Exophiala dermatitidis infection in cystic fibrosis

Haase, G.; Skopnik, H.; Kusenbach, G.

doi:10.1016/0140-6736(90)91721-l

Cited by 64 publications

(42 citation statements)

References 7 publications

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“…In CF patients, various fungi species have been reported to colonize the respiratory tract or to be causative agents of infection. Apart from non- fumigatus Aspergillus species, these species include the opportunistic pathogenic fungi Exophiala dermatitidis [11,12,13,14], P. boydii and S. prolificans [1,15,16,17] as well as soil fungi rarely isolated from human sources, such as Acrophialophora fusispora [18]. The number of cases may be underestimated because slow-growing fungi are overgrown by other microorganisms and/or because the fungi are not recognized by clinical microbiologists because of their slow growth [18].…”

Section: Discussionmentioning

confidence: 99%

Selective Isolation of Pseudallescheria and Scedosporium Species from Respiratory Tract Specimens of Cystic Fibrosis Patients

et al. 2008

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Background: Fungi of the Pseudallescheria/Scedosporium complex are known to be colonizers and infectious agents of the respiratory tract of cystic fibrosis (CF) patients. Colonized CF patients are at high risk for the development of disseminated scedosporiosis after lung transplantation. The detection of these fungi may be difficult, because they grow slowly and so will be overgrown by faster-developing microorganisms on the media routinely used in diagnostic laboratories. Objectives: To examine the usefulness of the isolation medium SceSel+ agar as a diagnostic tool for clinical samples from CF patients. Methods: 150 respiratory tract samples from 42 CF patients were inoculated on SceSel+ agar. During the incubation phase, which lasted up to 30 days at 36 ± 1°C, the cultures were inspected every 2 or 3 days. Results: The isolation of Scedosporium species was successful in 3 samples (2%) with standard microbiological media and procedures, while the isolation rate on SceSel+ agar was 5.3% (8 of 150 specimens). Conclusions: Our results suggest that standard microbiological media and procedures are not sufficient to detect colonization of the respiratory tract by Pseudallescheria/Scedosporium in CF patients. By use of SceSel+ agar, fungi belonging to this complex were isolated more frequently. Therefore, this semiselective mycological isolation medium should be used for the detection of these fungi in the respiratory tract of CF patients, especially in patients in whom a fungal infection is assumed or who are scheduled for lung transplantation.

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Section: Discussionmentioning

confidence: 99%

Selective Isolation of Pseudallescheria and Scedosporium Species from Respiratory Tract Specimens of Cystic Fibrosis Patients

et al. 2008

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“…However, the fungal biota colonizing the airways of CF patients could be even more complex, as suggested by the recent description of two strictly thermophilic fungi, Penicillium emersonii (anamorph state of Talaromyces emersonii) and Acrophialophora fusispora, in these patients (9,11). Additionally, other fungal species seem to be more common in some geographic areas, such as Scedosporium prolificans, which has mainly been reported for CF patients in Spain (14,17,35), and Exophiala dermatitidis, which has been isolated from CF patients in Germany (4,15,25,29,31). Due to the propensity of some of these molds to disseminate in an immunocompromised host and to their usually low susceptibility to current systemic antifungals, it may be important to detect and identify mold species which colonize the respiratory tract of the patients.…”

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confidence: 99%

Development of an Oligonucleotide Array for Direct Detection of Fungi in Sputum Samples from Patients with Cystic Fibrosis

Bouchara

Hsieh

Croquefer³

et al. 2009

J Clin Microbiol

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Cystic fibrosis (CF) is the most common inherited genetic disease in Caucasian populations. Besides bacteria, many species of fungi may colonize the respiratory tract of these patients, sometimes leading to true respiratory infections. In this study, an oligonucleotide array capable of identifying 20 fungal species was developed to directly detect fungi in the sputum samples of CF patients. Species-specific oligonucleotide probes were designed from the internal transcribed spacer (ITS) regions of the rRNA operon and immobilized on a nylon membrane. The fungal ITS regions were amplified by PCR and hybridized to the array for species identification. The array was validated by testing 182 target strains (strains which we aimed to identify) and 141 nontarget strains (135 species), and a sensitivity of 100% and a specificity of 99.2% were obtained. The validated array was then used for direct detection of fungi in 57 sputum samples from 39 CF patients, and the results were compared to those obtained by culture. For 16 sputum samples, the results obtained by the array corresponded with those obtained by culture. For 33 samples, the array detected more fungal species than culture did, while the reverse was found for eight samples. The accuracy of the array for fungal detection in sputum samples was confirmed (or partially confirmed) in some samples by cloning and resequencing the amplified ITS fragments. The present array is a useful tool for both the simultaneous detection of multiple fungal species present in the sputa of CF patients and the identification of fungi isolated from these patients.

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“…It is known to cause local infections of the skin, which may spread and cause disseminated disease and fungemia; the latter is seen particularly in immunocompromised patients (1,4,18). Only 2 decades ago, E. dermatitidis was revealed to be able to colonize patients with cystic fibrosis (12). The fungus is traditionally viewed as having low virulence and hence is considered to be a harmless inhabitant of the CF airways (20).…”

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confidence: 99%

High Rate of Exophiala dermatitidis Recovery in the Airways of Patients with Cystic Fibrosis Is Associated with Pancreatic Insufficiency

et al. 2011

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The black-pigmented fungus Exophiala dermatitidis is considered to be a harmless colonizer of the airways of cystic fibrosis (CF) patients. The aim of this study was to establish the recovery rate of E. dermatitidis in respiratory specimens from CF patients, transplant recipients, and subjects with other respiratory disorders in Sweden. Second, we wished to determine if particular clinical traits were associated with E. dermatitidis colonization of the airways and the antifungal susceptibility profiles of Exophiala strains. Sputum and bronchoalveolar lavage samples (n ‫؍‬ 492) derived from 275 patients were investigated. E. dermatitidis was isolated in respiratory specimens from 19% (18/97) of the CF patients but in none of the other patient categories. All isolates were recovered after 6 to 25 days of incubation on erythritol-chloramphenicol agar (ECA) medium. Morphological and genetic analyses confirmed species identity. Pancreatic insufficiency was positively associated with the presence of E. dermatitidis in sputum samples (P ‫؍‬ 0.0198). Antifungal susceptibility tests demonstrated that voriconazole and posaconazole had the lowest MICs against E. dermatitidis. In conclusion, E. dermatitidis is a frequent colonizer of the respiratory tract in CF patients in Sweden and appears to be associated with more advanced disease. Whether E. dermatitidis is pathogenic remains to be elucidated.

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Exophiala dermatitidis infection in cystic fibrosis

Cited by 64 publications

References 7 publications

Selective Isolation of <i>Pseudallescheria</i> and <i>Scedosporium </i>Species from Respiratory Tract Specimens of Cystic Fibrosis Patients

Selective Isolation of <i>Pseudallescheria</i> and <i>Scedosporium </i>Species from Respiratory Tract Specimens of Cystic Fibrosis Patients

Development of an Oligonucleotide Array for Direct Detection of Fungi in Sputum Samples from Patients with Cystic Fibrosis

High Rate of Exophiala dermatitidis Recovery in the Airways of Patients with Cystic Fibrosis Is Associated with Pancreatic Insufficiency

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