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Zhang X, Jin F, Ni F, Xu Y, Lu Y, Xia W. Clinical data analysis of 86 patients with invasive infections caused by Malassezia furfur from a tertiary medical center and 37 studies. Front Cell Infect Microbiol 2023; 13:1079535. [PMID: 37457952 PMCID: PMC10340522 DOI: 10.3389/fcimb.2023.1079535] [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: 11/11/2022] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Malassezia furfur (M. furfur) is a lipophilic, conditionally pathogenic yeast that mainly causes skin infections, but the reports of related invasive infections are increasing. The aim of this study is to provide clinical data to assist physicians in the management of patients with invasive infections caused by M. furfur. Methods A case of pulmonary infection caused by M. furfur in a hematopoietic stem cell transplant patient for aplastic anemia was reported. In addition, the literature on invasive infection by M. furfur published in PubMed and Web of Science in English until 31 July 2022 was reviewed. Results Clinical data analysis of 86 patients (from 37 studies and our case) revealed that most of them were preterm (44.2%), followed by adults (31.4%). M. furfur fungemia occurred in 79.1% of the 86 patients, and 45 of them were clearly obtained from catheter blood. Other patients developed catheter-related infections, pneumonia, peripheral thromboembolism, endocarditis, meningitis, peritonitis and disseminated infections. Thirty-eight preterm infants had underlying diseases such as very low birth weight and/or multiple organ hypoplasia. The remaining patients had compromised immunity or severe gastrointestinal diseases. 97.7% of patients underwent invasive procedures and 80.2% received total parenteral nutrition (TPN). Fever, thrombocytopenia and leukocytosis accounted for 55.8%, 38.4% and 24.4% of patients with M. furfur invasive infections, respectively. 69.8% of the patients received antifungal therapy, mainly amphotericin B (AmB) or azoles. Of 84 patients with indwelling catheters, 58.3% underwent the removal of catheters. TPN were discontinued in 30 of 69 patients. The all-cause mortality of 86 patients was 27.9%. Conclusions M. furfur can cause a variety of invasive infections. These patients mostly occur in premature infants, low immunity and severe gastrointestinal diseases. Indwelling catheters and TPN infusion are major risk factors. AmB, l-AmB and azoles are the most commonly used agents, and simultaneous removal of the catheter and termination of TPN infusion are important for the treatment of M. furfur invasive infections.
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Affiliation(s)
- Xiaohui Zhang
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
| | - Fei Jin
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
| | - Fang Ni
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
| | - Yuqiao Xu
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
| | - Yanfei Lu
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
| | - Wenying Xia
- Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
- Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China
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Hobi S, Cafarchia C, Romano V, Barrs VR. Malassezia: Zoonotic Implications, Parallels and Differences in Colonization and Disease in Humans and Animals. J Fungi (Basel) 2022; 8:jof8070708. [PMID: 35887463 PMCID: PMC9324274 DOI: 10.3390/jof8070708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 12/13/2022] Open
Abstract
Malassezia spp. are commensals of the skin, oral/sinonasal cavity, lower respiratory and gastrointestinal tract. Eighteen species have been recovered from humans, other mammals and birds. They can also be isolated from diverse environments, suggesting an evolutionary trajectory of adaption from an ecological niche in plants and soil to the mucocutaneous ecosystem of warm-blooded vertebrates. In humans, dogs and cats, Malassezia-associated dermatological conditions share some commonalities. Otomycosis is common in companion animals but is rare in humans. Systemic infections, which are increasingly reported in humans, have yet to be recognized in animals. Malassezia species have also been identified as pathogenetic contributors to some chronic human diseases. While Malassezia species are host-adapted, some species are zoophilic and can cause fungemia, with outbreaks in neonatal intensive care wards associated with temporary colonization of healthcare worker’s hands from contact with their pets. Although standardization is lacking, susceptibility testing is usually performed using a modified broth microdilution method. Antifungal susceptibility can vary depending on Malassezia species, body location, infection type, disease duration, presence of co-morbidities and immunosuppression. Antifungal resistance mechanisms include biofilm formation, mutations or overexpression of ERG11, overexpression of efflux pumps and gene rearrangements or overexpression in chromosome 4.
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Affiliation(s)
- Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Tat Chee Avenue, Kowloon, Hong Kong, China
- Correspondence: (S.H.); (V.R.B.)
| | - Claudia Cafarchia
- Department of Veterinary Medicine, University of Bari, Str. prov. per Casamassima Km 3, Valenzano, (Bari), 70010, Italy; (C.C.); (V.R.)
| | - Valentina Romano
- Department of Veterinary Medicine, University of Bari, Str. prov. per Casamassima Km 3, Valenzano, (Bari), 70010, Italy; (C.C.); (V.R.)
| | - Vanessa R. Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Tat Chee Avenue, Kowloon, Hong Kong, China
- Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong, China
- Correspondence: (S.H.); (V.R.B.)
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3
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Houhamdi-Hammou L, Benito Y, Boibieux A, Dupont D, Delahaye F, Thivolet-Bejui F, Wallon M, Vandenesch F, Bouchiat C. Malassezia restricta: An Underdiagnosed Causative Agent of Blood Culture-Negative Infective Endocarditis. Clin Infect Dis 2021; 73:1223-1230. [PMID: 34009270 DOI: 10.1093/cid/ciab377] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a severe disease requiring microbial identification to successfully adapt its treatment. Currently, identification of its etiological microorganism remains unresolved in 5.2% of cases. We aimed to improve IE diagnosis using an ultra-sensitive molecular technique on cardiac samples in microbiologically nondocumented (culture and conventional polymerase chain reaction [PCR]) IE (NDIE) cases. METHODS Cardiac samples explanted in a tertiary hospital in Lyon, France, from patients with definite IE over a 5-year period were retrospectively analyzed. NDIE was defined as Duke definite-IE associated with negative explorations including cardiac samples culture, bacterial amplification, and serologies. Ultrasensitive molecular diagnosis was achieved using the Universal Microbe Detection kit (Molzym®). Fungal identification was confirmed using 26S-rDNA and internal transcribed spacer amplifications. Fungal infection was confirmed using Grocott-Gromori staining, auto-immunohistochemistry on cardiac samples, and mannan serologies. RESULTS Among 88 included patients, microbial DNA was detected in all 16 NDIE cases. Bacterial taxa typical of IE etiologies were detected in 13/16 cases and Malassezia restricta in the 3 other cases. In these 3 cases, histological examination confirmed the presence of fungi pathognomonic of Malassezia that reacted with patient sera in an auto-immunohistochemistry assay and cross-reacted with Candida albicans in an indirect immunofluorescent assay. CONCLUSIONS M. restricta appears to be an underestimated causative agent of NDIE. Importantly, serological cross-reaction of M. restricta with C. albicans may lead to its misdiagnosis. This is of major concern since M. restricta is intrinsically resistant to echinocandins; the reference treatment for Candida-fungal IE.
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Affiliation(s)
- Linda Houhamdi-Hammou
- Laboratoire de Bactériologie. Institut des Agents Infectieux. Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Yvonne Benito
- Laboratoire de Bactériologie. Institut des Agents Infectieux. Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - André Boibieux
- Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Damien Dupont
- Laboratoire de Parasitologie-Mycologie, Institut des Agents Infectieux. Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - François Delahaye
- Service de Cardiologie, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Françoise Thivolet-Bejui
- Laboratoire d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - Martine Wallon
- Laboratoire de Parasitologie-Mycologie, Institut des Agents Infectieux. Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - François Vandenesch
- Laboratoire de Bactériologie. Institut des Agents Infectieux. Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Coralie Bouchiat
- Laboratoire de Bactériologie. Institut des Agents Infectieux. Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
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4
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Rhimi W, Theelen B, Boekhout T, Aneke CI, Otranto D, Cafarchia C. Conventional therapy and new antifungal drugs against Malassezia infections. Med Mycol 2021; 59:215-234. [PMID: 33099634 DOI: 10.1093/mmy/myaa087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 12/18/2022] Open
Abstract
Malassezia yeasts are commensal microorganisms occurring on the skin of humans and animals causing dermatological disorders or systemic infections in severely immunocompromised hosts. Despite attempts to control such yeast infections with topical and systemic antifungals, recurrence of clinical signs of skin infections as well as treatment failure in preventing or treating Malassezia furfur fungemia have been reported most likely due to wrong management of these infections (e.g., due to early termination of treatment) or due to the occurrence of resistant phenomena. Standardized methods for in vitro antifungal susceptibility tests of these yeasts are still lacking, thus resulting in variable susceptibility profiles to azoles among Malassezia spp. and a lack of clinical breakpoints. The inherent limitations to the current pharmacological treatments for Malassezia infections both in humans and animals, stimulated the interest of the scientific community to discover new, effective antifungal drugs or substances to treat these infections. In this review, data about the in vivo and in vitro antifungal activity of the most commonly employed drugs (i.e., azoles, polyenes, allylamines, and echinocandins) against Malassezia yeasts, with a focus on human bloodstream infections, are summarized and their clinical implications are discussed. In addition, the usefulness of alternative compounds is discussed.
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Affiliation(s)
- Wafa Rhimi
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy
| | - Bart Theelen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Teun Boekhout
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands.,Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, The Netherlands
| | - Chioma Inyang Aneke
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy.,Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, Nigeria
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy.,Faculty of Veterinary Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy
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5
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Rhimi W, Theelen B, Boekhout T, Otranto D, Cafarchia C. Malassezia spp. Yeasts of Emerging Concern in Fungemia. Front Cell Infect Microbiol 2020; 10:370. [PMID: 32850475 PMCID: PMC7399178 DOI: 10.3389/fcimb.2020.00370] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/16/2020] [Indexed: 12/23/2022] Open
Abstract
Malassezia spp. are lipid-dependent yeasts, inhabiting the skin and mucosa of humans and animals. They are involved in a variety of skin disorders in humans and animals and may cause bloodstream infections in severely immunocompromised patients. Despite a tremendous increase in scientific knowledge of these yeasts during the last two decades, the epidemiology of Malassezia spp. related to fungemia remains largely underestimated most likely due to the difficulty in the isolation of these yeasts species due to their lipid-dependence. This review summarizes and discusses the most recent literature on Malassezia spp. infection and fungemia, its occurrence, pathogenicity mechanisms, diagnostic methods, in vitro susceptibility testing and therapeutic approaches.
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Affiliation(s)
- Wafa Rhimi
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy
| | - Bart Theelen
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Teun Boekhout
- Yeast Research, Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,The Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam, Amsterdam, Netherlands.,Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Domenico Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy.,Faculty of Veterinary Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Claudia Cafarchia
- Dipartimento di Medicina Veterinaria, Università degli Studi "Aldo Moro", Bari, Italy
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6
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Angiolella L, Leone C, Rojas F, Mussin J, de Los Angeles Sosa M, Giusiano G. Biofilm, adherence, and hydrophobicity as virulence factors in Malassezia furfur. Med Mycol 2018; 56:110-116. [PMID: 28340187 DOI: 10.1093/mmy/myx014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/06/2017] [Indexed: 11/13/2022] Open
Abstract
Malassezia species are natural inhabitants of the healthy skin. However, under certain conditions, they may cause or exacerbate several skin diseases. The ability of this fungus to colonize or infect is determined by complex interactions between the fungal cell and its virulence factors. This study aims to evaluate "in vitro" the hydrophobicity levels, the adherence on a plastic surface and the biofilm formation of 16 clinical isolates of Malassezia furfur. Cellular surface hydrophobicity (CSH) levels were determined by two-phase system. The biofilm formation was determined by tetrazolium salt (XTT) reduction assay and by Scanning Electron Microscopy (SEM). Results showed many isolates were hydrophobic, adherent, and producers of biofilm on abiotic surfaces with different capacity. SEM observations confirmed an abundant extracellular matrix after 48 h of biofilm formation. About 63% of strains with high production of biofilm showed medium to high percentage of hydrophobicity and/or adherence. In addition, it has been demonstrated a correlation between hydrophobicity, adherence, and biofilm formation in about 60% of strains examined. These important virulence factors could be responsible of this yeast changing from a commensal to a pathogenic status.
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Affiliation(s)
- Letizia Angiolella
- Department of Public Health and Infectious Diseases. University of Rome "Sapienza", Italy. Piazzale Aldo Moro 5, 00100 Roma, Italy
| | - Claudia Leone
- Department of Public Health and Infectious Diseases. University of Rome "Sapienza", Italy. Piazzale Aldo Moro 5, 00100 Roma, Italy
| | - Florencia Rojas
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - Javier Mussin
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - María de Los Angeles Sosa
- Departamento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, Resistencia, Argentina
| | - Gustavo Giusiano
- Departamento de Micología, Instituto de Medicina Regional, Facultad de Medicina, Universidad Nacional del Nordeste, CONICET, Resistencia, Argentina
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7
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Sivasankar C, Gayathri S, Bhaskar JP, Krishnan V, Pandian SK. Evaluation of selected Indian medicinal plants for antagonistic potential against Malassezia spp. and the synergistic effect of embelin in combination with ketoconazole. Microb Pathog 2017. [PMID: 28645774 DOI: 10.1016/j.micpath.2017.06.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The genus Malassezia comprises of extremely lipophilic yeasts secreting lipases as a vital factor for survival. They are emerging as opportunistic pathogens in medical microbiology and dermatology by causing recurring and recalcitrant infection. Combinatorial therapy is a constructive way to combat infectious diseases. In that prospect, totally 16 Indian medicinal plants were screened, among which a maximum degree of antimicrobial activity was ascertained in Embelia ribes. Subsequently embelin was identified as the bioactive principle with antagonistic potential by comparative antimicrobial assay and FTIR analysis. The MIC of embelin was determined as 400 μg/ml exhibiting ∼75% of growth inhibition. Further, a fungistatic activity based on anti-lipase potential (65-89%) of embelin has been clearly substantiated by XTT and lipase assay. In addition, embelin exhibited a synergistic effect with the antifungal drug ketoconazole (KTZ) against four different Malassezia spp. with FIC index of 0.5. Therefore, the combinations of embelin and KTZ may represent a promising therapeutic regimen to treat Malassezia infections with subjugated clinical and environmental toxicity. To the best of our knowledge, this is the first report delineating the anti-lipase activity of embelin and in vitro synergistic interaction between embelin and KTZ against Malassezia spp.
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Affiliation(s)
- Chandran Sivasankar
- Department of Biotechnology, Alagappa University, Science Campus, Karaikudi 630003, India
| | | | | | - Venkat Krishnan
- ITC Life Sciences & Technology Centre, Peenya, Bengaluru 560058, India
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8
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Sivasankar C, Ponmalar A, Bhaskar JP, Pandian SK. Glutathione as a promising anti-hydrophobicity agent against Malassezia spp. Mycoses 2015; 58:620-31. [PMID: 26334025 DOI: 10.1111/myc.12370] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/20/2015] [Accepted: 07/17/2015] [Indexed: 11/29/2022]
Abstract
The genus Malassezia has recently attracted wide attention in medical microbiology and dermatology as a pathogen. They are lipophilic yeasts possessing high level of cell surface hydrophobicity (CSH). L-glutathione (GSH) is a ubiquitous antioxidant which offers protection against microbial infections. This study is intended to investigate the role of GSH as a potential anti-hydrophobicity agent against Malazessia spp. Microbial adherence to hydrocarbon assay was performed to assess the anti-hydrophobicity activity (AHA) of GSH against four Malassezia spp. The assay revealed that GSH at 400 μg ml(-1) concentration inhibited CSH, ranging from 84% to 95% in M. furfur, M. globosa, M. restricta and M. sympodialis without killing the cells. The AHA of GSH was corroborated by auto-aggregation assay and zeta-potential measurement, through which delayed cell aggregation was observed due to reduction in CSH level and not by modification in cell surface charge. In addition, colony-forming unit assay was performed in which 62-93% of CSH reduction was observed in Malassezia spp. tested. Furthermore, GSH treatment enhanced the sensitivity of Malassezia spp. towards human blood at the rate of 64-72%. The AHA was further confirmed through Fourier transform infrared analysis. Thus, this study portrays GSH as a prospective therapeutic alternative for Malassezia-mediated infections.
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Rojas FD, Sosa MDLA, Fernandez MS, Cattana ME, Cordoba SB, Giusiano GE. Antifungal susceptibility of Malassezia furfur, Malassezia sympodialis, and Malassezia globosa to azole drugs and amphotericin B evaluated using a broth microdilution method. Med Mycol 2014; 52:641-6. [DOI: 10.1093/mmy/myu010] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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10
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Kolecka A, Khayhan K, Arabatzis M, Velegraki A, Kostrzewa M, Andersson A, Scheynius A, Cafarchia C, Iatta R, Montagna M, Youngchim S, Cabañes F, Hoopman P, Kraak B, Groenewald M, Boekhout T. Efficient identification ofMalasseziayeasts by matrix‐assisted laser desorption ionization‐time of flight mass spectrometry (MALDI‐TOF MS). Br J Dermatol 2014; 170:332-41. [DOI: 10.1111/bjd.12680] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2013] [Indexed: 12/15/2022]
Affiliation(s)
- A. Kolecka
- Department of Yeast and Basidiomycete Research CBS‐KNAW Fungal Biodiversity Centre Uppsalalaan 8 3584CT Utrecht the Netherlands
| | - K. Khayhan
- Department of Yeast and Basidiomycete Research CBS‐KNAW Fungal Biodiversity Centre Uppsalalaan 8 3584CT Utrecht the Netherlands
- Department of Microbiology and Parasitology Faculty of Medical Sciences University of Phayao Phayao Thailand
| | - M. Arabatzis
- Research Mycology Laboratory (K.A. 70/3/6915) Microbiology Department Medical School of University of Athens Athens Greece
| | - A. Velegraki
- Research Mycology Laboratory (K.A. 70/3/6915) Microbiology Department Medical School of University of Athens Athens Greece
| | - M. Kostrzewa
- Bioanalytical Development Bruker Daltonics GmbH Bremen Germany
| | - A. Andersson
- Translational Immunology Unit Department of Medicine Solna Karolinska Institutet Stockholm Sweden
| | - A. Scheynius
- Translational Immunology Unit Department of Medicine Solna Karolinska Institutet Stockholm Sweden
| | - C. Cafarchia
- Department of Veterinary Medicine Aldo Moro University of Bari Bari Italy
| | - R. Iatta
- Department of Veterinary Medicine Aldo Moro University of Bari Bari Italy
| | - M.T. Montagna
- Department of Biomedical Science and Human Oncology Section of Hygiene Aldo Moro University of Bari Bari Italy
| | - S. Youngchim
- Department of Microbiology Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | - F.J. Cabañes
- Department of Animal Health and Anatomy Universitat Autònoma de Barcelona Bellaterra Barcelona Spain
| | - P. Hoopman
- Department of Yeast and Basidiomycete Research CBS‐KNAW Fungal Biodiversity Centre Uppsalalaan 8 3584CT Utrecht the Netherlands
| | - B. Kraak
- Department of Yeast and Basidiomycete Research CBS‐KNAW Fungal Biodiversity Centre Uppsalalaan 8 3584CT Utrecht the Netherlands
| | - M. Groenewald
- Department of Yeast and Basidiomycete Research CBS‐KNAW Fungal Biodiversity Centre Uppsalalaan 8 3584CT Utrecht the Netherlands
| | - T. Boekhout
- Department of Yeast and Basidiomycete Research CBS‐KNAW Fungal Biodiversity Centre Uppsalalaan 8 3584CT Utrecht the Netherlands
- Department of Internal Medicine and Infectious Diseases University Medical Center Utrecht the Netherlands
- Department of Dermatology Shanghai Key Laboratory of Molecular Medical Mycology Second Military Medical University Changzheng Hospital Institute of Dermatology and Medical Mycology Shanghai China
- Institute of Microbiology Chinese Academy of Sciences Beijing China
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Abstract
In the last 15 years, the genus Malassezia has been a topic of intense basic research on taxonomy, physiology, biochemistry, ecology, immunology, and metabolomics. Currently, the genus encompasses 14 species. The 1996 revision of the genus resulted in seven accepted taxa: M. furfur, M. pachydermatis, M. sympodialis, M. globosa, M. obtusa, M. restricta, and M. slooffiae. In the last decade, seven new taxa isolated from healthy and lesional human and animal skin have been accepted: M. dermatis, M. japonica, M. yamatoensis, M. nana, M. caprae, M. equina, and M. cuniculi. However, forthcoming multidisciplinary research is expected to show the etiopathological relationships between these new species and skin diseases. Hitherto, basic and clinical research has established etiological links between Malassezia yeasts, pityriasis versicolor, and sepsis of neonates and immunocompromised individuals. Their role in aggravating seborrheic dermatitis, dandruff, folliculitis, and onychomycosis, though often supported by histopathological evidence and favorable antifungal therapeutic outcomes, remains under investigation. A close association between skin and Malassezia IgE binding allergens in atopic eczema has been shown, while laboratory data support a role in psoriasis exacerbations. Finally, metabolomic research resulted in the proposal of a hypothesis on the contribution of Malassezia-synthesized aryl hydrocarbon receptor (AhR) ligands to basal cell carcinoma through UV radiation-induced carcinogenesis.
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[Labor epidural analgesia for a woman with a pityriasis versicolor in the lumbar region]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2011; 30:597-9. [PMID: 21680133 DOI: 10.1016/j.annfar.2011.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2010] [Accepted: 04/20/2011] [Indexed: 12/22/2022]
Abstract
Epidural analgesia is usually contraindicated in case of infection at the site of needle insertion. Tinea versicolor is a benign superficial cutaneous fungal infection caused by the proliferation of a skin commensal yeast of low pathogenicity. We report the case of a pregnant woman with a tinea versicolor in the lumbar region, who benefited from a labor epidural analgesia, realised with reinforced antiseptic measures. No neurological or infectious complication occurred.
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13
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Malassezia Species: A Rare Cause of Invasive Fungal Infections in Immunocompromised Patients. CURRENT FUNGAL INFECTION REPORTS 2010. [DOI: 10.1007/s12281-010-0037-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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14
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Tragiannidis A, Bisping G, Koehler G, Groll AH. Minireview:Malasseziainfections in immunocompromised patients. Mycoses 2010; 53:187-95. [DOI: 10.1111/j.1439-0507.2009.01814.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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15
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Sontineni SP, White M, Singh S, Arouni A, Cloutier D, Nair CK, Mohiuddin SM. Thrombectomy reduces the systemic complications in device-related right atrial septic thrombosis. Can J Cardiol 2009; 25:e36-41. [PMID: 19214299 DOI: 10.1016/s0828-282x(09)70482-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Septic thrombosis of the right atrium is an unusual complication associated with the use of indwelling devices. The optimal management of this condition is unclear. Our experience with a patient with hemodialysis catheter-related septic thrombosis of the right atrium illustrates the difficulties associated with this condition. OBJECTIVES To determine the effects of surgical thrombectomy compared with nonsurgical treatment with antibiotics (with or without anticoagulation) on mortality rates and complications in patients with device-related septic thrombosis of the right atrium. METHODS A retrospective analysis of all reported cases of device-related right heart septic thrombosis in which therapy and outcome were reported was conducted using a PubMed search in the English-language literature (1985 to 2006). RESULTS Forty cases of device-related right atrial septic thromboses were reported in the literature during the chosen time period. The treatments administered were none (12.5%), antibiotics (12.5%), antibiotics and anticoagulation (20%), and thrombectomy (55%). The mean clot size was significantly larger in patients who underwent thrombectomy. All untreated patients died. Excluding the untreated patients from the analysis, systemic complications were significantly lower in the thrombectomy group than in the groups receiving nonsurgical therapies. Using multivariate modelling with survival as the primary outcome, age, sex, clot size, clot location, microbial organism or type of treatment were not predictive of the outcome. CONCLUSION Device-related right atrial septic thrombosis is associated with significant mortality and is uniformly fatal if untreated. Surgical thrombectomy is associated with less frequent systemic complications. A well-designed prospective, randomized trial is needed to determine the optimal treatment of this condition.
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Cannizzo FT, Eraso E, Ezkurra PA, Villar-Vidal M, Bollo E, Castellá G, Cabañes FJ, Vidotto V, Quindós G. Biofilm development by clinical isolates ofMalassezia pachydermatis. Med Mycol 2007; 45:357-61. [PMID: 17510859 DOI: 10.1080/13693780701225767] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Malassezia pachydermatis fungemia has been reported in patients receiving parenteral nutrition. Biofilm formation on catheters may be related to the pathogenesis of this mycosis. We investigated the biofilm-forming ability of 12 M. pachydermatis strains using a metabolic activity plate-based model and electronic microscopic evaluation of catheter surfaces. All M. pachydermatis strains developed biofilms but biofilm formation showed variability among the different strains unrelated to their clinical origin. This study demonstrates the ability of M. pachydermatis to adhere to and form biofilms on the surfaces of different materials, such as polystyrene and polyurethane.
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Affiliation(s)
- Francesca T Cannizzo
- Laboratorio de Micología Médica, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Odontología, Universidad del País Vasco-Euskal Herriko Unibertsitatea, Bilbao, Spain
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Velegraki A, Alexopoulos EC, Kritikou S, Gaitanis G. Use of fatty acid RPMI 1640 media for testing susceptibilities of eight Malassezia species to the new triazole posaconazole and to six established antifungal agents by a modified NCCLS M27-A2 microdilution method and Etest. J Clin Microbiol 2004; 42:3589-93. [PMID: 15297502 PMCID: PMC497592 DOI: 10.1128/jcm.42.8.3589-3593.2004] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel formulation of RPMI 1640 medium for susceptibility testing of Malassezia yeasts by broth microdilution (BMD) and Etest is proposed. A modification of the NCCLS M27-A2 BMD method was used to test 53 isolates of Malassezia furfur (12 isolates), M. sympodialis (8 isolates), M. slooffiae (4 isolates), M. globosa (22 isolates), M. obtusa (2 isolates), M. restricta (2 isolates), M. pachydermatis (1 isolates), and M. dermatis (2 isolates) against amphotericin B, ketoconazole, itraconazole, fluconazole, voriconazole, terbinafine, and posaconazole by BMD and Etest. RPMI and antibiotic medium 3 (AM3) were supplemented with glucose, bile salts, a mixture of fatty acids, and n-octadecanoate fatty acids and Tween 20. M. furfur ATCC 14521 and M. globosa ATCC 96807 were used as quality control strains. Depending on the species, MICs were read after 48 or 72 h of incubation at 32 degrees C. Low azole and terbinafine MICs were recorded for all Malassezia species, whereas amphotericin B displayed higher MICs (>/=16 microg/ml) against M. furfur, M. restricta, M. globosa, and M. slooffiae strains, which were AM3 confirmed. Agreement of the two methods was 84 to 97%, and intraclass correlation coefficients were statistically significant (P < 0.001). Because of higher amphotericin B MICs provided by Etest for strains also displaying high BMD MICs (>/=1 microg/ml), agreement was poorer. The proposed media are used for the first time and can support optimum growth of eight Malassezia species for recording concordant BMD and Etest MICs.
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Affiliation(s)
- Aristea Velegraki
- Mycology Reference Laboratory, Department of Microbiology, Medical School, University of Athens, Mikras Asias 75-77, Goudi, Athens 115 27, Greece.
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Abstract
Malassezia species are members of the human cutaneous commensal flora, in addition to causing a wide range of cutaneous and systemic diseases in suitably predisposed individuals. Studies examining cellular and humoral immune responses specific to Malassezia species in patients with Malassezia-associated diseases and healthy controls have generally been unable to define significant differences in their immune response. The use of varied antigenic preparations and strains from different Malassezia classifications may partly be responsible for this, although these problems can now be overcome by using techniques based on recent work defining some important antigens and also a new taxonomy for the genus. The finding that the genus Malassezia is immunomodulatory is important in understanding its ability to cause disease. Stimulation of the reticuloendothelial system and activation of the complement cascade contrasts with its ability to suppress cytokine release and downregulate phagocytic uptake and killing. The lipid-rich layer around the yeast appears to be pivotal in this alteration of phenotype. Defining the nonspecific immune response to Malassezia species and the way in which the organisms modulate it may well be the key to understanding how Malassezia species can exist as both commensals and pathogens.
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Affiliation(s)
- H Ruth Ashbee
- Mycology Reference Centre, Division of Microbiology, University of Leeds and Leeds General Infirmary, Leeds, United Kingdom.
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