Clinical and microbiological efficacy of micafungin on Geosmithia argillacea infection in a cystic fibrosis patient

Marguet, Christophe; Favennec, Loïc; Matray, Olivier; Bertout, Sébastien; Giraud, Sandrine; Couderc, L.; Zouhair, Rachid; Leguillon, C.; Gargala, Gilles; Bouchara, Jean-Philippe

doi:10.1016/j.mmcr.2012.08.004

Cited by 18 publications

(23 citation statements)

References 10 publications

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“…infections. Notably, in the French reported case, although caspofungin treatment resulted in improvement in the clinical status of the patient, eradication was obtained only with high‐dose and prolonged micafungin therapy . Furthermore, in our in vitro combination testing we did not observe any synergy for itraconazole‐micafungin and terbinafine‐micafungin combinations.…”

Section: Discussionmentioning

confidence: 48%

Airway persistence by the emerging multi‐azole‐resistant Rasamsonia argillacea complex in cystic fibrosis

Abdolrasouli

Bercusson

Rhodes

et al. 2018

Mycoses

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Infections caused by Rasamsonia argillacea complex have been reported in various clinical settings. Cystic fibrosis (CF) is one of the main underlying conditions. An observational cohort study of CF patients with Rasamsonia in respiratory samples was conducted. Eight isolates from 6 patients were identified as R. argillacea complex and tested for antifungal susceptibility. All isolates had high MICs to voriconazole and posaconazole and low MECs to echinocandins. Four patients experienced lung function decline in the year preceding first Rasamsonia isolation. This continued in the year following first isolation in 3 out of 4 cases. Antifungal therapy was initiated in 2 patients, to which only one exhibited a clinical response. Three out of 6 patients died within 3 years of isolating Rasamsonia. Genotyping suggests that similar genotypes of Rasamsonia can persist in CF airways. Consistent with other fungi in CF, the clinical impact of airway colonisation by Rasamsonia is variable. In certain patients, Rasamsonia may be able to drive clinical decline. In others, though a clear impact on lung function may be difficult to determine, the appearance of Rasamsonia acts as a marker of disease severity. In others it does not appear to have an obvious clinical impact on disease progression.

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Section: Discussionmentioning

confidence: 48%

Airway persistence by the emerging multi‐azole‐resistant Rasamsonia argillacea complex in cystic fibrosis

Abdolrasouli

Bercusson

Rhodes

et al. 2018

Mycoses

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“…In contrast, it seems more limited in CF, with a unique case of respiratory infections caused by this species complex having been reported for this genetically inherited disease (14). Nevertheless, the present identification of some genotypes chronically colonizing the lower airways of patients with CF demonstrates the persisPatient P17 -sampling date 1 9 9 6 1 9 9 7 / 0 9 / 2 5 2 0 0 1 1 9 9 8 / 0 1 / 2 1 1 9 9 7 / 1 2 / 1 1 1 9 9 7 / 1 0 / 2 7 tence of these usually saprophytic fungi in the respiratory tract and their multiplication, suggesting their contribution to the inflammatory reaction which progressively leads to clinical and functional deterioration, as demonstrated for long-term colonization of the airways by Aspergillus fumigatus or Candida albicans (32,33,34).…”

Section: Discussionmentioning

confidence: 98%

“…In CF patients, all species of the R. argillacea complex except R. eburnea have been reported to colonize the airways (8). While no clear relationship was established in the CF context between the colonization of the airways by these fungi and a clinical or functional deterioration, the recent report of R. argillacea pathogenicity in one patient with CF prompts further investigation (14). In addition, differences between these closely related species in their antifungal susceptibility profiles further emphasize the need for an accurate identification of the fungus for optimal therapy (1,8).…”

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confidence: 98%

“…Chronic granulomatous disease (CGD) (9, 10, 11) and cystic fibrosis (CF) (12,13,14,15,16,17) are the major underlying clinical conditions. Rasamsonia infections may also occur in bone marrow transplant recipients (18, 19) but also may occur in the absence of any predisposing factors, as evidenced by the pulmonary and aortic graft infection reported by Doyon et al (20) in an immunocompetent individual.…”

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confidence: 99%

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Long-Term Rasamsonia argillacea Complex Species Colonization Revealed by PCR Amplification of Repetitive DNA Sequences in Cystic Fibrosis Patients

et al. 2016

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The aim of this work was to document molecular epidemiology of Rasamsonia argillacea species complex isolates from cystic fibrosis (CF) patients. In this work, 116 isolates belonging to this species complex and collected from 26 CF patients and one patient with chronic granulomatous disease were characterized using PCR amplification assays of repetitive DNA sequences and electrophoretic separation of amplicons (rep-PCR). Data revealed a clustering consistent with molecular species identification. A single species was recovered from most patients. Rasamsonia aegroticola was the most common species, followed by R. argillacea sensu stricto and R. piperina, while R. eburnea was not identified. Of 29 genotypes, 7 were shared by distinct patients while 22 were patient specific. In each clinical sample, most isolates exhibited an identical genotype. Genotyping of isolates recovered from sequential samples from the same patient confirmed the capability of R. aegroticola and R. argillacea isolates to chronically colonize the airways. A unique genotype was recovered from two siblings during a 6-month period. In the other cases, a largely dominant genotype was detected. Present results which support the use of rep-PCR for both identification and genotyping for the R. argillacea species complex provide the first molecular evidence of chronic airway colonization by these fungi in CF patients.R asamsonia argillacea, which was first reported in clinical practice as a Penicillium species, then reclassified in the genus Geosmithia, and finally reassigned in 2013 to the new genus Rasamsonia, is now considered an emerging pathogen (1). Since its first report in humans as Penicillium emersonii (2), there has been an increasing number of cases reported in both dogs (3, 4, 5) and humans (6). Nevertheless, it is likely that the number of human infections caused by this fungus has long been underestimated because of the lack of specificity of its morphological features and to subsequent misidentifications with some Penicillium or Paecilomyces species.Only six species were previously recognized in the genus Rasamsonia described in 2012, i.e., R. argillacea, R. composticola, R. brevistipitata, R. byssochlamydoides, R. cylindrospora, and R. emersonii (7). However, multilocus sequence analysis of several R. argillacea isolates revealed a clustering which superimposed some phenotypic differences. Therefore, R. argillacea is now considered a species complex comprising four distinct species: R. argillacea sensu stricto, R. piperina, R. aegroticola, and R. eburnea (8).Infections caused by species of the R. argillacea complex have been reported in various clinical contexts in human. Chronic granulomatous disease (CGD) (9, 10, 11) and cystic fibrosis (CF) (12,13,14,15,16,17) are the major underlying clinical conditions. Rasamsonia infections may also occur in bone marrow transplant recipients (18, 19) but also may occur in the absence of any predisposing factors, as evidenced by the pulmonary and aortic graft infection reported by Doyon et al. (...

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“…In total, four studies from France and the United Kingdom have reported the colonization of 18 CF patients by the R. argillacea species complex 8,9,19,20. However, the presence or persistence of these fungi was associated with a decrease in lung function or with pulmonary exacerbation in only one case 20. Our knowledge about the relevance and role of this fungus in CF is still limited because this pathogen has been only recently described, and data about its real prevalence in the CF population are lacking.…”

Section: Discussionmentioning

confidence: 99%

Validation of a novel real-time PCR for detecting Rasamsonia argillacea species complex in respiratory secretions from cystic fibrosis patients

Steinmann

Giraud

Schmidt

et al. 2014

New Microbes and New Infections

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Members of the recently introduced fungal genus Rasamsonia (formerly included in the Geosmithia genus) have been described as emerging pathogens in immunosuppressed hosts or patients with cystic fibrosis (CF). Rasamsonia species have often been misidentified as Penicillium or Paecilomyces because of similar morphological characteristics. We validated a commercially available real-time PCR assay (Primerdesign™, UK) for accurate detection of species from the Rasamsonia argillacea complex. First, we tested this assay with a collection of 74 reference strains and clinical isolates and then compared the PCR with cultures of 234 respiratory samples from 152 patients with CF from two University Hospitals in Germany and France. The assay reliably detected the three main species within the Rasamsonia argillacea species complex (R. argillacea, R. piperina, R. aegroticola), which are typically encountered in CF patients. The limit of DNA detection was between 0.01 and 1 pg/μL. Analysis of the DNA extracts from respiratory specimens of CF patients revealed that four out of the 153 patients studied (2.6%) were colonized with R. argillacea species complex. Two species from the R. argillacea complex grew in the parallel cultures from the same patients. In one patient the PCR was positive 5 months before culture. The real-time PCR assay is a sensitive and specific method for detecting the three most important species of the R. argillacea species complex encountered in the CF context. Detection of these emerging pathogens in respiratory secretions from CF patients by this novel assay may increase our understanding of the occurrence and epidemiology of the R. argillacea species complex.

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Clinical and microbiological efficacy of micafungin on Geosmithia argillacea infection in a cystic fibrosis patient

Cited by 18 publications

References 10 publications

Airway persistence by the emerging multi‐azole‐resistant Rasamsonia argillacea complex in cystic fibrosis

Airway persistence by the emerging multi‐azole‐resistant Rasamsonia argillacea complex in cystic fibrosis

Long-Term Rasamsonia argillacea Complex Species Colonization Revealed by PCR Amplification of Repetitive DNA Sequences in Cystic Fibrosis Patients

Validation of a novel real-time PCR for detecting Rasamsonia argillacea species complex in respiratory secretions from cystic fibrosis patients

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