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https://www.readbyqxmd.com/read/28087293/first-itraconazole-resistant-aspergillus-fumigatus-clinical-isolate-harbouring-a-g54e-substitution-in-cyp51ap-in-south-america
#1
Florencia Leonardelli, Laura Theill, María Elena Nardin, Daiana Macedo, Catiana Dudiuk, Emilce Mendez, Soledad Gamarra, Guillermo Garcia-Effron
BACKGROUND: A 27-year-old male rural worker was admitted with a fungal keratitis due to an injury involving plant detritus. MATERIALS AND METHODS: Specimens were collected for microscopy examination and culture. The isolate was identified by morphological and molecular criteria. Susceptibility testing was performed using CLSI methods. CYP51A gene was PCR amplified and sequenced. RESULTS: An Aspergillus fumigatus strain resistant to itraconazole (MIC>8μg/ml) was isolated...
January 10, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28080986/clinical-implications-of-globally-emerging-azole-resistance-in-aspergillus-fumigatus
#2
REVIEW
Jacques F Meis, Anuradha Chowdhary, Johanna L Rhodes, Matthew C Fisher, Paul E Verweij
Aspergillus fungi are the cause of an array of diseases affecting humans, animals and plants. The triazole antifungal agents itraconazole, voriconazole, isavuconazole and posaconazole are treatment options against diseases caused by Aspergillus However, resistance to azoles has recently emerged as a new therapeutic challenge in six continents. Although de novo azole resistance occurs occasionally in patients during azole therapy, the main burden is the aquisition of resistance through the environment. In this setting, the evolution of resistance is attributed to the widespread use of azole-based fungicides...
December 5, 2016: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28080217/synergistic-effects-of-tetrandrine-with-posaconazole-against-aspergillus-fumigatus
#3
Shui-Xiu Li, Yan-Jun Song, Ling Jiang, Ya-Jing Zhao, Hui Guo, Dong-Mei Li, Kun-Ju Zhu, Hong Zhang
In our earlier in vitro and in vivo studies, synergistic effects were observed when itraconazole or voriconazole were combined with tetrandrine (TET) against Aspergillus fumigatus, and the synergistic mechanism was related to inhibition of the drug efflux pump. Posaconazole (PCZ) is a broad-spectrum triazole antifungal agent used for the treatment of diverse fungal infections, including aspergillosis and candidiasis. Herein, the antifungal effects of TET are further investigated in vitro and in vivo alone or combined with PCZ against 20 clinical isolates of A...
January 12, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#4
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
BACKGROUND: Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents, including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacill-tazobactam, tobramycin, vancomycin, and voriconazole, are presented...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28070116/aspergillus-terreus-brain-abscess-complicated-by-tension-pneumocephalus-in-a-patient-with-angiosarcoma
#5
Thejal Srikumar, Smitha Pabbathi, Jorge Fernandez, Sowmya Nanjappa
BACKGROUND Aspergillus terreus is an evolving opportunistic pathogen, and patients with A. terreus often have poor outcomes due to its intrinsic resistance to several systemic antifungal agents. Here we present a unique case of intracranial abscesses of A. terreus in a patient with recurrent angiosarcoma, complicated by development of tension pneumocephalus. CASE REPORT A 67-year old gentleman with history of scalp angiosarcoma with wide excision two years prior presented to the hospital for left arm clumsiness, altered mental status, and low-grade fever...
January 10, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28070050/-clinical-comparative-analysis-for-pulmonary-histoplasmosis-and-progressive-disseminated-histoplasmosis
#6
Yan Zhang, Xiaoli Su, Yuanyuan Li, Ruoxi He, Chengping Hu, Pinhua Pan
To compare clinical features, diagnosis and therapeutic effect between pulmonary histoplasmosis and progressive disseminated histoplasmosis.
 Methods: A retrospective analysis for 12 cases of hospitalized patients with histoplasmosis, who was admitted in Xiangya Hospital, Central South University during the time from February 2009 to October 2015, was carried out. Four cases of pulmonary histoplasmosis and 8 cases of progressive disseminated histoplasmosis were included. The differences of clinical features, imaging tests, means for diagnosis and prognosis were analyzed between the two types of histoplasmosis...
December 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28069658/scy-078-is-fungicidal-in-time-kill-studies-against-candida-species
#7
Bernard Scorneaux, David Angulo, Katyna Borroto-Esoda, Mahmoud Ghannoum, Michael Peel, Stephen Wring
SCY-078 is an orally bioavailable ß-1,3-glucan synthesis inhibitor (GSI) and the first-in-class of structurally novel triterpine antifungals in clinical development for treating candidemia and invasive candidiasis. In vitro susceptibility by broth micro-dilution, antifungal carry-over, and time-kill dynamics were determined for 3 reference (ATCC) strains (C. albicans 90028, C. parapsilosis 90018, and C. tropicalis 750), a Quality Control (QC) strain (C krusei 6258), and 4 other strains (C. albicans MYA-2732, 64124, 76485 and C...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28057172/substrate-specificity-of-human-cytochrome-p450-cyp-2c-subfamily-and-effect-of-azole-antifungal-agents-on-cyp2c8
#8
Toshiro Niwa, Yurie Imagawa
PURPOSE: The metabolic activities of aminopyrine N-demethylation and tolbutamide methylhydroxylation by the human hepatic cytochrome P450 (P450 or CYP) 2C subfamily were compared and the effects of azole antifungal agent on the drug-metabolizing activity of CYP2C8 were investigated. METHODS: Aminopyrine N-demethylation and tolbutamide methylhydroxylation by CYP2C8, CYP2C9, and CYP2C19 were determined by the previous reported methods. The effects of five azole antifungal agents, fluconazole, itraconazole, ketoconazole, miconazole, and voriconazole, on the aminopyrine N-demethylation activity by CYP2C8 were investigated...
October 2016: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28054219/intracranial-aspergillosis-in-an-immunocompetent-young-woman
#9
Prasan Kumar Panda, Sunil Kumar Mavidi, Naveet Wig, Ajay Garg, Aasma Nalwa, M C Sharma
Intracranial aspergillosis (ICA) is very rare in the immunocompetent individuals, usually misdiagnosed as a tumor or an abscess. A high index of clinical suspicion is required in patients who present with focal neurological deficits, headache, or seizures. We report the case of a 25-year-old immunocompetent female, who presented with a 15-month history of headache, seizures, left-sided proptosis and ophthalmoplegia, and right hemiparesis. Recovery from the symptoms and decrease in the lesion size seen on the radiological assessment were achieved through two decompressive craniotomies followed by prolonged combined systemic antifungal therapies...
January 4, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28053850/disseminated-coccidioidomycosis-presenting-with-intramedullary-spinal-cord-abscesses-management-challenges
#10
Kristina L Bajema, Mark F Dalesandro, David N Fredricks, Meena Ramchandani
Coccidioides species are endemic to the southwestern United States and typically cause a mild or asymptomatic primary infection. In some instances, infection can disseminate and involve the central nervous system with meningitis being the most common manifestation. Non-osseous spinal cord involvement is exceedingly rare. We report a case of disseminated coccidioidomycosis in an otherwise healthy 20 year old man with diffuse leptomeningeal enhancement, cerebrospinal fluid findings suggestive of meningitis, and intramedullary spinal cord abscesses...
March 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28053848/rapid-development-of-a-mycotic-aneurysm-of-the-intracranial-artery-secondary-to-scedosporium-apiospermum-sinusitis
#11
Yoshihiko Ogawa, Masatoshi Sato, Masato Tashiro, Masayuki Miyazaki, Kiyoshi Nagata, Nobuyuki Takahashi, Kei Kasahara, Koichi Izumikawa, Hisakazu Yano, Keiichi Mikasa
An 85-year-old man complained of a 2-month history of pain on the left side of his face. Brain computed tomography (CT) and magnetic resonance imaging/magnetic resonance angiography did not clearly show any intracranial abnormality and only showed fluid effusion in his left sphenoid sinus. Filamentous fungi were detected from the left sphenoid sinus specimen. The isolate was Scedosporium apiospermum. He was empirically treated with voriconazole, to which the isolate was susceptible. His consciousness decreased rapidly...
December 2016: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28053212/multilocus-phylogeny-and-antifungal-susceptibility-of-aspergillus-section-circumdati-from-clinical-samples-and-description-of-a-pseudosclerotiorum-sp-nov
#12
J P Z Siqueira, D A Sutton, J Gené, D García, N Wiederhold, S W Peterson, J Guarro
A multilocus phylogenetic study was carried out to assess species identity of a set of 34 clinical isolates from Aspergillus section Circumdati from the USA, and to determine their in vitro antifungal susceptibility against eight antifungal drugs. The genetic markers used were ITS, BenA, CaM and RPB2, and the drugs tested were amphotericin B, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, micafungin, and terbinafine. The most common species sampled was A. westerdijkiae (29.4%), followed by a novel species, which was described here as A...
January 4, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28052853/activity-of-a-long-acting-echinocandin-cd101-and-seven-comparator-antifungal-agents-tested-against-a-global-collection-of-contemporary-invasive-fungal-isolates-in-the-sentry-2014-antifungal-surveillance-program
#13
Michael A Pfaller, Shawn A Messer, Paul R Rhomberg, Mariana Castanheira
The activity of CD101 and comparators was evaluated against 606 invasive fungal isolates collected worldwide during 2014 using the CLSI method. All C. albicans (n=251), C. tropicalis (n=51), C. krusei (n=16), and C. dubliniensis (n=11) were inhibited by ≤0.12 μg/ml of CD101 and were susceptible or wild type to other echinocandins. Five C. glabrata (n=100) displayed CD101 MIC values of 1-4 μg/ml, elevated caspofungin (2->8 μg/ml), anidulafungin (2-4 μg/ml), and micafungin (2-4 μg/ml) MICs, and carried mutations on fks1/fks2 C...
January 4, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28045862/comparing-azole-plasma-trough-levels-in-lung-transplant-recipients-percentage-of-therapeutic-levels-and-intra-patient-variability
#14
Stelzer Daniela, Weber Alexandra, Ihle Franziska, Matthes Sandhya, Ceelen Felix, Zimmermann Gregor, Kneidinger Nikolaus, Schramm Rene, Winter Hauke, Zoller Michael, Vogeser Michael, Behr Juergen, Neurohr Claus
BACKGROUND: This study compared therapeutic azole plasma trough levels (APL) of the azole antimycotics itraconazole (ITR), voriconazole (VOR), and posaconazole (POS) in lung transplant recipients and analyzed the influencing factors. In addition, intra-patient variability for each azole was determined. METHODS: From July 2012 to July 2015, 806 APL of ITR, VOR, POS liquid (POS-Liq), and POS tablets (POS-Tab) were measured in 173 patients of the Munich Lung Transplantation (LTx) Program...
December 29, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28031271/voriconazole-mics-are-predictive-for-the-outcome-of-experimental-disseminated-scedosporiosis
#15
Adela Martin-Vicente, Josep Guarro, Gloria M González, Cornelia Lass-Flörl, Michaela Lackner, Javier Capilla
BACKGROUND: Scedosporiosis is associated with a mortality rate of up to 90% in patients suffering from disseminated infections. Recommended first-line treatment is voriconazole, but epidemiological cut-off values and clinical breakpoints have not been determined. OBJECTIVES: To correlate voriconazole treatment response in mice suffering from disseminated scedosporiosis with MIC values determined using CLSI broth microdilution, Etest (bioMérieux) and disc diffusion...
December 28, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28031205/in-vitro-activity-of-posaconazole-against-talaromyces-marneffei-by-broth-microdilution-and-etest-methods-comparison-to-itraconazole-voriconazole-and-anidulafungin
#16
Susanna K P Lau, George C S Lo, Clare S K Lam, Wang-Ngai Chow, Antonio H Y Ngan, Alan K L Wu, Dominic N C Tsang, Cindy W S Tse, Tak-Lun Que, Bone S F Tang, Patrick C Y Woo
We determined the susceptibilities of 57 Talaromyces marneffei strains to anidulafungin, itraconazole, voriconazole and posaconazole, with MICs of 2-8, 0.002-0.004, 0.016-0.063 and 0.001-0.002 μg/ml by broth microdilution, and >32, ≤0.002-0.008, ≤0.002-0.008 and ≤0.002 μg/ml by Etest respectively at yeast phase; while MICs at mycelial phase for anidulafungin and posaconazole were 1-2 and 0.004-0.063 μg/ml respectively. The results suggest promising activities of posaconazole. Etest can be used for testing of azoles against T...
December 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28028453/identification-and-characterization-of-daldinia-eschscholtzii-isolated-from-skin-scrapings-nails-and-blood
#17
Kee Peng Ng, Chai Ling Chan, Su Mei Yew, Siok Koon Yeo, Yue Fen Toh, Hong Keat Looi, Shiang Ling Na, Kok Wei Lee, Wai-Yan Yee, Chee Sian Kuan
BACKGROUND: Daldinia eschscholtzii is a filamentous wood-inhabiting endophyte commonly found in woody plants. Here, we report the identification and characterization of nine D. eschscholtzii isolates from skin scrapings, nail clippings, and blood. METHODS: The nine isolates were identified based on colony morphology, light microscopy, and internal transcribed spacer (ITS)-based phylogeny. In vitro antifungal susceptibility of the fungal isolates was evaluated by the Etest to determine the minimum inhibitory concentration (MIC)...
2016: PeerJ
https://www.readbyqxmd.com/read/28025573/diagnosis-and-treatment-of-pythium-insidiosum-corneal-ulcer-in-a-chinese-child-a-case-report-and-literature-review
#18
Hong He, Hongshan Liu, Xiaolian Chen, Jiaochan Wu, Miao He, Xingwu Zhong
BACKGROUND Pythium insidiosum keratitis is a rare but sight-threatening disease with a high morbidity rate. It can be misdiagnosed as fungal keratitis in clinic settings. We report a case of severe Pythium insidiosum keratitis in a Chinese child, treated with combined approaches. CASE REPORT A 7-year-old boy from Hainan province in the south of China developed a suppurative corneal ulcer after being in a forest. A mass of hyphae was detected by confocal imaging in vivo, fungal smear test, and histochemical examination...
December 27, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/28018689/cryptococcus-gattii-in-an-immunocompetent-patient-in-the-southeastern-united-states
#19
John W Amburgy, Joseph H Miller, Benjamin J Ditty, Patrick Vande Lune, Shaaf Muhammad, Winfield S Fisher
Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is C. neoformans. In the Northwestern United States, C. gattii has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with C. gattii requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to C...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28018093/clinico-radiological-improvement-in-an-immunocompetent-patient-presented-with-scedosporium-apiospermum-osteomyelitis
#20
Rahul Mohan, T S Gopakumar
Scedosporium apiospermum is frequently found as a saprophyte in soil, sewage and contaminated water. Its manifestations in immunocompetent patients are usually localised and in immunodeficient patients, it causes invasive systemic diseases. We are reporting the case of a 40-year-old male, who presented with pain, oedema and multiple discharging sinuses over the lateral aspect of the left foot with history of thorn prick. On examination, there were multiple active sinuses with tenderness and local rise in temperature...
October 2016: Journal of Clinical Orthopaedics and Trauma
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