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Bosaeed M, Alshehri RA, Albarrak DA, Sharif T, Alghamdi M, Alsunidy AA. An unexpected opportunist: Magnusiomyces capitatus infection in an immunocompetent patient. Med Mycol Case Rep 2024; 45:100663. [PMID: 39155939 PMCID: PMC11326947 DOI: 10.1016/j.mmcr.2024.100663] [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: 04/17/2024] [Revised: 07/20/2024] [Accepted: 07/21/2024] [Indexed: 08/20/2024] Open
Abstract
Magnusiomyces capitatus is an uncommon opportunistic fungal pathogen primarily affecting immunocompromised individuals. While rare, cases have been reported in immunocompetent patients. We present a documented case of Magnusiomyces capitatus invasive infection in an immunocompetent patient with no previous medical history. This case shows that invasive fungal infections by Magnusiomyces capitatus might affect even the immunocompetent patients.
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Affiliation(s)
- Mohammad Bosaeed
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Rana Ayesh Alshehri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Danah Abdullah Albarrak
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Tauseef Sharif
- Department of Pathology & Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Majed Alghamdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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2
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Liu Y, Wu W, Xiao Y, Zou H, Hao S, Jiang Y. Application of metagenomic next-generation sequencing and targeted metagenomic next-generation sequencing in diagnosing pulmonary infections in immunocompetent and immunocompromised patients. Front Cell Infect Microbiol 2024; 14:1439472. [PMID: 39165919 PMCID: PMC11333343 DOI: 10.3389/fcimb.2024.1439472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/09/2024] [Indexed: 08/22/2024] Open
Abstract
Background Metagenomic next-generation sequencing (mNGS) technology has been widely used to diagnose various infections. Based on the most common pathogen profiles, targeted mNGS (tNGS) using multiplex PCR has been developed to detect pathogens with predesigned primers in the panel, significantly improving sensitivity and reducing economic burden on patients. However, there are few studies on summarizing pathogen profiles of pulmonary infections in immunocompetent and immunocompromised patients in Jilin Province of China on large scale. Methods From January 2021 to December 2023, bronchoalveolar lavage fluid (BALF) or sputum samples from 546 immunocompetent and immunocompromised patients with suspected community-acquired pneumonia were collected. Pathogen profiles in those patients on whom mNGS was performed were summarized. Additionally, we also evaluated the performance of tNGS in diagnosing pulmonary infections. Results Combined with results of mNGS and culture, we found that the most common bacterial pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii in both immunocompromised and immunocompetent patients with high detection rates of Staphylococcus aureus and Enterococcus faecium, respectively. For fungal pathogens, Pneumocystis jirovecii was commonly detected in patients, while fungal infections in immunocompetent patients were mainly caused by Candida albicans. Most of viral infections in patients were caused by Human betaherpesvirus 5 and Human gammaherpesvirus 4. It is worth noting that, compared with immunocompetent patients (34.9%, 76/218), more mixed infections were found in immunocompromised patients (37.8%, 14/37). Additionally, taking final comprehensive clinical diagnoses as reference standard, total coincidence rate of BALF tNGS (81.4%, 48/59) was much higher than that of BALF mNGS (40.0%, 112/280). Conclusions Our findings supplemented and classified the pathogen profiles of pulmonary infections in immunocompetent and immunocompromised patients in Jilin Province of China. Most importantly, our findings can accelerate the development and design of tNGS specifically used for regional pulmonary infections.
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Affiliation(s)
- Yong Liu
- Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
| | - Wencai Wu
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, Biomedical Informatics & Genomics Center, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Yunping Xiao
- Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
| | - Hongyan Zou
- Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
| | - Sijia Hao
- Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
| | - Yanfang Jiang
- Genetic Diagnosis Center, The First Hospital of Jilin University, Changchun, China
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Boutin CA, Durocher F, Beauchemin S, Ziegler D, Abou Chakra CN, Dufresne SF. Breakthrough Invasive Fungal Infections in Patients With High-Risk Hematological Disorders Receiving Voriconazole and Posaconazole Prophylaxis: A Systematic Review. Clin Infect Dis 2024; 79:151-160. [PMID: 38752732 PMCID: PMC11259221 DOI: 10.1093/cid/ciae203] [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: 12/31/2023] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Primary antifungal prophylaxis with mold-active azoles is used to prevent invasive fungal infections in patients with high-risk hematological disorders; however, breakthrough infections occur, and the reasons for treatment failure are still not fully understood. To help inform clinical decisions, we sought to define microbiological, clinical, and pharmacological characteristics of proven and probable breakthrough invasive fungal infections (bIFIs) in patients with high-risk hematological disorders receiving voriconazole or posaconazole prophylaxis. METHODS We performed a systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy was last conducted on 19 April 2023. RESULTS We assessed 5293 studies for eligibility, and 300 were selected for data extraction. These studies described 1076 cases of bIFIs occurring under voriconazole (42.5%) or posaconazole (57.5%). The most commonly found pathogens were Aspergillus (40%), Mucorales (20%), Candida (18%), and Fusarium (9%) species. Mucorales were more frequent among voriconazole-emerging cases, whereas Aspergillus and Fusarium were more prevalent among posaconazole-emerging cases. Definitive, putative, or probable antifungal resistance was found in 31% of cases. Therapeutic drug monitoring showed subtherapeutic azole concentration in 32 of 90 (36%) cases. Infection-related mortality was reported in 117 cases and reached 35%. CONCLUSIONS In our systemic review, the most common bIFIs were aspergillosis, mucormycosis, candidiasis, and fusariosis. Antifungal resistance explains only a minority of cases. Subtherapeutic prophylaxis was frequent but rarely reported. Prospective studies are needed to better understand these infections and to establish optimal management.
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Affiliation(s)
- Catherine-Audrey Boutin
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Division of Infectious Diseases, Department of Medicine, Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Florence Durocher
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Daniela Ziegler
- Direction de l’enseignement et de l’Académie, Bibliothèque, Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | | | - Simon Frédéric Dufresne
- Department of Microbiology, Infectious Diseases and Immunology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de Recherche de l’Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
- Division of Infectious Diseases and Clinical Microbiology, Department of Medicine, Hôpital Maisonneuve-Rosemont, Centre Intégré Universitaire de Santé et de Services Sociaux de l’Est-de-l’Île-de-Montréal, Montréal, Québec, Canada
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4
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Foglia F, Greco G, Zannella C, Chianese A, Ambrosino A, Conzo A, Conzo G, De Filippis A, Finamore E, Docimo L, Galdiero M. A case of Magnusiomyces capitatus isolated during monitoring in an antimicrobial diagnostic stewardship context. IDCases 2024; 36:e01959. [PMID: 38681078 PMCID: PMC11046207 DOI: 10.1016/j.idcr.2024.e01959] [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: 11/17/2023] [Revised: 03/12/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024] Open
Abstract
Magnusiomyces capitatus (M. capitatus) is an emerging opportunistic yeast in the Mediterranean region typically isolated from immunocompromised patients, usually affected by blood malignancies. We reported a rare case of M. capitatus infection, isolated from a drainage fluid in a patient affected by lung cancer recovered in the University Hospital of Campania "Luigi Vanvitelli", Naples, Italy. The isolate was identified by phenotypic methods, i.e., Gram and Lactophenol cotton blue (LCB) staining, and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis. We identified M. capitatus on the third day from Sabouraud Dextrose Agar supplemented with chloramphenicol and gentamicin. Antifungal susceptibility test revealed that 5-fluorocytosine was the most active drug against M. capitatus, followed by itraconazole and voriconazole, micafungin, amphotericin B and fluconazole, posaconazole, anidulafungin, and caspofungin. Our data showed the importance of an early cultural and fast microbiology diagnosis based on the characteristic morphologic features observed in Gram-stained smears of blood culture positive bottles, and the validation via MALDI-TOF MS. This dual approach has significant impact in the clinical management of infectious diseases and antibiotic stewardship, by integrating sample processing, fluid handling, and detection for rapid bacterial diagnosis.
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Affiliation(s)
- Francesco Foglia
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giuseppe Greco
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Carla Zannella
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Annalisa Chianese
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Annalisa Ambrosino
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Alessandra Conzo
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 1, 80131 Naples, Italy
| | - Giovanni Conzo
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 1, 80131 Naples, Italy
| | - Anna De Filippis
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Emiliana Finamore
- Complex Operative Unity of Virology and Microbiology, University Hospital of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Ludovico Docimo
- Division of General and Oncologic Surgery, Department of Cardiothoracic Sciences, University of Campania "Luigi Vanvitelli", Via Pansini 1, 80131 Naples, Italy
| | - Massimiliano Galdiero
- Department of Experimental Medicine, Section of Microbiology and Clinical Microbiology, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
- Complex Operative Unity of Virology and Microbiology, University Hospital of Campania "Luigi Vanvitelli", 80138 Naples, Italy
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Pfaller M, Huband M, Bien PA, Carvalhaes CG, Klauer A, Castanheira M. In vitro activity of manogepix and comparators against infrequently encountered yeast and mold isolates from the SENTRY Surveillance Program (2017-2022). Antimicrob Agents Chemother 2024; 68:e0113223. [PMID: 38205999 PMCID: PMC10848754 DOI: 10.1128/aac.01132-23] [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: 08/31/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024] Open
Abstract
Manogepix is a potent new antifungal agent targeting the fungal Gwt1 enzyme. Manogepix has previously demonstrated potent in vitro activity against clinical isolates of both Candida (except Candida krusei) and Aspergillus species. This study determined the in vitro activity of manogepix and comparators against a large collection of infrequently encountered yeast and molds. Manogepix demonstrated potent in vitro activity against infrequently encountered yeasts exhibiting elevated MIC values to other drug classes, including Candida spp. (MIC50/90, 0.008/0.12 mg/L), Saprochaete clavata (Magnusiomyces clavatus) (MIC50/90, 0.03/0.06 mg/L), Magnusiomyces capitatus (MICrange, 0.016-0.06 mg/L), Rhodotorula minuta (MIC, 0.016 mg/L), and Rhodotorula mucilaginosa (MIC50/90, 0.03/0.12 mg/L). Similarly, manogepix was active against infrequently encountered mold isolates and strains exhibiting elevated MIC/MEC values to echinocandins, azoles, and amphotericin B, including Coprinopsis cinerea (MEC, 0.004 mg/L), Fusarium spp. (MEC50/90, 0.016/0.06 mg/L), Fusarium (Gibberella) fujikuroi species complex (MEC50/90, 0.016/0.03 mg/L), Lomentospora prolificans (MEC50/90, 0.03/0.06 mg/L), Microascus cirrosus (MEC, 0.008 mg/L), Paecilomyces spp. (MEC50/90, ≤0.008/0.016 mg/L), Pleurostomophora richardsiae (MEC, 0.06 mg/L), Sarocladium kiliense (MEC range, 0.016-0.12 mg/L), and Scedosporium spp. (MEC50/90, 0.03/0.06 mg/L). Manogepix demonstrated potent activity against a majority of the infrequently encountered yeast and mold isolates tested including strains with elevated MIC/MEC values to other drug classes. Additional clinical development of manogepix (fosmanogepix) in difficult-to-treat, resistant fungal infections is warranted.
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Affiliation(s)
- Michael Pfaller
- JMI Laboratories, North Liberty, lowa, USA
- University of Iowa, Iowa City, lowa, USA
| | | | - Paul A. Bien
- PAB Pharma Consulting LLC, San Diego, California, USA
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Akıncı B, Atay D, Yenigürbüz FD, Akçay A, Akar O, Öztürk G. Fatal disseminated Magnusiomyces clavatus infection with rash in pediatric acute lymphoblastic leukemia: A case report. Diagn Microbiol Infect Dis 2024; 108:116148. [PMID: 38128321 DOI: 10.1016/j.diagmicrobio.2023.116148] [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: 10/07/2023] [Revised: 11/12/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
Magnusiomyces clavatus is a rare yeast-like fungus that can cause opportunistic infections in immunocompromised patients. Here, we present a 14-year-old patient who was followed up with the diagnosis of acute lymphoblastic leukemia, developed skin rashes, and Magnusiomyces clavatus infection detected. The patient died shortly after the infection was diagnosed.
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Affiliation(s)
- Burcu Akıncı
- Department of Pediatric Hematology-Oncology, Acıbadem University School of Medicine, Kayışdağı Street. No:32, Ataşehir, İstanbul 34752, Turkey.
| | - Didem Atay
- Department of Pediatric Hematology-Oncology, Acıbadem University School of Medicine, Kayışdağı Street. No:32, Ataşehir, İstanbul 34752, Turkey
| | - Fatma Demir Yenigürbüz
- Department of Pediatric Hematology-Oncology, Acıbadem University School of Medicine, Kayışdağı Street. No:32, Ataşehir, İstanbul 34752, Turkey
| | - Arzu Akçay
- Department of Pediatric Hematology-Oncology, Acıbadem University School of Medicine, Kayışdağı Street. No:32, Ataşehir, İstanbul 34752, Turkey
| | - Oğuz Akar
- Department of Microbiology, Acıbadem Altunizade Hospital, İstanbul, Turkey
| | - Gülyüz Öztürk
- Department of Pediatric Hematology-Oncology, Acıbadem University School of Medicine, Kayışdağı Street. No:32, Ataşehir, İstanbul 34752, Turkey
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Mawad TN, Alfaifi RA, Almazyed OM, Alhumaidi RA, Alsubaie AM. Fungemia Due to Saprochaete capitata in a Non-Neutropenic Critically Ill Patient. Cureus 2023; 15:e51147. [PMID: 38152295 PMCID: PMC10751558 DOI: 10.7759/cureus.51147] [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] [Accepted: 12/26/2023] [Indexed: 12/29/2023] Open
Abstract
Saprochaete capitata is an uncommon yeast species; its impact on non-neutropenic patients appears to be on the rise. We describe a case of S. capitata fungemia in a critically ill end-stage kidney disease (ESKD) patient on peritoneal dialysis. The patient presented with mesenteric ischemia and underwent several laparotomies during hospitalization. His hospital stay was complicated as fungemia developed and spread to multiple sites, which resulted in severe complications and ultimately led to fatal outcomes. S. capitata's diagnostic delay is a concern, but matrix-assisted laser desorption/Ionization time-of-flight (MALDI-TOF) mass spectrometry may help provide accurate identification. Our case highlights the need for prompt diagnosis and tailored antifungal therapy, especially when managing this challenging infection in immunocompromised patients.
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Affiliation(s)
- Tala N Mawad
- Infectious Diseases, King Saud University, Riyadh, SAU
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Styczynski T, Sadlok J, Richert-Przygonska M, Debski R, Zalas-Wiecek P, Czyzewski K, Styczynski J. Infection With Saprochaete Clavata in Children After Hematopoietic Cell Transplantation. J Pediatr Hematol Oncol 2023; 45:e976-e979. [PMID: 37278583 DOI: 10.1097/mph.0000000000002686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/16/2023] [Indexed: 06/07/2023]
Abstract
Septic shock is a very rare manifestation of invasive fungal disease (IFD) in children after allogeneic hematopoietic cell transplantation (allo-HCT). The objective of this paper is analysis of two cases of pediatric patients with IFD caused by Saprochaete clavata after allo-HCT. Literature data on this infection in children and its outcome were also summarized. Infection with Saprochaete clavate presenting with symptoms of septic shock was being reported in 4 children, and 2 of them survived the infection. In conclusion, with quick diagnosis and quick treatment, the outcome of therapy of infection with Saprochaete clavata was successful.
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Affiliation(s)
- Tomasz Styczynski
- Departments of Pediatric Hematology and Oncology
- Student Scientific Society, Collegium Medicum, Nicolaus Copernicus University, Poland
| | - Jagoda Sadlok
- Departments of Pediatric Hematology and Oncology
- Student Scientific Society, Collegium Medicum, Nicolaus Copernicus University, Poland
| | | | | | - Patrycja Zalas-Wiecek
- Microbiology, Collegium Medicum, Nicolaus Copernicus University, Jurasz University Hospital 1, Bydgoszcz
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9
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Abdolrasouli A, Schelenz S. Answer to the Photo Quiz: Bloodstream infection in a neutropenic patient with severe aplastic anemia. J Clin Microbiol 2023; 61:e0057623. [PMID: 37732748 PMCID: PMC10575292 DOI: 10.1128/jcm.00576-23] [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] [Indexed: 09/22/2023] Open
Abstract
Read the full article for the answer.
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Affiliation(s)
- Alireza Abdolrasouli
- Department of Medical Microbiology, King’s College hospital, London, United Kingdom
| | - Silke Schelenz
- Department of Medical Microbiology, King’s College hospital, London, United Kingdom
- School of Immunology & Microbial Sciences, King’s College, London, United Kingdom
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10
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Rahali FZ, Bounani F, Babokh F, El Hakkouni A. Saprochaete Capitata Peritonitis in a Non-neutropenic Patient Without Underlying Malignancies: A Case Report. Cureus 2023; 15:e45568. [PMID: 37868573 PMCID: PMC10585182 DOI: 10.7759/cureus.45568] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2023] [Indexed: 10/24/2023] Open
Abstract
Saprochaete capitata (S. capitata) is an opportunistic arthroconidial yeast-like fungus causing invasive infections in immunocompromised patients, mainly those with hematological malignancies and severe neutropenia. However, infections due to S. capitata are extremely rare in immunocompetent and non-neutropenic patients. Saprochaete spp. are microscopically characterized by arthroconidia with hyaline-septated hyphae. S. capitata is known to be intrinsically resistant to echinocandins and highly resistant to fluconazole. It is suggested to use amphotericin B or voriconazole (in monotherapy or in combination) as the gold standard treatment for S. capitatasystemic infections. We report a rare case of S. capitata peritonitis with fatal outcome in a non-neutropenic patient without underlying malignancies. This case report highlights the value of direct microscopic examination and stained smears in a prompt preliminary diagnosis of S. capitata invasive fungal infections. We also aim to emphasize the importance of early initiation of appropriate antifungal treatment in patients with S. capitata systemic infections, thus improving their therapeutic outcome.
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Affiliation(s)
- Fatima Zahra Rahali
- Department of Clinical Laboratory, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Marrakesh, MAR
| | - Fatima Bounani
- Department of Clinical Laboratory, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Marrakesh, MAR
| | - Fatima Babokh
- Department of Clinical Laboratory, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Marrakesh, MAR
| | - Awatif El Hakkouni
- Department of Biology/Department of Parasitology and Mycology, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Cadi Ayyad University, Marrakesh, MAR
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Abed AB, Hürkan K, Ünal A, Aydın B, Korcan SE. Phenotypic and molecular genetics study of Geotrichum candidumLink (1809) and Geotrichum silvicola Pimenta (2005) cultivated on mitis salivarius agar. Mol Biol Rep 2023:10.1007/s11033-023-08443-z. [PMID: 37294469 DOI: 10.1007/s11033-023-08443-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/11/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Geotrichum is a genus of fungi found in different habitats throughout the world. Although Geotrichum and its related species have been extensively reclassified and taxonomically revised, it is still the target for many researches. METHODS AND RESULTS In this study, phenotypic and molecular genetics comparisons were performed between Geotrichum candidum and Geotrichum silvicola. Mitis Salivarius Agar was used as the growing medium for the phenotypic comparison study, which was carried out at two temperatures (20-25 and 37 °C). For genotypic comparison, we compared the 18 S, ITS, and 28 S sequences of universal DNA barcode regions of both species. Important findings on the new culture media for fungal isolation were revealed by the results. The phenotypic variation between the two species' colonies, including their shapes, sizes, textures and growth rates, were strikingly different. DNA sequences of both species showed that pairwise identities of the species were 99.9% for 18 S, 100% for ITS and 99.6% for 28 S regions. CONCLUSIONS Contrary to what is commonly seen, the results showed that 18 S, ITS and 28 S failed to discriminate the species. The first investigation into the performance of Mitis Salivarius Agar as a fungus culture medium is reported in this work, and proved its efficiency. Additionally, this is the first study to compare G. candidum with G. silvicola by means of both phenotypic and genotypic analysis.
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Affiliation(s)
- Ahmed Badri Abed
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Uşak University, Uşak, 64200, Turkey.
| | - Kaan Hürkan
- Faculty of Agriculture, Department of Agricultural Biotechnology, Iğdır University, Iğdır, Turkey
| | - Arzu Ünal
- Faculty of Agriculture, Department of Agricultural Biotechnology, Iğdır University, Iğdır, Turkey
| | - Büşra Aydın
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Uşak University, Uşak, 64200, Turkey
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12
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Varghese JA, Guhan S, Zheng L. Emerging Fungal Infections and Cutaneous Manifestations in Immunosuppressed Patients. CURRENT DERMATOLOGY REPORTS 2023. [DOI: 10.1007/s13671-023-00386-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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13
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Mitchell PG, Chang BH, Walker LW. Disseminated fungal disease caused by Magnusiomyces clavatus in a pediatric cancer patient: Case report and review of the literature. Pediatr Blood Cancer 2023; 70:e30297. [PMID: 36912490 DOI: 10.1002/pbc.30297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 03/14/2023]
Affiliation(s)
- Paul G Mitchell
- Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon, USA
| | - Bill H Chang
- Division of Hematology and Oncology, Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon, USA
| | - Lorne W Walker
- Division of Pediatric Infectious Diseases, Department of Medical Informatics and Clinical Epidemiology, Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon, USA
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14
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Comparison between EUCAST Broth Microdilution and MIC Strip Test in Defining Isavuconazole In Vitro Susceptibility against Candida and Rare Yeast Clinical Isolates. Antibiotics (Basel) 2023; 12:antibiotics12020251. [PMID: 36830162 PMCID: PMC9952283 DOI: 10.3390/antibiotics12020251] [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: 12/22/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
Isavuconazole is a new broad-spectrum triazole, with significant in vitro activity against yeasts. Isavuconazole in vitro susceptibility can be evaluated through broth microdilution as a reference method. Considering difficulties in equipping such methods in a laboratory routine, a commercial MIC Strip test has been designed. This study aims to implement data about isavuconazole in vitro activity and compare EUCAST broth microdilution and MIC Strip test in defining yeast isavuconazole susceptibility. The study involved 629 isolates from positive blood cultures (January 2017-December 2021). The identified species were C. albicans (283), C. glabrata (53), C. krusei (23), C. tropicalis (68), C. parapsilosis complex (151), C. guilliermondii (12), C. famata (6), S. cerevisiae (12), C. neoformans (5), S. capitata (12), and Rhodotorula species (4). All the isolates were tested with EUCAST microdilution and MIC Strip methods. The total essential agreement between these two methods was 99.3%. As a result, we can consider that both methods are useful in testing isavuconazole susceptibility. Proposed cut-off values (P-ECOFF) were calculated using ECOFFinder software. Further studies could lead to either definitive E-COFF or clinical breakpoints, which represent the most important categorization tool of the laboratory data, allowing a better insertion of an antimicrobial drug in clinical practice.
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Pasqualone G, Buzzatti E, Palmieri R, Savi A, Pascale MR, Borsellino B, Guarnera L, Buccisano F, Voso MT, Maurillo L, Sconocchia G, Venditti A, Del Principe MI. Case report: A Saprochaete clavata (Magnusiomyces clavatus) severe infection effectively treated with granulocyte transfusion in a young patient with myeloid sarcoma. Front Oncol 2022; 12:970188. [PMID: 36185191 PMCID: PMC9521543 DOI: 10.3389/fonc.2022.970188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
Myeloid sarcoma is a hematologic malignancy consisting of extramedullary tissue involvement by myeloid blasts, usually considered as acute myeloid leukemia and treated accordingly. The disease itself, together with chemotherapy and disease-associated factors, may have an impact in increasing the risk of developing severe and frequently life-threatening infections. Herein, we describe the case of a patient with a right breast skin lesion, histologically diagnosed myeloid sarcoma, who developed a severe disseminated fungal infection by Saprochaete clavata (Magnusiomyces clavatus), during the first consolidation course of chemotherapy. Despite maximum antifungal therapy, the infection progressed and the fungus continued to be isolated until granulocyte transfusion therapy was initiated. Our experience suggests that patients with profound and long-lasting neutropenia could benefit from granulocyte transfusions as additional therapy in severe fungal infections resistant to broad-spectrum antimicrobial therapy.
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Affiliation(s)
- Gianmario Pasqualone
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Elisa Buzzatti
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Raffaele Palmieri
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Arianna Savi
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Maria Rosaria Pascale
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Beatrice Borsellino
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Luca Guarnera
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Francesco Buccisano
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Maria Teresa Voso
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Luca Maurillo
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Giuseppe Sconocchia
- Institute of Translational Pharmacology, Department of Biomedical Sciences, National Research Council (CNR), Rome, Italy
- *Correspondence: Giuseppe Sconocchia,
| | - Adriano Venditti
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Maria Ilaria Del Principe
- Hematology, Department of Biomedicine and Prevention, Università degli studi di Roma Tor Vergata, Rome, Italy
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Del Principe MI, Seidel D, Criscuolo M, Dargenio M, Rácil Z, Piedimonte M, Marchesi F, Nadali G, Koehler P, Fracchiolla N, Cattaneo C, Klimko N, Spolzino A, Yilmaz Karapinar D, Demiraslan H, Duarte RF, Demeter J, Stanzani M, Melillo LMA, Basilico CM, Cesaro S, Paterno G, Califano C, Delia M, Buzzatti E, Busca A, Cornely OA, Pagano L. Clincial features and prognostic factors of magnusiomyces (saprochaete) infections in hematology. a multicenter study of seifem/fungiscope. Mycoses 2022; 66:35-46. [PMID: 36064299 DOI: 10.1111/myc.13524] [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: 05/12/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Our multicenter study aims to identify baseline factors and provide guidance for therapeutic decisions regarding Magnusiomyces-associated infections, an emerging threat in patients with hematological malignancies. METHODS HM patients with proven M. capitatus or M. clavatus (formerly Saprochaete capitata and Saprochaete clavata) infection diagnosed between January 2010 and December 2020 were recorded from the SEIFEM (Sorveglianza Epidemiologica Infezioni nelle Emopatie) group and FungiScope (Global Emerging Fungal Infection Registry). Cases of Magnusiomyces fungemia were compared with candidemia. RESULTS Among 90 Magnusiomycescases (60 [66%] M. capitatus and 30 (34%) M. clavatus), median age was 50 years (range 2-78), 46 patients (51%) were female and 67 (74%) had acute leukemia. Thirty-six (40%) of Magnusiomyces-associated infections occurred during antifungal prophylaxis, mainly with posaconazole (n=13, 36%) and echinocandins (n=12, 34%). Instead, the candidemia rarely occurred during prophylaxis (p<0.0001). First-line antifungal therapy with azoles, alone or in combination, was associated with improved response compared to other antifungals (p=0.001). Overall day-30 mortality rate was 43%. Factors associated with higher mortality rates were septic shock (HR 2.696, 95%CI 1.396-5.204, p=.003), corticosteroid treatment longer than 14 days (HR 2.245, 95%CI 1.151-4.376, p=.018), and lack of neutrophil recovery (HR 3.997, 95%CI 2.102-7.601, p<.001). The latter was independently associated with poor outcome (HR 2.495, 95%CI 1.192-5.222, p=.015). CONCLUSIONS Magnusiomyces-associated infections are often breakthrough infections. Effective treatment regimens of these infections remain to be determined, but neutrophil recovery appears to play an important role in the favorable outcome.
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Affiliation(s)
- Maria Ilaria Del Principe
- Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italy
| | - Danila Seidel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Marianna Criscuolo
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Italy
| | - Michelina Dargenio
- Ematologia e Trapianto di Cellule Staminali, Ospedale Vito Fazzi, Lecce, Italy
| | - Zdenek Rácil
- Department of Physiology, Masaryk University, Brno Czech Republic. Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Monica Piedimonte
- Dipartimento di Medicina Clinica e Molecolare, Azienda Ospedaliera Universitaria Sant'Andrea di Roma Università Sapienza di Roma, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Roma, Italy
| | - Gianpaolo Nadali
- Unità Operativa Complessa di Ematologia, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Nicola Fracchiolla
- UOC di Ematologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Chiara Cattaneo
- Divisione di Ematologia, ASST-Spedali Civili di Brescia, Brescia, Italy
| | - Nikolai Klimko
- Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, St Petersburg, Russia
| | - Angelica Spolzino
- Department of Medicine and Surgery, University of Parma & Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy ; Present address: Onco Hematology, Department of Oncology, Veneto Institute of Oncology IOV, IRCCS, Padua, Italy
| | - Deniz Yilmaz Karapinar
- Ege University, Faculty of Medicine, Children's Hospital, Department of Pediatric Hematology, Izmir, Turkey
| | - Hayati Demiraslan
- Department of Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Rafael F Duarte
- Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Judit Demeter
- Semmelweis University, Department of Internal Medicine and Oncology, Division of Hematology, Budapest, Hungary
| | - Marta Stanzani
- Istituto di Ematologia ed Oncologia Medica "L. e A. Seragnoli", Ospedale Sant'Orsola Malpighi - Bologna, Italy
| | | | - Claudia Maria Basilico
- Division of Hematology, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Simone Cesaro
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata di Verona, Italy
| | - Giovangiacinto Paterno
- Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italy
| | | | - Mario Delia
- Sezione di Ematologia, Dipartimento dell'Emergenza e dei Trapianti d'Organo, Università di Bari, Bari, Italy
| | - Elisa Buzzatti
- Dipartimento di Biomedicina e Prevenzione, Università degli studi di Roma "Tor Vergata", Roma, Italy
| | - Alessandro Busca
- Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Torino, Italy
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Livio Pagano
- Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCSS-Università Cattolica del Sacro Cuore, Roma, Italy
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Nachate S, Abbassi S, Elfouar H, Zouine Y, Cherif Idrissi El Ganouni N, Tassi N, El Hakkouni A. A case of Saprochaete capitata pulmonary infection in a neutropenic HIV-infected patient. Access Microbiol 2022; 4:acmi000450. [PMID: 36133179 PMCID: PMC9484660 DOI: 10.1099/acmi.0.000450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction. Saprochaete capitata is an emerging opportunistic fungus that is responsible for an uncommon mycosis known as geotrichosis, mainly reported in patients with haematological malignancies. It is a life-threatening condition associated with a high mortality rate of over 52 %. S. capitata may affect any organ, with a predilection for the lungs. Case presentation. Here we report a case of pulmonary geotrichosis in a neutropenic HIV-infected patient with a prior history of treated tuberculosis. The main risk factor for pulmonary geotrichosis is profound and prolonged neutropenia. To our knowledge, this is the first reported case of S. capitata infection occurring on top of probable active miliary tuberculosis. Conclusion. The clinical and radiological features are non-specific and similar to those of other pulmonary fungal diseases, hence the importance of mycological examination to confirm the diagnosis. Through this report, we urge clinicians to vigilantly consider S. capitata as an aetiological agent in the differential diagnosis of fungal infections in HIV-infected individuals and to routinely screen for associated infections.
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Affiliation(s)
- Soumia Nachate
- Department of Medical Mycology and Parasitology, University Hospital Mohamed-VI, Avenue Ibn Sina, Marrakech 40080, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
| | - Saloua Abbassi
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
- Department of Medical Mycology and Parasitology, University Hospital Mohamed-VI, Avenue Ibn Sina, Marrakech 40080, Morocco
| | - Hajar Elfouar
- Infectious Diseases Department, University Hospital Mohamed-VI, Avenue Ibn Sina, Marrakech 40080, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
| | - Yousra Zouine
- Department of Radiology, University Hospital Mohamed-VI, Avenue Ibn Sina, Marrakech 40080, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
| | - Najat Cherif Idrissi El Ganouni
- Department of Radiology, University Hospital Mohamed-VI, Avenue Ibn Sina, Marrakech 40080, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
| | - Noura Tassi
- Infectious Diseases Department, University Hospital Mohamed-VI, Avenue Ibn Sina, Marrakech 40080, Morocco
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
| | - Awatif El Hakkouni
- Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech 40000, Morocco
- Department of Medical Mycology and Parasitology, University Hospital Mohamed-VI, Avenue Ibn Sina, Marrakech 40080, Morocco
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Invasive Fungal Infection Caused by Magnusiomyces capitatus in an Immunocompromised Pediatric Patient with Acute Lymphoblastic Leukemia in Mexico City: A Case Report. J Fungi (Basel) 2022; 8:jof8080851. [PMID: 36012839 PMCID: PMC9410127 DOI: 10.3390/jof8080851] [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: 07/11/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Magnusiomyces capitatus (also denominated “Geotrichum capitatum” and “the teleomorph stage of Saprochaete capitata”) mainly affects immunocompromised patients with hematological malignancies in rare cases of invasive fungal infections (IFIs). Few cases have been reported for pediatric patients with acute lymphoblastic leukemia (ALL), in part because conventional diagnostic methods do not consistently detect M. capitatus in infections. The current contribution describes a systemic infection in a 15-year-old female diagnosed with ALL. She arrived at the Children’s Hospital of Mexico City with a fever and neutropenia and developed symptoms of septic shock 4 days later. M. capitatus ENCB-HI-834, the causal agent, was isolated from the patient’s blood, urine, bile, and peritoneal fluid samples. It was identified with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and a phylogenetic reconstruction using internal transcribed spacer (ITS) and 28S ribosomal sequences. The phylogenetic sequence of M. capitatus ENCB-HI-834 clustered with other M. capitatus-type strains with a 100% identity. In vitro antifungal testing, conducted with the Sensititre YeastOne susceptibility system, found the following minimum inhibitory concentration (MIC) values (μg/mL): posaconazole 0.25, amphotericin B 1.0, fluconazole > 8.0, itraconazole 0.25, ketoconazole 0.5, 5-flucytosine ≤ 0.06, voriconazole 0.25, and caspofungin > 16.0. No clinical breakpoints have been defined for M. capitatus. This is the first clinical case reported in Mexico of an IFI caused by M. capitatus in a pediatric patient with ALL. It emphasizes the importance of close monitoring for a timely and accurate diagnosis of neutropenia-related IFIs to determine the proper treatment with antibiotics, antifungals, and chemotherapy for instance including children with ALL.
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Maquera-Afaray J, Escajadillo-Vergara C, Chire-Mercado J, Durand MP. Invasive fungal infection by Saprochaete capitata in a child with bone marrow aplasia. Rev Peru Med Exp Salud Publica 2022; 39:372-375. [PMID: 36478173 PMCID: PMC11397778 DOI: 10.17843/rpmesp.2022.393.10955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/17/2022] [Indexed: 11/09/2022] Open
Abstract
Saprochaete capitata is a rare cause of invasive fungal infection in immunocompromised patients with high mortality and antifungal resistance. We present the case of a 5-year-old boy with bone marrow aplasia, who underwent hematopoietic stem cell transplantation (HSCT) and presented persistent febrile neutropenia, abdominal pain, appearance of maculopapular lesions on the skin, and impaired renal function. The presence of S. capitata was identified by blood culture from a central venous catheter. This invasive fungal infection is rare but emergent and life-threatening, especially in immunocompromised patients with persistent febrile neutropenia and prolonged use of invasive devices such as central venous catheters.
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Affiliation(s)
- Julio Maquera-Afaray
- Instituto Nacional de Salud del Niño San Borja, Lima, Perú
- Universidad Privada de Tacna, Tacna, Perú
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Duminuco A, Vetro C, Maugeri C, Mauro E, Palumbo GAM, Parisi MS, Esposito B, Giuliano G, Romano A, Di Raimondo F. Saprochete capitata: Emerging Infections from Uncommon Microorganisms in Hematological Diseases. Hematol Rep 2022; 14:67-72. [PMID: 35466175 PMCID: PMC9036236 DOI: 10.3390/hematolrep14020011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/04/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Infections occurring in immunocompromised patients after intensive chemotherapy are often difficult to eradicate and are capable of even being fatal. New emergent and dangerous drug-resistant micro-organisms are likely to appear in these specific scenarios. Clinical features mainly include progressive pneumonia, bacteriemia/fungemia, or extrapulmonary dissemination among infections. The treatment of these microorganisms is still an open challenge since there is a lack of clear treatment guidelines. Indeed, infections from these microorganisms can lead to a rapidly fatal clinical course in immunocompromised patients, especially those who have acute leukemia. We describe the case of a young patient with acute myeloid leukemia who contracted an infection from Saprochaete capitata during post-chemotherapy aplasia.
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Affiliation(s)
- Andrea Duminuco
- Post Graduation School of Hematology, University of Catania, A.O.U. “Policlinico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
- Correspondence: ; Tel.: +39-095-378-2981; Fax: +39-095-378-2982
| | - Calogero Vetro
- Division of Hematology, A.O.U. “Policlinico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy; (C.V.); (C.M.); (E.M.); (M.S.P.); (F.D.R.)
| | - Cinzia Maugeri
- Division of Hematology, A.O.U. “Policlinico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy; (C.V.); (C.M.); (E.M.); (M.S.P.); (F.D.R.)
| | - Elisa Mauro
- Division of Hematology, A.O.U. “Policlinico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy; (C.V.); (C.M.); (E.M.); (M.S.P.); (F.D.R.)
| | - Giuseppe A. M. Palumbo
- Department of Scienze Mediche Chirurgiche e Tecnologie Avanzate “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (G.A.M.P.); (A.R.)
| | - Marina S. Parisi
- Division of Hematology, A.O.U. “Policlinico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy; (C.V.); (C.M.); (E.M.); (M.S.P.); (F.D.R.)
| | - Benedetta Esposito
- Post Graduation School of Hematology, University of Catania, A.O.U. “Policlinico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
| | - Giuseppe Giuliano
- Division of Anesthesiology and Intensive Care, A.O.U. “Policlinico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
| | - Alessandra Romano
- Department of Scienze Mediche Chirurgiche e Tecnologie Avanzate “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (G.A.M.P.); (A.R.)
| | - Francesco Di Raimondo
- Division of Hematology, A.O.U. “Policlinico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy; (C.V.); (C.M.); (E.M.); (M.S.P.); (F.D.R.)
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Bloodstream infections caused by Magnusiomyces capitatus and Magnusiomyces clavatus: epidemiological, clinical and microbiological features of two emerging yeast species. Antimicrob Agents Chemother 2021; 66:e0183421. [PMID: 34930027 PMCID: PMC8846490 DOI: 10.1128/aac.01834-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Magnusiomyces clavatus and Magnusiomyces capitatus are emerging yeasts with intrinsic resistance to many commonly used antifungal agents. Identification is difficult, and determination of susceptibility patterns with commercial and reference methods is equally challenging. For this reason, few data on invasive infections by Magnusiomyces spp. are available. OBJECTIVES To determine the epidemiology and susceptibility of Magnusiomyces isolates from bloodstream infections (BSI) isolated in Germany and Austria from 2001-2020. METHODS In seven institutions a total of 34 Magnusiomyces BSI were identified. Identification was done by ITS sequencing and MALDI-TOF MS. Antifungal susceptibility was determined by EUCAST broth microdilution and gradient tests. RESULTS Of the 34 isolates, M. clavatus was more common (N=24) compared to M. capitatus (N=10). BSI by Magnusiomyces spp. were more common in men (62%) and mostly occurred in patients with haemato-oncological malignancies (79%). The highest in vitro antifungal activity against M. clavatus/M. capitatus was observed for voriconazole (MIC50 0.03/0.125 mg/L), followed by posaconazole (MIC50 0.125/0.25 mg/L). M. clavatus isolates showed overall lower MICs compared to M. capitatus. With the exception of amphotericin B, low essential agreement between gradient test and microdilution was recorded for all antifungals (0-70%). Both species showed distinct morphologic traits on ChromAgar Orientation and Columbia blood agar, which can be used for differentiation if no MALDI-TOF or molecular identification is available. CONCLUSION Most BSI were caused by M. clavatus. The lowest MICs were recorded for voriconazole. Gradient tests demonstrated unacceptably low agreement and should preferably not be used for susceptibility testing of Magnusiomyces spp.
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Saprochaete clavata Infection in Immunosuppressed Patients: Systematic Review of Cases and Report of the First Oral Manifestation, Focusing on Differential Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052385. [PMID: 33804487 PMCID: PMC7957747 DOI: 10.3390/ijerph18052385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/22/2022]
Abstract
Background: Saprochaete clavata infection is an emerging issue in immunosuppressed patients, causing fulminant fungaemia. The purpose of this systematic review of cases is to retrieve all cases of S. clavata infection and describe oral lesions as the first manifestation of S. clavata infection. Methods: We report the first case of intraoral S. clavata infection in Acute Myeloid Leukemia (AML) affected subject, presenting as multiple grayish rapidly growing ulcerated swellings, and provide a review of all published cases of infection caused by S. clavata, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, conducted by searching SCOPUS, Medline, and CENTRAL databases. Only articles in English were considered. Individual patient data were analyzed to identify risk factors for S. clavata infection. Results: Seventeen of 68 retrieved articles were included in the review reporting data on 96 patients (mean age 51.8 years, 57 males and 38 females). Most cases were disseminated (86) with a 60.2% mortality rate. Ninety-five were hematological patients, with AML being the most common (57 cases). Conclusions:S. clavata infection in immunosuppressed patients has a poor prognosis: middle-age patients, male gender and Acute Myeloid Leukemia should be considered risk factors. In immunosuppressed patients, the clinical presentation can be particularly unusual, imposing difficult differential diagnosis, as in the reported case.
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