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https://www.readbyqxmd.com/read/29433463/scedosporium-apiospermum-infectious-scleritis-following-posterior-subtenon-triamcinolone-acetonide-injection-a-case-report-and-literature-review
#1
Daisuke Todokoro, Junki Hoshino, Ayaka Yo, Koichi Makimura, Junko Hirato, Hideo Akiyama
BACKGROUND: Ubiquitous fungi of the Scedosporium apiospermum species complex (SASC) cause various opportunistic infections. Posterior subtenon triamcinolone acetonide (STTA) injection is a standard therapy for intraocular inflammation and macular edema. We report a case of Scedosporium apiospermum infectious scleritis after a posterior STTA injection. CASE PRESENTATION: A 75-year-old man received a posterior STTA injection to treat macular edema in his left eye...
February 13, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29416360/clinical-characteristics-of-the-first-cases-of-invasive-candidiasis-in-china-due-to-pan-echinocandin-resistant-candida-tropicalis-and-candida-glabrata-isolates-with-delineation-of-their-resistance-mechanisms
#2
Meng Xiao, Xin Fan, Xin Hou, Sharon Ca Chen, He Wang, Fanrong Kong, Zi-Yong Sun, Yun-Zhuo Chu, Ying-Chun Xu
Echinocandin antifungal agents have become the first-line therapy for invasive candidiasis (IC) in many countries. Despite their increasing use, resistance to this class of drug is, overall, still uncommon. Here, we report two patients from the People's Republic of China with IC, one with infection caused by pan-echinocandin-resistant Candida tropicalis and the other by pan-echinocandin-resistant Candida glabrata. We also describe the mechanisms of drug resistance of these isolates. The echinocandin-resistant C...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29408183/invasive-pulmonary-aspergillosis-mimicking-organizing-pneumonia-after-mtor-inhibitor-therapy-a-case-report
#3
Yuki Iijima, Namiko Fujioka, Yoshinori Uchida, Yoichi Kobayashi, Toshiharu Tsutsui, Yumiko Kakizaki, Yoshihiro Miyashita
A 67-year old man visited our hospital with complaints of fever and cough. He had a past medical history of renal cell carcinoma and had just started treatment with temsirolimus, a mammalian target of rapamycin (mTOR) inhibitor. A 1-week course of antibiotics did not have any effect on his symptoms. Chest computed tomography (CT) scan showed reversed halo sign (RHS). Organizing pneumonia induced by mTOR inhibitor treatment was initially considered. However, transbronchial biopsy revealed clusters of fungal organisms, suggesting infection with Aspergillus spp...
February 3, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29384927/efficacy-and-safety-of-micafungin-for-the-treatment-of-patients-with-proven-or-probable-invasive-aspergillosis-a-non-comparative-multicenter-phase-iv-open-label-study
#4
Yu Ji, Yongping Song, Fang Zhou, Ting Liu, Ming Jiang, Xielan Zhao, Xiaojun Huang
INTRODUCTION: Few studies have assessed the efficacy and safety of micafungin in patients with proven or probable invasive aspergillosis (IA). This was the aim of the current study, which was conducted in 22 hospitals in China, where micafungin was approved for treatment of IA in 2006. METHODS: This was a non-comparative, phase IV open-label study (NCT02646774). Eligible patient were adults with proven or probable IA. Efficacy endpoints included rates of overall treatment success (primary endpoint) and clinical improvement, fungal clearance, mortality, and the site of Aspergillus infection (all secondary endpoints)...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29369937/antifungal-susceptibility-and-clinical-outcome-in-neonatal-candidiasis
#5
Julie Autmizguine, Sylvia Tan, Michael Cohen-Wolkowiez, C Michael Cotten, Nathan Wiederhold, Ronald N Goldberg, Ira Adams-Chapman, Barbara J Stoll, P Brian Smith, Daniel K Benjamin
BACKGROUND: Invasive candidiasis is an important cause of sepsis in extremely low birth weight infants (ELBW, <1000g), is often fatal, and frequently results in neurodevelopmental impairment (NDI) among survivors. We sought to assess the antifungal minimum inhibitory concentration (MIC) distribution for Candida in ELBW infants and evaluate the association between antifungal resistance and death or NDI. METHODS: This was a secondary analysis of the NICHD Neonatal Research Network study, "Early Diagnosis of Nosocomial Candidiasis"...
January 24, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29364548/efficacy-of-micafungin-for-the-treatment-of-invasive-candidiasis-and-candidaemia-in-patients-with-neutropenia
#6
Pranatharthi Chandrasekar, Bhawna Sirohi, Nita L Seibel, Jack W Hsu, Nkechi Azie, Chunzhang Wu, Markus Ruhnke
Neutropenia is linked to the development of invasive candidiasis/candidaemia, for which micafungin has demonstrated efficacy, but evidence in patients with neutropenia is limited. The aim of this study was to evaluate the efficacy of micafungin for the treatment of invasive candidiasis/candidaemia in patients with neutropenia (<500 neutrophils/μL) and without neutropenia. This pooled, post hoc analysis of 2 Phase 3 trials compared micafungin 100 mg/d (adults) and 2 mg/kg/d (paediatrics) with L-AmB 3 mg/kg/d (NCT00106288) and micafungin 100 mg/d and 150 mg/d with caspofungin 70 mg/d followed by 50 mg/d (adults) (NCT00105144); treatment duration 2-4 weeks (≤8 weeks for chronic disseminated candidiasis)...
January 24, 2018: Mycoses
https://www.readbyqxmd.com/read/29359870/breakthrough-exophiala-dermatitidis-infection-during-prophylactic-administration-of-micafungin-during-second-umbilical-cord-blood-transplantation-after-graft-failure
#7
Naoki Watanabe, Akihiko Gotoh, Shuichi Shirane, Yasuharu Hamano, Yuji Hirai, Maika Shimizu, Ayako Nakamura, Kana Matsumoto, Kunihiko Morita, Takeshi Mori, Akimichi Ohsaka, Norio Komatsu
Exophiala dermatitidis infections in patients with hematological malignancies are very rare. Our patient had a blood stream infection caused by E. dermatitidis following the second umbilical cord blood transplantation (UCBT) after graft failure during the first UCBT. To our knowledge, this is the first report describing a breakthrough fungal infection caused by E. dermatitidis during the prophylactic administration of micafungin (MCFG). Therefore, MCFG-treated patients should be monitored for breakthrough E...
January 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29333407/the-limited-role-of-serum-galactomannan-assay-in-screening-for-invasive-pulmonary-aspergillosis-in-allogeneic-stem-cell-transplantation-recipients-on-micafungin-prophylaxis-a-retrospective-study
#8
Ryul Kim, Youngil Koh, Dong-Yeop Shin, Pyoeng Gyun Choe, Nam Joong Kim, Sung-Soo Yoon, Myoung-Don Oh, Wan Beom Park, Inho Kim
Background: We evaluated the outcomes of serum galactomannan (GM) assay for the screening of invasive pulmonary aspergillosis (IPA) in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients while on primary antifungal prophylaxis (PAP). Methods: This study included patients with hematologic disorders who underwent alloHSCT from January 2013 to November 2015. Patients received routine PAP with fluconazole before 2014 and micafungin after 2014; serum GM tests were performed and retrospectively analyzed...
December 2017: Blood Research
https://www.readbyqxmd.com/read/29311063/mutant-prevention-concentration-and-mutant-selection-window-of-micafungin-and-anidulafungin-in-clinical-candida-glabrata-isolates
#9
María Ángeles Bordallo-Cardona, Laura Judith Marcos-Zambrano, Carlos Sánchez-Carrillo, Elia Gómez G de la Pedrosa, Rafael Cantón, Emilio Bouza, Pilar Escribano, Jesús Guinea
Background: We report the mutant prevention concentration (MPC) and mutant selection window (MSW) for micafungin and anidulafungin administered to treat Candida glabrata We also determine the mutation frequency.Methods: We studied 20 echinocandin-susceptible, fluconazole-intermediate, and FKS wild-type C. glabrata isolates. Adjusted inocula were stroked directly onto Sabouraud agar plates containing different concentrations of micafungin or anidulafungin and visually inspected daily for up to 5 days of incubation...
January 8, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29311061/enhanced-efflux-pump-activity-in-old-candida-glabrata
#10
Somanon Bhattacharya, Bettina C Fries
The effect of replicative aging on antifungal resistance in Candida glabrata was investigated. Our studies demonstrate significantly increased transcription of ABC transporters as well as efflux pump activity in old compared to young C. glabrata cells of a fluconazole sensitive and resistant strain. In addition, higher tolerance to killing by micafungin and amphotericin B was noted and is associated with higher transcription of glucan synthase gene FKS1 and lower ergosterol content in older cells.
January 8, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29304211/we-can-do-better-a-fresh-look-at-echinocandin-dosing
#11
Justin C Bader, Sujata M Bhavnani, David R Andes, Paul G Ambrose
First-line antifungal therapies are limited to azoles, polyenes and echinocandins, the former two of which are associated with high occurrences of severe treatment-emergent adverse events or frequent drug interactions. Among antifungals, echinocandins present a unique value proposition given their lower rates of toxic events as compared with azoles and polyenes. However, with the emergence of echinocandin-resistant Candida species and the fact that a pharmacometric approach to the development of anti-infective agents was not a mainstream practice at the time these agents were developed, we question whether echinocandins are being dosed optimally...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29303621/cost-effectiveness-of-de-escalation-from-micafungin-versus-escalation-from-fluconazole-for-invasive-candidiasis-in-china
#12
Dechang Chen, Xianyao Wan, Eliza Kruger, Can Chen, Xiaomeng Yue, Liang Wang, Jiuhong Wu
AIMS: Guidelines on treating invasive candidiasis recommend initial treatment with a broad-spectrum echinocandin (e.g. micafungin), then switching to fluconazole if isolates prove sensitive (de-escalation strategy). This study aimed to evaluate the cost-effectiveness of de-escalation from micafungin vs escalation from fluconazole from a Chinese public payers perspective. MATERIALS AND METHODS: Cost-effectiveness was estimated using a decision analytic model, in which patients begin treatment with fluconazole 400 mg/day (escalation) or micafungin 100 mg/day (de-escalation)...
January 11, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29282194/role-of-immune-status-in-chemotherapy-induced-transient-acantholytic-dermatosis
#13
Sogyong L Auh, Ingrid Polcari, Vesna Petronic-Rosic, Aisha Sethi
A 79-year-old man with a recent diagnosis of acute myeloblastic leukemia received induction chemotherapy with daunorubicin and cytarabine, plus moxifloxacin and fluconazole prophylaxis. Approximately 2 weeks later, an asymptomatic eruption appeared on his trunk. He then developed a neutropenic fever and was started on aztreonam, vancomycin, voriconazole, and amikacin and was transferred to our facility from an outside hospital. Micafungin was subsequently added, and the patient defervesced within a few days...
2017: Skinmed
https://www.readbyqxmd.com/read/29251580/successful-treatment-of-lung-aspergillus-terreus-infection-after-a-second-hematopoietic-stem-cell-transplant-in-a-patient-with-myelodysplastic-syndrome
#14
Yu Zhang, Junfa Chen, Lili Qian, Xuejing Yang, Jianping Shen
A 24-year-old man was diagnosed with myelodysplastic syndrome and received a haploidentical hematopoietic stem cell transplant. The patient experienced graft failure posttransplant. Analysis of specific antibodies revealed that the patient had strongly positive donor-specific antibodies; therefore, we changed the donor to the patient's mother and added a single unit of cord blood to perform the second transplant. Corresponding treatments targeting donor-specific antibodies were administered to reverse the graft rejection and to reduce the antibody load...
December 18, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29251506/scanning-quadrupole-data-independent-acquisition-part-b-application-to-the-analysis-of-the-calcineurin-interacting-proteins-during-treatment-of-aspergillus-fumigatus-with-azole-and-echinocandin-antifungal-drugs
#15
Praveen R Juvvadi, M Arthur Moseley, Christopher J Hughes, Erik J Soderblom, Sarah Lennon, Simon R Perkins, J Will Thompson, Scott J Geromanos, Jason Wildgoose, Keith Richardson, James I Langridge, Johannes P C Vissers, William J Steinbach
Calcineurin is a critical cell-signaling protein that orchestrates growth, stress response, virulence, and antifungal drug resistance in several fungal pathogens. Blocking calcineurin signaling increases the efficacy of several currently available antifungals and suppresses drug resistance. We demonstrate the application of a novel scanning quadrupole DIA method for the analysis of changes in the proteins coimmunoprecipitated with calcineurin during therapeutic antifungal drug treatments of the deadly human fungal pathogen Aspergillus fumigatus...
December 29, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/29228268/low-and-constant-micafungin-concentrations-may-be-sufficient-to-lead-to-resistance-mutations-in-fks2-gene-of-candida-glabrata
#16
María Ángeles Bordallo-Cardona, Pilar Escribano, Laura Judith Marcos-Zambrano, Judith Díaz-García, Elia Gómez de la Pedrosa, Rafael Cantón, Emilio Bouza, Jesús Guinea
We studied the ability of five echinocandin-susceptible C. glabrata isolates to acquire in vitro resistance to anidulafungin and micafungin. All isolates became phenotypically resistant after 2-4 days of exposure to low and constant micafungin concentrations (P < .05). Mutations in the HS1 region of the FKS2 gene were found in all isolates. The acquisition of resistance was not related to the previous use of antifungal treatment in the patients or the presence of mutations at MSH2 gene. We found differences (P < ...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29213345/the-management-of-chronic-pulmonary-aspergillosis-the-uk-national-aspergillosis-centre-approach
#17
REVIEW
Firas Maghrabi, David W Denning
Purpose of Review: Chronic pulmonary aspergillosis (CPA) is a serious long-term fungal disease of the lung with a worldwide prevalence. Treatment of CPA is not straightforward given the often-multiple associated co-morbidities, complex clinical picture, drug interactions, toxicities and intolerances. Recent Findings: First line treatment is oral itraconazole or voriconazole. In the event of intolerance or toxicity, patients may be swapped from itraconazole to voriconazole or vice versa...
2017: Current Fungal Infection Reports
https://www.readbyqxmd.com/read/29189615/multi-modal-treatment-of-rhinocerebral-mucormycosis-in-a-pediatric-patient-with-relapsed-pre-b-acute-lymphoblastic-leukemia
#18
Zephyr D Dworsky, John S Bradley, Matthew T Brigger, Alice L Pong, Dennis John Kuo
A 17-year-old female developed invasive rhinocerebral mucormycosis during intensive re-induction chemotherapy for relapsed pre-B acute lymphoblastic leukemia. Due to the high case fatality rate for invasive mucormycosis in profoundly immunosuppressed patients, an aggressive treatment regimen was pursued. In addition to the standard of care treatments with intravenous amphotericin and aggressive surgical debridements, she received intraventricular amphotericin to the brain via an Ommaya reservoir, hyperbaric oxygen treatments, filgrastim, intravenous immunoglobulin and anti-fungal in vitro synergy testing to allow for more targeted antifungal therapy with the addition of micafungin...
November 16, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29185089/pharmacoeconomic-evaluation-of-micafungin-versus-caspofungin-as-definitive-therapy-for-candidaemia-and-invasive-candidiasis-ic-in-turkey
#19
C F Neoh, E Senol, A Kara, E C Dinleyici, S J Turner, D C M Kong
Micafungin was shown to be as efficacious as caspofungin in treating patients with candidaemia and invasive candidiasis (IC). However, it remains unknown if micafungin or caspofungin is a cost-effective definitive therapy for candidaemia and IC in Turkey. The present study aimed to determine the economic impact of using micafungin versus caspofungin for treatment of candidaemia and IC in the Turkish setting. A decision analytic model was constructed and was populated with data (i.e. transition probabilities, duration of initial antifungal treatment, reasons for treatment failure, percentage of patients who stepped down to oral fluconazole, and duration on oral fluconazole) obtained from a published randomised clinical trial...
November 28, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29172033/in-vitro-antifungal-susceptibility-of-clinical-and-environmental-isolates-of-aspergillus-fumigatus-and-aspergillus-flavus-in-brazil
#20
Laura Bedin Denardi, Bianca Hoch Dalla-Lana, Francielli Pantella Kunz de Jesus, Cecília Bittencourt Severo, Janio Morais Santurio, Régis Adriel Zanette, Sydney Hartz Alves
The in vitro susceptibility of 105 clinical and environmental strains of Aspergillus fumigatus and Aspergillus flavus to antifungal drugs, such as amphotericin B, azoles, and echinocandins was evaluated by the broth microdilution method proposed by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Following the EUCAST-proposed breakpoints, 20% and 25% of the clinical and environmental isolates of A. fumigatus, respectively, were found to be resistant to itraconazole (Minimal Inhibitory Concentration, MIC>2...
November 21, 2017: Brazilian Journal of Infectious Diseases
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