Systemic and localized infection by Candida species in patients with rheumatic diseases receiving anti-TNF therapy

Aikawa, Nádia E.; Rosa, Daniela T.A.; Negro, G. Del; Moraes, Júlio César Bertacini de; Ribeiro, Ana C.; Saad, Carla G. S.; Silva, Clóvis A.; Bonfá, Eloísa

doi:10.1016/j.rbre.2015.08.004

Cited by 11 publications

(10 citation statements)

References 21 publications

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“…In addition to larger cohort studies, numerous individual cases of IFIs have been reported for adults under TNFα inhibitor treatment, including histoplasmosis, coccidioidomycosis, blastomycosis, pneumocystosis, invasive candidiasis, invasive aspergillosis, cryptococcosis, mucormycosis, sporotrichosis, trichosporonosis, scedosporiosis, Acremonium kiliense fungemia, and Malassezia infections . One case of protothecosis has been also reported .…”

Section: Risks For Invasive Fungal Infectionsmentioning

confidence: 99%

Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF‐α) inhibitors

Tragiannidis

Kyriakidis

Zündorf

et al. 2016

Mycoses

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Macromolecular immunosuppressive monoclonal antibodies and fusion proteins directed against molecules or cells involved in inflammation and immunity represent a recent and important addition to our therapeutic armamentarium. Tumor necrosis alpha (TNFα) is a cytokine involved in systemic inflammation and clinical utilization of its antagonists has revolutionized treatment of juvenile rheumatoid and psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and plaque psoriasis. Clinical utility has also been demonstrated for use against steroid-refractory graft-vs-host disease and other immune-mediated conditions. Currently, five anti-TNFα agents are approved by the European Medicines Agency (EMA), including the monoclonal anti-TNF antibodies infliximab, adalimumab, golimumab and certolizumab pegol along with etanercept, a TNFα-receptor/IgG-Fc fusion protein. Theoretical considerations related to their mode of action and clinical observations suggest that opportunistic infectious complications should be seriously considered as possible adverse events of macromolecular immunosuppressants. The purpose of this review is to critically analyze the literature on invasive fungal infections (IFIs) occurring in association with TNFα inhibitors alone or in combination with other immunosuppressive agents, with a focus on pediatric patients, and to provide a framework of evaluating the risk for IFIs in this population.

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Section: Risks For Invasive Fungal Infectionsmentioning

confidence: 99%

Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF‐α) inhibitors

Tragiannidis

Kyriakidis

Zündorf

et al. 2016

Mycoses

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“…During the past several decades, the incidence of infections caused by genus Candida has substantially increased due to the expansion of immunosuppressive situations. Moreover, those species once thought tobe non-pathogenic are currently considered as opportunistic pathogens [ 5 , 6 ]. The current changes in the epidemiology of candidiasis highlight a shift in the prevalence of Candida species so that a reduced proportion of C. albicans and an increase in non- albicans Candida species Can be seen [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

A comparison between CHROMagar, PCR-RFLP and PCR-FSP for identification of Candida species

et al. 2017

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Background and Purpose:The epidemiological alteration in the distribution of Candida species, as well as the significantly increasing trend of either intrinsic or acquired resistance of some of these fungi highlights the need for a reliable method for the identification of the species. Polymerase chain reaction (PCR) is one of the methods facilitating the quick and precise identification of Candida species. The aim of this study was to compare the efficiency of CHROMagar, PCR-restriction fragment length polymorphism (PCR-RFLP), and PCR-fragment size polymorphism (PCR-FSP) assays in the identification of Candida species to determine the benefits and limitations of these methods.Materials and Methods:This study was conducted on 107 Candida strains, including 20 standard strains and 87 clinical isolates. The identification of the isolates was accomplished by using CHROMagar as a conventional method. The PCR-RFLP assay was performed on the entire internal transcribed spacer (ITS) region of ribosomal DNA (rDNA), and the consequent enzymatic digestion was compared with PCR-FSP results in which ITS1 and ITS2 regions were separately PCR amplified. In both molecular assays, yeast identification was carried out through the specific electrophoretic profiles of the PCR products.Results:According to the results, the utilization of CHROMagar resulted in the identification of 29 (33.3%) Candida isolates, while the PCR-RFLP and PCR-FSP facilitated the identification of 83 (95.4%) and 80 (91.9%) clinical isolates, respectively. The obtained concordances between CHROMagar and PCR-RFLP, between CHROMagar and PCR-FSP, as well as between PCR-RFLP and PCR-FSP were 0.23, 0.20, and 0.77, respectively.Conclusion:The recognition of the benefits and limitations of PCR methods allows for the selection of the most efficient technique for a fast and correct differentiation. The PCR-RFLP and PCR-FSP assays had satisfactory concordance. The PCR-FSP provides a rapid, technically simple, and cost-effective method for the identification of Candida species. Nevertheless, to accurately differentiate among the taxonomically related species, PCR-RFLP should be implemented.

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“…El uso de terapias biológicas en enfermedades reumáticas no han sido asociadas con infecciones localizadas o sistémicas causadas por Candida albicans. 25 En cuanto a infecciones por Pneumocystis jirovecii, se han reportado neumonías relacionadas con el patógeno oportunista hasta en 86.5% de pacientes con artritis reumatoide bajo tratamiento con etanercept, y hasta 6.7% de mortalidad, debido a la severidad y rápido curso de la infección. 26 La mayoría de estos eventos ocurrieron en pacientes que reciben otros agentes inmunosupresores como metotrexato o glucocorticoides.…”

Section: Otras Micosis Oportunistasunclassified

Infecciones asociadas al uso de fármacos anti-TNF en enfermedades reumáticas

Nava-Valdivia¹,

Ponce-Guarneros²,

Echeverría-González³

et al. 2020

El Residente

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RESUMEN. El factor de necrosis tumoral alfa (TNF-α) es una citocina proinflamatoria fundamental en la respuesta del sistema inmune contra las infecciones, además de participar en la patogénesis inflamatoria de enfermedades crónicas de origen autoinmune. Las terapias biológicas basadas en anticuerpos dirigidos a TNF-α son un valioso recurso en el tratamiento de enfermedades reumáticas. Sin embargo, esto conduce a un aumento en la susceptibilidad a infecciones ante patógenos oportunistas y complicaciones en estos pacientes. Esta revisión tiene como objetivo reportar evidencias acerca de las principales infecciones presentadas tras el uso de terapias anti-TNF-α en pacientes con enfermedades reumáticas, así como las estrategias realizadas ante estos casos.

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Systemic and localized infection by Candida species in patients with rheumatic diseases receiving anti-TNF therapy

Abstract: This was the first study to assess the prevalence of invasive and localized fungal disease by Candida in a significant number of patients with rheumatic diseases on anti-TNF therapy, and demonstrated low risk of candidiasis, despite the high prevalence of immunosuppressive drug use.

Cited by 11 publications

References 21 publications

Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF‐α) inhibitors

Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF‐α) inhibitors

A comparison between CHROMagar, PCR-RFLP and PCR-FSP for identification of Candida species

Infecciones asociadas al uso de fármacos anti-TNF en enfermedades reumáticas

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