Invasive infection due to Trichosporon cutaneum in patients with hematologic malignancies

Kataoka‐Nishimura, Shigeko; Akiyama, Hideki; Saku, Kazue; Kashiwa, Machiko; Mori, Susumu; Tanikawa, S; Sakamaki, Hisashi; Onozawa, Y

doi:10.1002/(sici)1097-0142(19980201)82:3<484::aid-cncr9>3.3.co;2-d

Cited by 13 publications

(25 citation statements)

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“…T. asahii is occasionally found in nature and can be recovered as a soil saprobe or from leaf litter (39). This species has been isolated from various types of clinical specimens from immunocompromised patients, including blood, skin biopsy, and urine specimens (9,21,22,29,41). Invasive infection with T. asahii is frequently associated with granulocytopenia and impaired phagocyte function (9,41,44).…”

Section: Discussionmentioning

confidence: 99%

Multidrug-Resistant Trichosporon asahii Infection of Nongranulocytopenic Patients in Three Intensive Care Units

et al. 2001

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Trichosporon asahii (Trichosporon beigelii) infections are rare but have been associated with a wide spectrum of clinical manifestations, ranging from superficial involvement in immunocompetent individuals to severe systemic disease in immunocompromised patients. We report on the recent recovery of T. asahii isolates with reduced susceptibility in vitro to amphotericin B (AMB), flucytosine, and azoles from six nongranulocytopenic patients who exhibited risk factors and who developed either superficial infections (four individuals) or invasive infections (two individuals) while in intensive care units. The latter two patients responded clinically and microbiologically to AMB treatment. All six isolates were closely related according to random amplified polymorphic DNA studies and showed 71% similarity by amplified fragment length polymorphism analysis, suggesting a common nosocomial origin. We also review the literature pertaining to T. asahii infections and discuss the salient characteristics of this fungus and recent taxonomic proposals for the genus.Trichosporon infections are associated with a wide spectrum of clinical manifestations, ranging from superficial cutaneous involvement in immunocompetent individuals to severe systemic disease in immunocompromised patients (9, 44). Trichosporon asahii (Trichosporon beigelii) has increasingly been described as an opportunistic pathogen involved in disseminated infections in patients with profound granulocytopenia (9,11,26). Less commonly reported risk factors associated with infections caused by this agent include treatment with immunosuppressive drugs, transplantation, AIDS, extensive burns, and the presence of implanted prosthetic devices (9,11,14,20,24,27,29).Trichosporon species were the most common non-Candida cause of fungemia at a national cancer institute (23). Disseminated Trichosporon infections in immunocompromised patients are frequently fatal, despite therapy with amphotericin B (AMB) (9,44,46). This antifungal agent has been shown to have a limited in vitro effect against Trichosporon species. In contrast, azoles have been demonstrated to have in vitro activity against members of this genus and their use has been associated with favorable responses in animal models (2,3,9,27,31,32,45,46).We report on the recent recovery of T. asahii isolates resistant in vitro to AMB and azoles from six nongranulocytopenic patients who developed either invasive or superficial infections while hospitalized in different intensive care units (ICUs). We describe the demographic and major clinical characteristics of these patients and review the literature pertaining to T. asahii infections. Results from molecular biology-based studies based on random amplified polymorphic DNA (RAPD) and amplified fragment length polymorphism (AFLP) analyses suggest that the isolates recovered from specimens of these six patients were closely related. In addition, we discuss the salient characteristics of this fungus and recent taxonomic proposals for the genus. MATERIALS AND METHODSCase re...

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Section: Discussionmentioning

confidence: 99%

Multidrug-Resistant Trichosporon asahii Infection of Nongranulocytopenic Patients in Three Intensive Care Units

et al. 2001

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“…Deep-seated trichosporonosis is mainly observed in neutropenic patients receiving chemotherapy for haematological malignancies and solid tumours. This systemic disease is associated with morbidly severe conditions, such as progressive respiratory failure, renal failure and disseminated intravascular coagulation syndrome, and is also known to be associated with a poor prognosis [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Increased release of glucuronoxylomannan antigen and induced phenotypic changes in Trichosporon asahii by repeated passage in mice

Karashima

Yamakami

Yamagata

et al. 2002

Journal of Medical Microbiology

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“…asahii has been isolated from various types of clinical specimens from immunocompromised patients, including blood, skin biopsy, and urine specimens (9,17,19,29,32,43,52), but few were isolated from patients without immunological disorders (20). Factors that enhance mucosal colonization and subsequent invasion of Trichosporon species include broad-spectrum antibiotic treatment and scratches in mucosal barriers (6,24,56).…”

Section: Discussionmentioning

confidence: 99%

“…Trichosporon infections are rare but have been associated with a wide spectrum of clinical manifestations, ranging from superficial involvement in immunocompetent individuals such as white piedra (40,47) to severe systemic disease in immunocompromised patients with a pattern similar to candidiasis (6,19,29,30,43,58). Rodrigues et al (43) described twenty-two cases of nosocomial infection caused by T. asahii, detected during a period of six years (1999)(2000)(2001)(2002)(2003)(2004)(2005) in a Brazil hospital.…”

Section: Introductionmentioning

confidence: 99%

Genetic diversity and antifungal susceptibility testing of Trichosporon asahii isolated of Intensive Care Units patients

Silva¹,

Fusco‐Almeida²,

Matsumoto³

et al. 2008

Braz. J. Microbiol.

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Trichosporon asahii is an opportunistic pathogen, associated with a high mortality rate in immunocompromised patients. In this study, ten isolates, recovered from oral cavity and urine of patients in Intensive Care Units (ICU) over six months, were identified by classical and molecular methods, typed by RAPD and tested in vitro for susceptibility to fluconazole, itraconazole, 5-flucytosine and amphotericin B. A total agreement between the identification of Trichosporon sp by PCR based on sequences of the Internal Transcribed Spacer Regions (ITS) and on the sequences of small-subunit (SSU) ribosomal DNA (rDNA) was found. Randomly amplified of polymorphic DNA (RAPD), with primers P6 and M13, was used to determine the genomic profiles. The dendogram analysis indicated that almost all strains showed similarity >0.9 among them and all strains were multidrug-resistant. This study brings new results on the identification and genotyping of T. asahii isolated from Brazilian ICU patients and information about their antifungal drugs susceptibility.

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Invasive infection due to Trichosporon cutaneum in patients with hematologic malignancies

Abstract: More effective antifungal agents are required for the treatment of infections with this organism.

Cited by 13 publications

References 0 publications

Multidrug-Resistant Trichosporon asahii Infection of Nongranulocytopenic Patients in Three Intensive Care Units

Multidrug-Resistant Trichosporon asahii Infection of Nongranulocytopenic Patients in Three Intensive Care Units

Increased release of glucuronoxylomannan antigen and induced phenotypic changes in Trichosporon asahii by repeated passage in mice

Genetic diversity and antifungal susceptibility testing of Trichosporon asahii isolated of Intensive Care Units patients

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