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antifungal combination therapy

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https://www.readbyqxmd.com/read/29152230/rare-fungal-infectious-agents-a-lurking-enemy
#1
REVIEW
Anna Skiada, Ioannis Pavleas, Maria Drogari-Apiranthitou
In the expanding population of immunocompromised patients and those treated in intensive care units, rare fungal infectious agents have emerged as important pathogens, causing invasive infections associated with high morbidity and mortality. These infections may present either as de novo or as breakthrough invasive infections in high-risk patients with hematologic malignancies receiving prophylactic or empirical antifungal therapy or in patients with central venous catheters. Diagnosis and treatment are challenging...
2017: F1000Research
https://www.readbyqxmd.com/read/29120502/necrotizing-microascus-tracheo-bronchitis-in-a-bilateral-lung-transplant-recipient
#2
Olivier Taton, Benjamin Bernier, Isabelle Etienne, Benjamin Bondue, Sophie Lecomte, Christiane Knoop, Frederique Jacob, Isabel Montesinos
Invasive fungal infections are a major cause of mortality among solid organ transplant recipients. Scopulariopsis species and their teleomorph Microascus are molds found in soil and decaying organic matter. We report here the case of a woman who underwent bilateral lung transplantation for severe emphysema. On day 25 after transplantation, endobronchial green-black lesions were detected during routine endoscopy. Endobronchial swabs, biopsies, and broncho-alveolar lavage samples were positive for Microascus cirrosus...
November 9, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29116676/salvage-therapy-with-topical-posaconazole-in-lung-transplant-recipients-with-invasive-scedosporium-infection
#3
Amparo Solé, Ana A García-Robles, Carlos Jordá, Enrique Cases Viedma, Nuria Mancheño, José Luis Poveda-Andrés, Juan Pablo Reig Mezquida, Javier Pemán
Scedosporium is an important pathogen in cystic fibrosis (CF) and post-transplant, but it rarely causes invasive infection. Treatment remains challenging, particularly due to the inherent resistance to multiple antifungal agents. We present three complicated invasive tracheobronchial and lung Scedosporium apiospermum infections following lung transplant. In two of three cases, the infection was clinically and radiologically cured with frequent cleansing bronchoscopies, combining triazole with terbinafine therapy and nebulized posaconazole...
November 8, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29115366/update-on-management-of-invasive-candidiasis
#4
REVIEW
F J Candel, C Pazos Pacheco, I Ruiz-Camps, E Maseda, M R Sánchez-Benito, A Montero, M Puig, F Gilsanz, J Aguilar, M Matesanz
Given the growing incidence of invasive candidiasis in critically ill and haemato-oncological patients and its poor outcomes, an early diagnosis and treatment are need for get a better prognosis. This document reviews the current ap-proaches that help in diagnosis of invasive candidiasis based on culture-independent microbiological tests. The combination of clinical prediction scores with fungal serological markers could facilitate the approach in antifungal therapy, optimiz-ing it. This article also reviews the epidemiology and primary risk factors for invasive candidiasis in these patients, updating the therapeutic approach algorithms in both clinical contexts based on the main evidence and international guidelines...
November 6, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29112282/antifungals-discovery-an-insight-into-new-strategies-to-combat-antifungal-resistance
#5
REVIEW
Alexandre M Fuentefria, Bruna Pippi, Daiane F Dalla Lana, Katarzyna K Donato, Saulo F de Andrade
Undeniably, new antifungal treatments are necessary against pathogenic fungi. Fungal infections have significantly increased in recent decades, being highlighted as important causes of morbidity and mortality, particularly in immunocompromised patients. Five main antifungal classes are used: (i) azoles, (ii) echinocandins, (iii) polyenes, (iv) allylamines and (v) pyrimidine analogs. Moreover, the treatment of mycoses has several limitations, such as; undesirable side effects, narrow activity spectrum, a small number of targets and fungal resistance; which are still of major concern in clinical practice...
November 7, 2017: Letters in Applied Microbiology
https://www.readbyqxmd.com/read/29068216/tumor-progression-of-non-small-cell-lung-cancer-controlled-by-albumin-and-micellar-nanoparticles-of-itraconazole-a-multi-target-angiogenesis-inhibitor
#6
Ling Zhang, Zhengsheng Liu, Kuan Yang, Chao Kong, Chun Liu, Huijun Chen, Jinfeng Huang, Feng Qian
Itraconazole (ITA), an old and widely-prescribed antifungal drug with excellent safety profile, has more recently been demonstrated to be a multi-target anti-angiogenesis agent affecting multiple angiogenic stimulatory signals and pathways, including vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), vascular endothelial growth factor receptor 2 (VEGFR2) glycosylation, and mammalian target of rapamycin (mTOR). In this study, we developed two nanoparticle formulations, i.e., polymer micelles (IP2K) and albumin nanoparticles (IBSA), to solubilize the extremely hydrophobic and insoluble ITA to allow intravenous administration and pharmacokinetics (PK)/pharmacodynamics (PD) comparisons...
October 25, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29067630/pulmonary-aspergillus-overlap-syndromes
#7
Liyang Li, Zhilong Jiang, Changzhou Shao
BACKGROUND: Broadly, there are three main categories in pulmonary aspergillosis: chronic forms of aspergillosis; allergic bronchopulmonary aspergillosis; and invasive aspergillosis (IPA). IPA has been further subdivided into angioinvasive and airway-invasive aspergillosis. Aspergillus overlap syndromes is defined as the occurrence of more than one form aspergillus disease in a single individual. OBJECTIVES: To help clinicians correctly deal with AOS. METHODS: Retrospectively study the clinical findings of nine patients presenting with AOS...
October 24, 2017: Mycopathologia
https://www.readbyqxmd.com/read/29064157/inflammation-and-oxidative-stress-in-corneal-tissue-in-experimental-keratitis-due-to-fusarium-solani-amelioration-following-topical-therapy-with-voriconazole-and-epigallocatechin-gallate
#8
Vasanthakumar Vasantha Ruban, Archana P Teresa, Mahalingam Sundararajan, Pitchairaj Geraldine, Philip Aloysius Thomas
Combined antifungal and antioxidant therapy may help to reduce oxidative stress in fungal keratitis. Experimental Fusarium solani keratitis was induced by application of F. solani conidia to scarified cornea (right eye) of 16 rabbits (another 4 rabbits were negative controls [Group I]). Five days later, F. solani-infected animals began receiving hourly topical saline alone (Group II), voriconazole (10 mg/ml) alone (Group III), epigallocatechingallate (EGCG, 10 mg/ml) alone (Group IV) or voriconazole and EGCG (Group V)...
October 24, 2017: Mycoses
https://www.readbyqxmd.com/read/29061761/antileishmanial-efficacy-and-pharmacokinetics-of-db766-azole-combinations
#9
April C Joice, Sihyung Yang, Abdelbasset A Farahat, Heidi Meeds, Mei Feng, Junan Li, David W Boykin, Michael Zhuo Wang, Karl A Werbovetz
Given the limitations of current antileishmanial drugs and the utility of oral combination therapy for other infections, developing an oral combination against visceral leishmaniasis should be a high priority. In vitro combination studies with DB766 and antifungal azoles against intracellular L. donovani showed that posaconazole and ketoconazole, but not fluconazole, enhanced DB766 potency. Pharmacokinetic analysis of DB766-azole combinations in uninfected Swiss Webster mice revealed that DB766 exposure was increased by higher posaconazole and ketoconazole doses, while DB766 decreased ketoconazole exposure...
October 23, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29043231/voriconazole-plus-caspofungin-for-treatment-of-invasive-fungal-infection-in-children-with-acute-leukemia
#10
Kyu Ho Lee, Young Tae Lim, Jeong Ok Hah, Yu Kyung Kim, Chae Hoon Lee, Jae Min Lee
BACKGROUND: Invasive fungal infections (IFIs) are a life-threatening problem in immunocompromised patients. Despite timely diagnosis and appropriate antifungal therapy, clinical outcomes of IFIs remain unsatisfactory, necessitating treatment with a combination of antifungal agents. Therefore, childhood leukemic patients treated with voriconazole plus caspofungin were evaluated for the safety and efficacy of the combination antifungal therapy to treat IFIs. METHODS: In this retrospective study, medical records were retrieved for patients admitted to the Pediatric Department of Yeungnam University Hospital, Daegu, South Korea, between April 2009 and May 2013...
September 2017: Blood Research
https://www.readbyqxmd.com/read/29028140/report-of-12-cases-with-tracheobronchial-mucormycosis-and-a-review
#11
Ruoxi He, Chengping Hu, Yongjun Tang, Huaping Yang, Liming Cao, Ruichao Niu
OBJECTIVES: Tranchobronchial mucormycosis is a rare and invasive pulmonary mucormycosis involving the tracheobronchial tree. DATA SOURCE: at a 3500-bed tertiary care center. STUDY SELECTION: This was a retroactive study of 12 cases of tranchobronchial mucormycosis diagnosed in our hospital, and 48 cases that were previously reported in the English literature. RESULTS: Rhizopus was the predominant species of pathogen (66...
October 13, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28992308/relationship-between-intracranial-pressure-and-antifungal-agents-levels-in-the-csf-of-patients-with-cryptococcal-meningitis
#12
Fernanda Wirth, Maria Isabel de Azevedo, Carmen Pilla, Valério Rodrigues Aquino, Gustavo Wissmann Neto, Luciano Zubaran Goldani
The purpose of this study was to evaluate the influence of intracranial hypertension in the cerebrospinal fluid (CSF) levels of amphotericin B and fluconazole levels of patients with cryptococcal meningitis. CSF samples and intracranial pressure were obtained by means of routine punctures performed at days 1, 7, and 14 of therapy, respectively. Amphotericin B and fluconazole CSF levels were measured by HPLC method as previously described. The minimum inhibitory concentration for amphotericin B, fluconazole, 5΄flucytosine, and voriconazole of each Cryptococcus isolate was performed according to CLSI...
August 2, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28990144/biofilm-formation-by-candida-albicans-is-inhibited-by-photodynamic-antimicrobial-chemotherapy-pact-using-chlorin-e6-increase-in-both-ros-production-and-membrane-permeability
#13
Moisés Lopes Carvalho, Ana Paula Pinto, Leandro José Raniero, Maricilia Silva Costa
Candida albicans is an opportunistic fungal producing both superficial and systemic infections in immunocompromised patients. Furthermore, it has been described an increase in the frequency of infections which have become refractory to standard antifungal therapy. Photodynamic antimicrobial chemotherapy (PACT) is a potential antimicrobial therapy that combines visible light and a nontoxic dye, known as a photosensitizer, producing reactive oxygen species (ROS) that can kill the treated cells. The objective of this study was to investigate the effects of PACT, using chlorin e6, as a photosensitizer on C...
October 9, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28987453/hyalugel-integrated-liposomes-as-a-novel-ocular-nanosized-delivery-system-of-fluconazole-with-promising-prolonged-effect
#14
Mona A Moustafa, Yosra S R Elnaggar, Wessam M El-Refaie, Ossama Y Abdallah
Fungal infections need long-term therapy with the proper antifungal agent. Despite effectiveness, Fluconazole (FLZ) ocular delivery is constrained by limited penetration, short residence time, in addition to the common barriers of the eye. Hyalugel-integrated liposomes were designed as novel ocular delivery systems integrating hyaluronic acid (HA) inside and surrounding vesicles by a simple preparation technique. The impact of combining HA hydrogel and liposomes was investigated in a series of different formulations...
October 4, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28986661/-aspergillus-in-airway-material-ignore-or-treat
#15
REVIEW
H J F Salzer, C Lange, M Hönigl
Fungi of the genus Aspergillus are ubiquitously present. Even though humans inhale Aspergillus spores daily under natural conditions, Aspergillus-associated pulmonary diseases only occur under special circumstances. Whether an Aspergillus-associated disease develops and which type of Aspergillus-associated disease develops depends on the constitution of the host. The spectrum of Aspergillus-associated pulmonary diseases ranges from allergic diseases, such as hypersensitivity pneumonitis to allergic infectious diseases, such as allergic bronchopulmonary aspergillosis (ABPA) and bronchocentric granulomatosis (BG) to infectious diseases, such as invasive (IA) or semi-invasive aspergillosis (SIA) and chronic pulmonary aspergillosis (CPA)...
November 2017: Der Internist
https://www.readbyqxmd.com/read/28980592/-the-prevalence-of-the-fungal-flora-in-association-with-chronic-inflammatory-pathology-of-the-larynx
#16
V Ya Kunel'skaya, S G Romanenko, G B Shadrin, D I Krasnikova
The present article was designed to analyze the prevalence and clinical features of laryngomycosis associated with chronic inflammatory diseases of the larynx. We examined 430 patients suffering from chronic pharyngitis and found the fungal flora in 100 (23.2%) of them. Diagnostics of the fungal infection was performed by the microscopic study of the stained preparations (including the Gram method, Romanovskiy-Giemsa and fluorescent microscopy). The sowing on elective nutrient media was used. The study revealed the presence of yeast fungi (Candida) in 98 patients (98%) and mold fungi (Aspergillus) in the remaining two (2%)...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28977822/blocking-epithelial-to-mesenchymal-transition-in-glioblastoma-with-a-sextet-of-repurposed-drugs-the-eis-regimen
#17
Richard E Kast, Nicolas Skuli, Georg Karpel-Massler, Guido Frosina, Timothy Ryken, Marc-Eric Halatsch
This paper outlines a treatment protocol to run alongside of standard current treatment of glioblastoma- resection, temozolomide and radiation. The epithelial to mesenchymal transition (EMT) inhibiting sextet, EIS Regimen, uses the ancillary attributes of six older medicines to impede EMT during glioblastoma. EMT is an actively motile, therapy-resisting, low proliferation, transient state that is an integral feature of cancers' lethality generally and of glioblastoma specifically. It is believed to be during the EMT state that glioblastoma's centrifugal migration occurs...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28972025/differences-in-clinical-ocular-outcomes-between-exogenous-and-endogenous-endophthalmitis-caused-by-sporothrix-a-systematic-review-of-published-literature
#18
Max Carlos Ramírez Soto
BACKGROUND: Sporotrichosis is an implantation mycosis caused by Sporothrix species prevalent worldwide, which occasionally can also result in intraocular infection presenting as an exogenous or endogenous infection (disseminated sporotrichosis). Knowledge in its clinical recognition and management is limited. AIMS: To systematically review and analyse data from published literature with a view to comparing clinical outcomes between exogenous and endogenous endophthalmitis caused by Sporothrix...
September 28, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28966608/tacrolimus-increases-the-effectiveness-of-itraconazole-and-fluconazole-against-sporothrix-spp
#19
Luana P Borba-Santos, Leandro F Reis de Sá, Juliene A Ramos, Anderson M Rodrigues, Zoilo P de Camargo, Sonia Rozental, Antonio Ferreira-Pereira
Calcineurin inhibitors - such as the clinically used drug tacrolimus - are active against important fungal pathogens, particularly when combined with azoles. However, tacrolimus has not been tested against sporotrichosis, an endemic subcutaneous mycosis with worldwide distribution. Here, we evaluated the activity of tacrolimus and cyclosporine A in vitro - as monotherapy and in combination with itraconazole or fluconazole - against yeasts of Sporothrix brasiliensis and S. schenckii, the main sporotrichosis agents in Brazil...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28951848/successful-treatment-of-aureobasidium-pullulans-central-catheter-related-fungemia-and-septic-pulmonary-emboli
#20
Sanjay R Mehta, Scott Johns, Paul Stark, Joshua Fierer
INTRODUCTION: Aureobasidium pullulans is a saprophytic fungus that is widely distributed in the environment, and in the right host can be an opportunistic human pathogen. PRESENTATION OF CASE: A 66-year-old man with Crohn's disease with a single kidney, and requiring total parenteral nutrition via a Hickman catheter, was admitted with a 10-week history of progressive shortness of breath, fevers and weight loss. Chest imaging demonstrated new multifocal lung parenchymal opacities compatible with septic pulmonary emboli...
2017: IDCases
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