Three cases of Candida fermentati fungemia following hematopoietic stem cell transplantation

Morita, Kiyomi; Honda, Akira; Koya, Junji; Toyama, Kazuhiro; Ikeda, Mahoko; Misawa, Yoshiki; Okugawa, Shu; Nakamura, Fumihiko; Moriya, Kyoji; Kurokawa, Mineo

doi:10.1016/j.jiac.2017.12.015

Cited by 10 publications

(9 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As a result, routine antifungal primary prophylaxis, empiric, and/or pre‐emptive treatment are currently recommended and endorsed by international guidelines . However, routine use of these agents may lead to the emergence of breakthrough IFD with resistant Candida species and molds . Only few recent attempts have been made to assess the incidence and outcomes of primary and breakthrough IFD after allogeneic HSCT.…”

Section: Introductionmentioning

confidence: 99%

“…[17][18][19] However, routine use of these agents may lead to the emergence of breakthrough IFD with resistant Candida species and molds. [20][21][22][23][24] Only few recent attempts have been made to assess the incidence and outcomes of primary and breakthrough IFD after allogeneic HSCT. Therefore, we studied epidemiology of proven and probable IFD among all allogeneic HSCT recipients included in the Swiss Transplant Cohort Study from 2009 to 2013.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and outcome of invasive fungal diseases after allogeneic hematopoietic stem cell transplantation: A Swiss transplant cohort study

Kuster

Stampf

Gerber

et al. 2018

Transplant Infectious Dis

View full text Add to dashboard Cite

Contemporary, comprehensive data on epidemiology and outcomes of invasive fungal disease (IFD) including breakthrough IFD among allogeneic hematopoietic stem cell transplantation (HSCT) recipients are scarce. We included 479 allogeneic HSCT recipients with 10 invasive candidiasis (IC) and 31 probable/proven invasive mold disease (IMD) from the Swiss Transplant Cohort Study from 01.2009 to 08.2013. Overall cumulative incidence was 2.3% for IC and 8.5% for probable/proven IMI: 6% for invasive aspergillosis (IA) and 2.5% for non-AspergillusIMI. Among 41 IFD, 46% IFD were breakthrough, with an overall incidence of 4.6%, more frequently caused by other-than-Aspergillus fumigatus molds than primary IFD (47.6% (10/21) vs 13% (3/23), P = 0.04). Twelve-week mortality among patients with IC was 20% and 58.6% for probable/proven IMD (60% IA and 54.6% non-Aspergillus). Our results reveal that breakthrough IFD represent a marked burden of probable/proven IFD postallogeneic HSCT and mortality remains above 50% in patients with probable/proven IMD, underscoring the ongoing challenges to prevent and treat IFD in these patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and outcome of invasive fungal diseases after allogeneic hematopoietic stem cell transplantation: A Swiss transplant cohort study

Kuster

Stampf

Gerber

et al. 2018

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…Some reports have described resistance to LAmB, 18 caspofungin 4 and micafungin, 8,12,19 which are classified as echinocandins, and itraconazole 14 and voriconazole, 5‐7 which are classified as azoles. Increasing the frequency of use of one type of antifungal agent might increase the resistance to various fungi.…”

Section: Discussionmentioning

confidence: 99%

Intravenous itraconazole compared with liposomal amphotericin B as empirical antifungal therapy in patients with neutropaenia and persistent fever

Yoshida

Saito

Tanaka

et al. 2020

Mycoses

View full text Add to dashboard Cite

Summary Background Fungal infections are a major complication of neutropaenia following chemotherapy. Their early diagnosis is difficult, and empirical antifungal treatment is widely used, and uses of less toxic drugs that reduce breakthrough infection are required. Objective We conducted a multicentre, open‐label, randomised, non‐inferiority trial to compare the safety and efficacy of intravenous itraconazole (ivITCZ) and liposomal amphotericin B (LAmB) as empirical antifungal therapy in patients with haematological malignancies with neutropaenia and persistent fever. Methods Patients with haematological malignancies who developed fever refractory to broad‐spectrum antibacterial agents under neutropaenia conditions were enrolled. Patients were randomised for treatment with LAmB (3.0 mg/kg/d) or ivITCZ (induction: 400 mg/d, maintenance: 200 mg/d). Results Observed overall favourable response rates of 17/52 (32.7%) and 18/50 (36.0%) in the LAmB and ivITCZ groups, with a model‐based estimate of a 4% difference (90% CI, −12% to 20%), did not fulfil the statistical non‐inferiority criterion. In the LAmB group, there were two cases of breakthrough infection and five cases of probable invasive fungal disease, whereas in the itraconazole group, neither breakthrough infection nor probable invasive fungal disease occurred. Patients in the ivITCZ group had significantly fewer grade 3‐4 hypokalaemia‐related events than LAmB group patients ( P < .01). The overall incidence of adverse events tended to be lower in the ivITCZ group ( P = .07). Conclusion ivITCZ showed similar efficacy and safety as LAmB as empirical antifungal therapy in haematological malignancy patients with febrile neutropaenia, although the small sample size and various limitations prevented demonstration of its non‐inferiority.

show abstract

“…The mechanism of action is noncompetitively inhibits b-(1,3)-D-glucan synthase enzyme that is necessary for the synthesis of the cell wall in many fungal species (Lewis, 2011). Antifungal prophylaxis is more important because of the high morbidity and mortality associated with IFIs, especially in immuno-compromised pediatric patients undergoing allo-HSCT (Morita et al, 2018). It was an effective strategy that patients who received allo-HSCT underwent primary antifungal prophylaxis with caspofungin (Mariotti et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetics of Caspofungin and Dosing Optimization in Children With Allogeneic Hematopoietic Stem Cell Transplantation

Niu

Gao

et al. 2020

Front. Pharmacol.

View full text Add to dashboard Cite

Caspofungin is the first echinocandin antifungal agent that licented for pediatric use in invasive candidiasis and aspergillosis. In this study, we evaluated the population pharmacokinetics of caspofungin and investigate appropriate dosing optimization against Candida spp. in children with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in order to improve therapeutic efficacy. All participants received a recommended caspofungin 70 mg/m 2 loading dose followed by 50 mg/m 2 maintenance dose. A one-compartment model with first-order elimination was best fitted the data from 48 pediatric patients. Body surface area and aspartate aminotransferase had significant influence on caspofungin clearance from covariate analysis. Our results reviewed that dose adjustment is not necessary in patients with mild liver dysfunction. Monte Carlo simulations were performed using pharmacokinetic data from our study to evaluate the probability of target attainment (PTA) of caspofungin regimen in terms of AUC 24 /MIC targets against Candida spp. The results of simulations predicted that a caspofungin 70 mg/m 2 at first dose, 50 mg/m 2 of daily dose may have a high probability of successful outcome against C. albicans and C. glabrata whilst 60 mg/m 2 maintenance dose was required for fungistatic target against C. parapsilosis but may be not sufficient to achieve optimal fungicidal activity. Caspofungin standard regimen had high probability of successful outcome against C. albicans (MIC ⩽ 0.25 mg/L) and C. glabrata (MIC ⩽ 0.5 mg/L) but insufficient for C. parapsilosis with MIC > 0.25 mg/L. That may provide an evidence based support to caspofungin individualized administration and decrease the risk of therapeutic failure in allo-HSCT pediatric patients.

show abstract

Three cases of Candida fermentati fungemia following hematopoietic stem cell transplantation

Cited by 10 publications

References 10 publications

Incidence and outcome of invasive fungal diseases after allogeneic hematopoietic stem cell transplantation: A Swiss transplant cohort study

Incidence and outcome of invasive fungal diseases after allogeneic hematopoietic stem cell transplantation: A Swiss transplant cohort study

Intravenous itraconazole compared with liposomal amphotericin B as empirical antifungal therapy in patients with neutropaenia and persistent fever

Population Pharmacokinetics of Caspofungin and Dosing Optimization in Children With Allogeneic Hematopoietic Stem Cell Transplantation

Contact Info

Product

Resources

About