Das Deutsche Pilz-Keratitis-Register

Roth, Mathias; Daas, Loay; Renner-Wilde, A.; Cvetkova-Fischer, N.; Saeger, Mark; Herwig‐Carl, Martina C.; Matthaei, Mario; Fekete, Ágnes; Kakkassery, Vinodh; Walther, Grit; Lilienfeld-Toal, M von; Mertens, C.; Lenk, Janine; Mehlan, Juliane; Fischer, Charlotte; Fuest, Matthias; Kroll, Stewart; Bayoudh, W.; Viestenz, Arne; Фрингс, Андреас; MacKenzie, Colin R.; Messmer, Elisabeth M.; Seitz, Berthold; Kurzai, Oliver; Geerling, Gerd

doi:10.1007/s00347-019-0871-9

Cited by 35 publications

(32 citation statements)

References 45 publications

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“…Data from the German Fungal Keratitis Registry have shown that roughly one-third of cases in Germany are caused by Candida species, one-third is Fusarium keratitis, and one-third is caused by other filamentous fungi, including Aspergillus spp. [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Eye Infections Caused by Filamentous Fungi: Spectrum and Antifungal Susceptibility of the Prevailing Agents in Germany

Walther

Zimmermann

Theuersbacher

et al. 2021

JoF

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Fungal eye infections can lead to loss of vision and blindness. The disease is most prevalent in the tropics, although case numbers in moderate climates are increasing as well. This study aimed to determine the dominating filamentous fungi causing eye infections in Germany and their antifungal susceptibility profiles in order to improve treatment, including cases with unidentified pathogenic fungi. As such, we studied all filamentous fungi isolated from the eye or associated materials that were sent to the NRZMyk between 2014 and 2020. All strains were molecularly identified and antifungal susceptibility testing according to the EUCAST protocol was performed for common species. In total, 242 strains of 66 species were received. Fusarium was the dominating genus, followed by Aspergillus, Purpureocillium, Alternaria, and Scedosporium. The most prevalent species in eye samples were Fusarium petroliphilum, F. keratoplasticum, and F. solani of the Fusarium solani species complex. The spectrum of species comprises less susceptible taxa for amphotericin B, natamycin, and azoles, including voriconazole. Natamycin is effective for most species but not for Aspergillus flavus or Purpureocillium spp. Some strains of F. solani show MICs higher than 16 mg/L. Our data underline the importance of species identification for correct treatment.

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Section: Introductionmentioning

confidence: 99%

Eye Infections Caused by Filamentous Fungi: Spectrum and Antifungal Susceptibility of the Prevailing Agents in Germany

Walther

Zimmermann

Theuersbacher

et al. 2021

JoF

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“…The disease is triggered by events such as wearing contact lenses, getting dirt into the eye or immunosuppressive drug therapies. Epidemiologic investigations show that 57% of the fungal keratitis patients wore contact lenses, 30% of these had an eye operation previously and 19% had jobs in the agriculture or gardener sections (Roth et al, 2019). The main challenging tasks in clinical practice are early and precise diagnoses, differentiation from other ocular infections, followed by an adequate therapy of the fungal strain which has to be performed in time, so that dramatic consequences like tissue damages and loss of sight can be prevented.…”

Section: Introductionmentioning

confidence: 99%

“…The main challenging tasks in clinical practice are early and precise diagnoses, differentiation from other ocular infections, followed by an adequate therapy of the fungal strain which has to be performed in time, so that dramatic consequences like tissue damages and loss of sight can be prevented. In average, 32 days are necessary until the fungal infection of the eye is diagnosed (Roth et al, 2019). As consequence of the late diagnosis, keratomycosis is progressed and the therapy needs to be highly efficient for total patient recovery.…”

Section: Introductionmentioning

confidence: 99%

“…For fungal keratitis therapy, mainly Voriconazole and Amphotericin B (AmpB) are used solely or in combination via surface or anterior application therapy. The antimycotic therapy is characterized by high application frequency and high doses to reach complete recovery of the fungal infection (Behrens-Baumann et al, 2015;Farrell et al, 2017;Roth et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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In situ Gelling Amphotericin B Nanofibers: A New Option for the Treatment of Keratomycosis

Göttel

Lucas

Syrowatka

et al. 2020

Front. Bioeng. Biotechnol.

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The purpose of our research was the development of Amphotericin B-loaded in situ gelling nanofibers for the treatment of keratomycosis. Different formulation strategies were applied to increase the drug load of the sparingly water-soluble Amphotericin B in electrospun Gellan Gum/Pullulan fibers. These include bile salt addition, encapsulation in poly(lactic-co-glycolic acid) (PLGA) nanoparticles and formation of a polymeric Amphotericin B polyelectrolyte complex. The Amphotericin B polyelectrolyte complex (AmpB-Eu L) performed best and was very effective against the fungal strain Issatchenkia orientalis in vitro. The complex was characterized in detail by attenuated total reflection infrared spectroscopy, X-ray powder diffraction, and differential scanning calorimetry. A heat induced stress test was carried out to ensure the stability of the polyelectrolyte complex. To gain information about the cellular tolerance of the developed polyelectrolyte complex a new, innovative multilayered-stratified human cornea cell model was used for determination of the cellular toxicity in vitro. For a safe therapy, the applied ophthalmic drug delivery system has to be sterile. Sterilization by electron irradiation caused not degradation of pure Amphotericin B and also for the bile salt complex. Furthermore, the developed Amphotericin B polyelectrolyte complex was not degraded by the irradiation process. In conclusion, a new polyelectrolyte Amphotericin B complex has been found which retains the antifungal activity of the drug with sufficient stability against irradiation-sterilization induced drug degradation. Furthermore, in comparison with the conventional used eye drop formulation, the new AmpB-complex loaded nanofibers were less toxic to cornea cells in vitro. Electrospinning of the Amphotericin B polyelectrolyte complex with Gellan Gum/ Pullulan leads to the formation of nanofibers with in situ gelling properties, which is a new and promising option for the treatment of keratomycosis.

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“…Pilzkeratitiden sind ein relativ seltenes, aber sehr ernst zu nehmendes Krankheitsbild. Die korrekte Diagnose wird in Deutschland initial nur bei 1/5 der Fälle gestellt [ 1 , 10 ]. Die Gefahr für das Auge ist groß, denn nicht adäquat behandelt, kann es zu Hornhautvernarbungen, Augenperforationen oder Endophthalmitiden kommen, was die visuelle Prognose erheblich reduziert und den Erhalt des Auges unsicher macht.…”

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Mischinfektionen bei kontaktlinsenassoziierter mykotischer Keratitis mit Pseudomonas oder Akanthamöben

et al. 2020

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ZusammenfassungKontaktlinsenassoziierte Keratitiden werden immer häufiger. Die mykotische Keratitis ist ein relativ seltenes, aber sehr ernst zu nehmendes Krankheitsbild. Meist wird im Frühstadium eine falsche Diagnose gestellt und dadurch die adäquate Therapie verzögert. Bei der therapierefraktären kontaktlinsenassoziierten mykotischen Keratitis können nicht selten auch Koinfektionen oder Superinfektionen bestehen. Wir stellen 2 Patienten mit initial unklarer Keratitis vor, bei denen eine Mischinfektion der mykotischen Keratitis mit Pseudomonas aeruginosa bzw. Akanthamöben nachgewiesen werden konnte. In beiden Fällen war die zeitnahe perforierende Excimerlaser-Keratoplastik mit Einzelknüpfnähten und adäquater Lokaltherapie über 8 Wochen therapeutisch erfolgreich.

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Das Deutsche Pilz-Keratitis-Register

Cited by 35 publications

References 45 publications

Eye Infections Caused by Filamentous Fungi: Spectrum and Antifungal Susceptibility of the Prevailing Agents in Germany

Eye Infections Caused by Filamentous Fungi: Spectrum and Antifungal Susceptibility of the Prevailing Agents in Germany

In situ Gelling Amphotericin B Nanofibers: A New Option for the Treatment of Keratomycosis

Mischinfektionen bei kontaktlinsenassoziierter mykotischer Keratitis mit Pseudomonas oder Akanthamöben

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