Breakthrough invasive fungal infections: Who is at risk?

Jenks, Jeffrey D.; Cornely, Oliver A.; Chen, Sharon C.‐A.; Thompson, George R.; Hoenigl, Martin

doi:10.1111/myc.13148

Cited by 128 publications

(110 citation statements)

References 142 publications

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“…For those patients who develop IA while receiving systemic antifungal(s), defining whether or not this infection presents a breakthrough infection and warrants a change of antifungal treatment is important 4,5 . ECMM/MSG consensus criteria for defining breakthrough infections for research have been developed and also cover the ICU setting 6 .…”

Section: Ipa Definition In the Icumentioning

confidence: 99%

“…Worldwide estimates indicate that over 1.8 million cases of invasive fungal infections occurred in 2017, including around 250,000 cases of invasive aspergillosis (IA) 1 . Mould‐active prophylaxis has shown some success in reducing IA in patients with traditional risk factors for IA, such as those with underlying haematological malignancy and prolonged neutropenia, although breakthrough infections may occur 2–7 . In contrast, the prevalence of IA continues to increase in non‐neutropenic patients with severe underlying diseases, including those in intensive care units, 8–12 those with severe viral infections caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) or influenza virus, 12–16 solid organ transplant recipients, 17 those receiving systemic glucocorticoids, 18 those with solid cancers, 8,19 those with chronic obstructive pulmonary disorder (COPD) and other chronic respiratory disorders, and those who have received ibrutinib 8,20–22 .…”

Section: Introductionmentioning

confidence: 99%

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Invasive aspergillosis in critically ill patients: Review of definitions and diagnostic approaches

Jenks

Nam

Hoenigl

2021

Mycoses

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Invasive aspergillosis (IA) is an increasingly recognised phenomenon in critically ill patients in the intensive care unit, including in patients with severe influenza and severe coronavirus disease 2019 (COVID‐19) infection. To date, there are no consensus criteria on how to define IA in the ICU population, although several criteria are used, including the AspICU criteria and new consensus criteria to categorise COVID‐19‐associated pulmonary aspergillosis (CAPA). In this review, we describe the epidemiology of IA in critically ill patients, most common definitions used to define IA in this population, and most common clinical specimens obtained for establishing a mycological diagnosis of IA in the critically ill. We also review the most common diagnostic tests used to diagnose IA in this population, and lastly discuss the most common clinical presentation and imaging findings of IA in the critically ill and discuss areas of further needed investigation.

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Section: Ipa Definition In the Icumentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Invasive aspergillosis in critically ill patients: Review of definitions and diagnostic approaches

Jenks

Nam

Hoenigl

2021

Mycoses

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“…Invasive candidiasis is a well-known life-threatening disease and a major issue for a medical institution, leading to significant morbidity, mortality, and huge extra hospital costs ( Fuchs et al, 2019 ; Jenks et al, 2020 ). Regarding epidemiological data, invasive candidiasis was ranked the fourth leading nosocomial infectious disease with an overall mortality rate of 40% ( McCarty and Pappas, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Development and Application of a Multiple Cross Displacement Amplification Combined With Nanoparticle-Based Lateral Flow Biosensor Assay to Detect Candida tropicalis

et al. 2021

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Candida tropicalis is an increasingly opportunistic pathogen that causes serious invasive candidiasis threatening a patient’s life. Traditional methods to detect C. tropicalis infection depends on time-consuming, culture-based gold-standard methods. So, we sought to establish a new method that could detect target pathogens quickly, accurately, and straightforwardly. Herein, a combination of multiple cross displacement amplification (MCDA) and lateral flow biosensors (LFB) was employed to detect C. tropicalis. In the MCDA system, 10 primers were designed to identify the specific genes of C. tropicalis and amplify the genes in an isothermal amplification device. Then, MCDA amplification reaction products could be identified visibly by color change, and all the amplification products would be tested by LFB with no special equipment. The results demonstrated that the optimal reaction condition of C. tropicalis-MCDA assay was 64°C within 30 min, and only 10 fg DNA was required in each reaction. No cross-reaction was found between C. tropicalis strains and non-C. tropicalis strains. For 300 sputum samples, the results showed that MCDA-LFB assay could rapidly and successfully detect all of the C. tropicalis-positive (28/300) samples detected by the gold-standard method. The entire procedure, including specimen processing (40 min), isothermal reaction (30 min) and result reporting (within 2 min), could be completed within 75 min. Briefly, the study results demonstrated that the detection ability of C. tropicalis-MCDA-LFB assay was better than culture methods with more simplicity, rapidity, sensitivity and specificity. Hence, MCDA-LFB strategy is an effective tool to rapidly detect C. tropicalis in clinical samples, especially in resource-poor areas.

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“…A dramatic increase in fungal infections in recent years is associated with several factors such as prolonged dosage of broad-spectrum antibiotics, immunosuppressive therapy, extended stays in hospitals, burns, and recently undergone surgery as well as malignancy [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Mould War: Developing an Armamentarium against Fungal Pathogens Utilising Thymoquinone, Ocimene, and Miramistin within Bacterial Cellulose Matrices

et al. 2021

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An increase in antifungal resistance has seen a surge in fungal wound infections in patients who are immunocompromised resulting from chemotherapy, disease, and burns. Human pathogenic fungi are increasingly becoming resistant to a sparse repertoire of existing antifungal drugs, which has given rise to the need to develop novel treatments for potentially lethal infections. Bacterial cellulose (BC) produced by Gluconacetobacter xylinus has been shown to possess many properties that make it innately useful as a next-generation biopolymer to be utilised as a wound dressing. The current study demonstrates the creation of a pharmacologically active wound dressing by loading antifungal agents into a biopolymer hydrogel to produce a novel wound dressing. Amphotericin B is known to be highly hepatotoxic, which reduces its appeal as an antifungal drug, especially in patients who are immunocompromised. This, coupled with an increase in antifungal resistance, has seen a surge in fungal wound infections in patients who are immunodeficient due to chemotherapy, disease, or injury. Antifungal activity was conducted via Clinical & Laboratory Standards Institute (CLSI) M27, M38, M44, and M51 against Candida auris, Candida albicans, Aspergillus fumigatus, and Aspergillus niger. This study showed that thymoquinone has a comparable antifungal activity to amphotericin B with mean zones of inhibition of 21.425 ± 0.925 mm and 22.53 ± 0.969 mm, respectively. However, the mean survival rate of HEp-2 cells when treated with 50 mg/L amphotericin B was 29.25 ± 0.854% compared to 71.25 ± 1.797% when treated with 50 mg/L thymoquinone. Following cytotoxicity assays against HEp-2 cells, thymoquinone showed a 71.25 ± 3.594% cell survival, whereas amphotericin B had a mean cell survival rate of 29.25 ± 1.708%. The purpose of this study was to compare the efficacy of thymoquinone, ocimene, and miramistin against amphotericin B in the application of novel antifungal dressings.

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Breakthrough invasive fungal infections: Who is at risk?

Cited by 128 publications

References 142 publications

Invasive aspergillosis in critically ill patients: Review of definitions and diagnostic approaches

Invasive aspergillosis in critically ill patients: Review of definitions and diagnostic approaches

Development and Application of a Multiple Cross Displacement Amplification Combined With Nanoparticle-Based Lateral Flow Biosensor Assay to Detect Candida tropicalis

The Mould War: Developing an Armamentarium against Fungal Pathogens Utilising Thymoquinone, Ocimene, and Miramistin within Bacterial Cellulose Matrices

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