1
|
Melhem MSC, Leite Júnior DP, Takahashi JPF, Macioni MB, Oliveira LD, de Araújo LS, Fava WS, Bonfietti LX, Paniago AMM, Venturini J, Espinel-Ingroff A. Antifungal Resistance in Cryptococcal Infections. Pathogens 2024; 13:128. [PMID: 38392866 PMCID: PMC10891860 DOI: 10.3390/pathogens13020128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Antifungal therapy, especially with the azoles, could promote the incidence of less susceptible isolates of Cryptococcus neoformans and C. gattii species complexes (SC), mostly in developing countries. Given that these species affect mostly the immunocompromised host, the infections are severe and difficult to treat. This review encompasses the following topics: 1. infecting species and their virulence, 2. treatment, 3. antifungal susceptibility methods and available categorical endpoints, 4. genetic mechanisms of resistance, 5. clinical resistance, 6. fluconazole minimal inhibitory concentrations (MICs), clinical outcome, 7. environmental influences, and 8. the relevance of host factors, including pharmacokinetic/pharmacodynamic (PK/PD) parameters, in predicting the clinical outcome to therapy. As of now, epidemiologic cutoff endpoints (ECVs/ECOFFs) are the most reliable antifungal resistance detectors for these species, as only one clinical breakpoint (amphotericin B and C. neoformans VNI) is available.
Collapse
Affiliation(s)
- Marcia S C Melhem
- Graduate Program in Sciences, Secretary of Health, São Paulo 01246-002, SP, Brazil
- Graduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, MS, Brazil
- Graduate Program in Tropical Diseases, State University of São Paulo, Botucatu 18618-687, SP, Brazil
| | | | - Juliana P F Takahashi
- Graduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, MS, Brazil
- Pathology Division, Adolfo Lutz Institute, São Paulo 01246-002, SP, Brazil
| | | | | | - Lisandra Siufi de Araújo
- Graduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, MS, Brazil
- Central Public Health Laboratory-LACEN, Mycology Unit, Adolfo Lutz Institut, São Paulo 01246-002, SP, Brazil
| | - Wellington S Fava
- Graduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, MS, Brazil
| | - Lucas X Bonfietti
- Central Public Health Laboratory-LACEN, Mycology Unit, Adolfo Lutz Institut, São Paulo 01246-002, SP, Brazil
| | - Anamaria M M Paniago
- Graduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, MS, Brazil
| | - James Venturini
- Graduate Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, MS, Brazil
| | - Ana Espinel-Ingroff
- Central Public Health Laboratory-LACEN, Campo Grande 79074-460, MS, Brazil
- VCU Medical Center, Richmond, VA 23284, USA
| |
Collapse
|
2
|
Ferreira-Machado E, Navas-Suárez PE, Ervedosa TB, Figueiredo KB, de Carvalho ACSR, Takahashi JPF, Kimura LM, de Araújo LJT, de Azevedo Fernandes NCC, Sanches TC, Rivas L, Frediani M, Zwarg TM, Blume GR, Eloi RSA, de Oliveira LB, Santos ALRM, das Chagas NTC, Guerra JM. Infections by entomopathogenic fungi in common green iguanas (Iguana iguana) in captivity in Brazil. J Comp Pathol 2023; 201:16-22. [PMID: 36646035 DOI: 10.1016/j.jcpa.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/09/2022] [Accepted: 11/10/2022] [Indexed: 01/16/2023]
Abstract
Entomopathogenic fungi, widely available biological agents used to control agricultural pests, are sporadically reported to cause focal or disseminated infection in reptiles and mammals, including humans. This study summarizes the clinical presentation, histopathological and molecular findings by panfungal polymerase chain reaction and sequencing of four cases of hypocrealean fungal infections in captive common green iguanas (Iguana, iguana). One case of granulomatous pneumonia, hepatitis and serositis was related to Metarhizium flavoviride complex infection. Two disseminated fungal infection cases, with scarce inflammatory cell infiltration, were caused by Beauveria bassiana while there was one case of multifocal granulomatous and necrotizing pneumonia by Purpureocillium spp. To the best of our knowledge, this is the first report of fatal mycosis infection due to entomopathogenic fungi in captive common green iguanas.
Collapse
Affiliation(s)
- Eduardo Ferreira-Machado
- Pathology Center, Adolfo Lutz Institute, São Paulo, Brazil; Wildlife Comparative Pathology Laboratory (LAPCOM), Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Pedro E Navas-Suárez
- Pathology Center, Adolfo Lutz Institute, São Paulo, Brazil; Wildlife Comparative Pathology Laboratory (LAPCOM), Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | - Lidia M Kimura
- Pathology Center, Adolfo Lutz Institute, São Paulo, Brazil
| | | | - Natália C C de Azevedo Fernandes
- Pathology Center, Adolfo Lutz Institute, São Paulo, Brazil; Wildlife Comparative Pathology Laboratory (LAPCOM), Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Thaís C Sanches
- Centro de Manejo e Conservação de Animais Silvestres (CeMaCAS), Divisão da Fauna Silvestre, Prefeitura do Município de São Paulo, São Paulo, Brazil
| | - Luana Rivas
- Centro de Manejo e Conservação de Animais Silvestres (CeMaCAS), Divisão da Fauna Silvestre, Prefeitura do Município de São Paulo, São Paulo, Brazil
| | - Mayra Frediani
- Centro de Manejo e Conservação de Animais Silvestres (CeMaCAS), Divisão da Fauna Silvestre, Prefeitura do Município de São Paulo, São Paulo, Brazil
| | - Ticiana M Zwarg
- Centro de Manejo e Conservação de Animais Silvestres (CeMaCAS), Divisão da Fauna Silvestre, Prefeitura do Município de São Paulo, São Paulo, Brazil
| | - Guilherme R Blume
- HistoPato Laboratory - Veterinary Anatomopathological Analysis, Brasília, Distrito Federal, Brazil
| | - Rômulo S A Eloi
- HistoPato Laboratory - Veterinary Anatomopathological Analysis, Brasília, Distrito Federal, Brazil
| | - Letícia B de Oliveira
- HistoPato Laboratory - Veterinary Anatomopathological Analysis, Brasília, Distrito Federal, Brazil
| | - André L R M Santos
- HistoPato Laboratory - Veterinary Anatomopathological Analysis, Brasília, Distrito Federal, Brazil
| | | | | |
Collapse
|