Saccharomyces cerevisiae Fungemia: An Emerging Infectious Disease

Muñoz, Patricia; Bouza, Emilio; Cuenca‐Estrella, Manuel; Eirós, José María; Pérez, María Jesús; Sánchez-Somolinos, Mar; Rincón, Cristina; Hortal, Javier; Peláez, Teresa

doi:10.1086/429916

Cited by 411 publications

(292 citation statements)

References 82 publications

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“…Moreover, these are live organisms and they should be used cautiously, if at all, in individuals with signifi cant immune suppression because of the possible risk of bacteremia or fungemia. Th ere are cases of S. boulardii fungemia reported in patients with central venous catheters, and thus its use in an ICU or in immunocompromised patients is not recommended ( 113,114 ). Th ere are also numerous case reports of invasive lactobacillus infections in non-immunosuppressed (mostly elderly) patients ( 115 -117 ).…”

Section: Management Of CDI and Co-morbid Conditionsmentioning

confidence: 99%

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Surawicz

Brandt

Binion

et al. 2013

American Journal of Gastroenterology

1,478

1,408

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Clostridium diffi cile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness and places a high burden on our health-care system. Patients with CDI typically have extended lengths-of-stay in hospitals, and CDI is a frequent cause of large hospital outbreaks of disease. This guideline provides recommendations for the diagnosis and management of patients with CDI as well as for the prevention and control of outbreaks while supplementing previously published guidelines. New molecular diagnostic stool tests will likely replace current enzyme immunoassay tests. We suggest treatment of patients be stratifi ed depending on whether they have mild-to-moderate, severe, or complicated disease. Therapy with metronidazole remains the choice for mildto-moderate disease but may not be adequate for patients with severe or complicated disease. We propose a classifi cation of disease severity to guide therapy that is useful for clinicians. We review current treatment options for patients with recurrent CDI and recommendations for the control and prevention of outbreaks of CDI. Am J Gastroenterol 2013; 108:478-498; doi: 10.1038/ajg.2013 12. In patients in whom oral antibiotics cannot reach a segment of the colon, such as with Hartman's pouch, ileostomy, or colon diversion, vancomycin therapy delivered via enema should be added to treatments above until the patient improves. (Conditional recommendation, low-quality evidence)13. The use of anti-peristaltic agents to control diarrhea from confi rmed or suspected CDI should be limited or avoided, as they may obscure symptoms and precipitate complicated disease. Use of anti-peristaltic agents in the setting of CDI must always be accompanied by medical therapy for CDI. (Strong recommendation, low-quality evidence) Management of severe and complicated CDI14. Supportive care should be delivered to all patients and includes intravenous fl uid resuscitation, electrolyte replacement, and pharmacological venous thromboembolism prophylaxis. Furthermore, in the absence of ileus or signifi cant abdominal distention, oral or enteral feeding should be continued. 17. Vancomycin delivered orally (500 mg four times per day) and per rectum (500 mg in a volume of 500 ml four times a day) plus intravenous metronidazole (500 mg three times a day) is the treatment of choice for patients with complicated CDI with ileus or toxic colon and / or signifi cant abdominal distention. (Strong recommendation, low-quality evidence)18. Surgical consult should be obtained in all patients with complicated CDI. Surgical therapy should be considered in patients with any one of the following attributed to CDI: hypotension requiring vasopressor therapy; clinical signs of sepsis and organ dysfunction (renal and pulmonary); mental status changes; white blood cell count ≥ 50,000 cells / μ l, lactate ≥ 5 mmol / l; or failure to improve on medical therapy after 5 days. (Strong recommendation, moderate-quality evidence) Management of recurrent CDI (RCDI)19. The fi rst recurrence of CDI can be treated ...

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Section: Management Of CDI and Co-morbid Conditionsmentioning

confidence: 99%

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Surawicz

Brandt

Binion

et al. 2013

American Journal of Gastroenterology

1,478

1,408

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“…Very little is known, however, about the role of S. cerevisiae in humans. In fact, S. cerevisiae has been described only recently as an "emerging infectious disease" [12,13]. S. cerevisiae has mostly been identified as a pathogen in critically ill patients who are immunocompromised [14,15] and in infants [16].…”

Section: Review Of Literaturementioning

confidence: 99%

A Case Study of Gut Fermentation Syndrome (Auto-Brewery) with <i>Saccharomyces cerevisiae</i> as the Causative Organism

Cordell¹,

McCarthy²

2013

IJCM

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Gut Fermentation Syndrome also known as Auto-Brewery Syndrome is a relatively unknown phenomenon in modern medicine. Very few articles have been written on the syndrome and most of them are anecdotal. This article presents a case study of a 61 years old male with a well documented case of Gut Fermentation Syndrome verified with glucose and carbohydrate challenges. Stool cultures demonstrated the causative organism as Saccharomyces cerevisiae. The patient was treated with antifungals and a low carbohydrate diet and the syndrome resolved. Helicobacter pylori was also found and could have been a possible confounding variable although the symptoms resolved post-treatment of the S. cerevisiae.

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“…As far as is known, this emergence is not classically described for this population. [50] It is of interest to note that this "selection pressure" was maintained over time as suggested by the positive results obtained on subsequent hospitalizations, on average 3 weeks later, implying an increased vigilance for the remainder of the patient management.…”

Section: Discussionmentioning

confidence: 98%

Impact of fluconazole versus posaconazole prophylaxis on the incidence of fungal infections in patients receiving induction chemotherapy for acute myeloid leukemia

et al. 2015

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F ungal infections are related to human communal agents or to environmental saprophytes and are rare in healthy subjects. Known contributing factors are reduced defense mechanisms of the host, the use of certain Background: Invasive fungal infections (IFIs) remain one of the worrying complications in patients with acute myeloid leukemia (AML) due to their incidence and high level of attributable mortality. In light of these risks, antifungal prophylaxis has always been debated. We conducted a single-center retrospective study of two prophylactic antifungal agents (fluconazole/posaconazole) in 91 consecutive patients receiving induction chemotherapy for AML between 2005 and 2009, in order to evaluate the impact on the incidence of IFI and on the mycological flora of the patients. Methods:In total, 39 patients received prophylactic fluconazole versus 52 who received posaconazole. The baseline characteristics of the two groups were comparable. Results:Overall, 17 patients developed an IFI, with no difference in frequency between the two groups. Utilization of empirical or pre-emptive therapy was similar irrespective of the type of prophylaxis used. Mycological examination of stools revealed an increase in non-albicans Candida colonization in the fluconazole group during hospitalization and the appearance of Saccharomyces cerevisiae colonization in patients receiving posaconazole. Conclusion: The present study does no t distinguish between fluconazole and posaconazole as a primary effective prevention against fungal infections. More prospective studies and meta-analyses are warranted. (Biomed J 2015;38:235-243)

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Saccharomyces cerevisiae Fungemia: An Emerging Infectious Disease

Abstract: Use of S. cerevisiae probiotics should be carefully reassessed, particularly in immunosuppressed or critically ill patients.

Cited by 411 publications

References 82 publications

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

A Case Study of Gut Fermentation Syndrome (Auto-Brewery) with <i>Saccharomyces cerevisiae</i> as the Causative Organism

Impact of fluconazole versus posaconazole prophylaxis on the incidence of fungal infections in patients receiving induction chemotherapy for acute myeloid leukemia

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Saccharomyces cerevisiae Fungemia: An Emerging Infectious Disease

Abstract: Use of S. cerevisiae probiotics should be carefully reassessed, particularly in immunosuppressed or critically ill patients.

Cited by 411 publications

References 82 publications

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

Guidelines for Diagnosis, Treatment, and Prevention of Clostridium difficile Infections

A Case Study of Gut Fermentation Syndrome (Auto-Brewery) with &lt;i&gt;Saccharomyces cerevisiae&lt;/i&gt; as the Causative Organism

Impact of fluconazole versus posaconazole prophylaxis on the incidence of fungal infections in patients receiving induction chemotherapy for acute myeloid leukemia

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Product

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A Case Study of Gut Fermentation Syndrome (Auto-Brewery) with <i>Saccharomyces cerevisiae</i> as the Causative Organism