Fusarium dimerum infection in a stem cell transplant recipient treated successfully with voriconazole

Bigley, Venetia; Duarte, Rafael F.; Gosling, Roland; Kibbler, C C; Seaton, Shila; Potter, Michael

doi:10.1038/sj.bmt.1704660

Cited by 32 publications

(14 citation statements)

References 10 publications

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“…However, in our study, the VRC MICs were always higher than 2 g/ml, which agrees with the results of other studies (12,26). This drug was effective in a few clinical cases of fusariosis (2,4), although in none of them was the species involved referred to as F. solani. This is probably linked to the fact that in animal studies F. solani was clearly more virulent and more difficult to treat than F. oxysporum and F. verticillioides, the two other common species of the genus (13,18).…”

supporting

confidence: 82%

Universal In Vitro Antifungal Resistance of Genetic Clades of the Fusarium solani Species Complex

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Cano

et al. 2007

Antimicrob Agents Chemother

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Eleven antifungal drugs were tested against representative isolates of the four phylogenetic clades of the Fusarium solani species complex obtained in a multilocus sequence analysis. They all showed very poor activity, with no differences among the clades. Amphotericin B was the most active drug.Fusarium solani is a fungus that is widely distributed in nature and is able to produce many plant diseases with important economic impacts and, also, severe, usually fatal, human infections (7,9,15,23). These infections can be characterized by their resistance to practically all available antifungal drugs (3,21,24). Primary therapy with voriconazole (VRC) or a lipid formulation of amphotericin B (AMB) is currently recommended (22). Although the response of Fusarium spp. to AMB is poor in general, it depends on the species involved, with F. solani being the most resistant species, at least in vitro (24). Recently, Zhang et al. (29) used a multilocus sequence analysis approach to demonstrate that under the generic name F. solani, at least 45 phylogenetically distinct species exist, most of which have not been described formally. It is unknown if antifungal susceptibility varies among these phylogenetic species. If such differences exist, knowing them could be useful for guiding clinical treatments. Due to the difficulties of testing representative strains of all the phylogenetic species, we tested isolates belonging to the four major clades, inferred from a combined phylogenetic analysis of fragments of three genes, i.e., the translation elongation factor 1␣ (EF-1␣) and ␤-tubulin genes and the internal transcribed spacer (ITS) of the nuclear rRNA gene, against traditional and new antifungal drugs.Fifty isolates from clinical or environmental sources, morphologically identified as F. solani (6), were included in the study (Table 1). Isolates were stored by lyophilization and submerged in slant cultures in mineral oil at room temperature. The procedures for DNA extraction, amplification, and sequencing of the different regions analyzed were described by Gilgado et al. (8). The annealing temperature was 55°C, and the primers used were EF-1H and EF-2T (16) for EF-1␣, TUB-F (5) and T22 (17) for ␤-tubulin, and ITS5 and ITS4 (28) for the ITS. The phylogenetic analysis was performed using PAUP*, version 4.0b10 (27). Maximum parsimony trees were obtained after 100 heuristic searches with random sequence addition and tree bisection-reconnection branch-swapping algorithms, collapsing zero-length branches, and saving of all minimal-length trees (MulTrees). The results of the partition homogeneity test showed that the three locus sequence data sets were congruent (P ϭ 0.2) and could therefore be combined. Sequences of the three genes were analyzed phylogenetically as separate (data not shown) and combined data sets.We evaluated the in vitro activities of 11 antifungal drugs against 27 representative strains (22 clinical and 5 environmental) randomly chosen from the main clades obtained in the phylogenetic analysis. The isolates were g...

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supporting

confidence: 82%

Universal In Vitro Antifungal Resistance of Genetic Clades of the Fusarium solani Species Complex

Azor

Gené

Cano

et al. 2007

Antimicrob Agents Chemother

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“…This species is apparently a water-transmitted fungus (Hageskal et al 2006) that has been identified as an opportunistic human pathogen causing disseminated or localized infections in immunocompromised patients (Austen et al 2001;Bigley et al 2004;Krcmery et al 1997;Letscher-Bru et al 2002). Schroers et al (2009) mentioned an investigation at the Loyola University Medical Center (S. Johnson et al, unpublished data) where plumbing systems were supposed to be a source for F. dimerum.…”

Section: Discussionmentioning

confidence: 97%

Dishwashers – A man-made ecological niche accommodating human opportunistic fungal pathogens

et al. 2011

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“…Besides, it may lead to infections like conjunctivitis, ceratitis, endophthalmitis, maxillary sinus infection, osteomyelitis, septic arthritis, brain abscess, colonization in burns and necrotic wounds, ulceration on legs, deep tissue infections, contact dermatitis and onychomycosis, though they are rare in immunsupressed patients [6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Fusarium: A rare factor in diabetic foot infection

Özışık¹

2017

Journal of Microbiology and Infectious Diseases

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Diabetic foot infections are an important cause of morbidity. In humans, Fusarium causes external infections. A male obese patient at the age of 56 who had been getting treatment in various clinics due to ulceration and lymphedema. Treatment started with tigecycline 50 mg vial 2x1. Alcaligenes faecalis and Proteus vulgaris reproduced. Tigecycline treatment was stopped on the 4th day and piperacillin/tazobactam 4,5 gr vial 3x1 and liposomal amphotericin B 3 mg/kg/day were initiated. In direct microscopic examination, hypes were seen and Fusarium spp. reproduction was detected. Liposomal amphotericin treatment was stopped on the 15th day and voriconazole 200 mg tb po 2x1 was initiated. At the end of one month, the lesions were regressed entirely. It should not be forgotten that despite its scarcity, fungus factors might give rise to diabetic foot infections and patients should be evaluated in terms of fungus infections. J Microbiol Infect Dis 2017; 7(1): 42-45

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Fusarium dimerum infection in a stem cell transplant recipient treated successfully with voriconazole

Cited by 32 publications

References 10 publications

Universal In Vitro Antifungal Resistance of Genetic Clades of the Fusarium solani Species Complex

Universal In Vitro Antifungal Resistance of Genetic Clades of the Fusarium solani Species Complex

Dishwashers – A man-made ecological niche accommodating human opportunistic fungal pathogens

Fusarium: A rare factor in diabetic foot infection

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