Ventilator-associated pneumonia involving Aspergillus flavus in a patient with coronavirus disease 2019 (COVID-19) from Argentina

Fernández, Norma; Cáceres, Diego H.; Beer, Karlyn D.; Irrazabal, Célica; Delgado, Ghilka; Farias, Luciana; Chiller, Tom; Verweij, Paul E.; Stecher, Daniel

doi:10.1016/j.mmcr.2020.07.001

Cited by 32 publications

(29 citation statements)

References 16 publications

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“…and numerous opportunistic bacteria found in the respiratory secretions of individuals that are infected with SARS-CoV2 [ 87 , 88 , 89 ]. The risk of developing secondary infections caused by these microorganisms is likely confounded by patients being placed on ventilator support [ 88 ]. As we have discussed in previous sections, interactions between bacteria and fungi can result in changes in susceptibility to antibiotics and altered virulence of the organisms.…”

Section: Implications Of Bfis On Host Health and Diseasementioning

confidence: 99%

Let’s Get Physical: Bacterial-Fungal Interactions and Their Consequences in Agriculture and Health

Steffan

Venkatesh

Keller

2020

JoF

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Fungi serve as a biological scaffold for bacterial attachment. In some specialized interactions, the bacteria will invade the fungal host, which in turn provides protection and nutrients for the bacteria. Mechanisms of the physical interactions between fungi and bacteria have been studied in both clinical and agricultural settings, as discussed in this review. Fungi and bacteria that are a part of these dynamic interactions can have altered growth and development as well as changes in microbial fitness as it pertains to antibiotic resistance, nutrient acquisition, and microbial dispersal. Consequences of these interactions are not just limited to the respective microorganisms, but also have major impacts in the health of humans and plants alike. Examining the mechanisms behind the physical interactions of fungi and bacteria will provide us with an understanding of multi-kingdom community processes and allow for the development of therapeutic approaches for disease in both ecological settings.

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Section: Implications Of Bfis On Host Health and Diseasementioning

confidence: 99%

Let’s Get Physical: Bacterial-Fungal Interactions and Their Consequences in Agriculture and Health

Steffan

Venkatesh

Keller

2020

JoF

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“…COVID‐19‐associated pulmonary aspergillosis has been described to occur in patients that do not fulfil typical risk factors for IPA (such as underlying haematological malignancy or neutropenia) 1–18 . The criteria described by Blot et al and Schauwvlieghe et al may help differentiate between patients who are just colonised with Aspergillus spp.…”

Section: Introductionmentioning

confidence: 99%

Invasive pulmonary aspergillosis in the COVID‐19 era: An expected new entity

Machado

Valerio

Álvarez‐Uría

et al. 2020

Mycoses

165

173

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Objectives Information on the recently COVID‐19‐associated pulmonary aspergillosis (CAPA) entity is scarce. We describe eight CAPA patients, compare them to colonised ICU patients with coronavirus disease 2019 (COVID‐19), and review the published literature from Western countries. Methods Prospective study (March to May, 2020) that included all COVID‐19 patients admitted to a tertiary hospital. Modified AspICU and European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria were used. Results COVID‐19‐associated pulmonary aspergillosis was diagnosed in eight patients (3.3% of 239 ICU patients), mostly affected non‐immunocompromised patients (75%) with severe acute respiratory distress syndrome (ARDS) receiving corticosteroids. Diagnosis was established after a median of 15 days under mechanical ventilation. Bronchoalveolar lavage was performed in two patients with positive Aspergillus fumigatus cultures and galactomannan (GM) index. Serum GM was positive in 4/8 (50%). Thoracic CT scan findings fulfilled EORTC/MSG criteria in one case. Isavuconazole was used in 4/8 cases. CAPA‐related mortality was 100% (8/8). Compared with colonised patients, CAPA subjects were administered tocilizumab more often (100% vs. 40%, p = .04), underwent longer courses of antibacterial therapy (13 vs. 5 days, p = .008), and had a higher all‐cause mortality (100% vs. 40%, p = .04). We reviewed 96 similar cases from recent publications: 59 probable CAPA (also putative according modified AspICU), 56 putative cases and 13 colonisations according AspICU algorithm; according EORTC/MSG six proven and two probable. Overall, mortality in the reviewed series was 56.3%. Conclusions COVID‐19‐associated pulmonary aspergillosis must be considered a serious and potentially life‐threatening complication in patients with severe COVID‐19 receiving immunosuppressive treatment.

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“…A rapid diagnosis can lead to the development of an accurate therapeutic plan and probably to clinical remission only if the patient has no comorbidities nor extensive pulmonary damage. Through our experience we suggest adding a study of fungal colonization to the clinical management of all immunocompetent patients with one or more risk factors for the development of invasive fungal infection [ 13 ]. Immunocompetent patients with COVID-19 infection should be screened early for microbiological colonization before admission to critical wards, such as ICUs.…”

Section: Resultsmentioning

confidence: 99%

Fatal VAP-related pulmonary aspergillosis by Aspergillus niger in a positive COVID-19 patient

Trovato

Calvo

Migliorisi

et al. 2021

Respiratory Medicine Case Reports

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Invasive pulmonary aspergillosis, known as a complication in patients with severe respiratory syndromes, recently showed a correlation with COVID-19 pneumonia, and the clinical characteristics of COVID-19 associated pulmonary aspergillosis (CAPA) have been described. Unfortunately, infections by the Aspergillus genus are often diagnosed in post-mortem time, because of diagnostic delays and a rapid worsening of respiratory conditions. Literature data document, in fact, only few cases of COVID-19 Aspergillus niger coinfection. The aim of this study was to describe a case of a VAP-related probable pulmonary aspergillosis by Aspergillus niger in a COVID-19 patient. Despite the definition of fungal etiology and the rapid administration of antifungal therapy, the patient died while on ventilator support because of severe respiratory impairment.

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Ventilator-associated pneumonia involving Aspergillus flavus in a patient with coronavirus disease 2019 (COVID-19) from Argentina

Cited by 32 publications

References 16 publications

Let’s Get Physical: Bacterial-Fungal Interactions and Their Consequences in Agriculture and Health

Let’s Get Physical: Bacterial-Fungal Interactions and Their Consequences in Agriculture and Health

Invasive pulmonary aspergillosis in the COVID‐19 era: An expected new entity

Fatal VAP-related pulmonary aspergillosis by Aspergillus niger in a positive COVID-19 patient

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