Infections due to Pseudallescheria/Scedosporium species in patients with advanced HIV disease — a diagnostic and therapeutic challenge

Tammer, Ina; Tintelnot, Kathrin; Braun-Dullaeus, Ruediger C.; Mawrin, Christian; Scherlach, Cordula; Schlüter, Dirk; König, Wolfgang

doi:10.1016/j.ijid.2011.03.004

Cited by 30 publications

(18 citation statements)

References 65 publications

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“…These molds present a significant diagnostic challenge, as they cannot be distinguished from other filamentous fungi by histological examination alone, and rapid identification is necessary due to their poor response to certain antifungal agents (290). Twenty-two PSC reference strains and three clinical isolates were tested by using MALDI-TOF MS and the BioTyper software (Bruker).…”

Section: Pseudallescheria-scedosporium Complexmentioning

confidence: 99%

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry: a Fundamental Shift in the Routine Practice of Clinical Microbiology

et al. 2013

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SUMMARY Within the past decade, clinical microbiology laboratories experienced revolutionary changes in the way in which microorganisms are identified, moving away from slow, traditional microbial identification algorithms toward rapid molecular methods and mass spectrometry (MS). Historically, MS was clinically utilized as a high-complexity method adapted for protein-centered analysis of samples in chemistry and hematology laboratories. Today, matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) MS is adapted for use in microbiology laboratories, where it serves as a paradigm-shifting, rapid, and robust method for accurate microbial identification. Multiple instrument platforms, marketed by well-established manufacturers, are beginning to displace automated phenotypic identification instruments and in some cases genetic sequence-based identification practices. This review summarizes the current position of MALDI-TOF MS in clinical research and in diagnostic clinical microbiology laboratories and serves as a primer to examine the “nuts and bolts” of MALDI-TOF MS, highlighting research associated with sample preparation, spectral analysis, and accuracy. Currently available MALDI-TOF MS hardware and software platforms that support the use of MALDI-TOF with direct and precultured specimens and integration of the technology into the laboratory workflow are also discussed. Finally, this review closes with a prospective view of the future of MALDI-TOF MS in the clinical microbiology laboratory to accelerate diagnosis and microbial identification to improve patient care.

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Section: Pseudallescheria-scedosporium Complexmentioning

confidence: 99%

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry: a Fundamental Shift in the Routine Practice of Clinical Microbiology

et al. 2013

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“…Scedosporiosis has been reported in patients with advanced human immunodeficiency virus (HIV) infection [52,53] haematological malignancy [5, 8•, 21] and primary immunodeficiency disorders, particularly chronic granulomatous disease (CGD) [54,55]. Patients with haematological malignancy are more likely to be neutropenic at the time of diagnosis of scedosporiosis and more likely to present with fungaemia due to L. prolificans and disseminated disease [8•, 21].…”

Section: Infection In Immunocompromised Hosts Other Than Transplantationmentioning

confidence: 99%

“…Disseminated infection occurred in 66.7 % of patients, and the mortality rate was 75 %. Patients with invasive scedosporiosis were more likely to have CD4 cell counts <100/ul [53].…”

Section: Infection In Immunocompromised Hosts Other Than Transplantationmentioning

confidence: 99%

Epidemiology of Scedosporiosis

Subedi

Chen

2015

Curr Fungal Infect Rep

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Infections due to Scedosporium/Pseudallescheria species are increasingly recognized in both immunocompromised and immunocompetent hosts. Patients with organ and stem cell transplants and malignancy are at high risk for infection. Infection is also acquired through trauma and near-drowning incidents. Scedosporium apiospermum complex and Lomentospora prolificans (previously Scedosporium prolificans) account for most infections. Increasing use of sequencing-based molecular tools to identify these fungi has enabled better understanding of species-specific differences in geographical distribution, clinical epidemiology and presentation. S. apiospermum complex infections occur worldwide, affect diverse host groups and has protean clinical manifestations. L. prolificans typically causes infection in immunocompromised patients and is associated with disseminated infection and high mortality. S. aurantiacum (a member of S. apiospermum complex) has a propensity to be isolated from patients with cystic fibrosis and other chronic lung disease. Case clusters of L. prolificans infection have occurred. Appreciation of epidemiology is important to inform rapid diagnostics and antifungal therapy.

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“…It is an emerging opportunist that can cause trauma-associated, localized infections, colonization of pulmonary cavities in patients with predisposing pulmonary disorders (such as cystic fibrosis) and systemic invasive diseases in immunocompromised patients [2]. This mould is notorious for its therapy-refractory nature and resistance for several antifungal agents [1, 3]. Traumatic localized infections can occur in both immunocompromised and immunocompetent persons and are most frequently manifested as mycetomatous, chronic progressive subcutaneous infections, which may also reach the muscles and the bones [1].…”

Section: Introductionmentioning

confidence: 99%

Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature

Tóth

Nagy

Homa

et al. 2017

Ann Clin Microbiol Antimicrob

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Background Scedosporium apiospermum is an emerging opportunistic filamentous fungus, which is notorious for its high levels of antifungal-resistance. It is able to cause localized cutaneous or subcutaneous infections in both immunocompromised and immunocompetent persons, pulmonary infections in patients with predisposing pulmonary diseases and invasive mycoses in immunocompromised patients. Subcutaneous infections caused by this fungus frequently show chronic mycetomatous manifestation.Case reportWe report the case of a 70-year-old immunocompromised man, who developed a fungal mycetomatous infection on his right leg. There was no history of trauma; the aetiological agent was identified by microscopic examination and ITS sequencing. This is the second reported case of S. apiospermum subcutaneous infections in Hungary, which was successfully treated by surgical excision and terbinafine treatment. After 7 months, the patient remained asymptomatic. Considering the antifungal susceptibility and increasing incidence of the fungus, Scedosporium related subcutaneous infections reported in the past quarter of century in European countries were also reviewed.ConclusionsCorticosteroid treatment represents a serious risk factor of S. apiospermum infections, especially if the patient get in touch with manure-enriched or polluted soil or water. Such infections have emerged several times in European countries in the past decades. The presented data suggest that besides the commonly applied voriconazole, terbinafine may be an alternative for the therapy of mycetomatous Scedosporium infections.

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Infections due to Pseudallescheria/Scedosporium species in patients with advanced HIV disease — a diagnostic and therapeutic challenge

Cited by 30 publications

References 65 publications

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry: a Fundamental Shift in the Routine Practice of Clinical Microbiology

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry: a Fundamental Shift in the Routine Practice of Clinical Microbiology

Epidemiology of Scedosporiosis

Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature

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