Abstract
The incidence of infections by uncommon Candida species has increased in recent years, however, in vitro susceptibility data are scarce. Here we assess the susceptibility of C. krusei, C. ...dubliniensis, C. lusitaniae, and C. guilliermondii complex isolates (n = 120) to antifungal agents by the EUCAST methodology. C. dubliniensis proved to be the most susceptible species, similar to that of C. albicans (P < .05), whereas C. guilliermondii was the least susceptible. Two C. krusei isolates were echinocandin-resistant and harbored a point mutation (L701M) in the FKS1. Some isolates were either fluconazole-resistant (C. lusitaniae, n = 2) or fluconazole non-wild type (C. guilliermondii, n = 3).
We report a lung-invasive fungal disease with possible cutaneous needle tract seeding in a patient with a febrile neutropenia caused by the Basidiomycetes mold Inonotus spp. Although rare, Inonotus ...spp. should be added to the list of microorganisms causing invasive fungal disease in neutropenic patients with hematologic malignancies.
We assessed the ability of the Etest performed directly on positive blood cultures (ET
) to detect fluconazole susceptibility in 6 fluconazole-resistant and 12 fluconazole-susceptible
isolates, ...according to CLSI M27-A3 and EUCAST EDef 7.2 procedures. Categorical agreement between ET
and broth microdilution was 100% when the trays were incubated at 25°C and trailing effect was ruled out. ET
is a reliable procedure when screening for the presence of fluconazole resistance in
.
osteomyelitis is a rare complication of extrapulmonary invasive aspergillosis, which usually presents as spondylodiscitis. The clinical picture is usually paucisymptomatic and of long evolution, ...which leads to diagnostic difficulties, especially in immunosuppressed patients presenting a delayed systemic host response. We report a case of femoral osteomyelitis caused by
in a heart transplant recipient successfully treated with a combined surgical and antifungal approach. A 65-year-old heart transplant male presented with left knee pain lasting 3 months. X-ray and magnetic resonance imaging identified a lesion with aggressive characteristics at the distal third of the left femur, due to which the patient underwent excisional surgery.
was cultured from the removed material and antifungal treatment with oral isavuconazole was started. Chest imaging excluded pulmonary aspergillosis, while the positron emission tomography/computed tomography (PET/CT) identified a remnant of a prosthetic vascular graft sewn to the proximal third of the right axillary artery, through which a catheter-based micro-axial left ventricular assist device was implanted previously as bridge to transplant therapy. The patient presented a rapid clinical improvement with complete functional recovery following the surgical treatment and the antifungal therapy and finally underwent surgical removal of the residual vascular graft. This is the first reported episode of long bone osteomyelitis due to
that occurred in a heart transplant recipient without pulmonary infection and was successfully treated with isavuconazole. The PET/CT was useful in supporting the diagnostic process and follow-up. Cryptic fungal species can cause invasive infections, particularly in immunocompromised patients. Molecular methods are crucial in fungal identification.
Computed tomography (CT) findings can be used to classify invasive pulmonary aspergillosis (IPA) in 2 patterns: airway-invasive (AIR) or angioinvasive (ANG).
AIR-IPA was considered when the CT ...revealed peribronchial consolidation or a tree-in-bud pattern and ANG-IPA when a nodule, cavity, halo sign, infarct-shaped, or mass-like consolidation was found. We evaluated the correlation among IPA patterns on CT and outcomes in heart transplant (HT) recipients.
The study included 27 HT recipients with a CT scan performed at the time of IPA diagnosis. The study interval was from 1988 to 2011. Ten AIR-IPA patients (37.1%) were compared with 17 ANG-IPA patients (62.9%). During the post-transplantation period before IPA developed, AIR patients required hemodialysis more frequently (40% vs 5.9%, p = 0.04). AIR patients also had more intercurrent bacterial pneumonia (23.5% vs 70%, p < 0.001), and IPA was diagnosed later after onset of symptoms (2.7 vs 8.5 d, p = 0.09). After diagnosis, AIR-IPA patients required more mechanical ventilation (23.5% vs 90%, p < 0.01) and had a higher related mortality rate (23.5% vs 70%, p = 0.04).
Our study shows that the AIR pattern represents 37% of IPA episodes in HT recipients and is associated with a more protracted clinical presentation, later diagnosis, and higher mortality rate.
Eleven psychrophilic bacteria isolated from Antarctic coastal marine environments were subjected to a polyphasic taxonomic study. The isolates were oxidase-positive, halotolerant, gram-negative, ...non-motile coccobacilli with a strictly oxidative metabolism. The DNA G + C content ranged from 44 to 47 mol%. DNA-DNA hybridization experiments showed six homology groups, two of them related at the species level to the type strain of Psychrobacter immobilis, LMG 7203T (70-83%). The highest DNA relatedness of two other groups to known Psychrobacter species was found to the type strain of Psychrobacter glacincola, LMG 21282T (51-57%), and no significant similarity was found between Psychrobacter type strains and the last two groups. The predominant cellular fatty acids detected were typical of the genus Psychrobacter and included 18:1omega9c, 16:1omega7c and 17:1omega8c. 16S rRNA gene sequence analysis confirmed that the strains isolated belonged to the genus Psychrobacter. The results of the study assigned five isolates to P. immobilis, three isolates to P. glacincola and three isolates to novel Psychrobacter species. The names Psychrobacter luti sp. nov. (type strain NF11T=LMG 21276T=CECT 5885T) and Psychrobacter fozii sp. nov. (type strain NF23T=LMG 21280T=CECT 5889T) are proposed for these organisms.
An endospore-forming strain, 20CMT, was isolated from Antarctic sediment and identified as a member of the genus Paenibacillus on the basis of phenotypic and phylogenetic analyses. The organism ...stained Gram-variable and was facultatively anaerobic. Strain 20CMT was psychrotolerant, growing optimally at 10-15 degrees C. Like other Paenibacillus species, it contained anteiso-C(15 : 0) as the major cellular fatty acid. The DNA G + C content was 40.7 mol%. 16S rRNA gene sequence analysis placed strain 20CMT within the Paenibacillus cluster, with a similarity value of 99.5 % to Paenibacillus macquariensis DSM 2T. DNA-DNA hybridization experiments between the Antarctic isolate and P. macquariensis DSM 2T revealed a reassociation value of 47 %, indicating that strain 20CMT and P. macquariensis DSM 2T belong to different species. Based on evaluation of morphological, physiological, chemotaxonomic and phylogenetic analyses, a novel species, Paenibacillus antarcticus sp. nov., is proposed; the type strain is 20CMT (= LMG 22078T = CECT 5836T).
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