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Claudia Rosillo, Ana Maria Avila, Yao-Ting Huang, Sean Devlin, Christina Cho, Juan Montoro, Molly A Maloy, Genovefa A Papanicolaou, Pere Barba, Miguel-Angel Perales
BACKGROUND AND OBJECTIVES: Recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are at high risk for invasive mold infections (IMI). The goal of the study is to describe the incidence and outcome of IMI in patients after allo-HSCT in a large cohort of patients receiving anti-mold prophylaxis. METHODS: We conducted a retrospective review of 988 consecutive adults who underwent allo-HSCT in our center from 2008 through 2014. Standard prophylaxis consisted of micafungin 150mg IV daily from admission to day +7 +/- 3 followed by voriconazole until day +75 to +100...
April 18, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
T Kitazawa, S Ishigaki, K Seo, Y Yoshino, Y Ota
Rhodotorula species are environmental basidiomycete yeasts that have emerged as a cause of fungemia in immunocompromised hosts. The insertion of a central venous catheter was identified as a major risk factor for Rhodotorula fungemia. Few cases reports have reported (1→3)-β-D-glucan testing at the onset of Rhodotorula mucilaginosa fungemia. We report a case of catheter-related bloodstream infection due to R. mucilaginosa. Serum β-D-glucan level was normal at the onset of the bloodstream infection. It took 5 days to culture the isolate...
April 13, 2018: Journal de Mycologie Médicale
Emilio Maseda, Santiago Grau, Sonia Luque, Maria-Pilar Castillo-Mafla, Alejandro Suárez-de-la-Rica, Ana Montero-Feijoo, Patricia Salgado, Maria-Jose Gimenez, Carlos A García-Bernedo, Fernando Gilsanz, Jason A Roberts
BACKGROUND: Dosing in obese critically ill patients is challenging due to pathophysiological changes derived from obesity and/or critical illness, and it remains fully unexplored. This study estimated the micafungin probability of reaching adequate 24-h area under the curve (AUC0-24h )/minimum inhibitory concentration (MIC) values against Candida spp. for an obese/nonobese, critically ill/noncritically ill, large population. METHODS: Blood samples for pharmacokinetic analyses were collected from 10 critically ill nonobese patients, 10 noncritically ill obese patients, and 11 critically ill morbidly obese patients under empirical/directed micafungin treatment...
April 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
Célia F Rodrigues, Mariana Henriques
(1) Background: Candida glabrata is one of the most significant Candida species associated with severe cases of candidiasis. Biofilm formation is an important feature, closely associated with antifungal resistance, involving alterations of gene expression or mutations, which can result in the failure of antifungal treatments. Hence, the main goal of this work was to evaluate the role of a set of genes, associated with matrix production, in the resistance of C. glabrata biofilms to antifungal drugs. (2) Methods: the determination of the expression of BGL2 , XOG1 , FKS1 , FKS2 , GAS2 , KNH1 , UGP1 , and MNN2 genes in 48-h biofilm's cells of three C...
April 10, 2018: Genes
Hamed Fakhim, Afsane Vaezi, Eric Dannaoui, Cheshta Sharma, Bita Mousavi, Anuradha Chowdhary, Jacques F Meis, Hamid Badali
In vitro interaction of voriconazole with micafungin was evaluated against 33 clinical Aspergillus fumigatus isolates, including azole-resistant (n=31) and -susceptible (n=2) isolates. Interaction was synergistic for only 1 resistant isolate carrying the TR34 /L98H mutation. No antagonistic effects were observed for 96.8% of azole-resistant isolates.
March 8, 2018: Diagnostic Microbiology and Infectious Disease
Ashutosh Singh, Kelley R Healey, Priyanka Yadav, Gargi Upadhyaya, Neelam Sachdeva, Smita Sarma, Anil Kumar, Bansidhar Tarai, David S Perlin, Anuradha Chowdhary
Candida glabrata infections are increasing world-wide and exhibit greater rates of antifungal resistance than other species. DNA mismatch repair (MMR) gene deletions, such as msh2Δ , in C. glabrata resulting in a mutator phenotype has recently been reported to facilitate rapid acquisition of antifungal resistance. This study determined the antifungal susceptibility profile of 210 C. glabrata isolates, in 10 hospitals in India and investigated the impact of novel MSH 2 polymorphisms on mutation potential. No echinocandin or azole resistant strains were detected among C...
April 2, 2018: Antimicrobial Agents and Chemotherapy
M E Patch, E Weisz, A Cubillos, S J Estrada, M A Pfaller
Background: Delay in treatment of candidaemia and invasive candidiasis remains a cause of significant morbidity and mortality in high-risk patients. Widespread empirical utilization of antifungal therapy often occurs in an effort to minimize this risk. Objectives: This study assessed the impact of the T2Candida Panel in a multi-hospital community health system on time to initiation of antifungal therapy in candidaemic patients as well as the utilization of micafungin...
March 1, 2018: Journal of Antimicrobial Chemotherapy
Nazario D Rivera-Chaparro, Jessica Ericson, Huali Wu, P Brian Smith, Reese H Clark, Daniel K Benjamin, Michael Cohen-Wolkowiez, Rachel G Greenberg
Micafungin is used off-label in the United States to treat invasive candidiasis in neonates. We used an established pharmacokinetic model to determine micafungin exposures for 46 courses in 39 hospitalized infants. In this small cohort of infants, micafungin exposure was not associated with laboratory markers of liver toxicity, death, or failure of microbiological clearance.
March 29, 2018: Pediatric Infectious Disease Journal
Daniel K Benjamin, David A Kaufman, William W Hope, P Brian Smith, Antonio Arrieta, Paolo Manzoni, Laura L Kovanda, Christopher Lademacher, Brigit Isaacson, Deborah Jednachowski, Chunzhang Wu, Atsunori Kaibara, Thomas J Walsh
BACKGROUND: Amphotericin B deoxycholate (AmB-D) is standard of care treatment for neonatal invasive candidiasis (IC). Micafungin (MCA) has broad-spectrum fungicidal activity against Candida spp. We compared the efficacy and safety of intravenous MCA with intravenous AmB-D and assessed the pharmacokinetics (PK) of MCA in infants aged >2-120 days with proven IC in a phase 3, randomized, double-blind, multicenter, parallel-group, noninferiority study (NCT00815516). METHODS: Infants were randomized 2:1 to MCA (10 mg/kg/day) or AmB-D (1 mg/kg/day) for ≥21 days...
March 24, 2018: Pediatric Infectious Disease Journal
Magdalini Tsekoura, Maria Ioannidou, Zoi-Dorothea Pana, Anna-Bettina Haidich, Charalampos Antachopoulos, Elias Iosifidis, George Kolios, Emmanuel Roilides
BACKGROUND: Echinocandins are recommended for the treatment of suspected or confirmed invasive candidiasis (IC) in adults. Less is known about the use of echinocandins for the management of IC in children. The aim of this study was to investigate the overall efficacy and safety of echinocandin class in neonatal and pediatric patients with IC. METHODS: PubMed, Cochrane Central, Scopus and Clinical trial registries were searched up to July 27, 2017. Eligible studies were randomized trials (RCTs) that evaluated the efficacy and safety of any echinocandin versus agents of other antifungal classes for the treatment of IC in pediatric patients...
March 24, 2018: Pediatric Infectious Disease Journal
Logan C Joiner, Clay Tynes, John Arnold, Rachel R Miller, Greg Gorman
Purpose: The purpose of this study was to determine the physical compatibility of micafungin with commonly used concentrations of sodium bicarbonate hydration fluids administered via a Y-site connected to a central venous catheter (Y-site/CVC). Methods: Micafungin sodium (evaluated concentration of 1.5 mg/mL) was combined in a 3:1 (vehicle:drug) ratio with the following commonly used hydration vehicles: 40 mEq/L sodium bicarbonate in 5% dextrose in water with ¼ normal saline (40SB-D5W-1/4NS), 75 mEq/L sodium bicarbonate in D5W (75SB-D5W), and 154 mEq/L sodium bicarbonate in D5W (154SB-D5W)...
April 2018: Hospital Pharmacy
Tatsuro Hirayama, Taiga Miyazaki, Yuka Yamagishi, Hiroshige Mikamo, Takashi Ueda, Kazuhiko Nakajima, Yoshio Takesue, Yoshitsugu Higashi, Yoshihiro Yamamoto, Muneyoshi Kimura, Hideki Araoka, Shuichi Taniguchi, Yuichi Fukuda, Yumi Matsuo, Akiko Furutani, Kohei Yamashita, Takahiro Takazono, Tomomi Saijo, Shintaro Shimamura, Kazuko Yamamoto, Yoshifumi Imamura, Koichi Izumikawa, Katsunori Yanagihara, Shigeru Kohno, Hiroshi Mukae
The 46 clinical isolates of Candida guilliermondii and Candida famata were re-identified genetically, resulting in 27 C. guilliermondii and 12 Candida fermentati strains. The majority of C. guilliermondii , but no C. fermentati , were isolated from blood cultures. C. fermentati was more sensitive to antifungals, hydrogen peroxide and killing by murine macrophages than C. guilliermondii The C. guilliermondii isolates were echinocandin susceptible in vitro but resistant to micafungin in a murine model of invasive candidiasis...
March 26, 2018: Antimicrobial Agents and Chemotherapy
Raphaël Gaisne, Fakhri Jeddi, Florent Morio, Quentin-Côme Le Clerc, Maryvonne Hourmant, Gilles Blancho, Magali Giral, Diego Cantarovich, Jacques Dantal, Simon Ville
Infection due to species other than Candida albicans is increasing among solid organ transplant recipients. Candida utilis, commonly used in the food industry, is considered as a low-virulence yeast. We report the first case of C. utilis fungemia involving a solid organ transplant recipient. The infection was triggered by the withdrawal of a ureteral stent and was successfully treated with intravenous micafungin. We also propose a review of all reported cases of infection caused by C. utilis. This article is protected by copyright...
March 25, 2018: Mycoses
Greetje Vande Velde, Soňa Kucharíková, Patrick Van Dijck, Uwe Himmelreich
Fungal infections are a major problem for a growing number of mostly immune-compromised patients. Candida albicans is an important human fungal pathogen causing mucosal and deep tissue infections of which the majority is associated with biofilm formation on medical implants. The animal models that are currently in use to test antifungal drugs are limited to ex vivo analyses, requiring host sacrifice that excludes longitudinal monitoring of dynamic processes during biofilm formation in the live host. As a solution, we introduce non-invasive, dynamic imaging and quantification of C...
March 20, 2018: International Journal of Antimicrobial Agents
Takanori Funaki, Isao Miyairi
We identified eight pediatric patients on micafungin (≥3 doses) at our institution who had breakthrough candidemia (BC). The causative strains of the BC were C. parapsilosis in seven patients. The minimum inhibitory concentration of micafungin was ≤1 µg/ml (susceptible) in all eight isolates. Immunocompromised patients may develop BC caused by micafungin-susceptible strains.
March 19, 2018: Pediatric Infectious Disease Journal
Abigail L Goodman, Shawn R Lockhart, Colleen B Lysen, Lars F Westblade, Carey-Ann D Burnham, Eileen M Burd
We present two cases of keratitis due to Metarhizium anisopliae in geographically separated areas of the United States. The isolates were microscopically similar but morphologically different and were identified by ribosomal DNA sequencing. Both isolates had low minimum inhibitory concentration (MIC) values to caspofungin and micafungin, but high MIC values to amphotericin B. The morphologic and antifungal susceptibility differences between the two isolates indicate possible polyphylogeny of the group.
September 2018: Medical Mycology Case Reports
H-L Lei, L-H Li, W-S Chen, W-N Song, Y He, F-Y Hu, X-J Chen, W-P Cai, X-P Tang
Talaromyces marneffei (T. marneffei) can cause talaromycosis, a fatal systemic mycosis, in patients with AIDS. With the increasing number of talaromycosis cases in Guangdong, China, we aimed to investigate the susceptibility of 189 T. marneffei clinical strains to eight antifungal agents, including three echinocandins (anidulafungin, micafungin, and caspofungin), four azoles (posaconazole, itraconazole, voriconazole, and fluconazole), and amphotericin B, with determining minimal inhibition concentrations (MIC) by Sensititre YeastOne™ YO10 assay in the yeast phase...
March 13, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Muneyoshi Kimura, Hideki Araoka, Hisashi Yamamoto, Shigeki Nakamura, Minoru Nagi, Satoshi Yamagoe, Yoshitsugu Miyazaki, Sho Ogura, Takashi Mitsuki, Mitsuhiro Yuasa, Daisuke Kaji, Kosei Kageyama, Aya Nishida, Yuki Taya, Hiroshi Shimazu, Kazuya Ishiwata, Shinsuke Takagi, Go Yamamoto, Yuki Asano-Mori, Naoyuki Uchida, Atsushi Wake, Shuichi Taniguchi, Akiko Yoneyama
Limited data are available on micafungin breakthrough fungemia (MBF), fungemia that develops on administration of micafungin, in patients with hematological disorders. We reviewed medical and microbiological records of patients with hematological disorders who developed MBF between January 2008 and June 2015. A total of 39 patients with MBF were identified and Candida (30 strains) and non- Candida (9 strains) fungal species were recognized as causative strains. Among 35 stored strains, C. parapsilosis (14 strains), Trichosporon asahii (7 strains), C...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Mahdi Abastabar, Abdullah M S Al-Hatmi, Mohammad Vafaei Moghaddam, G Sybren de Hoog, Iman Haghani, Seyed Reza Aghili, Tahereh Shokohi, Mohammad Taghi Hedayati, Roshanak Daie Ghazvini, Reza Kachuei, Ali Rezaei-Matehkolaei, Koichi Makimura, Jacques F Meis, Hamid Badali
A collection of clinical (n=47) and environmental (n=79) Fusarium isolates were tested against 10 antifungal drugs, including two novel imidazoles. Luliconazole and lanoconazole demonstrated very low GM MIC values of 0.005 μg/ml and 0.013 μg/ml, respectively, in comparison with 0.51 μg/ml for micafungin, 0.85 μg/ml for efinaconazole, 1.12 μg/ml for natamycin, 1.18 μg/ml for anidulafungin, 1.31 μg/ml for voriconazole, 1.35 μg/ml for caspofungin, 1.9 μg/ml for amphotericin B and 4.08 μg/ml for itraconazole...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Whittney A Warren, Domingo Franco-Palacios, Christopher S King, Oksana A Shlobin, Steven D Nathan, Shalika B Katugaha, Haresh Mani, A Whitney Brown
A 24-year-old woman with ΔF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV1 of 30% predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation...
March 2018: Chest
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