Aspergillosis: Spectrum of Disease, Diagnosis, and Treatment

Barnes, Penelope D.; Marr, Kieren A.

doi:10.1016/j.idc.2006.06.001

Cited by 152 publications

(148 citation statements)

References 84 publications

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“…One of the most important clinical manifestations of Aspergillus is invasive aspergillosis (IA), which is associated with high morbidity and mortality rates (1,2). The genus Aspergillus is divided into eight subgenera that in turn are subdivided into several sections that include a large variety of closely related species (3,4).…”

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confidence: 99%

Cryptic and Rare Aspergillus Species in Brazil: Prevalence in Clinical Samples and In Vitro Susceptibility to Triazoles

et al. 2014

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confidence: 99%

Cryptic and Rare Aspergillus Species in Brazil: Prevalence in Clinical Samples and In Vitro Susceptibility to Triazoles

et al. 2014

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“…Invasive aspergillosis (IA) is second only to candidiasis as the most important invasive mycosis affecting humans (5,10,18,37,40). Although several hundred species of Aspergillus have been described, relatively few are known to cause disease in humans.…”

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Wild-Type MIC Distribution and Epidemiological Cutoff Values for Aspergillus fumigatus and Three Triazoles as Determined by the Clinical and Laboratory Standards Institute Broth Microdilution Methods

Diekema²,

et al. 2009

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Antifungal susceptibility testing of Aspergillus species has been standardized by both the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial SusceptibilityTesting (EUCAST). Recent studies suggest the emergence of strains of Aspergillus fumigatus with acquired resistance to azoles. The mechanisms of resistance involve mutations in the cyp51A (sterol demethylase) gene, and patterns of azole cross-resistance have been linked to specific mutations. Studies using the EUCAST broth microdilution (BMD) method have defined wild-type (WT) MIC distributions, epidemiological cutoff values (ECVs), and cross-resistance among the azoles. We tested a collection of 637 clinical isolates of A. fumigatus for which itraconazole MICs were <2 g/ml against posaconazole and voriconazole using the CLSI BMD method. An ECV of <1 g/ml encompassed the WT population of A. fumigatus for itraconazole and voriconazole, whereas an ECV of <0.25 g/ml was established for posaconazole. Our results demonstrate that the WT distribution and ECVs for A. fumigatus and the mold-active triazoles were the same when determined by the CLSI or the EUCAST BMD method. A collection of 43 isolates for which itraconazole MICs fell outside of the ECV were used to assess cross-resistance. Cross-resistance between itraconazole and posaconazole was seen for 53.5% of the isolates, whereas cross-resistance between itraconazole and voriconazole was apparent in only 7% of the isolates. The establishment of the WT MIC distribution and ECVs for the azoles and A. fumigatus will be useful in resistance surveillance and is an important step toward the development of clinical breakpoints.

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“…Los pacientes con FQ o tuberculosis presentan alteraciones predominantemente en lóbulos superiores, 46 mientras que la distribución central sugiere ABPA. 53 En cambio, bronquiectasias unilaterales en lóbulo inferior pueden sugerir secuestro pulmonar o CE. 60 Otras características radiológicas sugieren trastornos específicos: calibre aumentado de tráquea y bronquios centrales orienta a síndrome de MounierKuhn, 33 y atelectasia recurrente en lóbulo medio o língula sugiere síndrome de lóbulo medio.…”

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“…Su diagnóstico se basa en la combinación de criterios clínicos, radiológicos e inmunológicos. 53 En el déficit de alfa-1-antitripsina las bronquiectasias pueden ser una complicación pulmonar a largo plazo en adultos y niños, si bien es infrecuente y más en pediatría.…”

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Bronquiectasias en pediatría, aproximación diagnóstica y tratamiento

et al. 2012

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RESUMENLas bronquiectasias son un problema de salud en países desarrollados y en vías de desarrollo. La fibrosis quística es una causa importante, si bien fuera de ésta existen causas que convierten a las bronquiectasias no relacionadas con fibrosis quística en un diagnóstico frecuente. Su diagnóstico precoz basado en la clínica y posterior confirmación radiológica es el punto de partida para determinar la etiología e instaurar un tratamiento dirigido a la causa subyacente. Para ello es menester una evaluación ordenada y sistemá-tica. Se presenta una revisión sobre la etiología y tratamiento de las bronquiectasias, especialmente de las no relacionadas con fibrosis quística. Palabras clave: bronquiectasias, fibrosis quística, antibióticos, infección bronquial, diagnóstico. SUMMARYBronchiectasis is still an important health problem in both, developed and developing countries. Cystic fibrosis is one of the most important causes, but a great variety of other causes makes non cystic fibrosis bronchiectasis a relatively frequent diagnosis. Early diagnosis based on medical history and radiological confirmation is only the starting point to determine the specific etiology, in order to establish a treatment focused on the underlying cause. For this purpose, an orderly and systematic diagnostic evaluation is required. A review article about bronchiectasis, particularly those not related to cystic fibrosis, is presented.

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Aspergillosis: Spectrum of Disease, Diagnosis, and Treatment

Cited by 152 publications

References 84 publications

Cryptic and Rare Aspergillus Species in Brazil: Prevalence in Clinical Samples and In Vitro Susceptibility to Triazoles

Cryptic and Rare Aspergillus Species in Brazil: Prevalence in Clinical Samples and In Vitro Susceptibility to Triazoles

Wild-Type MIC Distribution and Epidemiological Cutoff Values for Aspergillus fumigatus and Three Triazoles as Determined by the Clinical and Laboratory Standards Institute Broth Microdilution Methods

Bronquiectasias en pediatría, aproximación diagnóstica y tratamiento

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