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https://www.readbyqxmd.com/read/27917735/top-1-of-inpatients-administered-antimicrobial-agents-comprising-50-of-expenditures-a-descriptive-study-and-opportunities-for-stewardship-intervention
#1
Jennifer Dela-Pena, Luiza Kerstenetzky, Lucas Schulz, Ron Kendall, Alexander Lepak, Barry Fox
OBJECTIVE To characterize the top 1% of inpatients who contributed to the 6-month antimicrobial budget in a tertiary, academic medical center and identify cost-effective intervention opportunities targeting high-cost antimicrobial utilization. DESIGN Retrospective cohort study. PATIENTS Top 1% of the antimicrobial budget from July 1 through December 31, 2014. METHODS Patients were identified through a pharmacy billing database. Baseline characteristics were collected through a retrospective medical chart review...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27909895/invasive-cutaneous-infection-due-to-scopulariopsis-brevicaulis-unsuccessfully-treated-with-high-dose-micafungin-in-a-neutropenic-patient
#2
Daniela Gavril, Paul-Louis Woerther, Aicha Ben Lakhdar, Linda Mahjoubi, Emilie Routier, Elisabeth Chachaty, Bertrand Gachot, Stephane De Botton, Jean-Baptiste Micol, Christophe Willekens
Scopulariopsis brevicaulis onychomycosis with local cutaneous invasion was diagnosed in an acute leukemia patient and unsuccessfully treated with high-dose micafungin, based on antifungal susceptibility testing. This case should alert clinicians to the possible severe evolution of onychomycosis in neutropenic patients and suggests that surgery should be preferred in such a situation.
December 1, 2016: Infection
https://www.readbyqxmd.com/read/27904738/recent-developments-in-the-management-of-invasive-fungal-infections-in-patients-with-oncohematological-diseases
#3
REVIEW
Markus Ruhnke, Stefan Schwartz
Patients with hematological cancer have a high risk of invasive fungal diseases (IFDs). These infections are mostly life threatening and an early diagnosis and initiation of appropriate antifungal therapy are essential for the clinical outcome. Most commonly, Aspergillus and Candida species are involved. However, other non-Aspergillus molds are increasingly be identified in cases of documented IFDs. Important risk factors are long lasting granulocytopenia with neutrophil counts below 500/μl for more than 10 days or graft-versus-host disease resulting from allogeneic stem-cell transplantation...
December 2016: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/27902377/comparison-of-susceptibility-patterns-using-commercially-available-susceptibility-testing-methods-performed-on-prevalent-candida-species
#4
David Cretella, Katie E Barber, S Travis King, Kayla R Stover
The rising rates of invasive fungal infections caused by non-albicans Candida and the increasing emergence of antifungal resistance complicate the management of invasive candidiasis. Accurate and timely antifungal susceptibility testing is critical to targeting antifungal therapy. The purpose of this study was to compare commercially available susceptibility testing methods using prospectively collected Candida isolates. Susceptibility testing was performed on 74 Candida isolates collected from July 2014-March 2015 using broth microdilution (BMD) according to the Clinical and Laboratory Standards Institute (CLSI) method, Etest, Vitek2 (YS-05), and Sensititre...
November 1, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27895625/evaluation-of-virulence-factors-in-vitro-resistance-to-osmotic-stress-and-antifungal-susceptibility-of-candida-tropicalis-isolated-from-the-coastal-environment-of-northeast-brazil
#5
Diana L Zuza-Alves, Sayama S T Q de Medeiros, Luanda B F C de Souza, Walicyranison P Silva-Rocha, Elaine C Francisco, Maria C B de Araújo, Reginaldo G Lima-Neto, Rejane P Neves, Analy S de Azevedo Melo, Guilherme M Chaves
Several studies have been developed regarding human health risks associated with the recreational use of beaches contaminated with domestic sewage. These wastes contain various micro-organisms, including Candida tropicalis. In this context, the objective of this study was to characterize C. tropicalis isolates from the sandy beach of Ponta Negra, Natal, Rio Grande do Norte, Brazil, regarding the expression of in vitro virulence factors, adaptation to osmotic stress and susceptibility to antifungal drugs. We analyzed 62 environmental isolates and observed a great variation among them for the various virulence factors evaluated...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27872063/in-vitro-exposure-to-increasing-micafungin-concentrations-easily-promotes-echinocandin-resistance-in-candida-glabrata-isolates
#6
María Ángeles Bordallo-Cardona, Pilar Escribano, Elia Gómez G de la Pedrosa, Laura Judith Marcos-Zambrano, Rafael Cantón, Emilio Bouza, Jesús Guinea
We assessed the in vitro susceptibility of five echinocandin-susceptible C. glabrata isolates after exposure to micafungin. The direct exposure to plates at different micafungin concentrations resulted in the inhibition of growth at 0.062 μg/ml. The progressive exposure was performed on plates with 0.031 μg/ml of micafungin and sequentially propagated on plates containing the next two-fold concentration; the MICs of micafungin and anidulafungin increased sequentially and all the isolates became echinocandin-resistant showing fks2 mutations...
November 21, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27865538/micafungin-in-the-treatment-of-invasive-fungal-infection-in-an-infant-with-extracorporeal
#7
Iolanda Jordan, Mónica Balaguer, Lluïsa Hernandez-Platero, Miquel Villaronga
No abstract text is available yet for this article.
November 16, 2016: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/27859978/breakthrough-fungemia-due-to-candida-fermentati-with-fks1p-mutation-under-micafungin-treatment-in-a-cord-blood-transplant-recipient
#8
Takaaki Konuma, Shunsuke Takahashi, Tomohiko Kiyuna, Yuta Miharu, Masato Suzuki, Hiroko Shibata, Seiko Kato, Satoshi Takahashi, Arinobu Tojo
The prophylactic use of antifungal drugs in allogeneic hematopoietic cell transplant recipients has revealed that the rate of non-albicans candidemia has increased. We herein report the case of a patient with adult T-cell leukemia who developed candidemia due to Candida fermentati during micafungin treatment after cord blood transplantation. The isolate was identified on day 47 by sequencing of the internal transcribed spacer region of the ribosomal RNA gene. The sequencing of the hot spot region of fks1p of isolate revealed naturally occurring amino acid substitutions, which conferred reduced echinocandin susceptibility...
November 15, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27850329/690-discontinuation-of-micafungin-therapy-utilizing-a-validated-clinical-predication-rule-for-candidemia
#9
Gabrielle Gibson, Mollie Gowan, Paul Juang, Scott Micek, Marin Kollef
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27821139/micafungin-versus-caspofungin-in-the-treatment-of-candida-glabrata-infection-a-case-report
#10
Shoko Merrit Yamada, Yusuke Tomita, Tomotsugu Yamaguchi, Toshiaki Matsuki
BACKGROUND: Micafungin and caspofungin, which are both echinocandins, elicit their antifungal effects by suppressing the synthesis of β-D-glucan, an essential component of fungal cell walls. If micafungin is not effective against a fungal infection, is it unreasonable to switch to caspofungin? CASE PRESENTATION: An 80-year-old Asian man presented to our hospital with brain and lung abscesses. Klebsiella pneumonia and Escherichia coli were identified by sputa culture and Streptococcus mitis was identified in the brain abscess culture obtained by drainage surgery...
November 8, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27816903/molecular-and-antifungal-susceptibility-study-on-trichosporonemia-and-emergence-of-trichosporon-mycotoxinivorans-as-a-bloodstream-pathogen
#11
Yubhisha Dabas, Immaculata Xess, Pratibha Kale
A total of 21 Trichosporon spp. isolates from blood over a period of 5 years (January 2009 to December 2013) were included in the study. The most common underlying diseases found were pancreatitis (33.3%) and cancer (33.3%). Trichosporon asahii (80.9%) was the commonest species followed by Trichosporon mycotoxinivorans (14.2%) and Trichosporon faecale (4.7%). On IGS1 region sequencing the most predominant T. asahii type in our region was genotype 1 (16/17 isolates; 94.1%) and one isolate belonged to genotype 4...
November 5, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27799221/frequency-of-the-paradoxical-effect-measured-using-eucast-with-micafungin-anidulafungin-and-caspofungin-against-candida-spp-isolates-causing-candidemia
#12
Laura Judith Marcos-Zambrano, Pilar Escribano, Carlos Sánchez-Carrillo, Emilio Bouza, Jesús Guinea
We report data on the frequency of the paradoxical effect of echinocandins against Candida spp. (n= 602 incident isolates) using the EUCAST EDef 7.2 procedure. The paradoxical effect for one or more echinocandins was observed in 16% of the isolates. However, differences between species were found, and the paradoxical effect was more common in Candida tropicalis (P<0.001). Caspofungin was the drug in which the paradoxical effect was most common, followed by anidulafungin and micafungin (P<0.001).
October 31, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27799206/a-multi-center-study-of-method-dependent-epidemiological-cutoff-values-ecvs-for-resistance-detection-in-candida-spp-and-aspergillus-spp-to-amphotericin-b-and-echinocandins-for-the-etest-agar-diffusion-method
#13
A Espinel-Ingroff, M Arendrup, E Cantón, S Cordoba, E Dannaoui, J García-Rodríguez, G M Gonzalez, N P Govender, E Martin-Mazuelos, C Lass-Flörl, M Lackner, M J Linares Sicilia, M A Rodriguez-Iglesias, T Pelaez, R K Shields, G Garcia-Effron, J Guinea, M Sanguinetti, J Turnidge
Method-dependent Etest epidemiological cutoff values (ECVs) are not available for susceptibility testing of either Candida or Aspergillus species with amphotericin B or echinocandins. In addition, reference caspofungin MICs for Candida spp. are unreliable. Candida and Aspergillus species wild-type (WT) Etest MIC distributions (microorganisms in a species-drug combination with no detectable phenotypic resistance) were established for 4,341 Candida albicans, 113 C. dubliniensis, 1,683 C. glabrata species complex (SC), 709 C...
October 31, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27798213/monotherapy-or-combination-therapy-of-isavuconazole-and-micafungin-for-treating-murine-mucormycosis
#14
Teclegiorgis Gebremariam, Nathan P Wiederhold, Abdullah Alqarihi, Priya Uppuluri, Nkechi Azie, John E Edwards, Ashraf S Ibrahim
OBJECTIVES: Previously we demonstrated the benefit of isavuconazole in treating murine mucormycosis due to Rhizopus. We wanted to determine the efficacy of isavuconazole in treating murine mucormycosis caused by Mucor, the second most common cause of the disease. Furthermore, because we previously determined that Rhizopus possesses the target enzyme for echinocandins and micafungin has activity against murine mucormycosis, we compared the activity of combination therapy (isavuconazole + micafungin) with placebo, either drug alone or standard therapy of liposomal amphotericin B (LAmB) in treating pulmonary murine mucormycosis caused by Rhizopus delemar...
October 24, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27782169/valproate-inhibits-map-kinase-signalling-and-cell-cycle-progression-in-s-cerevisiae
#15
Kristelle Desfossés-Baron, Ian Hammond-Martel, Antoine Simoneau, Adnane Sellam, Stephen Roberts, Hugo Wurtele
The mechanism of action of valproate (VPA), a widely prescribed short chain fatty acid with anticonvulsant and anticancer properties, remains poorly understood. Here, the yeast Saccharomyces cerevisiae was used as model to investigate the biological consequences of VPA exposure. We found that low pH strongly potentiates VPA-induced growth inhibition. Transcriptional profiling revealed that under these conditions, VPA modulates the expression of genes involved in diverse cellular processes including protein folding, cell wall organisation, sexual reproduction, and cell cycle progression...
October 26, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27750452/epidemiology-of-candidemia-and-antifungal-susceptibility-in-invasive-candida-species-in-the-asia-pacific-region
#16
He Wang, Ying-Chun Xu, Po-Ren Hsueh
In the Asia-Pacific region, Candida albicans is the predominant Candida species causing invasive candidiasis/candidemia in Australia, Japan, Korea, Hong Kong, Malaysia, Singapore and Thailand whereas C. tropicalis is the most frequently encountered Candida species in Pakistan and India. Invasive isolates of C. albicans, C. parapsilosis complex and C. tropicalis remain highly susceptible to fluconazole (>90% susceptible). Fluconazole resistance (6.8-15%), isolates with the non-wild-type phenotype for itraconazole susceptibility (3...
October 2016: Future Microbiology
https://www.readbyqxmd.com/read/27746090/-epidemiology-risk-factors-and-in-vitro-susceptibility-in-candidaemia-due-to-non-candida-albicans-species
#17
Elena M Marín Martínez, Ana Isabel Aller García, Estrella Martín-Mazuelos
BACKGROUND: Invasive fungal infection (IFI) has increased in recent years due to there being a greater number of risk factors. IFI caused by Candida is the most frequent, and although Candida albicans is the most isolated species, there is currently a decrease of C. albicans and an increase of other species of the genus. AIMS: To analyse the epidemiology, risk factors, and antifungal susceptibility of blood culture isolates of non-C.albicans Candida species in our hospital in the last 12years...
October 13, 2016: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/27742099/species-diversity-of-aspergillus-section-versicolores-in-clinical-samples-and-antifungal-susceptibility
#18
João Paulo Zen Siqueira, Deanna A Sutton, Dania García, Josepa Gené, Pamela Thomson, Nathan Wiederhold, Josep Guarro
Aspergillus section Versicolores includes species of clinical relevance and many others that have been poorly studied but are occasionally found in clinical samples. The aim of this study was to investigate, using a multilocus phylogenetic approach, the spectrum of species of the section Versicolores and to determine their in vitro antifungal susceptibility. The study was based on a set of 77 clinical isolates from different USA medical centres, which had been previously identified as belonging to this section...
November 2016: Fungal Biology
https://www.readbyqxmd.com/read/27706483/empirical-micafungin-treatment-and-survival-without-invasive-fungal-infection-in-adults-with-icu-acquired-sepsis-candida-colonization-and-multiple-organ-failure-the-empiricus-randomized-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
Jean-Francois Timsit, Elie Azoulay, Carole Schwebel, Pierre Emmanuel Charles, Muriel Cornet, Bertrand Souweine, Kada Klouche, Samir Jaber, Jean-Louis Trouillet, Fabrice Bruneel, Laurent Argaud, Joel Cousson, Ferhat Meziani, Didier Gruson, Adeline Paris, Michael Darmon, Maité Garrouste-Orgeas, Jean-Christophe Navellou, Arnaud Foucrier, Bernard Allaouchiche, Vincent Das, Jean-Pierre Gangneux, Stéphane Ruckly, Daniele Maubon, Vincent Jullien, Michel Wolff
Importance: Although frequently used in treating intensive care unit (ICU) patients with sepsis, empirical antifungal therapy, initiated for suspected fungal infection, has not been shown to improve outcome. Objective: To determine whether empirical micafungin reduces invasive fungal infection (IFI)-free survival at day 28. Design, Setting, and Participants: Multicenter double-blind placebo-controlled study of 260 nonneutropenic, nontransplanted, critically ill patients with ICU-acquired sepsis, multiple Candida colonization, multiple organ failure, exposed to broad-spectrum antibacterial agents, and enrolled between July 2012 and February 2015 in 19 French ICUs...
October 18, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27697761/high-dose-micafungin-for-preterm-neonates-and-infants-with-invasive-and-central-nervous-system-candidiasis
#20
Cinzia Auriti, Marco Falcone, Maria Paola Ronchetti, Bianca Maria Goffredo, Sara Cairoli, Rosamaria Crisafulli, Fiammetta Piersigilli, Tiziana Corsetti, Andrea Dotta, Manjunath P Pai
High doses of micafungin are advocated in neonates with systemic candidiasis, but limited pharmacokinetic (PK) and safety data are available to support their use. Eighteen preterm neonates and infants with systemic candidiasis, three of whom had meningitis, were treated for at least 14 days with 8 to 15 mg/kg of body weight/day of intravenous micafungin. Plasma micafungin concentrations (four measurements for each patient) were determined after the third dose, and the cerebrospinal fluid (CSF) micafungin concentrations in three patients were also obtained...
December 2016: Antimicrobial Agents and Chemotherapy
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