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Invasive aspergillosis

A J Ullmann, J M Aguado, S Arikan-Akdagli, D W Denning, A H Groll, K Lagrou, C Lass-Flörl, R E Lewis, P Munoz, P E Verweij, A Warris, F Ader, M Akova, M C Arendrup, R A Barnes, C Beigelman-Aubry, S Blot, E Bouza, R J M Brüggemann, D Buchheidt, J Cadranel, E Castagnola, A Chakrabarti, M Cuenca-Estrella, G Dimopoulos, J Fortun, J-P Gangneux, J Garbino, W J Heinz, R Herbrecht, C P Heussel, C C Kibbler, N Klimko, B J Kullberg, C Lange, T Lehrnbecher, J Löffler, O Lortholary, J Maertens, O Marchetti, J F Meis, L Pagano, P Ribaud, M Richardson, E Roilides, M Ruhnke, M Sanguinetti, D C Sheppard, J Sinkó, A Skiada, M J G T Vehreschild, C Viscoli, O A Cornely
The European Society for Clinical Microbiology and Infectious Diseases, the European Confederation of Medical Mycology and the European Respiratory Society Joint Clinical Guidelines focus on diagnosis and management of aspergillosis. Of the numerous recommendations, a few are summarized here. Chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA) are strongly recommended. For diagnosis, direct microscopy, preferably using optical brighteners, histopathology and culture are strongly recommended...
March 12, 2018: Clinical Microbiology and Infection
J Denis, M-P Ledoux, Y Nivoix, R Herbrecht
Triazoles compounds are first-line agents for the treatment of invasive fungal diseases. Isavuconazole is the most recent triazole compound, approved in 2015 by the FDA and the EMA to treat invasive aspergillosis and mucormycosis. We reviewed here the in vitro activity of isavuconazole against a vast spectrum of species. Isavuconazole MICs were evaluated using CLSI, EUCAST or Etest methods, with no significant differences between the technics. Low MIC50 and MIC90 (<1μg/mL) were described for isavuconazole against the majority of Candida spp...
March 10, 2018: Journal de Mycologie Médicale
Eva E Tejerina, Rebeca Padilla, Elena Abril, Fernando Frutos-Vivar, Aida Ballen, José María Rodríguez-Barbero, José Ángel Lorente, Andrés Esteban
We evaluate the evolution over time of discrepancies between clinical diagnoses and post-mortem findings in critically ill patients, and to assess the factors associated with these discrepancies. We conducted a prospective study of all consecutive patients who underwent autopsy autopsies in a medical-surgical ICU between January 2008 and December 2015. Among 7.655 patients admitted to our ICU, 671 (8.8%) died. Clinical autopsy was performed in 215 (32%) patients. Major missed diagnoses were noted in 38 patients (17...
March 9, 2018: Human Pathology
Dorina Esendagli, Irem Serifoglu, Serife Savas Bozbas, Merih Tepeoglu, Sule Akcay, Mehmet Haberal
Invasive pulmonary aspergillosis is an infection seen in patients receiving intensive immunosuppressive regimens, such as transplant recipients. Some risk factors that increase the incidence of infection have been determined, and patients defined as having high risk are recommended to take antifungal prophylaxis and be monitored closely. Here, we present a liver transplant patient with mild respiratory symptoms and a normal chest radiography on day 26 posttransplant. However, he had acute renal failure and underwent hemodialysis, which are both defined to increase significantly the risk of aspergillosis...
March 2018: Experimental and Clinical Transplantation
Hiroyasu Kaya, Jun Ozaki, Hirokazu Okumura
Objective This study retrospectively evaluated fungal dissemination due to hospital reconstruction and explored effective methods of predicting an outbreak. Methods Patients suspected of having invasive aspergillosis were tested for Aspergillus galactomannan antigen before and after reconstruction, and the mean values of three months of testing for positive patients were determined. The characteristics of patients with aspergillosis during this period were also assessed. Results Forty-five patients were positive for Aspergillus antigen (>0...
March 9, 2018: Internal Medicine
Vadim M Kemaykin, Nariman B Tabinbaev, Mahira S Khudaibergenova, Anastasia A Olifirovich, Layzzat M Abdrakhmanova, David W Denning, Nikolai Klimko
Our work aimed to generate a preliminary estimation of severe and chronic fungal diseases in the Republic of Kazakhstan with a model proposed by LIFE (Leading International Fungal Education). Calculations were carried out on data from 2015. Published results of studies of mycoses in Kazakhstan were identified; in the absence of national data from the scientific literature, the frequency of life-threatening and serious mycoses in defined groups of patients at risk from other countries were taken into account...
March 8, 2018: Journal of Fungi (Basel, Switzerland)
Nattachai Anantasit, Noramon Nuntacharruksa, Pimpin Incharoen, Aroonwan Preutthipan
Introduction: Invasive' pulmonary aspergillosis (IPA) has been one of the major causes of mortality in immunocompromised patients. The gold standard method for a diagnosis of IPA is histopathological examination of the lung tissue; however, post-procedural bleeding limits the feasibility of lung biopsy. The European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and The National Institute of Allergy and Infectious Disease Mycoses Study Group (EORTC/MSG) defined IPA...
2018: Frontiers in Pediatrics
Cristina Lazzarini, Krupanandan Haranahalli, Robert Rieger, Hari Krishna Ananthula, Pankaj B Desai, Alan Ashbaugh, Michael J Linke, Melanie T Cushion, Bela Ruzsicska, John Haley, Iwao Ojima, Maurizio Del Poeta
The incidence of invasive fungal infections has risen dramatically in the past decades. Current antifungal drugs are either toxic, likely to interact with other drugs, have a narrow spectrum of activity or induce fungal resistance. Hence, there is a great need for new antifungals, possibly with novel mechanisms of action. Previously our group reported an acylhydrazone called BHBM that targeted the sphingolipid pathway, and showed strong antifungal activity against several fungi. In this study, we screened 19 derivatives of BHBM...
March 5, 2018: Antimicrobial Agents and Chemotherapy
Anna Grancini, Anna Orlandi, Giovanna Lunghi, Dario Consonni, Cristina Pozzi, Valeria Rossetti, Alessandro Palleschi, Nicola Fracchiolla, Ernesto Melada, Monica Savioli, Milena Arghittu, Rita Maiavacca, Anna Prigitano
The present study investigated the improvement in the diagnosis of invasive pulmonary aspergillosis (IPA) adding a molecular test on bronchoalveolar lavage (BAL) to the routine diagnostic approach including microscopy, culture and galactomannan (GM) immunoassay. A total of 133 BAL samples were retrospectively tested for the Aspergillus DNA: 112 samples were from immunocompromised patients at risk of invasive fungal infection and 21 were from patients not at risk and without clinical evidence of IPA. The latter samples were used to identify the cut-off of positivity for the molecular test...
January 2018: New Microbiologica
Jata Shankar, Gustavo C Cerqueira, Jennifer R Wortman, Karl V Clemons, David A Stevens
With the increasing numbers of immunocompromised hosts, Aspergillus fumigatus emerges as a lethal opportunistic fungal pathogen. Understanding innate and acquired immunity responses of the host is important for a better therapeutic strategy to deal with aspergillosis patients. To determine the transcriptome in the kidneys in aspergillosis, we employed RNA-Seq to obtain single 76-base reads of whole-genome transcripts of murine kidneys on a temporal basis (days 0; uninfected, 1, 2, 3 and 8) during invasive aspergillosis...
March 2, 2018: Mycopathologia
Salia Farrokh, Edina Avdic
PURPOSE: Optimization of antifungal therapy with voriconazole can be challenging due to inter- and intrapatient variability in voriconazole pharmacokinetics (PK). In this case, we introduce challenges in voriconazole therapy due to drug-drug interactions, autoinduction, and saturable metabolism. SUMMARY: A 32-year-old male on chronic prednisone developed central nervous system (CNS) aspergillosis. He was started on high-dose intravenous (IV) voriconazole 8.5 mg/kg every 12 hours due to concerns for lasting induction effects of recent rifampin therapy...
January 1, 2018: Journal of Pharmacy Practice
Mihai Mareș, Valentina Ruxandra Moroti-Constantinescu, David W Denning
OBJECTIVE: To estimate for the first time the burden of fungal infections in Romania. METHODS: Data derived from the World Health Organization (WHO), National Institute of Statistics, Romanian public health agencies and non-profit health organizations, and published annual reports on local epidemiology were used in the present study. When no data were available, specific at-risk populations were used to calculate frequencies of serious fungal diseases, using previously published epidemiological parameters...
March 1, 2018: Journal of Fungi (Basel, Switzerland)
Jenny A Walldorf, Omayma A Kishk, James D Campbell, Allison B Lardieri
Voriconazole is the recommended agent of choice for treatment of invasive aspergillosis; however, achieving therapeutic serum concentrations while avoiding toxicity, both with intravenous and oral formulations, is challenging in infants. We report the case of an infant with confirmed invasive aspergillosis who developed renal toxicity possibly associated with IV voriconazole. Renal function improved upon withdrawal of the IV agent and switch to the oral formulation. The infant subsequently required large oral weight-based dosing to achieve therapeutic voriconazole serum concentrations...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
E Blanchard, F Gabriel, C Jeanne-Leroyer, V Servant, P-Y Dumas
INTRODUCTION: Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in a wide range of patients. Early recognition and diagnosis have become a major focus in improving the management and outcomes of this life-threatening disease. BACKGROUND: IPA typically occurs during a period of severe and prolonged neutropenia. However, solid organ transplant recipients, patients under immunosuppressive therapy or hospitalized in intensive care units are also at risk...
February 22, 2018: Revue des Maladies Respiratoires
Eloise Ballard, Willem J G Melchers, Jan Zoll, Alistair J P Brown, Paul E Verweij, Adilia Warris
In order to survive, Aspergillus fumigatus must adapt to specific niche environments. Adaptation to the human host includes modifications facilitating persistent colonisation and the development of azole resistance. The aim of this study is to advance understanding of the genetic and physiological adaptation of A. fumigatus in patients during infection and treatment. Thirteen A. fumigatus strains were isolated from a single chronic granulomatous disease patient suffering from persistent and recurrent invasive aspergillosis over a period of 2 years...
February 22, 2018: Fungal Genetics and Biology: FG & B
Julie Denis, Faezeh Forouzanfar, Raoul Herbrecht, Elise Toussaint, Romain Kessler, Marcela Sabou, Ermanno Candolfi, Valérie Letsher-Bru
Invasive pulmonary aspergillosis (IPA) is a common complication of immunosuppression. Rapid diagnosis using molecular techniques is essential to improve patient survival. PCR techniques are promising in enhancing Aspergillus detection in blood and respiratory samples. Here, we evaluate for the first time the performances of two commercial Real-Time PCR kits, the A. fumigatus® Bio-Evolution and the MycoGENIE® A. fumigatus for the detection of A. fumigatus DNA in broncho-alveolar lavage (BAL) from patients with and without IPA...
February 19, 2018: Journal of Molecular Diagnostics: JMD
Ingvild Nordøy, Liv Hesstvedt, Cecilie Torp Andersen, Haima Mylvaganam, Nicola Isabelle Kols, Birgit Margrethe Falch, Ståle Tofteland, Fredrik Müller, David William Denning
The aim of this study was to examine the burden of fungal disease in Norway, contributing to a worldwide effort to improve awareness of the needs for better diagnosis and treatment of such infections. We used national registers and actual data from the Departments of Microbiology from 2015 and estimated the incidence and/or prevalence of superficial, allergic and invasive fungal disease using published reports on specific populations at risk. One in 6 Norwegians suffered from fungal disease: Superficial skin infections (14...
February 21, 2018: Journal of Fungi (Basel, Switzerland)
Seung-Hwan Shin, Byung-Sik Cho, Sung-Soo Park, Sung-Yeon Cho, Young-Woo Jeon, Jae-Ho Yoon, Seung-Ah Yahng, Sung-Eun Lee, Dong-Gun Lee, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Chang-Ki Min, Seok-Goo Cho, Dong-Wook Kim, Jong-Wook Lee, Woo-Sung Min, Hee-Je Kim
To overcome unsatisfactory results of classical low-dose cytarabine (LDAC) of cytarabine ≤20 mg twice daily (BID) subcutaneously for 10 days for patients with elderly acute myeloid leukemia (eAML), we evaluated a modified LDAC (mLDAC) of cytarabine 20 mg/m2 BID subcutaneously plus etoposide 50 mg BID orally for 14 days. To determine its feasibility, we compared outcomes of 77 and 42 eAML patients who received, respectively, mLDAC and decitabine (DAC; 20 mg/m2 intravenously daily for 5 days), which has shown better outcomes compared to those of classical LDAC...
January 19, 2018: Oncotarget
Nicolás María González-Senac, Vicente Romero Estarlich, Eugenio Marañón Fernández, Jose Antonio Serra-Rexach
No abstract text is available yet for this article.
February 17, 2018: Revista Española de Geriatría y Gerontología
Juergen Prattes, Martin Hoenigl, Stefanie E-M Zinke, Sven Heldt, Susanne Eigl, Gemma L Johnson, Stephen Bustin, Evelyn Stelzl, Harald H Kessler
The newly developed AspID PCR assay for detection of Aspergillus spp. was evaluated with an interlaboratory quality control program panel and human bronchoalveolar lavage fluid (BALF) samples. With the quality control program, eight out of nine panel members were correctly identified. With the clinical study, 36 BALF samples that had been obtained from 18 patients with invasive pulmonary aspergillosis (IPA) and 18 without IPA were investigated. Sensitivity, specificity, positive and negative likelihood ratio for the AspID assay were 94...
February 20, 2018: Mycoses
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