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Rusheng Chew, Andrew Dorman, Marion L Woods
OBJECTIVE: To describe the clinical features and risk factors of and optimal antifungal therapy for Purpureocillium lilacinum keratitis. DESIGN: Retrospective case series in a quaternary referral hospital setting. METHODS: Comprehensive chart review of patients diagnosed with P. lilacinum keratitis in the past 10 years. PARTICIPANTS: Four patients were identified. All were aged 60 years or greater, with none having prior ocular trauma...
October 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Dnyaneshwar D Athavale, Robin Jones, Brett A O'Donnell, Martin Forer, Nigel Biggs
PURPOSE: To describe the non-exenteration management of sino-orbital fungal infection, a life-threatening condition for which orbital exenteration is generally considered a first-line treatment. METHODS: A retrospective case series is presented of 7 orbits in 6 consecutive patients admitted and treated at 2 major metropolitan tertiary teaching hospitals in Sydney, New South Wales, Australia. RESULTS: Seven orbits in 6 consecutive patients with sino-orbital fungal infection were treated conservatively with surgical debridement and intravenous antifungal agents...
October 20, 2016: Ophthalmic Plastic and Reconstructive Surgery
Matt Shirley, Lesley J Scott
Isavuconazole is a second-generation triazole with activity against a broad spectrum of clinically important fungi. Its water-soluble prodrug, isavuconazonium sulfate (Cresemba(®)), available in interchangeable intravenous and oral formulations, is approved in the USA and EU for the treatment of adults with invasive aspergillosis and mucormycosis. In international phase III clinical trials, isavuconazole was efficacious and generally well tolerated in the treatment of these life-threatening diseases. In the phase III SECURE trial, isavuconazole was non-inferior to voriconazole for the primary treatment of invasive mould disease (primarily aspergillosis) and was associated with fewer drug-related treatment-emergent adverse events (TEAEs) than voriconazole...
October 20, 2016: Drugs
Adela Martin-Vicente, Javier Capilla, Josep Guarro
Clinical and experimental data have shown discrepancies on the efficacy of combinations between triazoles and echinocandins. In this study, anidulafungin plus posaconazole have shown efficacy against a murine systemic infection by three strains of Aspergillus fumigatus The combination increased mice survival and reduced burden in the kidneys over the corresponding monotherapies and voriconazole. Clearance of kidneys was observed in 62% to 100% of animals (strain dependant). We observed good in vitro- in vivo correlation when a cutoff < 1 was indicative of synergy...
October 19, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Pedro Llinares, Isabel Ruiz, Rafael Zaragoza, Ricard Ferrer, Alejandro H Rodríguez, Emilio Maseda, Santiago Grau
BACKGROUND: Although in the past decade the management of invasive fungal infections has improved, a number of controversies persist regarding empirical antifungal treatment in critically-ill hematology patients. AIMS: To identify key clinical knowledge to elaborate a set of recommendations, with a high level of consensus, necessary for the approach to fungal infections in critically-ill hematology patients. METHODS: A Spanish prospective questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all specialists in fungal invasive infections from six scientific national societies; intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases...
October 14, 2016: Revista Iberoamericana de Micología
He Wang, Ying-Chun Xu, Po-Ren Hsueh
In the Asia-Pacific region, Candida albicans is the predominant Candida species causing invasive candidiasis/candidemia in Australia, Japan, Korea, Hong Kong, Malaysia, Singapore and Thailand whereas C. tropicalis is the most frequently encountered Candida species in Pakistan and India. Invasive isolates of C. albicans, C. parapsilosis complex and C. tropicalis remain highly susceptible to fluconazole (>90% susceptible). Fluconazole resistance (6.8-15%), isolates with the non-wild-type phenotype for itraconazole susceptibility (3...
October 18, 2016: Future Microbiology
Petra Füredi, Zsófia Edit Pápay, Kristóf Kovács, Borbála Dalmadi Kiss, Krisztina Ludányi, István Antal, Imre Klebovich
The number of topical fungal infections is growing, mostly owing to immunosuppressive therapy. Several topical fungal infections, such as eye mycoses, can be treated by local administration of antimycotic drugs. One major group of the antifungal agents is triazole, such as voriconazole (VCZ), which is used as the first line treatment of aspergillosis. A disadvantage of VCZ is its low water solubility making the drug difficult to administer in a liquid preparation. The lipid-based nanoparticles (LNP) have attracted increasing attention due to their advantageous properties...
October 1, 2016: Journal of Pharmaceutical and Biomedical Analysis
Elena M Marín Martínez, Ana Isabel Aller García, Estrella Martín-Mazuelos
BACKGROUND: Invasive fungal infection (IFI) has increased in recent years due to there being a greater number of risk factors. IFI caused by Candida is the most frequent, and although Candida albicans is the most isolated species, there is currently a decrease of C. albicans and an increase of other species of the genus. AIMS: To analyse the epidemiology, risk factors, and antifungal susceptibility of blood culture isolates of non-C.albicans Candida species in our hospital in the last 12years...
October 13, 2016: Revista Iberoamericana de Micología
Atefeh Abdollahi Gohar, Hamid Badali, Tahereh Shokohi, Mojtaba Nabili, Nasrin Amirrajab, Maryam Moazeni
Clinical management of fungal diseases is compromised by the emergence of antifungal drug resistance in fungi, which leads to elimination of available drug classes as treatment options. An understanding of antifungal resistance at molecular level is, therefore, essential for the development of strategies to combat the resistance. This study presents the assessment of molecular mechanisms associated with fluconazole resistance in clinical Candida glabrata isolates originated from Iran. Taking seven distinct fluconazole-resistant C...
October 15, 2016: Mycopathologia
João Paulo Zen Siqueira, Deanna A Sutton, Dania García, Josepa Gené, Pamela Thomson, Nathan Wiederhold, Josep Guarro
Aspergillus section Versicolores includes species of clinical relevance and many others that have been poorly studied but are occasionally found in clinical samples. The aim of this study was to investigate, using a multilocus phylogenetic approach, the spectrum of species of the section Versicolores and to determine their in vitro antifungal susceptibility. The study was based on a set of 77 clinical isolates from different USA medical centres, which had been previously identified as belonging to this section...
November 2016: Fungal Biology
Hamed Ebrahimzadeh Leylabadlo, Elham Zeinalzadeh, Najibeh Asl Rahnemaii Akbari, Hossein Samadi Kafil
Infection is a serious complication after implantation of total knee-prostheses. However, fungal infection is rarely found in periprosthetic joints, and in most reports, the infecting organism is a Candida species. This is a case report of infection after left knee total arthroplasty caused by Malassezia species. The patient is still undergoing antifungal therapy with voriconazole and is still being followed-up. To the authors' knowledge, the present case is the first report of Malassezia species in a patient after total knee arthroplasty...
2016: GMS Hygiene and Infection Control
Zi-Li Zhou, Chih-Chao Lin, Wen-Li Chu, Yun-Liang Yang, Hsiu-Jung Lo
The species distribution and drug susceptibilities of 1106 Candida isolates collected in Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) in 2014 were determined. Candida albicans is still the dominant species, accounting for 35.9%, followed by 28.3% C. glabrata, 26.6% C. tropicalis, 5.2% C. parapsilosis, 1.0% C. krusei, and 3.0% of 13 other species. Interestingly, the prevalence of candidemia caused by C. glabrata in the present study is significantly higher than that in previous three surveys (39/220 vs...
September 17, 2016: Diagnostic Microbiology and Infectious Disease
Maria Clara Padovani de Souza, Andrezza Gouvêa Dos Santos, Adriano Max Moreira Reis
Background The inappropriate use of systemic antifungal agents can result in unnecessary exposure, adverse events, increased microbial resistance and increased costs. Aim This study analysed the use of systemic antifungal agents and adherence to treatment guidelines for fungal infections. Setting A Brazilian tertiary hospital. Methods This cross-sectional study investigated 183 patients who were treated with systemic antifungals. Antifungal drugs were classified according to the fourth level of the Anatomical Therapeutic Chemical classification system...
October 6, 2016: International Journal of Clinical Pharmacy
Daisuke Hagiwara, Akira Watanabe, Katsuhiko Kamei, Gustavo H Goldman
Invasive aspergillosis is a life-threatening mycosis caused by the pathogenic fungus Aspergillus. The predominant causal species is Aspergillus fumigatus, and azole drugs are the treatment of choice. Azole drugs approved for clinical use include itraconazole, voriconazole, posaconazole, and the recently added isavuconazole. However, epidemiological research has indicated that the prevalence of azole-resistant A. fumigatus isolates has increased significantly over the last decade. What is worse is that azole-resistant strains are likely to have emerged not only in response to long-term drug treatment but also because of exposure to azole fungicides in the environment...
2016: Frontiers in Microbiology
Ozge Turhan, Asli Bostanci, Irem Hicran Ozbudak, Murat Turhan
Chronic invasive nongranulomatous fungal rhinosinusitis is a well-described but uncommon type of fungal rhinosinusitis (FRS). While the prevalence of chronic FRS is 0.11% in healthy individuals, only 1.3% of them are in nongranulomatous invasive nature. The majority of the cases in the literature have been reported from developing countries mostly located in the tropical regions, as typically occurring in the background of diabetes mellitus or corticosteroid treatment. The current paper reports four consecutive cases, who were diagnosed within a short period of six months at a single center of a country located outside the tropical climate zone...
2016: Case Reports in Otolaryngology
Krm Ferrier, C E van Elk, P E Bunskoek, Mph van den Broek
Bottlenose dolphins (Tursiops truncatus) can suffer from fungal infections, which can be treated with voriconazole. In common practice, the voriconazole doses are extrapolated from human doses by adjusting for body weight only, because no dose regimen is available yet. Therefore, the aim of this study was to define a dose regimen for voriconazole in bottlenose dolphins. Dolphins treated with voriconazole between November 2005 and September 2015 at the Dolfinarium Harderwijk, the Netherlands, and TDM was performed were included...
October 4, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Alina Tanase, Anca Colita, Gabriel Ianosi, Daniela Neagoe, Daciana Elena Branisteanu, Daniela Calina, Anca Oana Docea, Aristidis Tsatsakis, Simona Laura Ianosi
Fusarium infection is a severe fungal infection caused by fungi of the genus Fusarium. It most commonly occurs in immunocompromised patients with malignant hematological comorbidities or secondary to hematopoietic stem cell transplant. The classical route of contamination is through inhalation but infection may also occur through contiguity with a skin lesion. This report describes the case of a 24-year-old woman who developed graft-vs.-host disease (GVHD) at 220 days after receiving an allogeneic stem cell transplant from a sibling donor for Hodgkin disease...
October 2016: Experimental and Therapeutic Medicine
Pamela Thomson, Emilio Mayayo, Loida López-Fernández, Josep Guarro, Javier Capilla
Cryptococcus albidus and Cryptococcus laurentii are uncommon species of this genus that in recent decades have increasingly caused opportunistic infections in humans, mainly in immunocompromised patients; the best therapy for such infection being unknown. Using a murine model of systemic infection by these fungi, we have evaluated the efficacy of amphotericin B (AMB) at 0.8 mg/kg, administered intravenously, fluconazole (FLC) or voriconazole (VRC), both administered orally, at 25 mg/kg and the combination of AMB plus VRC against three C...
October 3, 2016: Mycoses
Soraya Eugenia Morales-López, Constanza G Taverna, María Eugenia Bosco-Borgeat, Ivana Maldonado, Walter Vivot, Wanda Szusz, Guillermo Garcia-Effron, Susana B Córdoba
The presence of the cryptic species belonging to the Candida glabrata complex has not been studied in Argentina. We analyzed a collection of 117 clinical isolates of C. glabrata complex belonging to a National Culture Collection of Instituto Nacional de Microbiología "Dr. Carlos G. Malbrán" from Argentina (40 isolates from blood samples, 18 from other normally sterile sites, 20 from vagina, 14 from urine, 7 from oral cavity, 3 from catheter, 1 from a stool sample and 14 isolates whose clinical origin was not recorded)...
September 28, 2016: Mycopathologia
Elham Rezazadeh, Azar Sabokbar, Maryam Moazeni, Mohammad Sadegh Rezai, Hamid Badali
BACKGROUND: Candida species, as opportunistic organisms, can cause various clinical manifestations, ranging from mild cutaneous infections to systemic candidiasis in otherwise healthy individuals. Remarkably, the incidence and mortality rates of candidemia have significantly increased worldwide, even after advances in medical interventions and the development of novel antifungal drugs. OBJECTIVES: Given the possible resistance to antifungal agents, susceptibility testing can be useful in defining the activity spectrum of antifungals and determining the appropriate treatment regime...
July 2016: Jundishapur Journal of Microbiology
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