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IDCases 2024is an emerging opportunistic yeast in the Mediterranean region typically isolated from immunocompromised patients, usually affected by blood malignancies. We reported a...
is an emerging opportunistic yeast in the Mediterranean region typically isolated from immunocompromised patients, usually affected by blood malignancies. We reported a rare case of infection, isolated from a drainage fluid in a patient affected by lung cancer recovered in the University Hospital of Campania "Luigi Vanvitelli", Naples, Italy. The isolate was identified by phenotypic methods, i.e., Gram and Lactophenol cotton blue (LCB) staining, and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis. We identified on the third day from Sabouraud Dextrose Agar supplemented with chloramphenicol and gentamicin. Antifungal susceptibility test revealed that 5-fluorocytosine was the most active drug against , followed by itraconazole and voriconazole, micafungin, amphotericin B and fluconazole, posaconazole, anidulafungin, and caspofungin. Our data showed the importance of an early cultural and fast microbiology diagnosis based on the characteristic morphologic features observed in Gram-stained smears of blood culture positive bottles, and the validation via MALDI-TOF MS. This dual approach has significant impact in the clinical management of infectious diseases and antibiotic stewardship, by integrating sample processing, fluid handling, and detection for rapid bacterial diagnosis.
PubMed: 38681078
DOI: 10.1016/j.idcr.2024.e01959 -
Journal of Infection in Developing... Feb 2024Magnusiomyces capitatus (M. capitatus) is an emerging opportunistic yeast, rarely found as a causal agent of invasive fungal infection. In this study, we report a...
Magnusiomyces capitatus (M. capitatus) is an emerging opportunistic yeast, rarely found as a causal agent of invasive fungal infection. In this study, we report a 31-year-old man infected with M. capitatus in the oral cavity, with a history of heroin and amphetamine abuse. M. capitatus was isolated through culture and microscopic analysis and identified by PCR amplification of the ITS DNA region. Based on the in vitro antifungal susceptibility test, the lowest MICs for M. capitatus were recorded for nystatin, itraconazole, and amphotericin, while higher MICs were observed for caspofungin and fluconazole. Treatment with nystatin successfully eliminated M. capitatus and relieved the clinical symptoms. This study presents the first case of M. capitatus in a patient with substance use disorder, manifesting as a plaque-like ulcer in the oral cavity.
Topics: Male; Humans; Adult; Antifungal Agents; Nystatin; Saccharomycetales; Mouth; Fluconazole; Microbial Sensitivity Tests
PubMed: 38484343
DOI: 10.3855/jidc.18099 -
Scientific Reports Jan 2024Yeast species are a group of coexistent microorganisms in the oral cavity that can cause opportunistic infections in vulnerable individuals, including addicts. This...
Yeast species are a group of coexistent microorganisms in the oral cavity that can cause opportunistic infections in vulnerable individuals, including addicts. This study aimed to identify the yeast species profile responsible for oral yeast colonization (OYC) and the associated risk factors in patients with substance use disorder (SUD) in Ahvaz, Iran. Oral samples were collected from drug users hospitalized in 12 addiction treatment centers, and the related clinical information was mined. Oral yeast species were identified using 21-plex PCR and sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). A total of 244 yeast strains were identified from 245 individuals with substance abuse. Candida albicans was the most common species (37.7%) and non-albicans Candida was responsible for 57.7% of OYC, primarily C. dubliniensis (33.2%) and C. glabrata (11.9%). Moreover, uncommon oral yeasts constituted 5.3% of species, including Saccharomyces cerevisiae, Clavispora lusitaniae, Pichia kluyveri, Geotrichum candidum, Magnusiomyces capitatus, Hanseniospora opuntiae, Wickerhamomyces subpelliculosus, Trichosporon asahii, and Aureobasidium pullulans. Importantly, OYC exhibited associations with such factors as duration of drug use, daily drug consumption rate, opioid utilization, oral drug administration, and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) score. The present study is the pioneering investigation revealing the prevalence and diversity of oral yeast species, along with associated risk factors, in individuals with SUD in southwestern Iran. Furthermore, it underscores the importance of developing efficient and cost-effective diagnostic methods tailored for resource-constrained settings.
Topics: Humans; Saccharomyces cerevisiae; Drug Users; Iran; Phylogeny; Yeast, Dried
PubMed: 38253731
DOI: 10.1038/s41598-024-52105-4 -
Antimicrobial Agents and Chemotherapy Feb 2024Manogepix is a potent new antifungal agent targeting the fungal Gwt1 enzyme. Manogepix has previously demonstrated potent activity against clinical isolates of both...
Manogepix is a potent new antifungal agent targeting the fungal Gwt1 enzyme. Manogepix has previously demonstrated potent activity against clinical isolates of both (except ) and species. This study determined the activity of manogepix and comparators against a large collection of infrequently encountered yeast and molds. Manogepix demonstrated potent activity against infrequently encountered yeasts exhibiting elevated MIC values to other drug classes, including spp. (MIC, 0.008/0.12 mg/L), () (MIC, 0.03/0.06 mg/L), (MIC, 0.016-0.06 mg/L), (MIC, 0.016 mg/L), and (MIC, 0.03/0.12 mg/L). Similarly, manogepix was active against infrequently encountered mold isolates and strains exhibiting elevated MIC/MEC values to echinocandins, azoles, and amphotericin B, including (MEC, 0.004 mg/L), spp. (MEC, 0.016/0.06 mg/L), () species complex (MEC, 0.016/0.03 mg/L), (MEC, 0.03/0.06 mg/L), (MEC, 0.008 mg/L), spp. (MEC, ≤0.008/0.016 mg/L), (MEC, 0.06 mg/L), (MEC range, 0.016-0.12 mg/L), and spp. (MEC, 0.03/0.06 mg/L). Manogepix demonstrated potent activity against a majority of the infrequently encountered yeast and mold isolates tested including strains with elevated MIC/MEC values to other drug classes. Additional clinical development of manogepix (fosmanogepix) in difficult-to-treat, resistant fungal infections is warranted.
Topics: Triazoles; Antifungal Agents; Fungi; Aminopyridines; Yeasts; Candida; Microbial Sensitivity Tests; Isoxazoles
PubMed: 38205999
DOI: 10.1128/aac.01132-23 -
Cureus Dec 2023is an uncommon yeast species; its impact on non-neutropenic patients appears to be on the rise. We describe a case of fungemia in a critically ill end-stage kidney...
is an uncommon yeast species; its impact on non-neutropenic patients appears to be on the rise. We describe a case of fungemia in a critically ill end-stage kidney disease (ESKD) patient on peritoneal dialysis. The patient presented with mesenteric ischemia and underwent several laparotomies during hospitalization. His hospital stay was complicated as fungemia developed and spread to multiple sites, which resulted in severe complications and ultimately led to fatal outcomes. 's diagnostic delay is a concern, but matrix-assisted laser desorption/Ionization time-of-flight (MALDI-TOF) mass spectrometry may help provide accurate identification. Our case highlights the need for prompt diagnosis and tailored antifungal therapy, especially when managing this challenging infection in immunocompromised patients.
PubMed: 38152295
DOI: 10.7759/cureus.51147 -
Cureus Sep 2023() is an opportunistic arthroconidial yeast-like fungus causing invasive infections in immunocompromised patients, mainly those with hematological malignancies and...
() is an opportunistic arthroconidial yeast-like fungus causing invasive infections in immunocompromised patients, mainly those with hematological malignancies and severe neutropenia. However, infections due to are extremely rare in immunocompetent and non-neutropenic patients. spp. are microscopically characterized by arthroconidia with hyaline-septated hyphae. is known to be intrinsically resistant to echinocandins and highly resistant to fluconazole. It is suggested to use amphotericin B or voriconazole (in monotherapy or in combination) as the gold standard treatment for systemic infections. We report a rare case of peritonitis with fatal outcome in a non-neutropenic patient without underlying malignancies. This case report highlights the value of direct microscopic examination and stained smears in a prompt preliminary diagnosis of invasive fungal infections. We also aim to emphasize the importance of early initiation of appropriate antifungal treatment in patients with systemic infections, thus improving their therapeutic outcome.
PubMed: 37868573
DOI: 10.7759/cureus.45568 -
Annals of Palliative Medicine Dec 2022Blastoschizomyces capitatus infection is a rare fungal infection; mainly occurring in immunodeficient patients, which can cause multiple organ involvement. At present,... (Review)
Review
BACKGROUND
Blastoschizomyces capitatus infection is a rare fungal infection; mainly occurring in immunodeficient patients, which can cause multiple organ involvement. At present, there is no clear designated treatment regimen. This case was a rare example of Blastoschizomyces capitatus lung infection in patient with normal immune function, which was effectively controlled by combined antifungal therapy.
CASE DESCRIPTION
We report a 67-year-old male smoker, who, after cleaning a small bungalow for a long period, without any protective measures, developed cough with expectoration, fever and dyspnea. Pre-admission anti-infective medication (amoxicillin and roxithromycin) had little effect, and the patient's condition worsened. He had a past history of pulmonary tuberculosis with pleurisy 6 years before. Chest computed tomography (CT) showed evidence of old tuberculosis in the right upper lobe and inflammation in both lower lobes. White blood cell count was 14.51×109/L, neutrophils was 13.39×109/L and C-reactive protein (CRP) was 170 mg/L. Broad-spectrum antibiotics piperacillin sodium 4.0 g and tazobactam sodium 0.5 g q8h were administered empirically for 5 days. Blastoschizomyces capitatus infection was confirmed by next generation of macro genome sequencing (NGS) of bronchoalveolar lavage fluid and mass spectrum analysis of sputum. He was then switched to voriconazole antifungal therapy combined with aerosol inhalation of amphotericin B. His temperature normalized, expectoration and dyspnea were relieved. Total white cell count fell to 8.10×109/L, neutrophils to 5.81×109/L, and CRP to 76.8 mg/L.
CONCLUSIONS
This case demonstrates that Blastoschizomyces capitatus infection can occur in patients with normal immune function. Mass spectrometry and metagenomic NGS methods may have an advantage over traditional methods in identifying this fungal infection. In addition, the combination of voriconazole and nebulized amphotericin B can be employed as a novel regimen for treating Blastoschizomyces capitatus infection. For pulmonary infection with a history of environmental exposure, early pathogen identification and culture, and appropriate antibiotic treatment are key to optimizing outcome.
Topics: Male; Humans; Aged; Antifungal Agents; Amphotericin B; Voriconazole; Mycoses; Pneumonia; Lung; Dyspnea
PubMed: 36636006
DOI: 10.21037/apm-22-1289 -
Journal of Fungi (Basel, Switzerland) Aug 2022Magnusiomyces capitatus (also denominated “Geotrichum capitatum” and “the teleomorph stage of Saprochaete capitata”) mainly affects immunocompromised patients...
Magnusiomyces capitatus (also denominated “Geotrichum capitatum” and “the teleomorph stage of Saprochaete capitata”) mainly affects immunocompromised patients with hematological malignancies in rare cases of invasive fungal infections (IFIs). Few cases have been reported for pediatric patients with acute lymphoblastic leukemia (ALL), in part because conventional diagnostic methods do not consistently detect M. capitatus in infections. The current contribution describes a systemic infection in a 15-year-old female diagnosed with ALL. She arrived at the Children’s Hospital of Mexico City with a fever and neutropenia and developed symptoms of septic shock 4 days later. M. capitatus ENCB-HI-834, the causal agent, was isolated from the patient’s blood, urine, bile, and peritoneal fluid samples. It was identified with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and a phylogenetic reconstruction using internal transcribed spacer (ITS) and 28S ribosomal sequences. The phylogenetic sequence of M. capitatus ENCB-HI-834 clustered with other M. capitatus-type strains with a 100% identity. In vitro antifungal testing, conducted with the Sensititre YeastOne susceptibility system, found the following minimum inhibitory concentration (MIC) values (μg/mL): posaconazole 0.25, amphotericin B 1.0, fluconazole > 8.0, itraconazole 0.25, ketoconazole 0.5, 5-flucytosine ≤ 0.06, voriconazole 0.25, and caspofungin > 16.0. No clinical breakpoints have been defined for M. capitatus. This is the first clinical case reported in Mexico of an IFI caused by M. capitatus in a pediatric patient with ALL. It emphasizes the importance of close monitoring for a timely and accurate diagnosis of neutropenia-related IFIs to determine the proper treatment with antibiotics, antifungals, and chemotherapy for instance including children with ALL.
PubMed: 36012839
DOI: 10.3390/jof8080851 -
The Pan African Medical Journal 2022Malignant external otitis (MEO) has a frequent bacterial origin, but we are currently witnessing the emergence of fungal agents, which poses difficulties in diagnosis...
Malignant external otitis (MEO) has a frequent bacterial origin, but we are currently witnessing the emergence of fungal agents, which poses difficulties in diagnosis and management. The aim of our work is to analyze the epidemiological and clinical profile of fungal MEO and to study the antifungal susceptibility of fungi involved. Our study is retrospective collecting 43 patients treated for fungal MEO between 2010 and 2019. Clinical, biological, and radiological data were collected from patient hospitalization records. Identification of yeasts was done by YST vitek2 card. The antifungal susceptibility testing was performed for yeasts by the AST vitek2 card and for other fungi by the E-test technique. The average age was 66 (± 12) years. We noted a male predominance in 63 % (n=27). Diabetes was found in 86%. Otalgia was a constant symptom. Cranial nerve palsies were observed in 16% (n=7) of cases. CT showed bone lysis in 74% (n=31>) of cases and Tc99 bone scintigraphy revealed hyperfixation in 100% (n=43) of cases. Candida spp. (n=21), Aspergillus spp. (n=18), and Geotrichum capitatum (n=2) were isolated. No resistance to antifungals has been demonstrated for Candida yeasts. Geotrichum capitatum isolates were resistant to fluconazole and caspofungin. Aspergillus isolates were resistant to amphotericin B and caspofungin in 50% (n=9) and 72% (n=12) of cases, respectively. Our study proves the predominance of Candida yeasts and Aspergillus as the fungal agents involved in MOE. Mycological diagnosis allows the identification and antifungal susceptibility testing. Thus, it allows using of the appropriate antifungal treatment and improves the prognosis of the disease.
Topics: Aged; Antifungal Agents; Aspergillus; Candida; Caspofungin; Female; Humans; Male; Microbial Sensitivity Tests; Otitis Externa; Otomycosis; Retrospective Studies; Saccharomycetales
PubMed: 35855033
DOI: 10.11604/pamj.2022.41.287.29585 -
Mycology 2022is an emerging opportunistic yeast, thus far mainly reported from the Western world where fungemia is the most frequent presentation in immunocompromised patients with...
is an emerging opportunistic yeast, thus far mainly reported from the Western world where fungemia is the most frequent presentation in immunocompromised patients with high mortality. We described a rare case of infection from our hospital in China and reviewed six further cases published to date in Chinese literature. It is noted that half more of the cases (4/7) presented with fungemia in younger, immunosuppressed patients, whereas the remaining cases were with pneumonia in elderly, immunocompetent patients. All seven Chinese cases had favourable outcome with antifungal therapy. Based on the limited in vitro and clinical data, a combination of amphotericin B either with 5-fluorocytosine or voriconazole for fungemia in immunocompromised patients, and although fluconazole is not recommended as first-line therapy in the guideline, in our study, fluconazole alone or with 5-fluorocytosine for local pulmonary infection in immunocompetent patients is effective with good outcome.
PubMed: 35186415
DOI: 10.1080/21501203.2021.2000059