Amphotericin B-resistant yeast infection in severely immunocompromised patients

Powderly, William G.; Kobayashi, George S.; Herzig, Geoffrey P.; Medoff, Gerald

doi:10.1016/0002-9343(88)90059-9

Cited by 213 publications

(103 citation statements)

References 18 publications

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“…Most of the resistant isolates to amphotericin B were recovered from immunocopromised individuals and this could be related to effects on cellular membrane of yeast, in relation to the multiple treatments received for these patients. 40 In general, resistance to amphotericin B because of previous exposure to this drug has not been detected. Pfaller et al [41] described different proportion of resistance to amphotericin B according to Candida strains considered, with 5% of C. albicans, 59% of C. glabrata and 100% to C. krusei resistant to amphotericin B.…”

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confidence: 99%

Oral yeast carriage in HIV‐infected and non‐infected populations in Rosario, Argentina

Luque¹,

Biasoli²,

Tosello³

et al. 2008

Mycoses

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Summary The objectives of the present study were: (i) to assess the frequency of oral colonisation by Candida species in HIV‐positive patients and to compare it with a population of HIV‐negative individuals, (ii) to determine the prevalence of C. dubliniensis in both populations and (iii) to determine the susceptibility of C. dubliniensis and other Candida species isolated from HIV‐positive patients to the most commonly used antifungal agents. Oral samples were obtained from 101 HIV‐positive and 108 HIV‐negative subjects. For yeast identification, we used morphology in cornmeal agar, the API 20C Aux, growth at 45 °C, d‐xylose assimilation, morphology in sunflower seed agar and PCR. The frequency of isolation of Candida in HIV‐positive patients was: C. albicans, 60.7%; C. dubliniensis, 20.2%; C. glabrata, 5.6%; C. krusei, 5.6%; C. tropicalis, 4.5%; others, <5%. The frequency of isolation of Candida in HIV‐negative patients was: C. albicans, 73.9%; C. tropicalis, 15.5%; C. dubliniensis, 2.1%; C. glabrata, 2.1%; C. parapsilosis, 2.1%; others, <5%. The oral colonisation by yeast in the HIV‐positive patients was higher than that in the HIV‐negative subjects. The susceptibilities of 42 Candida isolates to three antifungal agents were determined. All isolates of C. dubliniensis were susceptible to fluconazole, although several individuals had been previously treated with this drug. Out of the 42 Candida isolates, 10 presented resistance to fluconazole and 10 to itraconazole. The presence of Candida species, resistant to commonly used antifungal agents, represents a potential risk in immunocompromised patients.

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confidence: 99%

Oral yeast carriage in HIV‐infected and non‐infected populations in Rosario, Argentina

Luque¹,

Biasoli²,

Tosello³

et al. 2008

Mycoses

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“…Most infections appear to originate from the patients' alimentary tract microflora (32). The higher proportion of C. tropicalis in adult patients and older children hospitalized in oncology-hematology units might be partially explained by the prophylactic or empirical use of amphotericin B (23). However, other differences, such as host defense deficiency and mucosal integrity, may be related to this discrepancy.…”

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Candida tropicalis in a Neonatal Intensive Care Unit: Epidemiologic and Molecular Analysis of an Outbreak of Infection with an Uncommon Neonatal Pathogen

et al. 2003

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, two episodes of Candida tropicalis fungemia occurred in the Aristotle University neonatal intensive care unit (ICU). To investigate this uncommon event, a prospective study of fungal colonization and infection was conducted. From December 1998 to December 1999, surveillance cultures of the oral cavities and perinea of the 593 of the 781 neonates admitted to the neonatal ICU who were expected to stay for >7 days were performed. Potential environmental reservoirs and possible risk factors for acquisition of C. tropicalis were searched for. Molecular epidemiologic studies by two methods of restriction fragment length polymorphism analysis and two methods of random amplified polymorphic DNA analysis were performed. Seventy-two neonates were colonized by yeasts (12.1%), of which 30 were colonized by Candida albicans, 17 were colonized by C. tropicalis, and 5 were colonized by Candida parapsilosis. From December 1998 to December 1999, 10 cases of fungemia occurred; 6 were due to C. parapsilosis, 2 were due to C. tropicalis, 1 was due to Candida glabrata, and 1 was due to Trichosporon asahii (12.8/1,000 admissions). Fungemia occurred more frequently in colonized than in noncolonized neonates (P < 0.0001). Genetic analysis of 11 colonization isolates and the two late blood isolates of C. tropicalis demonstrated two genotypes. One blood isolate and nine colonization isolates belonged to a single type. The fungemia/colonization ratio of C. parapsilosis (3/5) was greater than that of C. tropicalis (2/17, P ‫؍‬ 0.05), other non-C. albicans Candida spp. (1/11, P ‫؍‬ 0.02), or C. albicans (0/27, P ‫؍‬ 0.05). Extensive environmental cultures revealed no common source of C. tropicalis or C. parapsilosis. There was neither prophylactic use of azoles nor other risk factors found for acquisition of C. tropicalis except for total parenteral nutrition. A substantial risk of colonization by non-C. albicans Candida spp. in the neonatal ICU may lead to a preponderance of C. tropicalis as a significant cause of neonatal fungemia.Candida spp. are common causes of nosocomial invasive infections in neonatal intensive care units (ICUs). Although Candida albicans has historically been the most frequently isolated species, infections caused by non-C. albicans Candida spp. have been diagnosed with increased frequency in recent years (14,17). In particular, Candida parapsilosis has become the predominant fungal pathogen in many neonatal ICUs (11,14,17). Moreover, recent studies have shown that C. parapsilosis is often a cause of clusters and common-source outbreaks (12, 29).In contrast, little is known about the roles of other non-C. albicans Candida spp. in neonatal ICUs (4). To our knowledge, Candida tropicalis fungemia in neonates has not been adequately described, and the significance of mucocutaneous colonization of neonates by this pathogen remains speculative.Two chronologically related unusual cases of C. tropicalis fungemia that occurred in the Aristotle University neonatal ICU prompted us to initiate a prospective study of fungal co...

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“…It has long been documented that polyene-resistance emerged under therapy of immunosuppressed patients with Amphothericin B [99][100][101][102][103][104][105][106][107]. Recently, C. albicans strains were isolated consecutively from biopsies and faeces of an immunocompromised patient which acquired stepwise resistances to Azoles, Echinocandins, and Amphothericin B [108].…”

Section: Polyene Resistance Recovered From Patients Treated Either Wimentioning

confidence: 99%

For Debate: May the Use of the Polyene Macrolide Natamycin as a Food Additive Foster Emergence of Polyene-Resistance in Candida Species?

Dalhoff¹

2017

Clin Microbiol

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Amphotericin B-resistant yeast infection in severely immunocompromised patients

Cited by 213 publications

References 18 publications

Oral yeast carriage in HIV‐infected and non‐infected populations in Rosario, Argentina

Oral yeast carriage in HIV‐infected and non‐infected populations in Rosario, Argentina

Candida tropicalis in a Neonatal Intensive Care Unit: Epidemiologic and Molecular Analysis of an Outbreak of Infection with an Uncommon Neonatal Pathogen

For Debate: May the Use of the Polyene Macrolide Natamycin as a Food Additive Foster Emergence of Polyene-Resistance in Candida Species?

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