Zygomycosis in Immunocompromised non-Haematological Patients

Zygomycoses caused by fungi of the mucorales order (mucormycoses) are emerging fungal diseases with a high fatality rate. The most important risk factors include neutropenia or functional neutropenia, diabetic ketoacidosis, iron overload, major trauma, prolonged use of corticosteroids, illicit intravenous drug (ID) use, neonatal prematurity, malnourishment, and maybe a previous exposure to antifungal agents with no activity against zygomycetes, such as voriconazole and echinocandins

Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon?

Raquel Sabino was not included as an author in the published article. It was corrected a posteriori.Erratum in - Corrigendum: Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon? [Front Microbiol. 2018] Front Microbiol. 2019 Jan 14;9:3245. doi: 10.3389/fmicb.2018.03245. eCollection 2018.Disponível em: https://www.frontiersin.org/articles/10.3389/fmicb.2018.03245/fullFree PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882871/ | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340063/Objectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied. Methods: A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene. Results: The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V. Conclusions:Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.This work was supported by ECMM, ISHAM, and EFISG and in part by an unrestricted research grant through the Investigator Initiated Studies Programof Astellas, MSD, and Pfizer. This study was fundet by the Christian Doppler Laboratory for invasive fungal infections.info:eu-repo/semantics/publishedVersio

Fusarium metavorans sp. Nov. : The frequent opportunist â € FSSC6'

The Fusarium solani species complex (FSSC) is the most common group of fusaria associated with superficial and life-threatening infections in humans. Here we formally introduce Fusarium metavorans sp. Nov., widely known as FSSC6 (Fusarium solani species complex lineage 6), one of the most frequent agents of human opportunistic infections. The species is described with multilocus molecular data including sequences of internal transcribed spacer region (ITS), portions of the translation elongation factor 1-a gene (TEF1), and the partial RNA polymerase II gene (rPB2). A phylogenetic approach was used to evaluate species delimitation. Topologies of the trees were concordant. Phylogenetic analyses suggest that the FSSC consists of three major clades encompassing a large number of phylogenetic species; Fusarium metavorans corresponds to phylogenetic species 6 within FSSC clade 3. The species has a global distribution and a wide ecological amplitude, also including strains from soil and agents of opportunistic plant disease; it was also isolated from the gut of the wood-boring cerambycid beetle Anoplophora glabripennis

A prospective international Aspergillus terreus survey: An EFISG, ISHAM and ECMM joint study

Objectives: A prospective international multicentre surveillance study was conducted to investigate the prevalence and amphotericin B susceptibility of Aspergillus terreus species complex infections. Methods: A total of 370 cases from 21 countries were evaluated. Results: The overall prevalence of A. terreus species complex among the investigated patients with mould-positive cultures was 5.2% (370/7116). Amphotericin B MICs ranged from 0.125 to 32 mg/L, (median 8 mg/L). Conclusions: Aspergillus terreus species complex infections cause a wide spectrum of aspergillosis and the majority of cryptic species display high amphotericin B MICs.Fil: Risslegger, Brigitte. Universidad de Innsbruck; AustriaFil: Zoran, Tamara. Universidad de Innsbruck; AustriaFil: Lackner, Michaela. Universidad de Innsbruck; AustriaFil: Aigner, María. Universidad de Innsbruck; AustriaFil: Sanchez Reus, Ferrán. Hospital de la Santa Creu I Sant Pau; EspañaFil: Rezusta, Antonio. Universidad de Zaragoza; EspañaFil: Chowdhary, Anuradha. University of Delhi; IndiaFil: Alcacer Sanchez, Juan Manuel. Hospital de la Santa Creu I Sant Pau;Fil: Taj Aldeen, Saad Jaber. Hamad Medical Corporation; QatarFil: Arendrup, Maiken C.. Universidad de Copenhagen; DinamarcaFil: Oliveri, Salvatore. Università degli Studi di Catania; ItaliaFil: Kontoyiannis, Dimitrios P.. The University of Texas MD Anderson Cancer Center; Estados UnidosFil: Alastruey Izquierdo, Ana. Universidad Carlos III de Madrid. Instituto de Salud; EspañaFil: Lagrou, Katrien. Katholikie Universiteit Leuven; BélgicaFil: Lo Cascio, Giuliana. Azienda Ospedaliera Universitaria Integrata; ItaliaFil: Meis, Jacques F.. Canisius Wilhelmina Hospital; Países BajosFil: Buzina, Walter. Medical University of Graz; AustriaFil: Farina, Claudio. ASST Papa Giovanni XXIII. Microbiology Institute; ItaliaFil: Drogari Apiranthitou, Miranda. Universidad Nacional y Kapodistriaca de Atenas; GreciaFil: Grancini, Anna. Cà Granda Ospedale Maggiore Policlinico; ItaliaFil: Tortorano, Anna Maria. Università degli Studi di Milano; ItaliaFil: Willinger, Birgit. Universidad de Viena; AustriaFil: Hamprecht, Axel. Universitat Zu Köln; AlemaniaFil: Johnson, Elizabeth. Public Health England. Mycology Reference Laboratory; Reino UnidoFil: Klingspor, Lena. Karolinska Huddinge Hospital; SueciaFil: Arsic Arsenijevic, Valentina. University of Belgrade; SerbiaFil: Cornely, Oliver A.. Universitat Zu Köln; AlemaniaFil: Meletiadis, Joseph. Universidad Nacional y Kapodistriaca de Atenas; GreciaFil: Prammer, Wolfgang. Klinikum Wels-Grieskirchen; AustriaFil: Tullio, Vivian. Università di Torino; ItaliaFil: Vehreschild, Jörg Janne. Universitat Bonn; Alemania. Universitat Zu Köln; AlemaniaFil: Trovato, Laura. Università degli Studi di Catania; ItaliaFil: Lewis, Russell E.. Universidad de Bologna; ItaliaFil: Segal, Esther. Tel Aviv University; IsraelFil: Rath, Peter Michael. Universitat Essen; AlemaniaFil: Hamal, Petr. Universtity Hospital Olomouc; República Checa. Palacky University Olomouc; República ChecaFil: Rodríguez Iglesias, Manuel. Universidad de Cádiz; EspañaFil: Roilides, Emmanuel. Aristotle University School of Health Sciences; GreciaFil: Arikan Akdagli, Sevtap. Hacettepe University; TurquíaFil: Chakrabarti, Arunaloke. Postgraduate Institute of Medical Education and Research; IndiaFil: Colombo, Arnaldo L.. Universidade Federal de Sao Paulo; BrasilFil: Fernández, Mariana Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Martin Gomez, M. Teresa. Vall d’Hebron University Hospital; EspañaFil: Badali, Hamid. Mazandaran University of Medical Sciences; IránFil: Petrikkos, Georgios. European University Cyprus; ChipreFil: Klimko, Nikolai. North Western State Medical University; RusiaFil: Heimann, Sebastian M.. Universitat Zu Köln; AlemaniaFil: Houbraken, Jos. Fungal Biodiversity Centre; Países BajosFil: Uzun, Omrum. Hacettepe University Medical School; TurquíaFil: Edlinger, Michael. Universidad de Innsbruck; AustriaFil: de la Fuente, Sonia. Hospital Ernest Lluch Martin; EspañaFil: Lass Flörl, Cornelia. Universidad de Innsbruck; Austri

DataSheet1.pdf

<p>Objectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied.</p><p>Methods: A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene.</p><p>Results: The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V.</p><p>Conclusions:Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.</p