Head-to-Head Comparison of the Activities of Currently Available Antifungal Agents against 3,378 Spanish Clinical Isolates of Yeasts and Filamentous Fungi

Cuenca‐Estrella, Manuel; Gómez-López, Alicia; Mellado, Emilia; Buitrago, María J.; Monzón, Araceli; Rodríguez-Tudela, Juan Luis

doi:10.1128/aac.50.3.917-921.2006

Cited by 271 publications

(199 citation statements)

References 28 publications

Supporting

Mentioning

175

Contrasting

Unclassified

Order By: Relevance

“…Here attention may also be drawn to the reports of breakthrough Trichosporon infection in leukaemic patients receiving caspofungin therapy (Matsue et al, 2006;Chitasombat et al, 2012). Trichosporon spp., although belonging to the basidiomycetous lineage, are similar in their arthroconidial morphological characteristics as well as in susceptibility profile to echinocandins (Cuenca-Estrella et al, 2006;Miceli et al, 2011). As echinocandins are now being used as first-line drugs for the treatment of Candida infections, it is important that yeast isolates are accurately identified and antifungal susceptibility determined before an echinocandin is prescribed.…”

Section: Discussionmentioning

confidence: 99%

Breakthrough disseminated Saprochaete capitata infection in a child with acute myeloid leukaemia receiving caspofungin therapy

et al. 2014

View full text Add to dashboard Cite

Introduction: We present a fatal case of disseminated infection in a child with leukaemia, caused by Saprochaete capitata, an ascomycetous yeast.Case presentation: The aetiological role of disseminated infection by S. capitata in a child with relapsed acute myeloid leukaemia following bone-marrow transplantation was established by its repeated isolation from blood, tracheal secretion and urine samples. The identity of S. capitata was confirmed by phenotypic and molecular methods. The isolate showed reduced susceptibility to caspofungin. Conclusion:This report indicates that patients receiving echinocandin prophylaxis are at risk of breakthrough infections caused by S. capitata or other arthroconidial yeast species. To the best of our knowledge, this is the first well-documented case of S. capitata infection from the Middle East.Keywords: Breakthrough infection; echinocandins; fungaemia; Saprochaete capitata. IntroductionSaprochaete capitata, an anamorph of Magnusiomyces capitatus (de Hoog & Smith, 2004), previously known as Geotrichum capitatum or Blastoschizomyces capitatus, is a rarely reported cause of disseminated disease (Girmenia et al., 2005). It is known to colonize the respiratory and digestive tracts of humans and appears to have similar pathogenesis to other yeast species colonizing mucosal surfaces (Birrenbach et al., 2012). Most cases of S. capitata infection have occurred in patients with haematological malignancies and persistent neutropenia receiving chemotherapy (Fouassier et al., 1998;Martino et al., 2004;Girmenia et al., 2005;Miceli et al., 2011; Lafayette et al., 2011;Ö zkaya-Parlakay et al., 2012;García-Ruiz et al., 2013). Disseminated S. capitata, infection is associated with high mortality, thus underscoring the need for accurate identification, prior antifungal susceptibility testing and early initiation of specific therapy (Girmenia et al., 2005). Here, we describe a fatal case of breakthrough S. capitata infection in a child who was on empirical caspofungin therapy. Case reportAn 11-year-old Egyptian female, a known case of acute myeloid leukaemia since December 2009, underwent allogeneic bone-marrow transplantation in August 2011. She was admitted for a relapse and received chemotherapy with fludarabine, L-asparaginase and idarubicin. During chemotherapy, she developed fever, cough, renal impairment and bacteraemia with Stenotrophomonas maltophilia (susceptible to cotrimoxazole and colistin), and she was transferred to the paediatric intensive care unit (PICU) and started on colistin, caspofungin and metronidazole. During her PICU stay, she remained severely neutropenic (absolute neutrophil count ,100 mm 21 ) and experienced two more episodes of bacteraemia, one due to Staphylococcus epidermidis and the other due to Stenotrophomonas maltophilia from blood drawn through the Port-A-Cath. For these infections, she was treated with teicoplanin, colistin, meropenem, clarithromycin and cotrimoxazole. Caspofungin was added empirically in the treatment regimen. The Port-A-Cath was not change...

show abstract

Section: Discussionmentioning

confidence: 99%

Breakthrough disseminated Saprochaete capitata infection in a child with acute myeloid leukaemia receiving caspofungin therapy

et al. 2014

View full text Add to dashboard Cite

show abstract

“…All isolates described so far have been fluconazolesensitive (Lockhart et al, 2008). This is not necessarily the case with other uncommonly identified non-albicans Candida species (Cuenca-Estrella et al, 2006). Given the range of fluconazole susceptibility, early rationalization of antifungal use may be appropriate.…”

Section: Discussionmentioning

confidence: 99%

“…These were tested by various methods including broth microdilution (Antifungal Susceptibility Testing Subcommittee of the European Committee on Antibiotic Susceptibility Testing for testing fermentative yeasts) and Etest (AB Biodisk) (Cuenca-Estrella et al, 2006;Tay et al, 2009). All isolates described so far have been fluconazolesensitive (Lockhart et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Lodderomyces elongisporus endocarditis in an intravenous drug user: a new entity in fungal endocarditis

Daveson

Woods

2012

Journal of Medical Microbiology

View full text Add to dashboard Cite

Lodderomyces elongisporus has been recently identified in the literature as an infrequent human bloodstream isolate, commonly mistaken for a non-albicans Candida. A case of Lodderomyces endocarditis in an intravenous drug user is described. To our knowledge, this report highlights the first documented case of Lodderomyces as a cause of endocarditis and summarizes the susceptibility patterns in the reported literature. All isolates reported so far have fluconazole MICs of ¡0.25 mg ml "1 . Case reportA 30-year-old male carpenter presented febrile to a hospital emergency department with associated recurrent swelling of his left forefoot. He had experienced a week of night sweats and rigors and no history of foot trauma. He had sought medical treatment in primary care for his foot symptoms in the preceding weeks prior to the commencement of the night sweats. The presumptive diagnosis had been a soft tissue injury and was treated symptomatically with no improvement.His past medical history included depression and claustrophobia. He was known to have a pre-existing cardiac murmur that had never been investigated. He was an intravenous heroin user, cigarette smoker and social drinker. He injected primarily via his left cubital fossa and occasionally the venous networks on the dorsal surfaces of his hands. He last admitted to intravenous drug use 8 weeks prior to presentation. His medications included oral quetiapine and he had no allergies.Vital signs on admission were as follows: temperature 38.4 u C, pulse rate regular at 102 beats min 21 , blood pressure of 102/ 74 and respiratory rate of 18 respirations min 21 . Examination revealed an ejection systolic murmur and oedema localized to the left ankle region associated with full range of movement. There were no peripheral stigmata of endocarditis, neurological abnormalities or cardiac failure.Three sets of blood cultures in addition to standard bloods were taken from two different sites (BacT/ALERT; bioMérieux). The aerobic bottles of all sets flagged positive after approximately 40 h (range 37.6-43.8 h). Yeast was seen on microscopy. Preliminary identification was that of a non-albicans Candida after growth on Sabouraud Dextrose Agar, a negative germ tube test and subsequent isolation of blue/green colonies on CHROMagar Candida media (BD Diagnostics). The isolate was referred to a reference laboratory for definitive identification. A further two sets of blood cultures taken 2 days later also flagged positive prior to the commencement of antifungal agents. He was empirically commenced on caspofungin whilst awaiting further investigations and results. Blood cultures taken 48 h after therapy was commenced had no growth.A transoesophageal echo was performed and demonstrated a bicuspid aortic valve with mild stenosis and aortic regurgitation. Bulky lesions up to 1 cm were attached to both leaflet margins. An MRI of his brain revealed right frontal and left parietal hyperintense lesions on the T2 weighted images consistent with presumed embolic lesions. A bone scan was con...

show abstract

“…At present, the new triazoles, voriconazole and posaconazole, as well as a combined treatment should be considered as a possible option to modify outcome. 41,[44][45] Even though the antifungal drugs registered for empiric therapy (AmB formulations and caspofungin) are not intrinsically active against Scedosporium spp, the very low incidence of scedosporiosis also in AML patients does not justify the use of other antifungal drugs active against these highly pathogenic fungi in the empiric setting.…”

confidence: 99%

“…Our literature review showed that therapeutic options for S. prolificans infection are more limited because of its resistance profile: in vitro susceptibility studies have invariably demonstrated an almost total resistance to AmB and to other available antifungal agents. 41 However, voriconazole has shown some promising in vitro activity, alone or in combination with terbinafine. 40,[42][43] The routine use of these new antifungal drugs seems to suggest an improved outcome in the future.…”

confidence: 99%

Scedosporiosis in patients with acute leukemia: a retrospective multicenter report

Caira¹,

Girmenia²,

Valentini³

et al. 2008

Haematologica

View full text Add to dashboard Cite

We retrospectively analyzed 542 proven/probable mould infections registered, in the course of 2 studies, in 8,633 patients with acute leukemia, focusing on scedosporiosis. We aimed to define scedosporiosis incidence and mortality rate over a 15-year period. Only 5 cases of scedosporiosis were identified, all of them involving patients with acute myeloid leukemia (AML). We also reviewed all cases of Scedosporium spp. infections in acute leukemia reported to date in the international literature. The 52 cases analyzed confirmed that acute myeloid leukemia is the category with the highest risk of scedosporiosis. Clinical features of scedosporiosis were extremely variable and closely related to patient immune status. Infection disseminated to multiple sites in a very high percentage of patients and outcome was confirmed to be very poor. In our surveys all patients died, in spite of Amphotericin B compounds or voriconazole administration. Our review of literature found scedosporiosis attributable mortality rate (AMR) to be 77%. In conclusion, scedosporiosis, although extremely rare, represents a big problem for clinicians because of its aggressive clinical presentation and the lack of an effective therapy. New drugs with in vitro activity against Scedosporium spp (voriconazole, posaconazole) should be considered. However, their clinical activity should be more widely demonstrated.

show abstract

Head-to-Head Comparison of the Activities of Currently Available Antifungal Agents against 3,378 Spanish Clinical Isolates of Yeasts and Filamentous Fungi

Cited by 271 publications

References 28 publications

Breakthrough disseminated Saprochaete capitata infection in a child with acute myeloid leukaemia receiving caspofungin therapy

Breakthrough disseminated Saprochaete capitata infection in a child with acute myeloid leukaemia receiving caspofungin therapy

Lodderomyces elongisporus endocarditis in an intravenous drug user: a new entity in fungal endocarditis

Scedosporiosis in patients with acute leukemia: a retrospective multicenter report

Contact Info

Product

Resources

About