Management of Scedosporium apiospermum in a pre- and post-lung transplant patient with cystic fibrosis

Rolfe, Nancy E.; Haddad, Tarik; Wills, Todd S.

doi:10.1016/j.mmcr.2013.01.002

Cited by 21 publications

(11 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, there is poor understanding of the clinical implications of its detection in the airway, with the exception of its role after CF lung transplantation . Case reports and series have described improved outcomes with antifungal therapy in CF patients chronically colonized with S. apiospermum complex . However, systematic investigation of this topic is lacking.…”

Section: Introductionmentioning

confidence: 99%

Inhaled antibiotic use is associated with Scedosporium/Lomentospora species isolation in cystic fibrosis

Hong

Lechtzin

Hadjiliadis

et al. 2018

Pediatric Pulmonology

View full text Add to dashboard Cite

Introduction: Prevalence of fungi has been rising in the cystic fibrosis (CF) population.Scedosporium species (spp) is the second most common mold seen in the CF respiratory tract. However, the characteristics associated with Scedosporium isolation and its clinical implications are poorly understood. The goal of this study was to determine clinical factors associated with Scedosporium spp to better understand the mechanisms that may contribute to the emergence of filamentous fungi in CF. Methods:We conducted a retrospective cohort study of subjects followed in the CF Foundation PatientPatients under 6 years of age, history of solid organ transplantation, and insufficient respiratory culture data were excluded. We used a multivariable logistic regression model to determine demographic data and baseline disease characteristics, medications and co-infections associated with Scedosporium spp recovery in CF sputum.Results: Among 19 023 subjects, prevalence of Scedosporium spp was 615 (3.2%).Older age (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.07, 1.26) and white race (OR 1.69, 95% CI 1.09, 2.63) were the demographic factors associated with Scedosporium spp isolation. Inhaled antibiotic use had a significant association with Scedosporium isolation (OR 2.01, 95% CI 1.61, 2.52). For every additional course of intravenous antibiotics, the odds of Scedosporium isolation increased by 8% (OR 1.08, 95% CI 1.03, 1.14). Conclusions:The association between inhaled antibiotics and Scedosporium informs us that chronic inhaled antibiotics may be playing a role in Scedosporium isolation. Further investigation to better characterize this relationship is necessary. K E Y W O R D S colonization, epidemiology, fungi, infection

show abstract

Section: Introductionmentioning

confidence: 99%

Inhaled antibiotic use is associated with Scedosporium/Lomentospora species isolation in cystic fibrosis

Hong

Lechtzin

Hadjiliadis

et al. 2018

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…The prevalence of Aspergillus species, the most common filamentous fungi in the CF airway, has increased from 6% to 12% over the past 2 decades (2,3). In addition, Scedosporium, Trichosporon, and Exophiala species have been increasingly detected in CF sputa (4)(5)(6)(7)(8)(9)(10)(11). Furthermore, there is increasing evidence that the chronic presence of Aspergillus, Scedosporium, Trichosporon, or Exophiala species in CF individuals is associated with pulmonary morbidity, including respiratory symptoms and pulmonary exacerbations, and even death in the post-lung transplant population (5-9, 11, 12).…”

mentioning

confidence: 99%

Use of Selective Fungal Culture Media Increases Rates of Detection of Fungi in the Respiratory Tract of Cystic Fibrosis Patients

Hong

Miller²,

Allgood³

et al. 2017

J Clin Microbiol

View full text Add to dashboard Cite

The prevalence of fungi in the respiratory tracts of cystic fibrosis (CF) patients has risen. However, fungal surveillance is not routinely performed in most clinical centers in the United States, which may lead to an underestimation of the true prevalence of the problem. We conducted a prospective study comparing the rates of detection for clinically important fungi (CIF), defined as ,, and species and, in CF sputa using standard bacterial and selective fungal culture media, including Sabouraud dextrose agar with gentamicin (SDA), inhibitory mold agar (IMA), and brain heart infusion (BHI) agar with chloramphenicol and gentamicin. We described the prevalence of these fungi in an adult CF population. A total of 487 CF respiratory samples were collected from 211 unique participants. CIF were detected in 184 (37.8%) samples. Only 26.1% of CIF-positive samples were detected in bacterial culture medium, whereas greater rates of detection for fungi were found in IMA (65.8%; < 0.001), in SDA (at 30°C, 64.7%; = 0.005), and in BHI agar (63.0%; = 0.001). The prevalences of and species were 40.8% and 5.2%, respectively, which are greater than the nationally reported prevalence numbers of 20.4% and 1.9%. Selective fungal culture media and longer incubation periods yielded higher rates of detection for CIF in CF sputum samples compared with that detected in bacterial culture medium, resulting in an underdetection of fungi by bacterial culture alone. The prevalence of fungi in CF may be better estimated by using selective fungal culture media, and this may translate to important clinical decisions.

show abstract

“…The combination of micafungin and voriconazole in vitro has been demonstrated to have a synergistic effect against several fungi including Scedosporium spp [ 13 ] . S tudies have shown that terbinafine monotherapy has poor potency against Scedosporium species (MIC90, >16 ug/mL) but the addition of terbinafine to voriconazole has a potential synergistic role based on case reports [ [14] , [15] , [16] , [17] ]. Henao-Martínez et al reported two cases of S. apiospermum CNS infections treated successfully with the combination of voriconazole and terbinafine [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Scedosporium apiospermum fungemia successfully treated with voriconazole and terbinafine

Hammoud

2020

IDCases

View full text Add to dashboard Cite

Scedosporium apiospermum is ubiquitous in the environment and is considered an emerging infection. Immunocompromised hosts can have a wide spectrum of diseases ranging from cutaneous to disseminated disease that may involve pulmonary, central nervous system, or bone. Disseminated disease in immunocompetent hosts is uncommon. Treatment of deep-seated infections is challenging because of the limited susceptibility of the Scedosporium species to all current antifungal drugs. We report a case of Scedosporidium apiospermum fungemia with a presumed pulmonary involvement in an immunocompetent patient. The fungemia was successfully treated with oral voriconazole and terbinafine.

show abstract

Management of Scedosporium apiospermum in a pre- and post-lung transplant patient with cystic fibrosis

Cited by 21 publications

References 19 publications

Inhaled antibiotic use is associated with Scedosporium/Lomentospora species isolation in cystic fibrosis

Inhaled antibiotic use is associated with Scedosporium/Lomentospora species isolation in cystic fibrosis

Use of Selective Fungal Culture Media Increases Rates of Detection of Fungi in the Respiratory Tract of Cystic Fibrosis Patients

Scedosporium apiospermum fungemia successfully treated with voriconazole and terbinafine

Contact Info

Product

Resources

About