Infección nosocomial por Trichosporon asahii: revisión clínica de 22 casos

Rodrigues, Gustavo da Silva; Faria, Rodrigo Rosa Ubatuba de; Guazzelli, Luciana Silva; Oliveira, Flávio de Mattos; Severo, Luiz Carlos

doi:10.1016/s1130-1406(06)70019-5

Cited by 30 publications

(12 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Regarding the species distribution within different human sites, we found that T. asahii was the most frequently isolated species (36 of 54 isolates) in both blood and urine samples, as previously described by other studies [12], [25], [38], [39]. In addition to T. asahii , other publications reported that T. mucoides and T. asteroides are among the species most isolated from invasive fungal infections due to Trichosporon spp.…”

Section: Discussionsupporting

confidence: 84%

Multiple Species of Trichosporon Produce Biofilms Highly Resistant to Triazoles and Amphotericin B

et al. 2014

View full text Add to dashboard Cite

Invasive infections caused by Trichosporon spp. have increased considerably in recent years, especially in neutropenic and critically ill patients using catheters and antibiotics. The genus presents limited sensitivity to different antifungal agents, but triazoles are the first choice for treatment. Here, we investigated the biofilm production and antifungal susceptibility to triazoles and amphotericin B of 54 Trichosporon spp. isolates obtained from blood samples (19), urine (20) and superficial mycosis (15). All isolates and 7 reference strains were identified by sequence analysis and phylogenetic inferences of the IGS1 region of the rDNA. Biofilms were grown on 96-well plates and quantitation was performed using crystal violet staining, complemented with Scanning Electron Microscopy (SEM). Susceptibility tests for fluconazole, itraconazole, voriconazole and amphotericin B were processed using the microdilution broth method (CLSI) for planktonic cells and XTT reduction assay for biofilm-forming cells. Our results showed that T. asahii was the most frequent species identified (66.7%), followed by T. faecale (11.1%), T. asteroides (9.3%), T. inkin (7.4%), T. dermatis (3.7%) and one T. coremiiforme (1.8%). We identified 4 genotypes within T. asahii isolates (G1, G3, G4 and G5) and 2 genotypes within T. faecale (G1 and G3). All species exhibited high adhesion and biofilm formation capabilities, mainly T. inkin, T. asteroides and T. faecale. Microscopy images of high biofilm-producing isolates showed that T. asahii presented mainly hyphae and arthroconidia, whereas T. asteroides exhibited mainly short arthroconidia and few filaments. Voriconazole exhibited the best in vitro activity against all species tested. Biofilm-forming cells of isolates and reference strains were highly resistant to all antifungals tested. We concluded that levels of biofilm formation by Trichosporon spp. were similar or even greater than those described for the Candida genus. Biofilm-forming cells were at least 1,000 times more resistant to antifungals than planktonic cells, especially to voriconazole.

show abstract

Section: Discussionsupporting

confidence: 84%

Multiple Species of Trichosporon Produce Biofilms Highly Resistant to Triazoles and Amphotericin B

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Other risk factors recently described include chronic illnesses such as uncontrolled diabetes mellitus, alterations of the skin or mucus membranes, and use of corticosteroids. In a European study, Trichosporon species were the most common nonCandida yeast isolates found in the bloodstream at a national cancer institute [29]. Clinicians, therefore, must have an increased awareness of this organism and recognize that trichosporonosis may present like disseminated candidiasis both in its clinical spectrum and its histopathologic appearance in similar patient populations.…”

Section: Discussionmentioning

confidence: 99%

Trichosporon Infection

Vázquez

2010

Curr Fungal Infect Rep

View full text Add to dashboard Cite

Yeast exist throughout nature in association with soil, plants, mammals, and fish. As a result of this continued exposure, all humans are exposed to many different types of yeast through a variety of different routes. Recently, because of the increased population of immunocompromised patients and the extensive use of different antifungals, the incidence of infections due to non-Candida yeast has increased. Of these classic "nonpathogenic" yeast, Trichosporon species have been increasingly described producing deep-seated and disseminated infections that are difficult to predict and diagnose. In addition, the different species of Trichosporon have been found to be less susceptible or resistant to commonly used antifungals. Because of this intrinsic variation in antifungal susceptibility and the fact that these infections are generally seen in severely immunocompromised hosts, they are associated with significant morbidity and mortality, despite their known "nonpathogenic" characteristics described in superficial infections.

show abstract

“…All the four patients died despite treatment with anphotericin B. The remaining case [16] was a Brazilian woman who was treated with immunosuppressors because of liver transplant. She received antibiotic therapy and had indwelling intravenous catheter as risk factors.…”

Section: Discussionmentioning

confidence: 99%