<i>Trichosporon loubieri</i>
            Infection in a Patient with Adult Polycystic Kidney Disease

Padhye, A. A.; Verghese, S; Ravichandran, Palani; Balamurugan, G.; Hall, Leslie; Padmaja, P; Fernández, María Celia

doi:10.1128/jcm.41.1.479-482.2003

Cited by 45 publications

(29 citation statements)

References 20 publications

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“…For example T. mucoides T. cutaneum, T. asahii, T. asteroides, T. ovoides, and T. inkin are the most commonly encountered pathogens (17). The other species are prevalent soil fungi, some of which (e.g., T. loubieri) have the potential to become opportunistic pathogens (17,24).…”

Section: Resultsmentioning

confidence: 99%

“…The clinical cases caused by opportunistic fungal infection are constantly rising, and new species within the genus are emerging as new opportunistic pathogens (14,24,33). For example, one recent clinical case has confirmed the emergence of T. loubieri as a new human pathogen that can cause death if the disease is left unattended (24).…”

Section: Ovoides T Cutaneum T Asahii T Asteroides and T Mucoimentioning

confidence: 99%

“…For example, one recent clinical case has confirmed the emergence of T. loubieri as a new human pathogen that can cause death if the disease is left unattended (24). To make matters worse, the prognosis for patients is relatively poor.…”

Section: Ovoides T Cutaneum T Asahii T Asteroides and T Mucoimentioning

confidence: 99%

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High-Throughput Detection of Pathogenic Yeasts of the Genus Trichosporon

2004

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The need for a rapid and accurate method for the detection of fungal pathogens has become imperative as the incidence of fungal infections has increased dramatically. Herein, we tested the Luminex 100, a novel flow cytometer, for the detection of the medically important genus Trichosporon. This genus was selected as our proof-of-concept model due to the close phylogenetic relationship between the species. The method, which is based on a nucleotide hybridization assay, consists of a combination of different sets of fluorescent beads covalently bound to species-specific capture probes. Upon hybridization, the beads bearing the target amplicons are classified by their spectral addresses with a 635-nm laser. Quantitation of the hybridized biotinylated amplicon is based on fluorescence detection with a 532-nm laser. We tested in various multiplex formats 48 species-specific and group-specific capture probes designed in the D1/D2 region of ribosomal DNA, internal transcribed spacer regions, and intergenic spacer region. Species-specific biotinylated amplicons were generated with three sets of primers to yield fragments from the three regions. The assay was specific and fast, as it discriminated species differing by 1 nucleotide and required less than 50 min following amplification to process a 96-well plate. The sensitivity of the assay allowed the detection of 10 2 genome molecules in PCRs and 10 7 to 10 8 molecules of biotinylated amplification product. This technology provided a rapid means of detection of Trichosporon species with the flexibility to identify species in a multiplex format by combining different sets of beads.

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Section: Resultsmentioning

confidence: 99%

Section: Ovoides T Cutaneum T Asahii T Asteroides and T Mucoimentioning

confidence: 99%

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High-Throughput Detection of Pathogenic Yeasts of the Genus Trichosporon

2004

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“…In addition there have been case reports of invasive infection due to T. loubieri (4,16) and T. pullulans (4), which were not previously linked to human disease. T. inkin is most commonly associated with the superficial condition known as white piedra, causing a disease of hair follicles; this species is particularly associated with pubic hair (5,20).…”

Section: Case Reportmentioning

confidence: 99%

“…Identification was confirmed by sequencing of the D1-D2 region of the large ribosomal subunit, producing 100% identity with T. inkin (6). Susceptibility testing was performed using the CLSI (formerly NCCLS) M27-A2 method (15), and the following MICs were obtained: for amphotericin B, 1.0 mg/liter; for caspofungin, 16.0 mg/liter; for fluconazole, 0.25 mg/liter; for itraconazole, 0.06 mg/liter; and for voriconazole, Ͻ0.03 mg/liter.…”

Section: Case Reportmentioning

confidence: 99%

Sternal Wound Infection byTrichosporon inkinfollowing Cardiac Surgery

Davies

Logan

Johnson³

et al. 2006

J Clin Microbiol

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Wound infection following cardiac surgery is well described but is rarely due to fungal infection. We describe a case of sternal wound infection caused by Trichosporon inkin with a fatal outcome, in an immunocompetent patient following aortic root surgery. CASE REPORTA 71-year-old female with known severe aortic stenosis and a dilated aortic root was admitted for elective aortic root replacement surgery. She had a medical history of severe emphysema, leading to breathlessness at rest, and spirometry revealed a forced expiratory volume in 1 s of just 500 ml. The operation involved implantation of a porcine aortic root and a Dacron graft but was complicated by bleeding from the left coronary artery origin, necessitating saphenous vein grafting onto the left coronary. The surgery lasted for 8 h, and teicoplanin and gentamicin were administered as antibiotic prophylaxis prior to surgery, in accordance with local protocols.Postoperatively the patient was transferred to the intensive care unit, where she remained intubated and ventilated. A tracheostomy was performed on day 3, because a prolonged period of ventilation was anticipated. Further complications included acute renal failure, requiring continuous venous-venous hemofiltration. The patient also developed an intrinsic nodal cardiac rhythm and was paced via epicardial wires, inserted in theater and removed on day 7. On day 8 of her intensive care stay, she developed a ventilator-associated pneumonia, which was treated with cefuroxime and gentamicin, with some clinical response.A subsequent septic decline (accompanied by negative blood cultures) was treated with an empirical course of vancomycin and ceftazidime, but with no substantial change in the patient's condition and a continued inotrope requirement. On day 24 of admission, Candida albicans was isolated from a central venous catheter tip, urine, and respiratory secretions, and treatment with intravenous fluconazole (400 mg daily) was commenced. It was noted, on examination, that the patient had developed a left pleural rub, and a small left-sided pleural effusion was seen on a chest radiograph. Bloody material began to ooze from the lower portion of the sternal wound and previous epicardial pacing wire sites. The gram stain of this fluid revealed numerous pus cells with yeasts and fungal hyphae (Fig. 1). The wound dehisced, and one liter of pus drained spontaneously from the wound. There was associated sternal instability elicited upon examination. The patient was not considered a candidate for further surgical intervention, and her condition continued to deteriorate. She died 2 days later, 26 days postoperatively. No autopsy was performed.Subsequent to her death, blood cultures became positive after 2 days of incubation (Fig. 2) using the BacT/ALERT system (bioMérieux Inc., Durham, N.C.). The yeast isolated from both blood and sternal fluid was identified by the Mycology Reference Laboratory (HPA, Bristol, United Kingdom) as Trichosporon inkin by using AUXACOLOR (Bio-Rad, Marnes la Coquette, France), givin...

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Serious Infections Caused by Uncommon Yeasts

Maenza

Merz

2010

Topley &Amp; Wilson's Microbiology and Microbial Infections

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Trichosporon loubieri Infection in a Patient with Adult Polycystic Kidney Disease

Cited by 45 publications

References 20 publications

High-Throughput Detection of Pathogenic Yeasts of the Genus Trichosporon

High-Throughput Detection of Pathogenic Yeasts of the Genus Trichosporon

Sternal Wound Infection byTrichosporon inkinfollowing Cardiac Surgery

Serious Infections Caused by Uncommon Yeasts

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