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Invasive aspergillosis

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https://www.readbyqxmd.com/read/28722255/drug-drug-interactions-between-triazole-antifungal-agents-used-to-treat-invasive-aspergillosis-and-immunosuppressants-metabolized-by-cytochrome-p450-3a4
#1
REVIEW
Andreas H Groll, Robert Townsend, Amit Desai, Nkechi Azie, Mark Jones, Marc Engelhardt, Anne-Hortense Schmitt-Hoffman, Robert J Brüggemann
Patients undergoing treatment with immunosuppressant drugs following solid organ or hematopoietic stem cell transplantation are at particular risk for development of serious infections such as invasive aspergillosis. Four triazole antifungal drugs, voriconazole, posaconazole, itraconazole, and isavuconazole, are approved to treat invasive aspergillosis either as first- or second-line therapy. All of these agents are inhibitors of cytochrome P450 3A4, which plays a key role in metabolizing immunosuppressant drugs such as cyclosporine, tacrolimus, and sirolimus...
July 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28717638/spatial-patterns-and-impacts-of-environmental-and-climatic-factors-on-canine-sinonasal-aspergillosis-in-northern-california
#2
Monise Magro, Jane Sykes, Polina Vishkautsan, Beatriz Martínez-López
Sinonasal aspergillosis (SNA) causes chronic nasal discharge in dogs and has a worldwide distribution, although most reports of SNA in North America originate from the western USA. SNA is mainly caused by Aspergillus fumigatus, a ubiquitous saprophytic filamentous fungus. Infection is thought to follow inhalation of spores. SNA is a disease of the nasal cavity and/or sinuses with variable degrees of local invasion and destruction. While some host factors appear to predispose to SNA (such as belonging to a dolichocephalic breed), environmental risk factors have been scarcely studied...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28717040/flucloxacillin-results-in-suboptimal-voriconazole-plasma-concentrations
#3
Eline W Muilwijk, Bart G J Dekkers, Stefanie Henriet, Paul E Verweij, Bregje Witjes, Astrid M L Oude Lashof, Geert H Groeneveld, Johannes van der Hoeven, Jan Willem C Alffenaar, Frans G M Russel, Frank van de Veerdonk, Roger J M Brüggemann
Combining voriconazole and flucloxacillin is indicated in patient cohorts experiencing both invasive aspergillosis and gram-positive infections (e.g. patients with chronic granulomatous disease or post-influenza pulmonary aspergillosis). We report a highly relevant interaction between voriconazole and flucloxacillin resulting in subtherapeutic voriconazole plasma concentrations in more than 50% of patients, posing a severe threat if not managed properly.
July 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28712819/clinical-characteristics-radiologic-findings-risk-factors-and-outcomes-of-serum-galactomannan-negative-invasive-pulmonary%C3%A2-aspergillosis
#4
Jiwon Jung, Mi Young Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim
BACKGROUND: The sensitivity of galactomannan (GM) assay is suboptimal for detecting invasive pulmonary aspergillosis (IPA) in serum samples. However, the clinical characteristics, radiologic findings, and outcomes in patients with GM-negative IPA have not been fully elucidated. METHODS: Over a 7-year period, adult patients with proven or probable IPA by the EORTC/MSG definition were retrospectively enrolled. Patients with negative GM results and positive Aspergillus spp...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28702763/pharmacokinetics-of-antifungal-drugs-practical-implications-for-optimized-treatment-of-patients
#5
REVIEW
Romuald Bellmann, Piotr Smuszkiewicz
INTRODUCTION: Because of the high mortality of invasive fungal infections (IFIs), appropriate exposure to antifungals appears to be crucial for therapeutic efficacy and safety. MATERIALS AND METHODS: This review summarises published pharmacokinetic data on systemically administered antifungals focusing on co-morbidities, target-site penetration, and combination antifungal therapy. CONCLUSIONS AND DISCUSSION: Amphotericin B is eliminated unchanged via urine and faeces...
July 12, 2017: Infection
https://www.readbyqxmd.com/read/28701850/invasive-mediastinal-aspergillosis-in-immunocompetent-male-with-invasion-of-left-atrium-and-hilar-structures
#6
Munta Kartik, Arun Kanala, Sunilnadikuda, S Manimala Rao, P Swathi Prakasham
Aspergillus is described as mould characterised by septate hyphae about 2-4μ in diameter, it is ubiquitous in nature and spreads by inhalation of spores. It causes opportunistic infections in almost six forms namely Allergic bronchopulmonary aspergillosis, Aspergillus sinusitis, Cutaneous aspergillosis, Aspergilloma, Chronic pulmonary aspergillosis, Invasive aspergillosis. Invasive aspergillosis of mediastinum in an immunocompetent patient has rarely been reported. We present a case of a young male who had presented with chest pain, cough and breathleness was later diagnosed as fulminant mediastinal aspergillosis...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28696236/combination-therapy-with-isavuconazole-and-micafungin-for-treatment-of-experimental-invasive-pulmonary-aspergillosis
#7
Vidmantas Petraitis, Ruta Petraitiene, Matthew W McCarthy, Laura L Kovanda, Myo H Zaw, Kaiser Hussain, Naima Shaikh, Bo Bo W Maung, Navjot K Sekhon, William W Hope, Thomas J Walsh
Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity and mortality in immunocompromised patients. We hypothesized that simultaneous inhibition of biosynthesis of ergosterol in the fungal cell membrane and (1→3)-β-D-glucan in the cell wall, respectively, by the antifungal triazole isavuconazole and the echinocandin micafungin, may result in improved outcome in experimental IPA in persistently neutropenic rabbits. Treatment groups included isavuconazole (ISA) at 20 (ISA20), 40 (ISA40), and 60 (ISA60) mg/kg/day, micafungin at 2 mg/kg/day (MFG2), or combinations of (ISA20+MFG2), (ISA40+MFG2), (ISA60+MFG2), and untreated rabbits (UC)...
July 10, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28693685/effect-of-involved-aspergillus-species-on-galactomannan-in-bronchoalveolar-lavage-of-patients-with-invasive-aspergillosis
#8
Mojtaba Taghizadeh-Armaki, Mohammad T Hedayati, Vahid Moqarabzadeh, Saham Ansari, Saeed Mahdavi Omran, Hossein Zarrinfar, Sasan Saber, Paul E Verweij, David W Denning, Seyedmojtaba Seyedmousavi
PURPOSE: The detection of galactomannan (GM) in bronchoalveolar lavage (BAL) fluid is an important surrogate marker for the early diagnosis and therapeutic monitoring of invasive aspergillosis (IA), regardless of the involved species of Aspergillus. Here, we utilized the Platelia Aspergillus GM enzyme immunoassay (Bio-Rad) to evaluate the GM index in BAL fluid samples from patients with proven, probable or putative IA due to Aspergillusflavus versus Aspergillusfumigatus. METHODOLOGY: In a prospective study between 2009 and 2015, 116 BAL samples were collected from suspected IA patients referred to two university hospitals in Tehran, Iran...
July 10, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28689016/long-term-follow-up-of-invasive-aspergillosis-in-allogeneic-stem-cell-transplantation-recipients-and-leukemia-patients-differences-in-risk-factors-and-outcomes
#9
S Bonnet, R Duléry, K Regany, M Bouketouche, L Magro, V Coiteux, S Alfandari, C Berthon, B Quesnel, I Yakoub-Agha
Antifungal prophylaxis (AP) has dramatically changed the epidemiology of invasive aspergillosis (IA). To better understand the differences in terms of clinical significance of IA between allogeneic stem cell transplantation (allo-SCT) recipients and patients treated for leukemia, we report a single-center study of 735 unselected consecutive patients treated between 2000 and 2004, before the era of systematic AP. Probable or confirmed IA were observed in 29 patients (2008 EORTC/MSG criteria), including 7/235 undergoing allo-SCT (5...
July 5, 2017: Current Research in Translational Medicine
https://www.readbyqxmd.com/read/28687215/invasive-fungal-infections-in-the-intensive-care-unit
#10
REVIEW
Luis Ostrosky-Zeichner, Mohanad Al-Obaidi
Intensive care unit (ICU) patients are exposed to multiple stressors that predispose them to invasive fungal infections (IFIs), which carry high morbidity and mortality. Getting acquainted with the diagnostic methods and therapies is imperative for patient safety and for providing high-quality health care. This article focuses on the most frequent IFIs: invasive candidiasis and invasive aspergillosis.
July 5, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28681812/evaluation-of-serum-galactomannan-enzyme-immunoassay-at-two-different-cut-offs-for-the-diagnosis-of-invasive-aspergillosis-in-patients-with-febrile-neutropenia
#11
Ritin Mohindra, Malini R Capoor, Shikha Puri, Hitesh Raheja, Dinesh K Gupta, B Gupta, Ranadip Chowdhury
BACKGROUND: Invasive aspergillosis (IA) is an increasingly common and fatal opportunistic fungal infection in patients with haematological diseases. Early diagnosis is difficult as mycological culture techniques have low sensitivity and the radiological tools have low specificity. Galactomannan enzyme immunoassay (GEI) detects galactomannan in the human serum with a reported sensitivity and specificity between 30% and 100%. AIMS: The aim of this study was to analyse the role of GEI in diagnosis of IA in patients with febrile neutropenia and to evaluate the role of GEI in the diagnosis of IA as per the revised (2008) European Organization for Research and Treatment of Cancer-Mycoses Study Group (EORTC-MSG) criteria at two different optical density (OD) cut-offs of 0...
April 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28681028/osteomyelitis-and-lung-abscess-due-to-aspergillus-fumigatus-in-a-chronic-granulomatous-disease-patient
#12
S Mamishi, K Zomorodian, F Saadat, S Z Jalali, M Geramishoar
BACKGROUND AND PURPOSE: Chronic granulomatous disease (CGD) is an inherited disorder of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex. This disorder results in recurrent life-threatening bacterial and fungal infections. Aspergillus species are the most common fungal infections in these patients. CASE REPORT: Herein, we present a case of fungal infection in a girl with CGD. We confirmed aspergillosis through the positive microscopic and macroscopic examinations, as well as radiology results...
September 2016: Advances in Medical Mycology (Iran)
https://www.readbyqxmd.com/read/28680526/lateral-flow-assays-for-the-diagnosis-of-invasive-aspergillosis-current-status
#13
REVIEW
Sven Heldt, Martin Hoenigl
PURPOSE OF REVIEW: Diagnosis during early stages of invasive aspergillosis (IA) and targeted antifungal treatment has the potential to improve survival significantly. Despite advances in the diagnostic arsenal, invasive mold infections remain difficult to diagnose-especially at early stages before typical radiological signs develop. Varying availability and time-to-results are important limitations of current approved biomarkers and molecular assays for diagnosis of IA. Here, we will give an update on the Aspergillus-specific lateral-flow device (LFD) test...
2017: Current Fungal Infection Reports
https://www.readbyqxmd.com/read/28680340/successful-treatment-of-pulmonary-candidiasis-and-aspergillosis-in-patient-with-refractory-hodgkin-lymphoma-using-micafungin-case-study-and-brief-literature-review
#14
Marta Barańska, Renata Kroll-Balcerzak, Lidia Gil, Joanna Rupa-Matysek, Mieczysław Komarnicki
The number of patients with hematological malignancies who develop invasive fungal disease (IFD) has increased dramatically in recent decades. This increase is attributed to impairment of the host immune system due to intensive cytotoxic chemotherapies, use of corticosteroids and profound immunosuppression after hematopoietic stem cell transplantation (HSCT). Additionally, the increasing prevalence of fungal infections caused by emerging and rare pathogens, IFD of mixed etiology or of atypical localization is observed...
2017: Central-European Journal of Immunology
https://www.readbyqxmd.com/read/28671171/early-onset-de-novo-invasive-pulmonary-aspergillosis-in-an-orthotopic-heart-transplant-recipient
#15
Zaw Min, Manik Veer, Parth Rali, Anil Singh, Nitin Bhanot
Invasive aspergillosis generally occurs during the first 1-6 months after heart transplantation. It has been rarely seen in the first 2 weeks postcardiac transplant. We herein describe a unique case of invasive pulmonary aspergillosis (IPA) diagnosed on day 9 postorthotopic heart transplantation. The known risk factors for IPA in cardiac transplant recipients were not identified in our case. The organ recipients from the same donor did not report Aspergillus infection. Hospital environmental samplings failed to demonstrate Aspergillus spores in the patient's room and his adjacent rooms...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28669830/drivers-and-impact-of-antifungal-therapy-in-critically-ill-patients-with-aspergillus-positive-respiratory-tract-cultures
#16
J A Paiva, P Mergulhão, A Gomes, F S Taccone, A-M Van den Abeele, P Bulpa, B Misset, W Meersseman, G Dimopoulos, J Rello, D Vogelaers, S Blot
BACKGROUND: Invasive pulmonary aspergillosis (IPA) is an increasingly recognized problem in critically ill patients. Little is known about how intensivists react to a Aspergillus-positive respiratory sample and about the efficacy of antifungals. Our goal was to identify drivers of antifungal therapy (AFT) prescription and diagnostic workup in patients with Aspergillus isolation in respiratory specimens as well as the impact of AFT in these patients. METHODS: ICU patients with a Aspergillus-positive respiratory sample from the database of a previous observational multicenter study were analysed...
June 29, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28667276/diagnostic-performance-of-contrast-enhanced-pulmonary-computed-tomography-angiography-for-the-detection-of-angioinvasive-pulmonary-aspergillosis-in-immunocompromised-patients
#17
C Henzler, T Henzler, D Buchheidt, John W Nance, C A Weis, R Vogelmann, U Benck, T Viergutz, T Becher, T Boch, S A Klein, D Heidenreich, L Pilz, M Meyer, P M Deckert, W-K Hofmann, S O Schoenberg, M Reinwald
Invasive pulmonary aspergillosis (IPA) is one of the major complications in immunocompromised patients. The mainstay of diagnostic imaging is non-enhanced chest-computed-tomography (CT), for which various non-specific signs for IPA have been described. However, contrast-enhanced CT pulmonary angiography (CTPA) has shown promising results, as the vessel occlusion sign (VOS) seems to be more sensitive and specific for IPA in hematologic patients. The aim of this study was to evaluate the diagnostic accuracy of CTPA in a larger cohort including non-hematologic immunocompromised patients...
June 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28666752/dosing-of-caspofungin-based-on-a-pharmacokinetic-pharmacodynamic-index-for-the-treatment-of-invasive-fungal-infections-in-critically-ill-patients-on-continuous-venovenous-haemodiafiltration
#18
Alejandro Pérez-Pitarch, Rafael Ferriols-Lisart, Gerardo Aguilar, Carlos Ezquer-Garín, F Javier Belda, Beatriz Guglieri-López
INTRODUCTION: The objective of this study was to evaluate the efficacy of different dosages of caspofungin in the treatment of invasive candidiasis and aspergillosis, in relation to the probability of pharmacokinetic/pharmacodynamic target attainment, using modelling and Monte Carlo simulations in critically ill adult patients on continuous haemodiafltration. METHODS: Critically ill adult patients on continuous venovenous haemodiafiltration treated with caspofungin were analysed...
June 27, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28653258/azole-resistance-in-aspergillus-fumigatus-in-patients-with-cystic-fibrosis-a-matter-of-concern
#19
A Hamprecht, F Morio, O Bader, P Le Pape, J Steinmann, E Dannaoui
Aspergillus fumigatus is the most frequent filamentous fungus isolated from respiratory specimens from patients with cystic fibrosis (CF). Triazoles are the most widely used antifungals in the treatment of allergic bronchopulmonary aspergillosis (ABPA) and invasive aspergillosis (IA) in CF patients. Treatment success could be severely compromised by the occurrence of azole-resistant A. fumigatus (ARAf), which is increasingly reported worldwide from both clinical samples and the environment. In previous studies, ARAf has been detected in up to 8% of CF patients...
June 26, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28652112/multinational-retrospective-case-control-study-of-risk-factors-for-the-development-of-late-invasive-pulmonary-aspergillosis-following-kidney-transplantation
#20
Francisco López-Medrano, Mario Fernández-Ruiz, José Tiago Silva, Peggy L Carver, Christian van Delden, Esperanza Merino, María José Pérez-Saez, Milagros Montero, Julien Coussement, Milene de Abreu Mazzolin, Carlos Cervera, Lidia Santos, Nuria Sabé, Anne Scemla, Elisa Cordero, Leónidas Cruzado-Vega, Paloma Leticia Martín-Moreno, Óscar Len, Eddison Rudas, Alfredo Ponce de León, Mariano Arriola, Ricardo Lauzurica, Miruna D David, Claudia González-Rico, Fernando Henríquez-Palop, Jesús Fortún, Marcio Nucci, Oriol Manuel, José Ramón Paño-Pardo, Miguel Montejo, Antonio Vena, Beatriz Sánchez-Sobrino, Auxiliadora Mazuecos, Julio Pascual, Juan Pablo Horcajada, Thanh Lecompte, Asunción Moreno, Jordi Carratalà, Marino Blanes, Domingo Hernández, Erick Alejandro Hernández-Méndez, María Carmen Fariñas, Manuel Perelló-Carrascosa, Patricia Muñoz, Amado Andrés, José María Aguado
OBJECTIVES: To assess the risk factors for the development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT). METHODS: We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls were matched (1:1 ratio) by center and date of transplantation. Immunosuppression-related events (IREs) included the occurrence of non-ventilator-associated pneumonia, tuberculosis, cytomegalovirus disease and/or de novo malignancy...
June 23, 2017: Clinical Microbiology and Infection
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