Susceptibility Testing and Molecular Classification of
            <i>Paecilomyces</i>
            spp

Castelli, María Victoria; Alastruey‐Izquierdo, Ana; Cuesta, Isabel; Monzón, Araceli; Mellado, Emilia; Rodríguez-Tudela, Juan Luis; Cuenca‐Estrella, Manuel

doi:10.1128/aac.00538-08

Cited by 74 publications

(72 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding is also consistent with the susceptibility profile of our isolate. In contrast, P. variotii isolates were susceptible to amphotericin B, itraconazole, and echinocandins, but showed reduced susceptibility to voriconazole (5). Similar susceptibility results were reported by Gonzalez et al (11), where voriconazole, posaconazole, and ravuconazole demonstrated good in vitro activity against P. lilacinum.…”

supporting

confidence: 75%

“…Voriconazole and posaconazole were found to possess maximum activity, whereas amphotericin B was least active. Echinocandins have shown variable in vitro activity against P. lilacinum (5,8,29,38). Voriconazole, consistent with its in vitro activity against P. lilacinum, has been used successfully for treatment of several cases with different clinical manifestations, including the present case (6,10,18,21).…”

mentioning

confidence: 99%

“…The efficacy of voriconazole has also been demonstrated in an experimental murine model of P. lilacinum infection in comparison to amphotericin B (33). However, it is important to recognize that strains of P. lilacinum showing in vitro resistance to voriconazole have also been reported (5,29). Clinical experience with posaconazole or other newer triazoles does not exist.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Purpureocillium lilacinum as a Cause of Cavitary Pulmonary Disease: a New Clinical Presentation and Observations on Atypical Morphologic Characteristics of the Isolate

et al. 2012

View full text Add to dashboard Cite

The first case of cavitary pulmonary disease caused by Purpureocillium lilacinum is described. The isolate showed atypical microscopic characteristics similar to Acremonium and Fusarium spp., which necessitated molecular identification by sequencing of multiple conserved loci. The patient responded to voriconazole, reinforcing its therapeutic efficacy for P. lilacinum infections. CASE REPORTA n 80-year-old asthmatic woman presented with a 3-week history of productive cough, associated with fever and pleuritic chest pain, which did not respond to a week of treatment with antibiotics and steroid therapy. She had a history of asthma, coronary artery disease, diabetes mellitus, hypertension, dyslipidemia, rheumatoid arthritis, and osteoporosis. Clinically, she presented with fever, tachypnea, tachycardia, and hypotension. Chest auscultation revealed bilateral scattered wheezes. The rest of the physical findings were unremarkable. Within 24 h of admission, her condition progressively deteriorated, requiring mechanical ventilation. As the patient was febrile, she was empirically started on ceftriaxone and clarithromycin. Her initial assessment revealed a normal white cell count, but the chest X-ray showed a consolidative lesion in the left upper lobe (LUL). The sputum culture showed heavy growth of Pseudomonas aeruginosa. Consequently, her antibiotic regimen was modified to include ciprofloxacin and meropenem for a course of 14 days, followed by a 3-week course of tazocin-ciprofloxacin. Despite an initial clinical improvement, the follow-up chest X ray showed persistence of the LUL lesion. Therefore, a computed tomography (CT) scan of the chest was performed on 7 October 2010, which revealed a cavitary lesion in the anterior segment of the LUL (Fig. 1A).Since her condition deteriorated further, as assessed by her oxygen requirements, sputum specimens were collected on 11 and 18 October 2010 and were sent to the Mycology Reference Laboratory (MRL), Faculty of Medicine, Kuwait University. Both specimens showed septate hyphal elements when examined with calcofluor-potassium hydroxide (Fig. 2) and grew a white mold after 5 days on Sabouraud dextrose agar (Difco, Becton, Dickinson and Company, Sparks, MD). On 21 October 2010, a bronchoalveolar lavage (BAL) specimen from the LUL was obtained and sent to the MRL to establish the role of this white mold in the etiology of her cavitary lung lesion. The BAL specimen also showed septate fungal elements in the calcofluor-KOH mount (Fig. 2) and yielded a morphologically identical mold culture. The mold was provisionally identified as Acremonium or Paecilomyces. Although no defined antifungal susceptibility breakpoints exist for these organisms, the isolate demonstrated high MICs to amphotericin B (Ն32 g/ml), caspofungin (4 g/ml), and itraconazole (Ն32 g/ml), suggesting resistance, but low MICs for posaconazole (0.5 g/ml) and voriconazole (0.064 g/ml), suggesting clinical efficacy. The patient was thus started on voriconazole, at 6 mg/kg of body weight at 12-h intervals for the fir...

show abstract

supporting

confidence: 75%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Purpureocillium lilacinum as a Cause of Cavitary Pulmonary Disease: a New Clinical Presentation and Observations on Atypical Morphologic Characteristics of the Isolate

et al. 2012

View full text Add to dashboard Cite

show abstract

“…In vitro amphotericin B was active against clinical P. variotii isolates but not against P. lilacinus (8). Among the azoles, only itraconazole and posaconazole showed clinically relevant activity against P. variotii.…”

mentioning

confidence: 92%

“…Interestingly, the echinocandins, especially micafungin and anidulafungin, were highly active against P. variotii, with MIC values being as low as 0.016 mg/liter. Conversely, P. lilacinus was not inhibited by the echinocandins, underscoring the importance of correct species identification (8).…”

mentioning

confidence: 99%

Identification ofPaecilomyces variotiiin Clinical Samples and Settings

et al. 2010

View full text Add to dashboard Cite

Paecilomyces variotii is a commonly occurring species in air and food, but it is also associated with many types of human infections and is among the emerging causative agents of opportunistic mycoses in immunocompromised hosts. Paecilomyces can cause hyalohyphomycosis, and two species, Paecilomyces lilacinus and P. variotii, are the most frequently encountered organisms. In the present study, a set of 34 clinical isolates morphologically identified as P. variotii or P. lilacinus were formally identified by sequencing intergenic transcribed spacer regions 1 and 2 (including 5.8S rDNA) and a part of the ␤-tubulin gene. Three isolates were identified as P. lilacinus, and five of the presumptive P. variotii isolates did not belong to the genus Paecilomyces but were identified as Talaromyces eburneus (anamorph, Geosmithia argillacea) or Hamigera avellanea (anamorph, Merimbla ingelheimense). Applying the most recent taxonomy, we found that the clinical P. variotii isolates could be identified as P. variotii sensu stricto (14 strains), P. formosus (11 strains), and P. dactylethromorphus (1 strain). These data indicate that P. formosus occurs in clinical samples as commonly as P. variotii. Susceptibility tests showed that the antifungal susceptibility profiles of P. variotii, P. formosus, and P. dactylethromorphus are similar and that all strains tested were susceptible to amphotericin B in vitro. P. lilanicus, T. eburneus, and H. avellanea had different susceptibility profiles; and flucytosine and voriconazole were the least active of the antifungal drugs tested against these species. Our results indicate that correct species identification is important to help guide appropriate antifungal therapy.Paecilomyces variotii is a commonly occurring species that has previously been isolated from various substrates, including (pasteurized) foods, soil, indoor air, and wood (23,36,41,42,43). However, it is also associated with many types of human infections and is listed among the emerging causative agents of opportunistic mycoses in immunocompromised hosts. Paecilomyces can cause hyalohyphomycosis (1), and two species, Paecilomyces lilacinus and P. variotii, are the most frequently encountered (20, 52). Both species are morphologically similar but can be differentiated on the basis of conidial color and growth rates (41). However, small-subunit ribosomal gene sequences showed that the two species are unrelated: P. variotii belongs to the order Eurotiales, while P. lilacinus is a member of the order Hypocreales (27). Although they are uncommon, Paecilomyces infections are associated with almost any organ or system of the human body (40). Most cases concern immunocompromised patients and are cutaneous or catheter related. However, dissemination, for example, that involving the central nervous system, has been observed in a number of cases (15,24). Ocular infections associated with prolonged contact lens use or ocular surgery have also been reported (40), as has peritonitis in patients with continuous ambulatory peritoneal dialy...

show abstract

Fusarium and Other Opportunistic Hyaline Fungi

Zhang,

O'Donnell,

Wiederhold

et al. 2023

ClinMicroNow

View full text Add to dashboard Cite

The opportunistic hyaline or lightly colored molds constitute a phylogenetically diverse group of common to rare fungi, some of which are only known to reproduce asexually while others possess sexual and asexual life cycles. Serologic procedures currently have little clinical utility in the diagnosis of uncommon hyaline opportunistic fungi. Identification of uncommon hyaline molds should always be evaluated considering the patient's immune status as well as the anatomic site of recovery and frequency of isolation. This chapter describes the salient colony and microscopic features of medically important species in the genus Fusarium and other select hyaline opportunists. As for Aspergillus and Candida , multilocus DNA typing systems have been developed to identify clinically and veterinary important isolates of Fusarium . The typical antifungal susceptibility profiles of Fusarium species are of relative resistance to most antifungal agents.

show abstract

Susceptibility Testing and Molecular Classification of Paecilomyces spp

Cited by 74 publications

References 16 publications

Purpureocillium lilacinum as a Cause of Cavitary Pulmonary Disease: a New Clinical Presentation and Observations on Atypical Morphologic Characteristics of the Isolate

Purpureocillium lilacinum as a Cause of Cavitary Pulmonary Disease: a New Clinical Presentation and Observations on Atypical Morphologic Characteristics of the Isolate

Identification ofPaecilomyces variotiiin Clinical Samples and Settings

Fusarium and Other Opportunistic Hyaline Fungi

Contact Info

Product

Resources

About