001 Leuven, Belgium; (H.C.); (S.P.)
- Laboratory of Molecular Cell Biology, Department of Biology, KU Leuven, 3001 Leuven, Belgium
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Stemler J, Koehler P, Maurer C, Müller C, Cornely OA. Antifungal prophylaxis and novel drugs in acute myeloid leukemia: the midostaurin and posaconazole dilemma. Ann Hematol 2020; 99:1429-1440. [PMID: 32514626 PMCID: PMC7316674 DOI: 10.1007/s00277-020-04107-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/27/2020] [Indexed: 12/21/2022]
Abstract
With the advent of new targeted drugs in hematology and oncology patient prognosis is improved. Combination with antifungal prophylaxis challenges clinicians due to pharmacological profiles prone to drug–drug interactions (DDI). Midostaurin is a novel agent for FLT3-TKD/-ITDmut-acute myeloid leukemia (AML) and metabolized via cytochrome P450 3A4 (CYP3A4). Posaconazole is a standard of care antifungal agent used for prophylaxis during induction treatment of AML and a strong CYP3A4 inhibitor. Concomitant administration of both drugs leads to elevated midostaurin exposure. Both drugs improve overall survival at low numbers needed to treat. The impact of CYP3A4-related DDI remains to be determined. Severe adverse events have been observed; however, it remains unclear if they can be directly linked to DDI. The lack of prospective clinical studies assessing incidence of invasive fungal infections and clinical impact of DDI contributes to neglecting live-saving antifungal prophylaxis. Management strategies to combine both drugs have been proposed, but evidence on which approach to use is scarce. In this review, we discuss several approaches in the specific clinical setting of concomitant administration of midostaurin and posaconazole and give examples from everyday clinical practice. Therapeutic drug monitoring will become increasingly important to individualize and personalize antineoplastic concomitant and antifungal treatment in the context of DDI. Pharmaceutical companies addressing the issue in clinical trials may take a pioneer role in this field. Other recently developed and approved drugs for the treatment of AML likely inhere potential of DDI marking a foreseeable issue in future treatment of this life-threatening disease.
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Affiliation(s)
- Jannik Stemler
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
| | - Philipp Koehler
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Christian Maurer
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
| | - Carsten Müller
- Centre of Pharmacology, Therapeutic Drug Monitoring, Faculty of Medicine, Cologne, University Hospital of Cologne, Cologne, Germany
| | - Oliver A Cornely
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany. .,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany. .,German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany. .,Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany.
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