Fatal disseminated Acremonium strictum infection in a preterm newborn: a very rare cause of neonatal septicaemia

Yalaz, Mehmet; Hilmioğlu, Süleyha; Metin, Dilek Yeşim; Akısü, Mete; Nart, Denız; Çetin, Hasan; Öztürk, Cengiz; Isik, Ecmel; Kültürsay, Nilgün

doi:10.1099/jmm.0.05140-0

Cited by 20 publications

(14 citation statements)

References 12 publications

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“…While a disseminated infection by an Acremonium sp. in a patient with Addison's disease was successfully treated with that drug (36), failure has mainly been reported in cases of fungemia or disseminated infections (21,23,32,33). Although this drug was able to reduce fungal load in some organs in our study, it was ineffective in prolonging survival for any of the strains tested, which suggests that this drug should be used with caution in cases of human infection.…”

Section: Discussioncontrasting

confidence: 46%

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Evaluation of the Efficacies of Amphotericin B, Posaconazole, Voriconazole, and Anidulafungin in a Murine Disseminated Infection by the Emerging Opportunistic Fungus Sarocladium (Acremonium) kiliense

Fernández-Silva

Capilla²,

Mayayo³

et al. 2013

Antimicrob Agents Chemother

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We evaluated and compared the efficacies of different antifungal drugs against Sarocladium kiliense (formerly Acremonium kiliense), a clinically relevant opportunistic fungus, in a murine model of systemic infection. Three clinical strains of this fungus were tested, and the therapy administered was as follows: posaconazole at 20 mg/kg of body weight (twice daily), voriconazole at 40 mg/kg, anidulafungin at 10 mg/kg, or amphotericin B at 0.8 mg/kg. The efficacy was evaluated by prolonged animal survival, tissue burden reduction, and (1¡3)-␤-D-glucan serum levels. In general, the four antifungal drugs showed high MICs and poor in vitro activity. The efficacy of the different treatments was only modest, since survival rates were never higher than 40% and no drug was able to reduce fungal load in all the organs for the three strains tested. Posaconazole, in spite of its high MICs (>16 g/ ml), showed the highest efficacy. The (1¡3)-␤-D-glucan serum levels were equally reduced by all drugs evaluated.A cremonium kiliense is a saprobic fungus with a worldwide distribution which has been reported in recent years as an emerging opportunistic pathogen able to cause a wide range of human infections (1-4). Localized infections, such as mycetoma, keratitis, or onychomycosis, are acquired mainly by immunocompetent patients through trauma (5-11). Invasive infections generally affect immunosuppressed hosts such as those undergoing transplantation or those with AIDS, resulting in a high degree of fatality (12-16). More rarely, though, invasive infections have also been reported in immunocompetent individuals (17,18). Recently, based on molecular studies, this fungus has been transferred to the genus Sarocladium as Sarocladium kiliense (1). This species is the most clinically relevant of the genus and apparently also the most virulent (4,19,20). Considering that the morphological identification of these fungi is difficult, it is likely that some clinical isolates of this species have been misidentified as Acremonium strictum, another clinically important species of Acremonium (19). Infections by Acremonium spp. are difficult to treat due to the intrinsic resistance to the current antifungal agents, and an effective treatment has not yet been determined (19,(21)(22)(23). Amphotericin B (AMB) is the drug most commonly used to treat severe fungal infections caused by opportunistic molds (4). Despite its poor in vitro activity and variable clinical results, this drug still remains the first therapeutic choice against invasive Acremonium infections (2, 4, 19). Clinical experience with other drugs, such as posaconazole (PSC), voriconazole (VRC), and the echinocandins, is very poor.To evaluate possible therapeutic strategies, we tested the efficacies of PSC, VRC, and anidulafungin (AFG) compared to that of AMB against S. kiliense in a recently developed murine model of disseminated infection (20). MATERIALS AND METHODSThree clinical strains of Sarocladium kiliense, UTHSC 01-2238, UTHSC 03-3197, and UTHSC 07-550, previously identified by...

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Section: Discussioncontrasting

confidence: 46%

“…AMB has been the drug most commonly used to treat Acremo- nium infection on the basis of its in vitro activity, with very variable results (14,19,21,23,(32)(33)(34)(35)(36). While a disseminated infection by an Acremonium sp.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacies of Amphotericin B, Posaconazole, Voriconazole, and Anidulafungin in a Murine Disseminated Infection by the Emerging Opportunistic Fungus Sarocladium (Acremonium) kiliense

Fernández-Silva

Capilla²,

Mayayo³

et al. 2013

Antimicrob Agents Chemother

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“…53 Patients succumbed to the infection in seven cases. 8,25,27,28,59,61 These cases perfectly illustrate the need for mycological analysis of blood samples in febrile neutropenic patients. It is also worth mentioning that antifungal susceptibility testing of the isolates involved in the reported cases of fungaemia was crucial to selecting the best treatment, since traditional therapy with AMB failed in numerous cases.…”

Section: Fungaemiamentioning

confidence: 83%

“…Fungaemia is the most common clinical manifestation of Sarocladium/Acremonium infections, with 106 different cases described. [8][9][10]19,[25][26][27][28][51][52][53][54][55][56][57][58][59][60][61][62] This condition has affected patients ranging from 27 weeks to 74 years old, although 90% of the patients from the two biggest outbreaks (Colombia and Chile) were younger than 16 years old. Most of the cases were reported from Chile (67) and Colombia (16), and practically all of them resulted from receiving contaminated intravenous medication.…”

Section: Fungaemiamentioning

confidence: 99%

SarocladiumandAcremoniuminfections: New faces of an old opportunistic fungus

Pérez-Cantero

Guarro

2020

Mycoses

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The genera Sarocladium and Acremonium (order Hypocreales) are a very diverse group of morphologically and genetically related fungi that are generally found in the environment. Numerous species of these genera are soil saprobes and opportunistic pathogens of plants, other fungi, animals or humans. 1 They are distributed worldwide, and Acremonium isolates have even been found in rocks on continental Antarctica. 2 In addition, these fungi are very relevant in the clinical field, as they have been proven to be involved in a wide range of human conditions and manifestations. As will be discussed later, diagnosis and management of these infections are quite challenging, mostly due to the difficulties in the correct identification and to the poor antifungal response they generally show. As a matter of fact, Acremonium and Sarocladium species cannot be distinguished by histopathological examination from some other opportunistic fungi, such as Fusarium and its relatives; therefore, DNA sequence analysis is required. This review, based on an exhaustive literature search of the PubMed database, compiles and discusses the current knowledge of Sarocladium and Acremonium infections in terms of taxonomy, clinical presentations and prognoses, diagnosis, treatment, outcomes, antifungal susceptibility and their impact in animals.

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“…As a result of increased life expectancy, duration of hospitalization is also increasing and in spite of new antibiotics and new supportive measures, neonatal sepsis and its treatment has become a major problem in NCU. To overcome this problem it is important to know the distribution of etiological agents and their antimicrobial sensitivity [6][7][8] 15 Group B Streptococcus, a common cause of neonatal sepsis in the Western countries is infrequent in India and in other tropical countries. [15][16] Our study also shows the absence of this organism causing sepsis in newborn.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Sepsis in A Tertiary Care Hospital: Evaluation of Causative Agents and Antimicrobial Susceptibilities

Nahar¹,

Afroza²,

Roy³

et al. 2013

Bangladesh J Child Health

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Fatal disseminated Acremonium strictum infection in a preterm newborn: a very rare cause of neonatal septicaemia

Cited by 20 publications

References 12 publications

Evaluation of the Efficacies of Amphotericin B, Posaconazole, Voriconazole, and Anidulafungin in a Murine Disseminated Infection by the Emerging Opportunistic Fungus Sarocladium (Acremonium) kiliense

Evaluation of the Efficacies of Amphotericin B, Posaconazole, Voriconazole, and Anidulafungin in a Murine Disseminated Infection by the Emerging Opportunistic Fungus Sarocladium (Acremonium) kiliense

SarocladiumandAcremoniuminfections: New faces of an old opportunistic fungus

Neonatal Sepsis in A Tertiary Care Hospital: Evaluation of Causative Agents and Antimicrobial Susceptibilities

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