Invasive mold infections in cancer patients: 5 years' experience withAspergillus, Mucor, Fusarium andAcremonium infections

Krčméry, V.; Kunova, E.; Jesenská, Zdenka; Trupl, J.; Špánik, S.; Mardiak, J; Studena, M.; Kukuckova, E.

doi:10.1007/bf01769874

Cited by 31 publications

(28 citation statements)

References 20 publications

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“…In one autopsy-proven study of invasive mold infections in cancer patients, 10% of the cases were caused by Acremonium spp. (14). The present case of peritonitis highlights the clinical importance of A. kiliense in human infections.…”

Section: Case Reportmentioning

confidence: 60%

“…The last 2 decades have witnessed a steady increase in the spectrum of hyaline fungi incriminated as opportunistic pathogens in immunocompromised patients (5,14,28). Many soil saprobes and plant pathogens with no obvious pathogenic potential have now emerged as etiologic agents under a variety of clinical conditions, thus posing new diagnostic and therapeutic challenges (38).…”

Section: Case Reportmentioning

confidence: 99%

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Acremonium kiliense: Reappraisal of Its Clinical Significance

et al. 2011

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A case of Acremonium kiliense peritonitis is described. Diagnosis was established by repeated isolation of the fungus from peritoneal dialysate and by its identification on the basis of morphological characteristics and sequencing of internal transcribed spacer (ITS) regions of ribosomal DNA (rDNA). This report and available literature suggest that A. kiliense may have a greater clinical significance than hitherto recognized. CASE REPORTA 75-year-old Jordanian man with a long history of diabetes mellitus and hypertension developed end-stage kidney disease requiring continuous ambulatory peritoneal dialysis (CAPD). His course of CAPD was largely uneventful except for a single episode of bacterial peritonitis, for which he was hospitalized and treated with parenteral antibiotics, with an excellent response. In January 2010, he became febrile, with clinical evidence of peritonitis, and was admitted to the hospital. The peritoneal fluid was turbid, with a white blood cell (WBC) count of 2.1 ϫ 10 9 /liter. On initial microscopic examination, the presence of fungal elements in the peritoneal dialysate was missed. The peritoneal fluid sample was inoculated into aerobic Bactec blood culture bottles, which yielded a growth after 59 h of incubation. The Gram-stained smear from blood culture bottles showed branched hyphal elements. On Sabouraud dextrose agar (SDA; Oxoid Ltd., Basingstoke, England), the specimen yielded slimy colonies with a pinkish appearance ( Fig. 1). Microscopic examination of the primary culture (isolate Kw441-2010) showed hyaline hyphae, with scanty sporulation. A provisional identification of Acremonium/Fusarium species was made, and the growth was subcultured on Sabouraud dextrose agar and oatmeal agar (OMA; oatmeal [30 g], agar [20 g], distilled water [1 liter]) for further identification and antifungal susceptibility testing. Subsequent cultures of the peritoneal fluid yielded the same fungus on three occasions. A serum sample was obtained for the detection of galactomannan (Platelia Aspergillus enzyme immunoassay [EIA] kit; BioRad, Marnes-la-Coquette, France) and (1-3)-␤-D-glucan (Fungitell; Associates of Cape Cod); the latter test was positive (253 pg/ml). An Etest performed on RPMI 1640 medium supplemented with 2% glucose revealed that the isolate was resistant to amphotericin B and caspofungin but susceptible to voriconazole and posaconazole, with MIC values of Ͼ32 g/ml, Ͼ32 g/ml, 0.064 g/ml, and 0.75 g/ml, respectively. The patient was started on voriconazole, with a loading dose of 400 mg, followed by a maintenance dose of 200 mg, given every 12 h via the oral route. Although the patient showed clinical improvement after 2 weeks of voriconazole therapy, the peritoneal dialysate remained turbid (WBC counts, 2.0 ϫ 10 9 / liter). Abdominal ultrasound examination did not reveal any evidence of intraperitoneal adhesions or organ invasion. Since the response to treatment was not adequate, the Tenckhoff catheter was removed and the patient was temporarily switched to hemodialysis. After 1 week of a...

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Section: Case Reportmentioning

confidence: 60%

Section: Case Reportmentioning

confidence: 99%

Acremonium kiliense: Reappraisal of Its Clinical Significance

et al. 2011

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“…It has already been reported that aspergillosis (55%) is the most common invasive fungal disease, followed by mucormycosis (zygomycosis) (15%), fusariosis (15%), and acremoniosis (10%) (25). The pathogenic fungi responsible for these disease were not considered previously to be important human pathogens but are widely present in soil, plants, and elsewhere in the environment.…”

Section: Structural Characterization Of Oligosaccharides Of Ngls-mentioning

confidence: 99%

Newly Discovered Neutral Glycosphingolipids in Aureobasidin A-resistant Zygomycetes

Aoki

Uchiyama

Yamauchi

et al. 2004

Journal of Biological Chemistry

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We found for the first time that Zygomycetes species showed resistance to Aureobasidin A, an antifungal agent. A novel family of neutral glycosphingolipids (GSLs) was found in these fungi and isolated from Mucor hiemalis, which is a typical Zygomycetes species. Their structures were completely determined by compositional sugar, fatty acid, and sphingoid analyses, methylation analysis, matrix-assisted laser desorption ionization time-of-flight/mass spectrometry, and 1 H NMR spectroscopy. They were as follows: Gal␤1-6Gal␤1-1Cer (CDS), Gal␣1-6Gal␤1-6Gal␤1-1Cer (CTS), Gal␣1-6Gal␣1-6Gal␤1-6Gal␤1-1Cer (CTeS), and Gal␣1-6Gal␣1-6Gal␣1-6Gal␤1-6Gal␤1-1Cer (CPS). The ceramide moieties of these GSLs consist of 24:0, 25:0, and 26:0 2-hydroxy acids as major fatty acids and 4-hydroxyoctadecasphinganine (phytosphingosine) as the sole sphingoid. However, the glycosylinositolphosphoceramide families that are the major GSLs components in fungi were not detected in Zygomycetes at all. This seems to be the reason that Aureobasidin A is not effective for Zygomycetes as an antifungal agent. Our results indicate that the biosynthetic pathway for GSLs in Zygomycetes is significantly different from those in other fungi and suggest that any inhibitor of this pathway may be effective for mucormycosis, which is a serious pathogenic disease for humans.

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“…Invasive fungal infections are a major medical problem, particularly among immunocompromised hosts such as patients with hematological malignancies and those who have undergone stem cell or solid organ transplantation (3,8,20,22,23,33). Some fungal species, including Fusarium spp., rarely cause disease but are considered emerging pathogens (8,23).…”

mentioning

confidence: 99%

Clinical and Epidemiological Aspects of Infections Caused byFusariumSpecies: a Collaborative Study from Israel

Nir-Paz

Strahilevitz²,

Shapiro

et al. 2004

J Clin Microbiol

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Fusarium infections are an important problem worldwide, commonly affecting immunocompromised individuals. We conducted a retrospective study in two Israeli tertiary medical centers of factors predisposing to infection by Fusarium spp. and their influence on the epidemiology and clinical outcome of this infection. Fusarium spp. were isolated from 89 patients with a median age of 57 years. Sixty-eight patients were considered immunocompetent. Seven patients had disseminated disease, 34 had locally invasive disease, and 48 had superficial infection. Most infections were limited and occurred mainly in lower limbs. Factors associated with in-hospital mortality were chronic renal failure, hematological malignancy, immunosuppression, disseminated infection, and positive blood culture. Multivariate analysis showed that chronic renal failure, hematological malignancy, burns, and disseminated infection were independently associated with mortality. A surge in the frequency of infections was noticed during the summer for patients from rural areas, involving mainly the eyes and lungs. At one of the hospitals (in a mountainous area), there was an increase in the isolation rate over time.

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Invasive mold infections in cancer patients: 5 years' experience withAspergillus, Mucor, Fusarium andAcremonium infections

Cited by 31 publications

References 20 publications

Acremonium kiliense: Reappraisal of Its Clinical Significance

Acremonium kiliense: Reappraisal of Its Clinical Significance

Newly Discovered Neutral Glycosphingolipids in Aureobasidin A-resistant Zygomycetes

Clinical and Epidemiological Aspects of Infections Caused byFusariumSpecies: a Collaborative Study from Israel

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