Multicenter Outbreak of Infections by
            <i>Saprochaete clavata</i>
            , an Unrecognized Opportunistic Fungal Pathogen

Vaux, Sophie; Criscuolo, Alexis; Desnos‐Ollivier, Marie; Diancourt, Laure; Tarnaud, Chloé; Vandenbogaert, Mathias; Brisse, Sylvain; Coignard, B.; Dromer, Françoise

doi:10.1128/mbio.02309-14

Cited by 81 publications

(144 citation statements)

References 39 publications

Supporting

Mentioning

138

Contrasting

Unclassified

Order By: Relevance

“…To date, no antifungal breakpoints are defined for Saprochaete or Geotrichum . Concordant with previous studies, all Saprochaete isolates had elevated MICs for the echinocandins anidulafungin, caspofungin and micafungin . All S. clavata isolates had lower MIC values for micafungin compared to other echinocandins.…”

Section: Discussionsupporting

confidence: 78%

Invasive infections due to Saprochaete and Geotrichum species: Report of 23 cases from the FungiScope Registry

Graeff

Seidel

Vehreschild

et al. 2017

Mycoses

View full text Add to dashboard Cite

Saprochaete and Geotrichum spp. are rare emerging fungi causing invasive fungal diseases in immunosuppressed patients and scarce evidence is available for treatment decisions. Among 505 cases of rare IFD from the FungiScope registry, we identified 23 cases of invasive infections caused by these fungi reported from 10 countries over a 12-year period. All cases were adults and previous chemotherapy with associated neutropenia was the most common co-morbidity. Fungaemia was confirmed in 14 (61%) cases and deep organ involvement included lungs, liver, spleen, central nervous system and kidneys. Fungi were S. capitata (n=14), S. clavata (n=5), G. candidum (n=2) and Geotrichum spp. (n=2). Susceptibility was tested in 16 (70%) isolates. All S. capitata and S. clavata isolates with the exception of one S. capitata (MIC 4 mg/L) isolate had MICs>32 mg/L for caspofungin. For micafungin and anidulafungin, MICs varied between 0.25 and >32 mg/L. One case was diagnosed postmortem, 22 patients received targeted treatment, with voriconazole as the most frequent first line drug. Overall mortality was 65% (n=15). Initial echinocandin treatment was associated with worse outcome at day 30 when compared to treatment with other antifungals (amphotericin B ± flucytosine, voriconazole, fluconazole and itraconazole) (P=.036). Echinocandins are not an option for these infections.

show abstract

Section: Discussionsupporting

confidence: 78%

Invasive infections due to Saprochaete and Geotrichum species: Report of 23 cases from the FungiScope Registry

Graeff

Seidel

Vehreschild

et al. 2017

Mycoses

View full text Add to dashboard Cite

show abstract

“…The prognosis of invasive Saprochaete spp . infection is extremely guarded with a mortality rate of 60 to 80% …”

Section: Case Reportmentioning

confidence: 99%

“…Currently, there are no clear recommendations for the treatment or prophylaxis of invasive S clavata , which are known to be resistant to echinocandins (anidulafungin, caspofungin, and micafungin). A few papers have reported sensitivity to amphotericin B, voriconazole, posaconazole, and 5‐flucytosine, but there is no evidence to suggest that dual antifungal therapy is superior to monotherapy …”

Section: Case Reportmentioning

confidence: 99%

A rare case of purpuric rash caused by Saprochaete clavata in a pediatric patient with acute leukemia

Wee

Ling

Chong

et al. 2019

Pediatric Dermatology

View full text Add to dashboard Cite

show abstract

“…Saprochaete clavata can be cultured from wood, soil, animals and dairy products and is reported to be a commensal yeast in humans living in Mediterranean climates that can be cultured from the respiratory secretions or gastrointestinal (GI) tract . In rare cases, S clavata may cause fulminant fungaemia with deep organ involvement, particularly during periods of severe neutropenia and mucositis following chemotherapy …”

Section: Introductionmentioning

confidence: 99%

“…The optimal therapy of disseminated S clavata is uncertain. Echinocandins have no role in the treatment of S clavata due to high intrinsic resistance . Voriconazole, itraconazole, posaconazole, amphotericin B and 5‐fluorocytosine have more predictable potency in vitro and in vivo, while higher MICs have been reported for fluconazole and isavuconazole .…”

Section: Introductionmentioning

confidence: 99%

Saprochaete clavata infections in patients undergoing treatment for haematological malignancies: A report of a monocentric outbreak and review of the literature

Stanzani

Cricca

Sassi

et al. 2019

Mycoses

View full text Add to dashboard Cite

Summary Saprochaete clavata is a rare cause of fungaemia with deep organ involvement in patients with haematological malignancies with reported mortality rates of 60%‐80%. We describe four cases of S clavata infection in a haematology unit over several months that were treated with voriconazole‐based regimens. We also review the literature on factors that could contribute to earlier recognition and effective treatment of S clavata. We included all cases of culture‐positive S clavata from sterile sites with associated signs of infection in patients undergoing treatment for a haematological malignancy. Isolates were identified by MALDI‐TOF MS, and spectrum profiles were used to prepare clustering analysis of isolates. Susceptibility testing was performed using a commercial microtitre methods. Saprochaete clavata was isolated from the bloodstream in three cases and bronchial alveolar lavage (BAL) fluid in one case. Clustering analysis suggested strains of S clavata were clonal without evidence of divergence although a common source was not identified. Susceptibility testing yielded elevated MICs to fluconazole (8 mg/L) and echinocandins (>1‐8 mg/L). All patients were treated with voriconazole‐based regimens resulting in survival of 3/4 patients, who continued chemotherapy for their underlying malignancy without evidence of relapse. Saprochaete clavata is a rare but aggressive cause of breakthrough yeast infection in patients undergoing treatment for haematological malignancies, particularly patients with a prior history of echinocandin treatment. Timely initiation of appropriate treatment, aided by more rapid identification in microbiology laboratory, can reduce the risk of deep organ dissemination and patient death.

show abstract

Multicenter Outbreak of Infections by Saprochaete clavata , an Unrecognized Opportunistic Fungal Pathogen

Cited by 81 publications

References 39 publications

Invasive infections due to Saprochaete and Geotrichum species: Report of 23 cases from the FungiScope Registry

Invasive infections due to Saprochaete and Geotrichum species: Report of 23 cases from the FungiScope Registry

A rare case of purpuric rash caused by Saprochaete clavata in a pediatric patient with acute leukemia

Saprochaete clavata infections in patients undergoing treatment for haematological malignancies: A report of a monocentric outbreak and review of the literature

Contact Info

Product

Resources

About