Fungemia due to <i>Rhodotorula mucilaginosa</i> after allogeneic hematopoietic stem cell transplantation

Mori, Takehiko; Nakamura, Yukinori; Kato, Jun; Sugita, Kayoko; Murata, Mitsuru; Kamei, Katsuhiko; Okamoto, Shinichiro

doi:10.1111/j.1399-3062.2011.00647.x

Cited by 25 publications

(26 citation statements)

References 13 publications

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“…So far the characterisation of infection by Rhodotorula derived from either overlapping reviews of the literature or smaller monocentric studies . Our study confirms that Rhodotorula infections in haematological patients is associated with the presence of CVC in the majority of cases.…”

Section: Discussionsupporting

confidence: 74%

“…The risk factors most frequently reported for developing Rhodotorula spp infection overlap with the ones of candidiasis and include neutropenia, administration of immunosuppressive drugs and the presence of cancer either solid or haematologic. Nevertheless, there is a paucity of data regarding invasive Rhodotorula infections in the most vulnerable population,that one of patients with haematological cancer and/or hematopoietic stem cell transplantation . To that end, we report on the largest collection of Rhodotorula cases in haematological patients from tertiary care centres and in order to describe risk factors and treatment outcome.…”

Section: Introductionmentioning

confidence: 99%

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Rhodotorula infection in haematological patient: Risk factors and outcome

Potenza

Chitasombat

Климко

et al. 2018

Mycoses

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Summary Background Rhodotorula spp are uncommon yeasts able to cause infections with high mortality rates. Rhodotorula infections have been associated with the presence of central venous catheter (CVC), immunosuppression, exposure to antifungals and the presence of either solid or haematologic malignancies. However, in this latter setting, only a few cases have so far been reported. Objectives We have conducted a survey for Rhodotorula infections in haematologic patients. Methods Patients’ clinical and microbiological data were collected and correlated to the outcome. Results A total of 27 cases were detected from 13 tertiary care hospitals. About 78% and 89% of patients had acute leukaemia and CVC. About 70% of patients were exposed to prophylaxis with azoles, mainly posaconazole (37%), 59% were severely neutropenic and 37% underwent allogeneic stem cell transplantation (alloSCT). The most frequent treatments were liposomal amphotericin B (L‐AmB) and CVC removal in 17 and 16 patients, respectively. One month post‐diagnosis, mortality was 26% and was associated with the presence of mucositis (P = 0.034). Conclusions Our study shows that Rhodotorula spp should be considered as aetiologic agents of breakthrough infections in acute leukaemia patients with a CVC, mucositis, who receive prophylaxis with azoles, including posaconazole, and/or undergo alloSCT. Prompt measures, such as L‐AmB administration and CVC removal, should be carried out to avoid the high mortality risk of Rhodotorula infections.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Rhodotorula infection in haematological patient: Risk factors and outcome

Potenza

Chitasombat

Климко

et al. 2018

Mycoses

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“…Most of cases reported in the literature date back to after 1994, when CVCs and intensive therapies were widely available. Table 1 shows a summary of reported cases of fungemia related to CVC use between 2000 and 2011 [46–68]. In all cases listed, the patients were using CVC, short- or long-term CAPD, and umbilical catheter.…”

Section: Rhodotorula In Humansmentioning

confidence: 99%

Epidemiology ofRhodotorula: An Emerging Pathogen

Wirth

Goldani

2012

Interdisciplinary Perspectives on Infectious Diseases

244

226

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This is an updated paper focusing on the general epidemiological aspects of Rhodotorula in humans, animals, and the environment. Previously considered nonpathogenic, Rhodotorula species have emerged as opportunistic pathogens that have the ability to colonise and infect susceptible patients. Rhodotorula species are ubiquitous saprophytic yeasts that can be recovered from many environmental sources. Several authors describe the isolation of this fungus from different ecosystems, including sites with unfavourable conditions. Compared to R. mucilaginosa, R. glutinis and R. minuta are less frequently isolated from natural environments. Among the few references to the pathogenicity of Rhodotorula spp. in animals, there are several reports of an outbreak of skin infections in chickens and sea animals and lung infections and otitis in sheep and cattle. Most of the cases of infection due to Rhodotorula in humans were fungemia associated with central venous catheter (CVC) use. The most common underlying diseases included solid and haematologic malignancies in patients who were receiving corticosteroids and cytotoxic drugs, the presence of CVC, and the use of broad-spectrum antibiotics. Unlike fungemia, some of the other localised infections caused by Rhodotorula, including meningeal, skin, ocular, peritoneal, and prosthetic joint infections, are not necessarily linked to the use of CVCs or immunosuppression.

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“…In a series of 33 patients with haematological malignancies in five hospitals in Japan between 1992 and 2007, trichosporonosis occurred as a breakthrough infection during antifungal therapy in 30 patients (91%), 18 of whom were receiving micafungin 59 . Reports also exist of breakthrough fungal infections due to zygomycetes , 3,60 Fusarium species, 3 Blastoschizomyces capitatus 61 and Rhodotorula mucilaginosa after allogeneic HSCT 62 in haematological malignancy patients receiving micafungin, whereas the combination of micafungin and fluconazole was found to be effective against disseminated blastoschizomycosis 63 . Of note, combination therapy of micafungin and voriconazole failed to result in favourable outcome in a case of subcutaneous Alternaria alternata infection in a 58‐year‐old febrile neutropenic male with refractory CLL 64 …”

Section: Micafungin As Treatment For Documented Ifis In Patients Withmentioning

confidence: 99%

Micafungin in haematology

Gamaletsou

Sipsas

Kontoyiannis

2012

Mycoses

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Summary Invasive fungal infections have emerged as a major cause of increased morbidity and mortality among severely immunosuppressed patients with haematological malignancy. Micafungin, a new member of the echinocandin class, is a valuable addition to the antifungal armamentarium of the 21st century as it is active against Candida species, Aspergillus species, and other unusual mycoses that frequently affect these high risk patients. Available data on the safety and efficacy of micafungin as prophylaxis, preemptive/empirical treatment, or treatment of documented invasive fungal infection in patients with haematological malignancies are summarized in this review.

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Fungemia due to Rhodotorula mucilaginosa after allogeneic hematopoietic stem cell transplantation

Cited by 25 publications

References 13 publications

Rhodotorula infection in haematological patient: Risk factors and outcome

Rhodotorula infection in haematological patient: Risk factors and outcome

Epidemiology ofRhodotorula: An Emerging Pathogen

Micafungin in haematology

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