Trichosporon asahii infection of a dialysis PTFE arteriovenous graft

Krzossok, Stefan; Birck, Rainer; Henke, Suzanne; Hof, Holger; Woude, Fokko J. van der; Braun, Claude

doi:10.5414/cnp62066

Cited by 19 publications

(9 citation statements)

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“…Trichosporon asahii is the most common cause of fatal disseminated trichosporonosis (12,30), frequently associated with indwelling medical devices (13,15,18,22,26,28). In spite of antifungal drugs administered, trichosporonosis is often persistent or reestablished soon after treatment (12,34).…”

Section: Discussionmentioning

confidence: 99%

“…Although most of the reported cases of hematogenous T. asahii infections occurred in patients with leukemia during a neutropenic phase, another relevant predisposing factor for infection is represented by the presence of invasive devices, such as intravenous or urinary catheters (13,22,26,28), endoscopic forceps (18), and arteriovenous graft (15). These findings suggest that prosthetic devices could act as substrates for adhesion and, possibly, growth as biofilms, structured microbial communities embedded in an extracellular polymeric substance (EPS).…”

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confidence: 99%

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Biofilm Formation by the Emerging Fungal Pathogen Trichosporon asahii : Development, Architecture, and Antifungal Resistance

Bonaventura

Pompilio

Picciani

et al. 2006

Antimicrob Agents Chemother

205

131

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Trichosporon asahii is the most common cause of fatal disseminated trichosporonosis, frequently associated with indwelling medical devices. Despite the use of antifungal drugs to treat trichosporonosis, infection is often persistent and is associated with high mortality. This drove our interest in evaluating the capability of T. asahii to form a biofilm on biomaterial-representative polystyrene surfaces through the development and optimization of a reproducible T. asahii-associated biofilm model. Time course analyses of viable counts and a formazan salt reduction assay, as well as microscopy studies, revealed that biofilm formation by T. asahii occurred in an organized fashion through four distinct developmental phases: initial adherence of yeast cells (0 to 2 h), germination and microcolony formation (2 to 4 h), filamentation (4 to 6 h), and proliferation and maturation (24 to 72 h). Scanning electron microscopy and confocal scanning laser microscopy revealed that mature T. asahii biofilms (72-h) displayed a complex, heterogeneous three-dimensional structure, consisting of a dense network of metabolically active yeast cells and hyphal elements completely embedded within exopolymeric material. Antifungal susceptibility testing demonstrated a remarkable rise in the MICs of sessile T. asahii cells against clinically used amphotericin B, caspofungin, voriconazole, and fluconazole compared to their planktonic counterparts. In particular, T. asahii biofilms were up to 16,000 times more resistant to voriconazole, the most active agent against planktonic cells (MIC, 0.06 g/ml). Our results suggest that the ability of T. asahii to form a biofilm may be a major factor in determining persistence of the infection in spite of in vitro susceptibility of clinical isolates.Candida species are the most common cause of disseminated nosocomial fungal infections (34). Invasive infections by rarer opportunistic fungal pathogens, however, have recently emerged as a significant problem in treatment of immunocompromised patients (8, 34).In particular, disseminated life-threatening Trichosporon infection is becoming increasingly common in patients with underlying hematological malignancies, extensive burns, solid tumors, and AIDS, accounting for approximately 10% of all confirmed cases of disseminated fungal infections (8,12,14,(32)(33)(34). Likewise, nonimmunosuppressed patients have suffered from Trichosporon infections associated with ophthalmologic surgery, infections of prosthetic devices, intravenous drug abuse, and peritoneal dialysis (1, 17, 21).Trichosporon beigelii was formerly considered the causative agent in trichosporonosis, but recent taxonomic findings based on partial sequences of large-subunit rRNA and DNA relatedness (9, 29, 30) revealed that T. beigelii actually consists of six distinct pathogenic Trichosporon species.In particular, Trichosporon asahii is the major cause of disseminated or deep-seated trichosporonosis (12,30). Although most of the reported cases of hematogenous T. asahii infections occurred in patie...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Biofilm Formation by the Emerging Fungal Pathogen Trichosporon asahii : Development, Architecture, and Antifungal Resistance

Bonaventura

Pompilio

Picciani

et al. 2006

Antimicrob Agents Chemother

205

131

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“…Cryptococcus neoformans has been shown to colonize and subsequently form biofilms on ventricular shunts [15], peritoneal dialysis fistulas [16], prosthetic hip joints [17], and cardiac valves [18]. Different Trichosporon species can cause disseminated life-threatening infections associated with biofilm-related infections [14, 19, 20], including cardiac grafts [21], catheters [22], and breast implants [23]. Malassezia pachydermatis has been isolated from patients undergoing parenteral nutrition [13], Blastoschizomyces capitatus has been associated with catheter-related fungemia [11], Saccharomyces cerevisiae has been detected from dentures of stomatitis patients [24], and recurrent meningitis has been associated with a Coccidioides immitis biofilm at the tip of a ventriculoperitoneal shunt tubing [8].…”

Section: Clinical Significance Of Fungal Biofilmsmentioning

confidence: 99%

Fungal Biofilm Resistance

Ramage

Rajendran

Sherry

et al. 2012

International Journal of Microbiology

448

402

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Fungal biofilm infections have become increasingly recognised as a significant clinical problem. One of the major reasons behind this is the impact that these have upon treatment, as antifungal therapy often fails and surgical intervention is required. This places a large financial burden on health care providers. This paper aims to illustrate the importance of fungal biofilms, particularlyCandida albicans, and discusses some of the key fungal biofilm resistance mechanisms that include, extracellular matrix (ECM), efflux pump activity, persisters, cell density, overexpression of drug targets, stress responses, and the general physiology of the cell. The paper demonstrates the multifaceted nature of fungal biofilm resistance, which encompasses some of the newest data and ideas in the field.

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“…Ventriculoatrial shunt (Walsh et al 1986), prosthetic valve (Banerjee et al 1997), and prosthetic dialysis fistula (Braun et al 1994) C. neoformans Glucurunoxylomannan and sugars such as xylose, mannose, glucose, and galactoxylomannan (Martinez and Casadevall 2007) Organized structure containing yeast cells surrounded by matrix material (Martinez and Casadevall 2007) Trichosporon species Dialysis graft (Krzossok et al 2004) and breast implants (Reddy et al 2002) Trichosporon asahii -Biofilm consisting of yeast and hyphal cells embedded in ECM (Di Bonaventura et al 2006) One useful approach to define biofilm gene functions has been to identify transcription factors that are required for biofilm formation. The rationale behind the approach came from the suspicion that many gene products-such as the large families of ALS (agglutinin-like sequence) proteins, CFEM (common in fungal extracellular membranes) proteins, and proteins resembling Hyr1-might have compensatory or overlapping functions in biofilm formation .…”

Section: Cryptococcus Neoformansmentioning

confidence: 99%

Fungal Biofilms, Drug Resistance, and Recurrent Infection

Desai

Mitchell

Andes

2014

Cold Spring Harbor Perspectives in Medicine

208

148

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A biofilm is a surface-associated microbial community. Diverse fungi are capable of biofilm growth. The significance of this growth form for infection biology is that biofilm formation on implanted devices is a major cause of recurrent infection. Biofilms also have limited drug susceptibility, making device-associated infection extremely difficult to treat. Biofilm-like growth can occur during many kinds of infection, even when an implanted device is not present. Here we summarize the current understanding of fungal biofilm formation, its genetic control, and the basis for biofilm drug resistance.

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Trichosporon asahii infection of a dialysis PTFE arteriovenous graft

Cited by 19 publications

References 0 publications

Biofilm Formation by the Emerging Fungal Pathogen Trichosporon asahii : Development, Architecture, and Antifungal Resistance

Biofilm Formation by the Emerging Fungal Pathogen Trichosporon asahii : Development, Architecture, and Antifungal Resistance

Fungal Biofilm Resistance

Fungal Biofilms, Drug Resistance, and Recurrent Infection

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