1
|
Parinyasiri U, Uppamai S, Chamroensakchai T, Sirinual S, sukmee K, Banjongjit A, Kanjanabuch T. Peritonitis due to Aspergillus tamarii in peritoneal dialysis patients. Med Mycol Case Rep 2023; 40:44-46. [PMID: 37090162 PMCID: PMC10114152 DOI: 10.1016/j.mmcr.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Aspergillus peritonitis is uncommon, but it is associated with high mortality and morbidity in patients undergoing peritoneal dialysis (PD). We report two cases of Aspergillus tamarii peritonitis that were initially misidentified as A. flavus by the conventional culture method. Nucleotide sequences of internal transcribed spacer regions of the ribosomal DNA gene as A. tamarii correctly identified the isolate. Despite early catheter removal and an appropriate antifunal agent, both patients had dismal outcomes. Nucleic acid sequencing offers an additional tool for better diagnosing the species within the genus of pathogenic microbes.
Collapse
|
2
|
Chamroensakchai T, Sanaklang N, Hurdeal VG, Banjongjit A, Hyde KD, Kanjanabuch T. Candida nivariensis, an emerging fungus causing peritonitis in a patient receiving peritoneal dialysis. Med Mycol Case Rep 2022; 39:5-7. [PMID: 36568645 PMCID: PMC9772606 DOI: 10.1016/j.mmcr.2022.11.002] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/20/2022] [Accepted: 11/26/2022] [Indexed: 12/12/2022] Open
Abstract
Fungal peritonitis (FP) is usually associated with poor patient outcomes and is mostly caused by non-albicans Candida species. We present a Candida nivariensis-associated peritonitis in a 68-year-old woman with end-stage kidney disease on peritoneal dialysis (PD). Biochemical profiling of the cultured yeast of the effluent sample did not adequately identify the yeast. Hence, molecular phylogeny and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) mass spectroscopy were employed which correctly identified the causative species, C. nivariensis. PD catheter was removed and oral fluconazole was promptly started according to the 2022 International Society for PD (ISPD) Peritonitis Guidelines. However, the patient achieved only a partial clinical response and eventually died. The susceptibility test showed that the pathogen was susceptible to amphotericin B and voriconazole but resistant to other triazoles. This report underlines the importance of identifying the species, though rarely reported, and the drug susceptibility of the organism.
Collapse
Key Words
- CAPD, Continuous ambulatory peritoneal dialysis
- CLSI, Clinical and Laboratory Standards Institute
- Candida nivariensis
- ESKD, End-stage kidney disease
- Fungal peritonitis
- IP, Intraperitoneal
- ISPD, International Society for Peritoneal Dialysis
- ITS, Internal transcribed space
- KCMH, King Chulalongkorn Memorial Hospital
- MIC, Minimum inhibitory concentration
- PD, Peritoneal dialysis
- PDE, Peritoneal dialysis effluent
- Peritoneal dialysis
Collapse
Affiliation(s)
- Tamonwan Chamroensakchai
- Center of Excellence in Kidney Metabolic Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | - Vedprakash G. Hurdeal
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand,School of Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Athiphat Banjongjit
- Nephrology Unit, Department of Medicine, Vichaiyut Hospital, Bangkok, 10400, Thailand
| | - Kevin D. Hyde
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Talerngsak Kanjanabuch
- Center of Excellence in Kidney Metabolic Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand,Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand,CAPD Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand,Corresponding author. Center of Excellence in Kidney Metabolic Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
| |
Collapse
|
3
|
Sookto P, Kanjanabuch T, Chamroensakchai T, Thongbor N, Eiam-Ong S. Peritonitis after exposure to biocontrol-agent fumes containing Talaromyces flavus: a case report in peritoneal dialysis patient. BMC Nephrol 2022; 23:279. [PMID: 35945494 PMCID: PMC9364596 DOI: 10.1186/s12882-022-02898-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background The first case of Taralomyces flavus infection in human and peritoneal dialysis (PD) patient after exposure to biocontrol agent fumes is reported here. Case presentation A 77-year-old Thai female farmer with kidney failure presented with peritonitis and PD catheter obstruction from fungal biofilms. The potential root cause of infection was associated with exposure to biocontrol-agent fumes containing pathogen during agricultural work in her garden. This source of infection has not been mentioned previously. Showering and changing clothes right after outdoor activity with a high density of fungal matters or dust should be added to the routine aseptic technique before performing PD bag exchange to prevent the system contamination. Although the patient received early treatment with liposomal amphotericin B, itraconazole, and catheter removal, according to the ISPD Guideline 2016 and the Global Guideline 2021, the outcome was unfavorable. Antifungal susceptibility testing later revealed that the pathogen was only susceptible to voriconazole. Thus, antifungal susceptibility should be tested if the patient fails or slowly responds to the primary antifungal regimen. Conclusions T. flavus peritonitis is reported here after exposure to biocontrol-agent fumes containing the pathogen. This work also alerts and reiterates nephrology peers to be aware of this overlooked source of peritonitis, the exposure to dusty environments, specifically containing biocontrol-agent fumes.
Collapse
Affiliation(s)
- Phanit Sookto
- Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand. .,Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Dialysis Policy and Practices Program, School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,CAPD Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
| | - Tamonwan Chamroensakchai
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nisa Thongbor
- Department of Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| |
Collapse
|
4
|
Jabgratog P, Chamroensakchai T, Kanjanabuch T, Ampaipun J, Thongbor N, Hurdeal VG, Hyde KD. Peritoneal dialysis-associated peritonitis caused by Exophiala spinifera: A case report and review of literature. Med Mycol Case Rep 2022; 35:43-47. [PMID: 35256961 PMCID: PMC8897172 DOI: 10.1016/j.mmcr.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/14/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022] Open
Abstract
Exophiala spinifera is a black ascomycetous yeast and is responsible for phaeohyphomycosis. We provide the first case report of peritoneal dialysis (PD)-associated peritonitis in a female patient with progressive impairment of visual capacity. The infection was caused by a cutaneous infection of her hands. The patient responded well with PD catheter removal and 2-week antifungal medication. This case emphasizes the importance of hand hygiene and regular eye evaluation in preventing environment-bound infection in patients on PD. 2012 Elsevier Ltd. All rights reserved.
Collapse
Affiliation(s)
| | | | - Talerngsak Kanjanabuch
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Bangkok, Thailand
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- CAPD Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Corresponding author. Center of Excellence in Kidney Metabolic Disorders and Dialysis Policy and Practice Program (DiP3), School of Global Health, Faculty of Medicine, Chulalongkorn University, BKK, Thailand.
| | | | - Nisa Thongbor
- Sunpasitthiprasong Hospital, Ubon Ratchathanee, Thailand
| | - Vedprakash G. Hurdeal
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand
- School of Science, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - Kevin D. Hyde
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| |
Collapse
|
5
|
Chamroensakchai T, Kleebchaiyaphum C, Tatiyanupanwong S, Eiam-Ong S, Kanjanabuch T. Tinea nigra palmaris-associated peritonitis, caused by Hortaea werneckii: The first case report in a peritoneal dialysis patient. Perit Dial Int 2020; 41:333-336. [PMID: 32783526 DOI: 10.1177/0896860820944778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report the first case of peritoneal dialysis (PD) patients with peritonitis from Hortaea werneckii, a halotolerant black yeast-like fungus. The pathogen was confirmed by nucleotide sequences of internal transcribed spacer regions of the ribosomal RNA gene. A potential cause of this infection was tinea nigra on the patient's palm. Therefore, gloving might be advised during PD bag exchange in patients or caregivers who have an obvious lesion of the palm.
Collapse
Affiliation(s)
- Tamonwan Chamroensakchai
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand
| | | | | | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand
| | - Talerngsak Kanjanabuch
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand.,Division of Nephrology, Department of Medicine, Faculty of Medicine, 26683Chulalongkorn University, Bangkok, Thailand.,CAPD Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| |
Collapse
|
6
|
Chamroensakchai T, Manuprasert W, Leelahavanichkul A, Takkavatakarn K, Thongbor N, Jaroenpattrawut B, Kanjanabuch T. Rhodococcus induced false-positive galactomannan (GM), a biomarker of fungal presentation, in patients with peritoneal dialysis: case reports. BMC Nephrol 2019; 20:445. [PMID: 31791274 PMCID: PMC6889329 DOI: 10.1186/s12882-019-1642-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Galactomannan index (GMI) at a level higher than 0.5 provides high sensitivity and specificity for the diagnosis of fungal peritonitis. Here, we report the false-positive of GMI in peritoneal dialysis (PD) effluent (PDE) due to Rhodococcus peritonitis in PD patients. CASE PRESENTATION GMI in PDE of case #1 and case #2 were 1.53 and 0.76, respectively, while serum GMI of both cases was less than 0.5. In addition, GMI from the specimens obtained directly from the stationary phase of Rhodococcus colonies were 1.27 and 1.56, which were isolated from case #1 and #2, accordingly. CONCLUSION High GMI in PDE of PD patients is not specific just for fungal infections but may also be secondary to other infections, such as Rhodococcus spp., especially in endemic areas.
Collapse
Affiliation(s)
- Tamonwan Chamroensakchai
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wasin Manuprasert
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Asada Leelahavanichkul
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kullaya Takkavatakarn
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nisa Thongbor
- Department of Medicine, Sunpasitthiprasong Hosptial, Ubon Ratchathani, Thailand
| | - Bunpring Jaroenpattrawut
- Continuous Ambulatory Peritoneal Dialysis Clinic (CAPD), Nakhon Pathom Hospital, Nakhon Pathom, Thailand
| | - Talerngsak Kanjanabuch
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,CAPD Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
| |
Collapse
|
7
|
Chamroensakchai T, Leedumrongwattanakul K, Takkavatakarn K, Manuprasert W, Kanjanabuch T. Peritoneal dialysis (PD) catheter-related peritonitis from Aureobasidium pullulans caused by poor caregiver's hand hygiene. Med Mycol Case Rep 2019; 25:35-38. [PMID: 31388481 PMCID: PMC6676155 DOI: 10.1016/j.mmcr.2019.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/06/2019] [Accepted: 07/29/2019] [Indexed: 11/29/2022] Open
Abstract
Catheter-related peritonitis is common but rarely caused by fungal infection. We report the first case of PD patients with catheter-related peritonitis form Aureobasidium pullulans, a black yeast-like dematiaceous fungus, and reviewing the relevant literatures. A potential cause of this infection is poor hand hygiene and improper fingernail care. The infection could be prevented if patient and caregiver strictly follow hand-washing protocols.
Collapse
Affiliation(s)
- Tamonwan Chamroensakchai
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.,Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | - Kullaya Takkavatakarn
- Division of Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand
| | - Wasin Manuprasert
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Talerngsak Kanjanabuch
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.,Division of Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand.,CAPD Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand
| |
Collapse
|