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antifungal combination therapy

Nicole Robbins, Gerard D Wright, Leah E Cowen
Invasive fungal infections are becoming an increasingly important cause of human mortality and morbidity, particularly for immunocompromised populations. The fungal pathogens Candida albicans, Cryptococcus neoformans, and Aspergillus fumigatus collectively contribute to over 1 million human deaths annually. Hence, the importance of safe and effective antifungal therapeutics for the practice of modern medicine has never been greater. Given that fungi are eukaryotes like their human host, the number of unique molecular targets that can be exploited for drug development remains limited...
October 2016: Microbiology Spectrum
Mansoure Masoudi, Mahmoud Rafieian Kopaei, Sepideh Miraj
BACKGROUND: Bacterial vaginosis is one of the most prevalent complications among reproductive-aged women. Antibacterial and antifungal effects of Berberis vulgaris have been demonstrated in vitro and in vivo. OBJECTIVES: This study aimed to compare the therapeutic effects of the vaginal gel of Berberis vulgaris 5% (in metronidazole base) with metronidazole vaginal gel 0.75% on bacterial vaginosis on 80 patients referred to the Hajar Hospital from January 2012 to April 2013...
August 2016: Electronic Physician
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
M H Minooeianhaghighi, L Sepehrian, H Shokri
OBJECTIVE: Recurrent vulvovaginal candidiasis (RVVC), which affects approximately 5% of women of reproductive age, is defined as 4 or more episodes of symptomatic Candida vaginitis within a year. The purposes of this study were to determine the chemical compositions and antifungal susceptibility of Cuminum cyminum (C. cyminum) and Lavandula binaludensis (L. binaludensis) essential oils and their combination against Candida albicans (C. albicans) strains isolated from patients with RVVC...
October 14, 2016: Journal de Mycologie Médicale
Susanne Eigl, Martin Hoenigl, Birgit Spiess, Sven Heldt, Juergen Prattes, Peter Neumeister, Albert Wolfler, Jasmin Rabensteiner, Florian Prueller, Robert Krause, Mark Reinwald, Holger Flick, Dieter Buchheidt, Tobias Boch
In recent years galactomannan antigen testing (GM) and also Aspergillus PCR have become increasingly important for diagnosis of invasive aspergillosis (IA). Whether or not these tests need to be performed with bronchoalveolar lavage fluid (BALF; i.e., primary site of infection), or testing of blood samples is sufficient, remains, however, a matter of debate. We evaluated the diagnostic performance of GM ELISA, and Aspergillus PCR by using BALF samples and blood samples obtained at the same day from a total of 53 immunocompromised patients (16 with probable/proven IA and 37 with no evidence of IA according to the revised EORTC/MSG criteria; 38 patients with hematological malignancies were prospectively enrolled at the Medical University of Graz, Austria, 15 patients with mixed underlying diseases at the Mannheim University Hospital)...
October 14, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Fernanda Sangalli-Leite, Liliana Scorzoni, Ana Carolina Alves de Paula E Silva, Julhiany de Fátima da Silva, Haroldo Cesar de Oliveira, Junya de Lacorte Singulani, Fernanda Patrícia Gullo, Rosangela Moraes da Silva, Luis Octávio Regasini, Dulce Helena Siqueira da Silva, Vanderlan da Silva Bolzani, Ana Marisa Fusco-Almeida, Maria José Soares Mendes-Giannini
Cryptococcosis is an opportunistic fungal infection responsible for high morbidity and mortality in immunocompromised patients. Combination of antifungal substances is a promising way to increase the percentage of successful treatment. Pedalitin (PED) is a natural substance obtained from Pterogyne nitens. The aim of this study was to verify the efficacy of PED alone and in combination with amphotericin B (AmB) in vitro and in vivo against Cryptococcus spp. In the in vitro assay, minimum inhibitory concentrations (MICs) of 0...
September 29, 2016: International Journal of Antimicrobial Agents
Shi-Min Yuan
Fungal endocarditis is a rare and fatal condition. The Candida and Aspergillus species are the two most common etiologic fungi found responsible for fungal endocarditis. Fever and changing heart murmur are the most common clinical manifestations. Some patients may have a fever of unknown origin as the onset symptom. The diagnosis of fungal endocarditis is challenging, and diagnosis of prosthetic valve fungal endocarditis is extremely difficult. The optimum antifungal therapy still remains debatable. Treating Candida endocarditis can be difficult because the Candida species can form biofilms on native and prosthetic heart valves...
May 2016: Brazilian Journal of Cardiovascular Surgery
Jianzhang Hu, Jingjin Zhang, Yanling Li, Xiaoli Han, Weidong Zheng, Juan Yang, Guoxing Xu
Purpose. To evaluate the efficacy of a combination of intrastromal and intracameral injections of amphotericin B in the treatment of severe recalcitrant fungal keratitis. Methods. Patients with severe fungal keratitis who were resistant to conventional antifungal medical treatments and needed potential surgical intervention were recruited at the First Affiliated Hospital of Fujian Medical University between January 2012 and July 2013. The patients were treated with a combination of intrastromal and intracameral injections of amphotericin B (25 μg/mL and 50 μg/mL, resp...
2016: Journal of Ophthalmology
Tatsuya Ueno, Haruo Nishijima, Rie Haga, Masahiko Tomiyama
No abstract text is available yet for this article.
November 2016: Clinical Neurology and Neurosurgery
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
Mohsen Meidani, Atousa Hakamifard, Amir Hossein Sarrami
Central nervous system (CNS) aspergillosis is uncommon and considered the most lethal form of aspergillosis. Indeed, current therapeutic strategies such as combination antifungal regimen, neurosurgical resection of infected tissue, and removal of infection source fail to improve the unsatisfactory prognosis of CNS aspergillosis in the majority of the patients. The authors describe a case of chronic pulmonary aspergillosis with concomitant CNS lesions that dramatically responded to antifungal therapy and the CNS lesions resolved in follow-up imaging...
October 2016: Asian Journal of Neurosurgery
Cristiane Bigatti Pereira, Nívea Pereira de Sá, Beatriz Martins Borelli, Carlos Augusto Rosa, Paulo Jorge Sanches Barbeira, Betania Barros Cota, Susana Johann
The antifungal effects of two eicosanoic acids, 2-amino-3,4-dihydroxy-2-25-(hydroxymethyl)-14-oxo-6,12-eicosenoic acid (compound 1) and myriocin (compound 2), isolated from Mycosphaerella sp. were evaluated against Cryptococcus neoformans and C. gattii. The compounds displayed antifungal activities against several isolates of C. neoformans and C. gattii, with minimal inhibitory concentration (MIC) values ranging from 0.49 to 7.82 μM for compound 1 and 0.48-1.95 μM for compound 2. In the checkerboard microtiter test, both compounds exhibited synergistic activity with amphotericin B against C...
September 28, 2016: Microbial Pathogenesis
Zoi-Dorothea Pana, Katerina Vikelouda, Emmanuel Roilides
The optimal management of invasive fungal infections (IFIs) in children requires prompt and precise diagnosis that enables timely implementation of appropriate antifungal therapy and decreased use of unnecessary toxic antifungals. Areas covered: Traditional approaches such as culture, microscopy and histopathology remain the gold standard but are often not sufficiently sensitive and specific. These limitations have led to the development of alternative non-invasive diagnostic methods that in most cases detect fungal components, such as antigens or nucleic acids...
October 11, 2016: Expert Review of Anti-infective Therapy
Noa Eliakim-Raz, Roi Babaoff, Dafna Yahav, Shirly Yanai, Hila Shaked, Jihad Bishara
BACKGROUND: The clinical characteristics of internal medicine ward (IMW) patients with candidemia are unclear. The aim of this study was to define the clinical characteristics of candidemic IMW patients and to study the incidence, species distribution, and outcomes of these patients compared to surgical and intensive care unit (ICU) candidemic patients. METHODS: A retrospective cohort of candidemic patients in IMWs, general surgery wards, and an ICU at Beilinson Hospital during the period 2007-2014 was analyzed...
September 20, 2016: International Journal of Infectious Diseases: IJID
Janaína de Cássia Orlandi Sardi, Fernanda Patrícia Gullo, Irlan Almeida Freires, Nayla de Souza Pitangui, Maicon Petrônio Segalla, Ana Marisa Fusco-Almeida, Pedro Luiz Rosalen, Luís Octávio Regasini, Maria José Soares Mendes-Giannini
We tested the antifungal potential of caffeic acid and 8 of its derivative esters against Candidaalbicans ATCC 90028 and 9 clinical isolatesand carried out a synergism assay with fluconazole and nystatin. Propyl caffeate (C3) showed the best antifungal activity against the tested strains. When in combination, C3 markedly reduced the MIC of fluconazole and nystatin with synergistic effect up to 64-fold. Finally, C3 showed a high IC50 value and selective indexagainst oral keratinocytes, demonstrating low toxicity against this cell type and selectivity for yeast cells...
August 8, 2016: Diagnostic Microbiology and Infectious Disease
W Zhou, Q Liu, W D Zhao, H P Yu, X C Sun, J J Wang, Z F Liu, H Y Li, C Q Zheng, S Y Wang, D H Wang
OBJECTIVE: To evaluate the survival outcomes of invasive fungal rhinosinusitis by analyzing the clinical features. METHODS: A retrospective analysis was performed for cases of invasive fungal sinusitis proved by histological analysis between March 2006 and November 2015. All relevant factors including interval from the onset of symptoms to initiation of diagnosis, clinical characteristics, features of CT and MRI, treatment and prognosis were collected. A total of 18 patients (10 males; 8 females) were identified...
August 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Jessica E Morgan, Hadeel Hassan, Julia V Cockle, Christopher Lethaby, Beki James, Robert S Phillips
PURPOSE: The incidence of invasive fungal disease (IFD) is rising, but its treatment in paediatric haematology and oncology patients is not yet standardised. This review aimed to critically appraise and analyse the clinical practice guidelines (CPGs) that are available for paediatric IFD. METHODS: Electronic searches of MEDLINE, MEDLINE in-Process & Other non-Indexed Citations, the Guidelines International Network (GIN), and Google were performed and combined fungal disease (Fung* OR antifung*OR Candida* OR Aspergill*) with prophylaxis or treatment (prophyl* OR therap* OR treatment)...
September 11, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Maria N Gamaletsou, Blandine Rammaert, Marimelle A Bueno, Nikolaos V Sipsas, Brad Moriyama, Dimitrios P Kontoyiannis, Emmanuel Roilides, Valerie Zeller, Saad J Taj-Aldeen, Michael Henry, Vidmantas Petraitis, David W Denning, Olivier Lortholary, Thomas J Walsh
Aspergillus arthritis is a debilitating form of invasive aspergillosis. Little is known about its epidemiology, clinical manifestations, laboratory features, treatment, and prognosis. Cases of Aspergillus arthritis were reviewed in the English literature from 1967 through 2015 for variables of arthritis with Aspergillus spp. recovered from joint and/or adjacent bone, underlying conditions, symptoms, signs, inflammatory biomarkers, diagnostic imaging, management, and outcome. Among 31 evaluable cases, 87% were males and 13% pediatric...
September 8, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Stefanie Desmet, Liesbeth Smets, Katrien Lagrou, Inge Derdelinckx, Jeroen Neyt, Johan Maertens, Raf Sciot, Philip Demaerel, Bert Bammens
Cladophialophora bantiana is a neurotropic dematiaceous fungus which rarely causes disseminated disease. We report a case of proven C. bantiana osteomyelitis in a renal transplant recipient, complicated with probable cerebral disease. Stable disease was reached after combined antifungal therapies, immune enhancement and amputation of the infected lower limb.
June 2016: Medical Mycology Case Reports
Fernando Cobo, Javier Rodríguez-Granger, Enrique M López, Gemma Jiménez, Antonio Sampedro, Luis Aliaga-Martínez, José María Navarro-Marí
BACKGROUND: The clinical and microbiological characteristics of prosthetic joint infection (PJI) caused by Candida species is described, including 72 cases in the literature and a case of Candida glabrata infection handled at the present centre. METHODS: We describe one patient and using the key words 'fungal prosthetic joint infection' and 'candida prosthetic joint infection' we searched MEDLINE (National Library of Medicine, Bethesda, MD), Web of Science, CINAHL and Cochrane systematic review databases for case reports of this condition...
September 1, 2016: Infectious Diseases
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