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antifungal hematology

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https://www.readbyqxmd.com/read/29619911/early-use-of-etanercept-for-graft-versus-host-disease-after-liver-transplant-the-importance-of-broad-spectrum-infective-prophylaxis
#1
Annalisa Boscolo, Eugenia Menin, Beatrice Zelaschi, Laura Albertoni, Giacomo Zanus, Fabio Baratto
Graft-versus-host-disease after orthotopic liver transplant is a rare and life-threatening complication. The diagnosis is challenging and usually confirmed by chimerism and skin biopsies. The most common cause of death is sepsis (60%), and broad-spectrum antibiotics and antifungal prophylaxis are strongly recommended. We present a case of a 61-year-old man with hepatocellular carcinoma and a previous history of metabolic and alcoholic cirrhosis who underwent orthotopic liver transplant. The immunosuppression regimen consisted of corticosteroids, calcineurin inhibitor, and mammalian target of rapamycin complex 1 inhibitor...
April 4, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29581122/pharmacokinetics-of-intravenous-posaconazole-in-critically-ill-patients
#2
Fekade B Sime, Janine Stuart, Jenie Butler, Therese Starr, Steven C Wallis, Saurabh Pandey, Jeffrey Lipman, Jason A Roberts
To date, there is no information on the IV posaconazole pharmacokinetics in ICU patients. This prospective observational study aimed to describe the pharmacokinetics of a single dose of IV posaconazole in critically ill patients. Patients with no history of allergy to triazole antifungals and requiring systemic antifungal therapy were enrolled if aged ≥ 18 years, central venous access was available, were not pregnant, and didn't receive prior posaconazole or drugs interacting with posaconazole. A single dose of 300 mg posaconazole was administered over 90 minutes...
March 26, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29581116/antifungal-prophylaxis-with-posaconazole-delayed-release-tablet-and-oral-suspension-in-a-real-life-setting-plasma-levels-efficacy-and-tolerability
#3
David Lenczuk, Wilma Zinke-Cerwenka, Hildegard Greinix, Albert Wölfler, Jürgen Prattes, Ines Zollner-Schwetz, Thomas Valentin, Timothy C Lin, Andreas Meinitzer, Martin Hoenigl, Robert Krause
We continuously determined Posaconazole plasma concentrations (PPCs) in 61 patients with hematological malignancies receiving Posaconazole (PCZ) delayed-release tablet (DRT) (48 patients, median duration of intake 92 days) and PCZ oral solution (OS) (13 patients, median duration of intake 124 days). PCZ DRT and OS antifungal prophylaxis was efficient and well tolerated. Thirty-four of 48 patients (71%) receiving DRT always had PPCs >0.7 mg/L, while 14 of 48 patients (29%) had at least one PPC ≤0.7 mg/L...
March 26, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29570914/voriconazole-concentration-is-inversely-correlated-with-corticosteroid-usage-in-immunocompromized-patients
#4
Osamu Imataki, Kazunori Yamaguchi, Makiko Uemura, Noriyasu Fukuoka
BACKGROUND: Voriconazole (VRCZ) is a broad-spectrum antifungal agent that can be administered both orally and intravenously. A high level of intra- and interindividual variability in serum drug therapeutic concentrations has been reported. We analyzed the influence of corticosteroid use on serum VRCZ concentration by assessing the correlation between corticosteroid dose and VRCZ trough level. METHODS: Immunocompromized patients treated with VRCZ with or without corticosteroid use from June 2010 through March 2017 (6 years and 8 months) were reviewed in our institute...
March 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29538730/challenges-in-the-diagnosis-and-treatment-of-mucormycosis
#5
A Skiada, C Lass-Floerl, N Klimko, A Ibrahim, E Roilides, G Petrikkos
The diagnosis and treatment of mucormycosis are challenging. The incidence of the disease seems to be increasing. Hematological malignancies are the most common underlying disease in countries with high income and uncontrolled diabetes in developing countries. Clinical approach to diagnosis lacks sensitivity and specificity. Radiologically, multiple (≥10) nodules and pleural effusion are reportedly associated with pulmonary mucormycosis. Another finding on computerized tomography (CT) scan, which seems to indicate the presence of mucormycosis, is the reverse halo sign...
April 1, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29535812/superior-efficacy-of-the-antifungal-agent-ciclopirox-olamine-over-gemcitabine-in-pancreatic-cancer-models
#6
Chrysovalantou Mihailidou, Pavlos Papakotoulas, Athanasios G Papavassiliou, Michalis V Karamouzis
Ciclopirox olamine (CPX) is an antifungal agent that has recently demonstrated promising anti-neoplastic activity against hematologic and solid tumors. Here, we evaluated CPX compared with gemcitabine alone as well as their combination in human pancreatic cancer cell lines; BxPC-3, Panc-1, and MIA PaCa-2 and in humanized xenograft mouse models. We also examined the preclinical pharmacodynamic activity of CPX. CPX caused a pronounced decrease in cell proliferation and clonogenic growth potential. These inhibitory effects were accompanied by induction of reactive oxygen species (ROS), which were strongly associated with reduced Bcl-xL and survivin levels and activation of a panel of caspases, especially caspase-3, and finally resulted in apoptotic death...
February 13, 2018: Oncotarget
https://www.readbyqxmd.com/read/29530846/micafungin-breakthrough-fungemia-in-patients-with-hematological-disorders
#7
Muneyoshi Kimura, Hideki Araoka, Hisashi Yamamoto, Shigeki Nakamura, Minoru Nagi, Satoshi Yamagoe, Yoshitsugu Miyazaki, Sho Ogura, Takashi Mitsuki, Mitsuhiro Yuasa, Daisuke Kaji, Kosei Kageyama, Aya Nishida, Yuki Taya, Hiroshi Shimazu, Kazuya Ishiwata, Shinsuke Takagi, Go Yamamoto, Yuki Asano-Mori, Naoyuki Uchida, Atsushi Wake, Shuichi Taniguchi, Akiko Yoneyama
Limited data are available on micafungin breakthrough fungemia (MBF), fungemia that develops on administration of micafungin, in patients with hematological disorders. We reviewed medical and microbiological records of patients with hematological disorders who developed MBF between January 2008 and June 2015. A total of 39 patients with MBF were identified and Candida (30 strains) and non- Candida (9 strains) fungal species were recognized as causative strains. Among 35 stored strains, C. parapsilosis (14 strains), Trichosporon asahii (7 strains), C...
March 12, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29526943/usefulness-of-aspergillus-galactomannan-antigen-testing-and-the-prediction-of-an-outbreak-during-hospital-reconstruction
#8
Hiroyasu Kaya, Jun Ozaki, Hirokazu Okumura
Objective This study retrospectively evaluated fungal dissemination due to hospital reconstruction and explored effective methods of predicting an outbreak. Methods Patients suspected of having invasive aspergillosis were tested for Aspergillus galactomannan antigen before and after reconstruction, and the mean values of three months of testing for positive patients were determined. The characteristics of patients with aspergillosis during this period were also assessed. Results Forty-five patients were positive for Aspergillus antigen (>0...
March 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29488017/network-analysis-of-drug-related-problems-in-hospitalized-patients-with-hematologic-malignancies
#9
Myeong Gyu Kim, Chae Reen Jeong, Hyun Jee Kim, Jae Hyun Kim, Yun-Kyoung Song, Kyung Im Kim, Eunhee Ji, Sung-Soo Yoon, Youngil Koh, Yoon-Sook Cho, In-Wha Kim, Jung Mi Oh
PURPOSE: Network analysis was conducted to systematically analyze the relationship between causative drugs and types of drug-related problems (DRPs) in hospitalized patients with hematologic malignancies. METHODS: A total of 1187 DRPs identified in hematology wards between 2013 and 2015 were analyzed. DRPs were classified into 11 sub-domains for problems and 35 sub-domains for causes according to Pharmaceutical Care Network Europe classification. Causative drugs were classified by Anatomical Therapeutic Chemical code...
February 27, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29487735/antifungal-susceptibility-patterns-of-colonized-candida-species-isolates-from-immunocompromised-pediatric-patients-in-five-university-hospitals
#10
Parisa Badiee, Maral Choopanizadeh, Abdolkarim Ghadimi Moghadam, Ali Hossaini Nasab, Hadis Jafarian, Ahmad Shamsizadeh, Jafar Soltani
Background and Objectives: Colonization of Candida species is common in pediatric patients admitted to hematology-oncology wards. The aim of this study was to identify colonized Candida species and their susceptibility patterns in hematologic pediatric patients. Materials and Methods: Samples were collected from mouth, nose, urine and stool of the patients admitted to five university hospitals and cultured on sabouraud dextrose agar. The isolates were identified by API 20 C AUX system and their susceptibility patterns were evaluated by CLSI M27-A3 and S4...
December 2017: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/29450209/creation-and-assessment-of-a-clinical-predictive-calculator-and-mortality-associated-with-candida-krusei-bloodstream-infections
#11
Ryan Kronen, Kevin Hsueh, Charlotte Lin, William G Powderly, Andrej Spec
Background: Candida krusei bloodstream infection (CK BSI) is associated with high mortality, but whether this is due to underlying comorbidities in affected patients or the organism itself is unknown. Identifying patient characteristics that are associated with CK BSI is crucial for clinical decision-making and prognosis. Methods: We conducted a retrospective analysis of hospitalized patients with Candida BSI at our institution between 2002 and 2015. Data were collected on demographics, comorbidities, medications, procedures, central lines, vital signs, and laboratory values...
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29404266/necrotizing-fungal-gingivitis-in-a-patient-with-acute-myelogenous-leukemia-visible-yet-obscure
#12
Prajwal Boddu, Pei-Ling Chen, Priyadharsini Nagarajan, Victor G Prieto, Alex Won, Mark Chambers, Steven Kornblau
Oral fungal infections present with atypical and varied manifestations, and distinguishing them from other entities including leukemic infiltration can be diagnostically challenging. In this report, we describe a 62 year old female with acute myeloid leukemia who presented, towards the end of her second treatment cycle of decitabine in a prolonged neutropenic state, with a month of painful, necrotic-appearing marginal gingival lesions. She was duly initiated on empiric broad spectrum antifungal treatment but did not show a clinical response with the appearance of new skin lesions concerning for progressive fungemia...
January 2018: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
https://www.readbyqxmd.com/read/29391334/invasive-fungal-infections-in-patients-with-hematological-malignancies-emergence-of-resistant-pathogens-and-new-antifungal-therapies
#13
Maria N Gamaletsou, Thomas J Walsh, Nikolaos V Sipsas
Invasive fungal infections caused by drug-resistant organisms, are an emerging threat to heavily immunosuppressed patients with haematological malignancies. Modern early antifungal treatment strategies, such as prophylaxis, empirical and pre-emptive therapy result in long term exposure to antifungal agents, which is a major driving force for the development of resistance. The extended use of central venous catheters, the non-linear pharmacokinetics of certain antifungal agents, neutropenia, other forms of intense immunosuppression, and drug toxicities are other contributing factors...
February 2, 2018: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/29373716/epidemiological-trends-of-cryptococcosis-in-italy-molecular-typing-and-susceptibility-pattern-of-cryptococcus-neoformans-isolates-collected-during-a-20-year-period
#14
Massimo Cogliati, Anna Prigitano, Maria Carmela Esposto, Luisa Romanò, Anna Grancini, Alberto Zani, Anna Maria Tortorano
In the present study clinical data and isolates from cases of cryptococcosis recorded during clinical surveys carried out in Italy from 1997 to 2016, were investigated. Molecular typing and antifungal susceptibility testing were performed in order to delineate the epidemiological trend of cryptococcosis in Italy and to define wild-type population for four different antifungal compounds. During the studied period, a total of 302 cases collected from 32 centers of 11 Italian regions were recorded. Analysis of clinical data showed a significant increase of frequency (from 7% to 38%) of cryptococcosis in human immunodeficiency virus (HIV)-negative patients primarily with hematologic malignancies and solid organ transplantations...
January 23, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29371536/reduced-multidrug-susceptibility-profile-is-a-common-feature-of-opportunistic-fusarium-species-fusarium-multi-drug-resistant-pattern
#15
REVIEW
Saad J Taj-Aldeen
The resistance among various opportunistic Fusarium species to different antifungal agents has emerged as a cause of public health problems worldwide. Considering the significance of multi-drug resistant (MDR), this paper emphasizes the problems associated with MDR and the need to understand its clinical significance to combat microbial infections. The search platform PubMed/MEDLINE and a review of 32 cases revealed a common multidrug-resistant profile exists, and clinically relevant members of Fusarium are intrinsically resistant to most currently used antifungals...
April 10, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29371065/three-cases-of-candida-fermentati-fungemia-following-hematopoietic-stem-cell-transplantation
#16
Kiyomi Morita, Akira Honda, Junji Koya, Kazuhiro Toyama, Ikeda Mahoko, Yoshiki Misawa, Shu Okugawa, Fumihiko Nakamura, Kyoji Moriya, Mineo Kurokawa
Bloodstream infection with non-Candida albicans Candida species is one of the serious complications among patients with hematological malignancies who receive long-term prophylactic antifungal agents. Here we describe three cases of Candida fermentati (C. fermentati) candidemia after allogeneic stem cell transplantation for hematological malignancies. Case 1 is fluconazole-breakthrough C. fermentati fungemia, which was well controlled with liposomal amphotericin B. Case 2 and 3 were caspofungin-breakthrough C...
January 19, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29333407/the-limited-role-of-serum-galactomannan-assay-in-screening-for-invasive-pulmonary-aspergillosis-in-allogeneic-stem-cell-transplantation-recipients-on-micafungin-prophylaxis-a-retrospective-study
#17
Ryul Kim, Youngil Koh, Dong-Yeop Shin, Pyoeng Gyun Choe, Nam Joong Kim, Sung-Soo Yoon, Myoung-Don Oh, Wan Beom Park, Inho Kim
Background: We evaluated the outcomes of serum galactomannan (GM) assay for the screening of invasive pulmonary aspergillosis (IPA) in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients while on primary antifungal prophylaxis (PAP). Methods: This study included patients with hematologic disorders who underwent alloHSCT from January 2013 to November 2015. Patients received routine PAP with fluconazole before 2014 and micafungin after 2014; serum GM tests were performed and retrospectively analyzed...
December 2017: Blood Research
https://www.readbyqxmd.com/read/29310582/identification-of-uncommon-oral-yeasts-from-cancer-patients-by-maldi-tof-mass-spectrometry
#18
Narges Aslani, Ghasem Janbabaei, Mahdi Abastabar, Jacques F Meis, Mahasti Babaeian, Sadegh Khodavaisy, Teun Boekhout, Hamid Badali
BACKGROUND: Opportunistic infections due to Candida species occur frequently in cancer patients because of their inherent immunosuppression. The aim of the present study was to investigate the epidemiology of yeast species from the oral cavity of patients during treatment for oncological and haematological malignancies. METHODS: MALDI-TOF was performed to identify yeasts isolated from the oral cavity of 350 cancer patients. Moreover, antifungal susceptibility testing was performed in according to CLSI guidelines (M27-A3)...
January 8, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29305017/potential-usefulness-of-early-potassium-supplementation-for-preventing-severe-hypokalemia-induced-by-liposomal-amphotericin-b-in-hematologic-patients-a-retrospective-study
#19
Naoto Okada, Momoyo Azuma, Masaki Imanishi, Yoshito Zamami, Yasushi Kirino, Toshimi Nakamura, Kazuhiko Teraoka, Masahiro Abe, Keisuke Ishizawa
PURPOSE: Liposomal amphotericin B (L-AMB) is an essential antifungal agent for patients with hematologic diseases; however, the drug causes severe hypokalemia at a high frequency. Meanwhile, there is little evidence regarding the risk factors for L-AMB-induced severe hypokalemia, and the prevention protocol has not been established. The goal of this study was to identify the risk factors related to severe hypokalemia induced by L-AMB in hematologic patients. METHODS: Seventy-eight hematologic patients with a first administration of L-AMB were enrolled in the study...
February 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29283878/occupational-cns-aspergillosis-in-an-immunocompetent-individual-a-diagnostic-challange
#20
Parul Punia, Nidhi Goel, Ishwar Singh, Uma Chaudhary
INTRODUCTION: Immunocompetent individuals are rarely affected by Aspergillus species and its prime importance lies in immunocompromised patients where it can cause disease, ranging from primarily pulmonary infections to dissemination anywhere in the body. Invasive aspergillosis (IA) occurs in patients with risk factors including prolonged neutropenia, neutrophil dysfunction, patient on cytotoxic drugs, steroid therapy, hematological malignancy, AIDS or in patients with bone marrow transplantation...
December 28, 2017: Archives of Environmental & Occupational Health
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