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Invasive fungal infections

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https://www.readbyqxmd.com/read/28542092/approach-to-skin-and-soft-tissue-infections-in-non-hiv-immunocompromised-hosts
#1
Victoria E Burke, Fred A Lopez
PURPOSE OF REVIEW: Skin and soft tissue infections are frequent contributors to morbidity and mortality in the immunocompromised host. This article reviews the changing epidemiology and clinical manifestations of the most common cutaneous pathogens in non-HIV immunocompromised hosts, including patients with solid organ transplants, stem cell transplants, solid tumors, hematologic malignancies, and receiving chronic immunosuppressive therapy for inflammatory disorders. RECENT FINDINGS: Defects in the innate or adaptive immune response can predispose the immunocompromised host to certain cutaneous infections in a predictive fashion...
May 24, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28539346/rapid-and-accurate-molecular-identification-of-the-emerging-multidrug-resistant-pathogen-candida-auris
#2
Milena Kordalewska, Yanan Zhao, Shawn R Lockhart, Anuradha Chowdhary, Indira Berrio, David S Perlin
Candida auris is an emerging multidrug resistant fungal pathogen causing nosocomial and invasive infections associated with high mortality. C. auris is commonly misidentified as several different yeast species by commercially available phenotypic identification platforms. Thus, there is an urgent need for a reliable diagnostic method. In this paper we present fast, robust, easy to perform and interpret PCR and real-time PCR assays to identify C. auris and related species: Candida duobushaemulonii, Candida haemulonii, and Candida lusitaniae Targeting rDNA region nucleotide sequences, primers specific for C...
May 24, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28538702/translational-development-and-application-of-1%C3%A2-3-%C3%AE-d-glucan-for-diagnosis-and-therapeutic-monitoring-of-invasive-mycoses
#3
REVIEW
Matthew W McCarthy, Ruta Petraitiene, Thomas J Walsh
Early diagnosis and prompt initiation of appropriate antimicrobial therapy are crucial steps in the management of patients with invasive fungal infections. However, the diagnosis of invasive mycoses remains a major challenge in clinical practice, because presenting symptoms may be subtle and non-invasive diagnostic assays often lack sensitivity and specificity. Diagnosis is often expressed on a scale of probability (proven, probable and possible) based on a constellation of imaging findings, microbiological tools and histopathology, as there is no stand-alone assay for diagnosis...
May 24, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28523894/primary-cutaneous-mucormycosis-in-an-extremely-preterm-infant-successfully-treated-with-liposomal-amphotericin-b
#4
Christopher D Lowe, Rebecca J Sainato, David R Stagliano, Maribel M Morgan, Brian P Green
Cutaneous mucormycosis is a rare but often fatal invasive fungal infection that occurs most commonly in patients with diabetes, malignancy, and other immunocompromising conditions. We report an extremely preterm (<28 weeks) baby boy who developed polymicrobial sepsis and primary cutaneous mucormycosis within his first 10 days of life. He was successfully treated with medical management alone since he was not a candidate for surgery. Successful treatment of cutaneous mucormycosis without surgical debridement has been reported on only two other occasions...
May 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28516956/selective-bet-bromodomain-inhibition-as-an-antifungal-therapeutic-strategy
#5
Flore Mietton, Elena Ferri, Morgane Champleboux, Ninon Zala, Danièle Maubon, Yingsheng Zhou, Mike Harbut, Didier Spittler, Cécile Garnaud, Marie Courçon, Murielle Chauvel, Christophe d'Enfert, Boris A Kashemirov, Mitchell Hull, Muriel Cornet, Charles E McKenna, Jérôme Govin, Carlo Petosa
Invasive fungal infections cause significant morbidity and mortality among immunocompromised individuals, posing an urgent need for new antifungal therapeutic strategies. Here we investigate a chromatin-interacting module, the bromodomain (BD) from the BET family of proteins, as a potential antifungal target in Candida albicans, a major human fungal pathogen. We show that the BET protein Bdf1 is essential in C. albicans and that mutations inactivating its two BDs result in a loss of viability in vitro and decreased virulence in mice...
May 18, 2017: Nature Communications
https://www.readbyqxmd.com/read/28516246/aspergillus-species-in-bronchiectasis-challenges-in-the-cystic-fibrosis-and-non-cystic-fibrosis-airways
#6
REVIEW
Sanjay H Chotirmall, Maria Teresa Martin-Gomez
Bronchiectasis is a chronic irreversible airway abnormality associated with infectious agents that either cause or superinfect the airways. While the role of bacteria is well studied, much remains to be determined about fungi in both cystic fibrosis- and non-cystic fibrosis-related bronchiectasis. The airway is constantly exposed to inhaled ambient moulds of which Aspergillus represent the most ubiquitous. In a normal healthy host, this situation is of little consequence. The presence of anatomical or immunological abnormalities such as those in bronchiectasis leads to a range of fungal-related pathologies from asymptomatic airway colonization to fungal sensitization, allergic bronchopulmonary aspergillosis or chronic pulmonary aspergillosis...
May 17, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28515716/antifungal-activity-of-the-biphosphinic-cyclopalladate-c7a-against-candida-albicans-yeast-forms-in-vitro-and-in-vivo
#7
Julian E Muñoz, Diego C P Rossi, Kelly Ishida, Cristina C Spadari, Marcia S C Melhem, Daniel M Garcia, Antonio C F Caires, Carlos P Taborda, Elaine G Rodrigues
Vulvovaginal and invasive candidiasis are frequent conditions in immunosuppressed individuals caused by Candida albicans and non-albicans Candida spp. Fluconazole and Amphotericin B are the main drugs used to fight the infection. However, resistance to fluconazole and other azole antifungal drugs is an important clinical problem that encourages the search for new therapeutic alternatives. In this work, we evaluate the antifungal activity of the biphosphinic cyclopalladate C7a in the in vitro and in vivo model...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28513771/species-distribution-and-antifungal-susceptibility-patterns-of-candida-isolates-from-a-public-tertiary-teaching-hospital-in-the-eastern-cape-province-south-africa
#8
P Mnge, B I Okeleye, S D Vasaikar, T Apalata
Candida species are the leading cause of invasive fungal infections, and over the past decade there has been an increased isolation of drug resistant Candida species. This study aimed to identify the species distribution of Candida isolates and to determine their unique antifungal susceptibility and resistance patterns. During a cross-sectional study, 209 Candida isolates (recovered from 206 clinical samples) were collected and their species distribution was determined using ChromAgar Candida. The Vitek-2 system (Biomerieux, South Africa) was used to determine minimum inhibitory concentrations (MICs) to azoles (fluconazole, voriconazole), echinocandins (caspofungin, micafungin), polyenes (amphotericin B) and flucytosine...
May 15, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28512683/messenger-rna-transport-in-the-opportunistic-fungal-pathogen-candida-albicans
#9
REVIEW
Anne E McBride
Candida albicans, a common commensal fungus, can cause disease in immunocompromised hosts ranging from mild mucosal infections to severe bloodstream infections with high mortality rates. The ability of C. albicans cells to switch between a budding yeast form and an elongated hyphal form is linked to pathogenicity in animal models. Hyphal-specific proteins such as cell-surface adhesins and secreted hydrolases facilitate tissue invasion and host cell damage, but the specific mechanisms leading to asymmetric protein localization in hyphae remain poorly understood...
May 16, 2017: Current Genetics
https://www.readbyqxmd.com/read/28510690/trichosporonosis-in-pediatric-patients-with-a-hematologic-disorder
#10
Catherine E Foster, Morven S Edwards, Julienne Brackett, Deborah A Schady, C Mary Healy, Carol J Baker
Background.: Trichosporonosis is an emerging and often fatal opportunistic fungal infection in immunocompromised patients, particularly those with hematologic malignancy, but data in children are lacking. Methods.: We report here 3 cases of invasive infection caused by Trichosporon asahii in pediatric patients with acute lymphoblastic leukemia at Texas Children's Hospital in Houston, Texas. We also conducted a literature review and identified 16 additional reports of pediatric patients with invasive T asahii infection and an underlying malignant or nonmalignant hematologic disorder...
May 16, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28508692/seifem-2010-e-economic-evaluation-of-posaconazole-for-antifungal-prophylaxis-in-patients-with-acute-myeloid-leukemia-receiving-induction-chemotherapy
#11
Alessandro Busca, Federica Lessi, Luisa Verga, Anna Candoni, Chiara Cattaneo, Simone Cesaro, Giulia Dragonetti, Mario Delia, Alessio De Luca, Gaspare Guglielmi, Mario Tumbarello, Giordana Martino, Gianpaolo Nadali, Rosa Fanci, Marco Picardi, Leonardo Potenza, Annamaria Nosari, Franco Aversa, Livio Pagano
Posaconazole demonstrated clinical superiority over fluconazole and itraconazole for prophylaxis of mold infections, although concerns exist regarding the high acquisition cost for posaconazole. In this respect, we sought to analyze the costs of antifungal prophylaxis in patients with acute myeloid leukemia (AML) who received prophylactic posaconazole (n = 510, 58%), itraconazole (n = 120, 14%) or fluconazole (n = 175, 20%) during induction chemotherapy. The estimated cost of antifungal prophylaxis as well as the costs of subsequent systemic antifungal therapy for treatening an invasive fungal infections (IFI) was higher in the posaconazole group compared to itraconazole and fluconazole groups...
May 16, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28507111/real-life-assessment-of-the-safety-and-effectiveness-of-the-new-tablet-and-intravenous-formulations-of-posaconazole-in-the-prophylaxis-of-invasive-fungal-infections-analysis-of-343-courses
#12
Frank P Tverdek, Sang Taek Heo, Samuel L Aitken, Bruno Granwehr, Dimitrios P Kontoyiannis
BACKGROUND: Posaconazole is the preferred mold-active azole for prophylaxis against invasive fungal infection (IFI) in patients with hematologic malignancy (HM). Delayed release tablet and intravenous formulations of posaconazole have recently become available, but clinical data are limited. We sought to examine the real-world pharmacokinetics and prophylactic effectiveness of the new formulations of posaconazole given as prophylaxis in patients with HM. METHODS: A retrospective cohort of all consecutive adult inpatients with HM who received ≥3 days of posaconazole as tablet or intravenous from 12/1/2013-12/31/2015 for primary IFI prophylaxis at MD Anderson Cancer center...
May 15, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28506688/human-immunodeficiency-virus-and-fungal-infections
#13
REVIEW
Jeannette Guarner
The discovery of HIV was largely due to the presence of Pneumocystis pneumonia (PCP) in young patients that did not have the usual known causes of immune deficiencies in the early 1980s. Currently, treatment with highly active anti-retroviral therapy (HAART) and the use of prophylaxis for PCP have lowered the frequency of fungal infections; however, these infections continue to cause morbidity and mortality in those patients that fall out or are not in care. The frequency of specific fungal diseases in HIV patients will depend on the prevalence of fungi in the particular geographic location...
April 8, 2017: Seminars in Diagnostic Pathology
https://www.readbyqxmd.com/read/28505035/invasive-fungal-sinusitis-treatment-of-the-orbit
#14
Evan Kalin-Hajdu, Kristin E Hirabayashi, M Reza Vagefi, Robert C Kersten
PURPOSE OF REVIEW: To summarize diagnostic techniques for invasive fungal rhinosinusitis and provide a review of treatment options once disease has spread to the orbit. RECENT FINDINGS: Improved imaging criteria, polymerase chain reaction and other serologic tests show promise in advancing our ability to accurately diagnose invasive fungal disease. Currently, there exists three treatment options for infected orbital tissue: exenteration, conservative debridement and transcutaneous retrobulbar injection of amphotericin B...
May 12, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28501934/cx-4945-the-protein-kinase-ck2-inhibitor-and-anti-cancer-drug-shows-anti-fungal-activity
#15
Maciej Masłyk, Monika Janeczko, Aleksandra Martyna, Konrad Kubiński
CX-4945 is a selective inhibitor of protein kinase CK2 exhibiting clinical significance. Its antitumor properties arise from the abrogation of CK2-mediated pro-survival cellular pathways. The presented data reveal the influence of CX-4945 on the growth of yeast cells showing variable potency against Saccharomyces cerevisiae deletion strains with different contents of CK2 subunits. The catalytic subunit CK2α appears to sensitize yeast to the CX-4945 action. Moreover, the compound suppresses hyphal growth and cell adhesion of Candida albicans, thereby abolishing some hallmarks of invasiveness of the pathogen...
May 13, 2017: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/28501465/candiduria-evidence-based-approach-to-management-are-we-there-yet
#16
REVIEW
W A Alfouzan, R Dhar
Candiduria is considered one of the most controversial issues in patient management. Neither the diagnosis nor the optimal treatment options are standardized. This is further complicated by lack of defined laboratory criteria for diagnosis as most of the studies were set for bacterial rather than fungal urinary tract infection (UTI). Furthermore, since Candida species is a known commensal of the genitourinary tract its presence in the urine sample adds ambiguity to making a definitive diagnosis of candidal UTI...
May 10, 2017: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/28497502/improving-outcome-of-fungal-diseases-guiding-experts-and-patients-towards-excellence
#17
Oliver A Cornely, Cornelia Lass-Flörl, Katrien Lagrou, Valentina Arsic-Arsenijevic, Martin Hoenigl
Invasive fungal infections are on the rise and during recent years understanding the epidemiology of fungal infections improved. Over 1 billion people are affected and 25 million patients are at imminent risk of severe organ damage or death due to fungal infection. The European Confederation of Medical Mycology (ECMM), founded in 1993, is the roof organisation of 23 National Medical Mycology Societies in Europe. ECMM fights fungal infections at various levels, by creating and distributing scientific knowledge and promoting scientific exchange...
May 12, 2017: Mycoses
https://www.readbyqxmd.com/read/28496543/combination-antifungal-therapy-a-review-of-current-data
#18
REVIEW
Marco Campitelli, Nabil Zeineddine, Ghassan Samaha, Stephen Maslak
The incidence of invasive fungal infections has been on the rise, particularly in transplant recipients and in patients with hematological malignancies and other forms of immunosuppression. There is a mismatch between the rate of antifungal resistance and the development of new antifungal agents. Based on this, the idea of combining antifungals in the treatment of invasive fungal infections appears tempting for many clinicians, particularly after many in vitro studies showed synergism between many antifungal agents...
June 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28496146/the-antifungal-pipeline-a-reality-check
#19
REVIEW
John R Perfect
Invasive fungal infections continue to appear in record numbers as the immunocompromised population of the world increases, owing partially to the increased number of individuals who are infected with HIV and partially to the successful treatment of serious underlying diseases. The effectiveness of current antifungal therapies - polyenes, flucytosine, azoles and echinocandins (as monotherapies or in combinations for prophylaxis, or as empiric, pre-emptive or specific therapies) - in the management of these infections has plateaued...
May 12, 2017: Nature Reviews. Drug Discovery
https://www.readbyqxmd.com/read/28495641/safety-and-efficacy-of-infliximab-therapy-in-the-setting-of-steroid-refractory-acute-graft-versus-host-disease
#20
Fevzi F Yalniz, Mehrdad Hefazi, Kristen McCollough, Mark R Litzow, William J Hogan, Robert Wolf, Hassan Alkhateeb, Ankit Kansagra, Moussab Damlaj, Mrinal M Patnaik
Acute graft versus host disease (aGVHD) is the leading cause of morbidity and mortality following allogenic hematopoietic cell transplantation (HCT). Corticosteroids are the first line treatment; however, less than half of the patients achieve durable remissions. Studies suggest that tumor necrosis factor alpha (TNF-α), a cytokine released from the bone marrow during conditioning, is involved in the pathogenesis of aGVHD. We retrospectively evaluated the outcome of anti-tumor necrosis factor alpha (TNF-α) therapy with infliximab in 35 patients with steroid refractory aGVHD (SR-aGVHD)...
May 8, 2017: Biology of Blood and Marrow Transplantation
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