<i>In vitro </i>susceptibility of 15 strains of zygomycetes to nine antifungal agents as determined by the NCCLS M38‐A microdilution method

Singh, Jyoti; Rimek, Dagmar; Kappe, Reinhard

doi:10.1111/j.1439-0507.2005.01132.x

Cited by 54 publications

(41 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therapy with liposomal AMB together with surgical debridement was effective in treating our patient. Mucor circinelloides, as well as other zygomycetes, have been reported to be susceptible to AMB in vitro (22,24). Posaconazole also may be considered for therapy of zygomycosis based on susceptibility and compassionate-treatment data (11,24).…”

Section: Discussionmentioning

confidence: 99%

Mucor circinelloides Was Identified by Molecular Methods as a Cause of Primary Cutaneous Zygomycosis

Iwen¹,

Sigler

Noel³

et al. 2007

J Clin Microbiol

View full text Add to dashboard Cite

A case of primary cutaneous zygomycosis caused by Mucor circinelloides is described. Histopathology showed typical hyphae along with chlamydospores. The isolate was identified by molecular and phenotypic methods. The utility of sequence analysis of the internal transcribed spacer region is highlighted; however, further studies are needed to assess species genetic heterogeneity. CASE REPORTA 90-year-old male presented to his primary-care physician with fever, fatigue, and lower-right-leg cellulitis following trauma to the leg. The trauma, which occurred about 1 month prior to presentation, was described by the patient as being "struck by a shrub branch while trimming brush." He had a 2-year history of progressive pancytopenia subsequently diagnosed as myelodysplastic syndrome (MDS) and a 20-year history of diabetes mellitus type II controlled by insulin injections.On physical examination, the temperature was 38°C, and laboratory examination showed pancytopenia with an absolute neutrophil count of 1.0 ϫ 10 3 per mm 3 (normal range, 1.3 ϫ 10 3 to 7.5 ϫ 10 3 per mm 3 ) and hyperglycemia with a serum glucose level of 525 mg per dl (normal range, 70 to 125 mg per dl). He was hospitalized at the Nebraska Medical Center and started on filgrastim (Neupogen; Amgen, Inc., Thousand Oaks, CA) to improve neutropenia and on insulin to control the serum glucose level. Intravenous ceftriaxone and ciprofloxacin were given for the lower-right-leg skin/soft tissue infection. The patient was discharged on day 7 post-primary admission (PPA) with improvement of the leg cellulitis.A follow-up exam on day 14 PPA showed progression of the leg wound, now with a black eschar developing. The patient was readmitted to the hospital with neutropenia (absolute neutrophil cell count, 0.9 ϫ 10 3 per mm 3 ) and hyperglycemia (serum glucose level, 1,160 mg per dl). He was taken to the operating room for debridement of the wound, and tissue was submitted to the hospital clinical microbiology laboratory for bacterial and fungal cultures. The results of a histopathological examination of this tissue were reported as "hemorrhage and extensive necrosis, focal formation of granulation tissue, and numerous invasive fungal organisms (septate hyphae and thick-walled yeast forms)" (Fig. 1). Based on a diagnosis of an invasive fungal (mold) infection, liposomal amphotericin B (AMB) at 5 mg per kg of body weight per day (Abelcet; ENZON Pharmaceuticals, Piscataway, NJ) was begun (day 16 PPA). A fungus grew within 4 days on Sabouraud dextrose (Emmons) agar (Remel Labs, Lenexa, KS) but did not grow on Mycobiotic agar (Remel Labs) after incubation at 30°C. The isolate, which was morphologically identified as a Mucor species, was subsequently sent to the Molecular Mycology Laboratory located at the University of Nebraska Medical Center (UNMC) for species identification. A DNA sequence of the isolate obtained from the internal transcribed spacer (ITS) regions of the rRNA gene was submitted for a BLAST search of the GenBank database (National Center for Biotechnology...

show abstract

Section: Discussionmentioning

confidence: 99%

Mucor circinelloides Was Identified by Molecular Methods as a Cause of Primary Cutaneous Zygomycosis

Iwen¹,

Sigler

Noel³

et al. 2007

J Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…and members of the Zygomycete family are resistant to echinocandin drugs (MIC> 16 μg/ml) (Pfaller et al, 1998;Singh et al, 2005). The mechanism of this inherent resistance is not related to target insensitivity, as glucan synthase activity from Cryptococcus and several moulds were strongly inhibited by caspofungin in in vitro assays (Maligie et al, 2005;Kahn et al, 2006).…”

Section: Mechanism Of Inherent Resistance In Non-candida Spp Remainsmentioning

confidence: 99%

Resistance to echinocandin-class antifungal drugs

Perlin¹

2007

Drug Resistance Updates

451

400

View full text Add to dashboard Cite

Invasive fungal infections cause morbidity and mortality in severely ill patients, and limited drug classes restrict treatment choices. The echinocandins drugs are the first new class of antifungal compounds that target the fungal cell wall by blocking β-1,3-D-glucan synthase. Elevated MIC values with occasional treatment failure have been reported for strains of Candida. Yet, an uncertain correlation exists between clinical failure and elevated MIC values for the echinocandin drugs. Fungi display several adaptive physiological mechanisms that result in elevated MIC values. However, resistance to echinocandin drugs among clinical isolates is associated with amino acid substitutions in two "hot-spot" regions of Fks1, the major subunit of glucan synthase. The mutations, yielding highly elevated MIC values, are genetically dominant and confer cross-resistance to all echinocandin drugs. Prominent Fks1 mutations decrease the sensitivity of glucan synthase for drug by one thousand-fold or more, and strains harboring such mutations may require a concomitant increase in drug to reduce fungal organ burdens in animal infection models. The Fks1-mediated resistance mechanism is conserved in a wide variety of Candida spp. and can account for intrinsic reduced susceptibility of certain species. Fks1 mutations confer resistance in both yeasts and moulds suggesting that this mechanism is pervasive in the fungal kingdom.

show abstract

“…Previously, a study has suggested that Liposome amphotericin B was safer, with an improved effect and smaller accumulated dose, compared with amphotericin B alone (7). Singh's study indicated that, in addition to the Amphotericin B with good effect, antifungal drugs, such as itraconazole and vorico nazole, may be a clinical option (8). For the patients who do not tolerate the traditional drug or with whom the drug exhibited no effect, novel triazole fungicide posaconazole is better than voriconazole and fluconazole (9).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of pulmonary mucormycosis: A case report

Luo

Zhang

2017

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. Pulmonary mucormycosis, a relatively rare pulmonary fungal disease, is difficult to diagnose and lacks effective treatment. The present study reports the case of a 64-year-old patient who was treated successfully for pulmonary mucormycosis in Xuan Wu Hospital. The patient presented with low-grade fever and a productive cough that persisted for 1 month with no evident cause, and also suffered from diabetes mellitus. Prior antibiotic treatment with levofloxacin had been ineffective. Culture of mucus obtained by bronchoscopy resulted in a diagnosis of pulmonary mucormycosis. The patient received a cumulative dose of 1,355 mg amphotericin B over 2 months and presented a full recovery.

show abstract

In vitro susceptibility of 15 strains of zygomycetes to nine antifungal agents as determined by the NCCLS M38‐A microdilution method

Cited by 54 publications

References 24 publications

Mucor circinelloides Was Identified by Molecular Methods as a Cause of Primary Cutaneous Zygomycosis

Mucor circinelloides Was Identified by Molecular Methods as a Cause of Primary Cutaneous Zygomycosis

Resistance to echinocandin-class antifungal drugs

Diagnosis and treatment of pulmonary mucormycosis: A case report

Contact Info

Product

Resources

About