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aspergillus guidelines

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
Tobias Lahmer, Jürgen Held, Sebastian Rasch, Christopher Schnappauf, Analena Beitz, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Invasive fungal disease (IFD) remains a significant cause of morbidity and mortality in critically ill patients. METHODS: Examination of 1,3-β-D-glucan (BDG) for IFD and as outcome parameter in immunocompromised critically ill patients with septic shock. RESULTS: Thirty-two (69 %) out of 46 included patients had BDG beyond the cutoff of >80 pg/ml (mean 320 pg/ml). Twelve (37 %) had findings of Aspergillus spp. in BAL (mean BDG 413 pg/ml)...
September 12, 2016: Mycopathologia
M Khalid Ijaz, Bahram Zargar, Kathryn E Wright, Joseph R Rubino, Syed A Sattar
Indoor air can be an important vehicle for a variety of human pathogens. This review provides examples of airborne transmission of infectious agents from experimental and field studies and discusses how airborne pathogens can contaminate other parts of the environment to give rise to secondary vehicles leading air-surface-air nexus with possible transmission to susceptible hosts. The following groups of human pathogens are covered because of their known or potential airborne spread: vegetative bacteria (staphylococci and legionellae), fungi (Aspergillus, Penicillium, and Cladosporium spp and Stachybotrys chartarum), enteric viruses (noro- and rotaviruses), respiratory viruses (influenza and coronaviruses), mycobacteria (tuberculous and nontuberculous), and bacterial spore formers (Clostridium difficile and Bacillus anthracis)...
September 2, 2016: American Journal of Infection Control
Martha F Mushi, Gustave Buname, Oliver Bader, Uwe Groß, Stephen E Mshana
BACKGROUND: Suppurative otitis media (SOM) is a major public health concern worldwide and is associated with increased morbidity. Cases of fungal suppurative otitis media were studied to establish the effect of fungi in otitis media. METHODS: Ear swabs from 410 patients were collected aseptically using sterile cotton swabs from discharging ear through perforated tympanic membrane. Swabs were subjected to microscopic and culture investigations. The species of fungal growing on Sabouraud's agar were identified using MALDI-TOF MS...
2016: BMC Infectious Diseases
Catriona L Halliday, Sharon C-A Chen, Sarah E Kidd, Sebastian van Hal, Belinda Chapman, Christopher H Heath, Andie Lee, Karina J Kennedy, Kathryn Daveson, Tania C Sorrell, C Orla Morrissey, Deborah J Marriott, Monica A Slavin
Antifungal susceptibilities of non-Aspergillus filamentous fungal pathogens cannot always be inferred from their identification. Here we determined, using the Sensititre(®) YeastOne(®) YO10 panel, the in vitro activities of nine antifungal agents against 52 clinical isolates of emergent non-Aspergillus moulds representing 17 fungal groups in Australia. Isolates comprised Mucorales (n = 14), Scedosporium/Lomentospora spp. (n = 18) and a range of hyaline hyphomycetes (n = 9) and other dematiaceous fungi (n = 11)...
October 2016: International Journal of Antimicrobial Agents
Paul E Verweij, Pieter P A Lestrade, Willem J G Melchers, Jacques F Meis
Azole resistance is a growing concern with Aspergillus fumigatus, and may cause increased mortality in patients with azole-resistant invasive aspergillosis (IA). Microbial surveillance has been recognized as a fundamental component of resistance management. Surveillance information may be used to inform decisions regarding health services and research funding allocation, to guide local infection control in hospitals and communities, and to direct local and national drug policies and guidelines. Azole resistance frequencies have been based on screening of unselected A...
August 2016: Journal of Antimicrobial Chemotherapy
Tzar Mohd Nizam, Rabiatul Adawiyah Ag Binting, Shafika Mohd Saari, Thivyananthini Vijaya Kumar, Marianayati Muhammad, Hartini Satim, Hamidah Yusoff, Jacinta Santhanam
BACKGROUND: This study aimed to determine the minimum inhibitory concentrations (MICs) of various antifungal agents against moulds isolated from dermatological specimens. METHODS: We identified 29 moulds from dermatological specimens between October 2012 and March 2013 by conventional methods. We performed antifungal susceptibility testing on six antifungal agents, amphotericin B, clotrimazole, itraconazole, ketoconazole, miconazole and terbinafine, according to the Clinical and Laboratory Standards Institute guidelines contained in the M38-A2 document...
May 2016: Malaysian Journal of Medical Sciences: MJMS
Rajendra S Kadam, Johannes N Van Den Anker
Voriconazole is a potent antifungal agent used for the treatment of invasive fungal infections caused by Aspergillus and Candida species in adult and pediatric patients. Voriconazole has a narrow therapeutic index and a large intra- and inter-individual pharmacokinetics (PK) variability. Several factors including non-linear PK, age, body weight, cytochrome P450 2C19 genotype, concomitant drugs, liver function, and food are responsible for the large variability in voriconazole PK. A combination of a narrow therapeutic index with a large PK variability results in treatment failure in many patients at clinically recommended doses...
September 2016: Clinical Pharmacokinetics
Yvonne Schmiedel, Stephan Zimmerli
Every year, Candida, Aspergillus, Cryptococcus and Pneumocystis infect an estimated two million individuals worldwide. Most are immunocompromised or critically ill. Candida is the most common fungal pathogen of the critically ill and of recipients of transplanted abdominal organs. In high-risk haemato-oncological patients, in contrast, the introduction of antifungal prophylaxis with fluconazole and later with mould-active posaconazole has led to a remarkable reduction of invasive candidiasis and is likely to have a similar effect on invasive aspergillosis...
2016: Swiss Medical Weekly
David W Denning, Jacques Cadranel, Catherine Beigelman-Aubry, Florence Ader, Arunaloke Chakrabarti, Stijn Blot, Andrew J Ullmann, George Dimopoulos, Christoph Lange
Chronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders, thought to affect ~240 000 people in Europe. The most common form of CPA is chronic cavitary pulmonary aspergillosis (CCPA), which untreated may progress to chronic fibrosing pulmonary aspergillosis. Less common manifestations include: Aspergillus nodule and single aspergilloma. All these entities are found in non-immunocompromised patients with prior or current lung disease...
January 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
A Espinel-Ingroff, A L Colombo, S Cordoba, P J Dufresne, J Fuller, M Ghannoum, G M Gonzalez, J Guarro, S E Kidd, J F Meis, T M S C Melhem, T Pelaez, M A Pfaller, M W Szeszs, J P Takahaschi, A M Tortorano, N P Wiederhold, J Turnidge
The CLSI epidemiological cutoff values (ECVs) of antifungal agents are available for various Candida spp., Aspergillus spp., and the Mucorales. However, those categorical endpoints have not been established for Fusarium spp., mostly due to the difficulties associated with collecting sufficient CLSI MICs for clinical isolates identified according to the currently recommended molecular DNA-PCR-based identification methodologies. CLSI MIC distributions were established for 53 Fusarium dimerum species complex (SC), 10 F...
February 2016: Antimicrobial Agents and Chemotherapy
M Mansh, M Binstock, K Williams, F Hafeez, J Kim, D Glidden, R Boettger, S Hays, J Kukreja, J Golden, M M Asgari, P Chin-Hong, J P Singer, S T Arron
Voriconazole is a triazole antifungal used to prevent and treat invasive fungal infections after lung transplantation, but it has been associated with an increased risk of developing cutaneous squamous cell carcinoma (SCC). Despite widespread use, there are no clear guidelines for optimal prophylactic regimens that balance the competing risks and benefits. We conducted a retrospective cohort study of all lung transplant recipients at the University of California, San Francisco, who were transplanted between October 1991 and December 2012 (n = 455) to investigate whether voriconazole exposure affected development of SCC, Aspergillus colonization, invasive aspergillosis and all-cause mortality...
January 2016: American Journal of Transplantation
Maria Aigner, Cornelia Lass-Flörl
Triazole antifungals are frontline drugs for the treatment and prophylaxis of infections due to Aspergillus species. Azole resistance is an emerging problem and is associated with treatment failure in several case series. The management of azole-resistant invasive aspergillosis remains a challenge and there are no guidelines with appropriate recommendations. The current clinical practice suggests that liposomal amphotericin B or a combination of voriconazole or posaconazole with an echinocandin may be effective...
2015: Expert Opinion on Pharmacotherapy
Betsy Colon-Acevedo, Jaya Kumar, Michael J Richard, Julie A Woodward
OBJECTIVE: Invasive sino-orbital fungal infections are life-threatening complications of immunonosupression that are difficult to treat. Currently there are no standard treatment guidelines. The most widely accepted therapy includes parenteral anti-fungal therapy and surgical debridement of sinuses with orbital exenteration, a procedure that is not only disfiguring, but may increase morbidity. Injection of retrobulbar Liposomal Amphotericin B (L-AMB) is an alternative approach that provides local administration to infected tissues...
September 2015: Ophthalmic Plastic and Reconstructive Surgery
Tomoko Okazaki, Shoichi Shiraishi, Naoki Iwasa, Emi Kitamura, Tetsu Mizutani, Yukiko Hanada, Takehiko Yanagihara
Central nervous system (CNS) aspergillosis with stroke has a high mortality and poor prognosis generally. We report a 78-years-old woman with diabetes mellitus, who developed invasive paranasal sinus aspergillosis with the orbital apex syndrome on the right side and cerebral infarction caused by intracranial occlusion of the right internal carotid artery. Based on the presence of a mass lesion in the ethmoid sinus extending to the orbital apex on the right side with cranial CT, the mass lesion was surgically removed and the pathological examination of the surgical specimen revealed aspergillus mold...
2015: Rinshō Shinkeigaku, Clinical Neurology
Bassel Sabbagh, Victor Costina, Dieter Buchheidt, Mark Reinwald, Michael Neumaier, Peter Findeisen
Invasive aspergillosis (IA) remains difficult to diagnose in immunocompromised patients, because diagnostic criteria according to EORTC/MSG guidelines are often not met and have low sensitivity. Hence there is an urgent need to improve diagnostic procedures by developing novel approaches. In the present study, we present a proof of concept experiment for the monitoring of Aspergillus associated protease activity in serum specimens for diagnostic purpose. Synthetic peptides that are selectively cleaved by proteases secreted from Aspergillus species were selected from our own experiments and published data...
July 2015: International Journal of Oncology
Abdolmajid Fadaei, Masoud Amiri
Previous studies have shown that mismanaged swimming pools could transmit water-borne diseases. The objective of the present study was the quality assessment of chemical, biological and physical characteristics of swimming pools in Shahrekord city, southwest of Iran. The two main indoor swimming pools of Shahrekord city were considered during the summer and winter of 2013. The number of 459 samples were analysed from swimming pools, showers and dressing rooms for chemical, biological and physical quality assessment...
2015: Global Journal of Health Science
Adilia Warris
Azole-resistance in Aspergillus fumigatus is emerging and is becoming an increasing problem in the management of aspergillosis. Two types of development of resistance have been described; resistance acquired during azole treatment in an individual patient and through environmental exposure to fungicides. The main molecular mechanism of azole resistance in A. fumigatus is explained by mutations in the cyp51A-gene. The environmental route of resistance development is particularly worrying and may affect all patients whether azole exposed or naïve, and whether suffering from acute or chronic aspergillosis...
June 2015: Journal of Infection
Sandra Cabo Verde, Susana Marta Almeida, João Matos, Duarte Guerreiro, Marcia Meneses, Tiago Faria, Daniel Botelho, Mateus Santos, Carla Viegas
Poor hospital indoor air quality (IAQ) may lead to hospital-acquired infections, sick hospital syndrome and various occupational hazards. Air-control measures are crucial for reducing dissemination of airborne biological particles in hospitals. The objective of this study was to perform a survey of bioaerosol quality in different sites in a Portuguese Hospital, namely the operating theater (OT), the emergency service (ES) and the surgical ward (SW). Aerobic mesophilic bacterial counts (BCs) and fungal load (FL) were assessed by impaction directly onto tryptic soy agar and malt extract agar supplemented with antibiotic chloramphenicol (0...
September 2015: Research in Microbiology
Marios Arvanitis, Eleftherios Mylonakis
BACKGROUND: Invasive aspergillosis is an infection with high morbidity and mortality that affects mostly immunocompromised individuals. Early identification and targeted treatment of the infection is essential to improve survival of affected patients. The purpose of our review is to highlight the most recent developments in diagnosis and screening for invasive aspergillosis (IA) along with the challenges associated with the development and validation of novel diagnostic approaches. METHODS: Ovid MEDLINE and The Cochrane library were searched for studies that evaluated serologic, molecular and novel methodologies for the diagnosis of IA...
June 2015: European Journal of Clinical Investigation
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