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[Clinical analysis of 14 cases with childhood acute lymphoblastic leukemia complicated with tropical candidemia].

Objective: To investigate the clinical feature, diagnosis, treatment and prognosis of childhood acute lymphoblastic leukemia (ALL) complicat … lity rate were high. For azole-resistant tropical candida, amphotericin B liposome or echinocandins(caspofungin) -fluorocytosine combined therapy was recommended to reduce treatment-related deaths.

[A Rare Yeast: Cases of Rhodotorula mucilaginosa Infection Followed Up in a Tertiary University Hospital].

Rhodotorula species are yeasts that are common in the environment,but are not frequently encountered as an infectious agent in humans. Rhodo … road spectrum antibiotics for a long time. When the yeast growth was reported in the blood culture, caspofungin treatment was initiated. Although the treatment was switched to amphotericin B lipid complex after the culture result was reported as R.mucilaginosa, the patient died after 12 hours. The third case was a 70-year-old woman with hypertension, dementia …

Candida auris in a Tertiary Care Hospital in Oman: A Five-Year Study of Epidemiology, Clinical Characteristics, and Antifungal Susceptibility.

Background Candida auris (C. auris) is an emerging multidrug-resistant pathogen known for causing persistent colonization, invasive infectio … vity (5.2%), intermediate voriconazole susceptibility (44.8%), and preserved echinocandin activity (caspofungin, 96.6%; micafungin, 100%) and flucytosine activity (80.0%). Conclusions The findings demonstrate that C. auris imposes a considerable burden on hospitalized patients, with marked morbidity in those who develop invasive disease, particularly candidem …

[Cardiac invasive aspergillosis in a heart transplant recipient].

BACKGROUND: Solid organ transplant recipients are a population at risk of invasive aspergillosis. The lung and the central nervous system are usually affected. OBJECTIVES: We report the case of a patient with proven cardiac invasive aspergillosis two years after heart transplantation, and perform a review of cardiac aspergillosis in solid organ transplant recipients. CASE REPORT: A 52-year old woman received a heart transplant. Several complications appeared in the post-operative period, including the development of invasive aspergillosis in the surgical wound. She was readmitted two years l

[Severe malnutrition during pregnancy complicated with acute pyelonephritis causing sepsis, refractory septic shock and multiple organ failure: A case report].

This study reports the diagnosis and treatment of a 26-year-old pregnant woman with severe malnutrition combined with acute pyelonephritis c … to improve cardiac function. While etiological specimens were delivered, meropenem, teicoplanin and caspofungin were given as initial empiric antimicrobial therapy. Unfortunately, the intrauterine fetal death occurred on the night of admission to ICU. On the 3rd day of ICU admission, a still-born child was delivered vaginally with 1/5 defect of the fetal memb …

The Aspergillus fumigatus P-type Golgi apparatus Ca2+/Mn2+ ATPase PmrA is involved in cation homeostasis and cell wall integrity but is not essential for pathogenesis.

The Aspergillus fumigatus DeltapmrA (Golgi apparatus Ca(2+)/Mn(2+) P-type ATPase) strain has osmotically suppressible basal growth defects and cationic tolerance associated with increased expression of calcineurin pathway genes. Despite increased beta-glucan and chitin content, it is hypersensitive to cell wall inhibitors but remains virulent, suggesting a role for PmrA in cation homeostasis and cell wall integrity.

Evaluation of resistance patterns and bioremoval efficiency of hydrocarbons and heavy metals by the mycobiome of petroleum refining wastewater in Jazan with assessment of molecular typing and cytotoxicity of Scedosporium apiospermum JAZ-20.

Jazan Industrial Economic City (JIEC) is located on the Red Sea coast in the province of Jazan, southwest of Saudi Arabia anchors diverse he … conazole, voriconazole, posaconazole, isavuconazole and ketoconazole), echinocandin (anidulafungin, caspofungin and micafungin) and polyene (amphotericin B) drugs proved the prevalence of antibiotic resistance among the mycobiome of refinery industry in Saudi Arabia is relatively low. The fungal isolate under isolation code JAZ-20 showed the highest bioremova …

Analysis of Microbiological and Clinical Characteristics of Bacterial Infection in Patients with Pulmonary Infection.

OBJECTIVE: Using data investigation, the microbiology of bacterial infection in patients with pulmonary infection was discussed, and its cli … zithromycin. Regarding Candida albicans, the drug resistance rates from high to low were 22.41% for caspofungin, 15.52% for itraconazole, and 9.09% for fluconazole. The results of univariate analysis of pulmonary bacterial infection indicated that there were no significant differences in sex and body mass index between nonbacterial infection group and bacteri …

Incidence and risk factors of post-engraftment invasive fungal disease in adult allogeneic hematopoietic stem cell transplant recipients receiving oral azoles prophylaxis.

Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving >40 days who engrafted and were discharged without prior IFD. All patients who received ⩾20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/M

Autologous transplantation of CD133 selected hematopoietic progenitor cells for treatment of relapsed acute lymphoblastic leukemia.

A 21-year-old white male with relapsed acute lymphoblastic leukemia (ALL) developed an invasive Zygomycosis infection 3 weeks after beginning re-induction chemotherapy. Because of the high risk of fatal recurrence of the fungal infection, neither long-term maintenance chemotherapy nor allogeneic hematopoietic stem cell transplant (HSCT) was considered appropriate. Because his ALL blasts expressed CD34 but lacked CD133, he received a CD133 selected autologous graft following high-dose consolidation chemotherapy. The patient survives in remission 19 months after HSCT.

Primary prophylaxis of invasive fungal diseases in patients with haematological malignancies: 2022 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO).

Patients with haematological malignancies (HM) are at high risk of developing invasive fungal disease (IFD) with high morbidity and attributable mortality. We reviewed data published until September 2021 to update the 2017 antifungal prophylaxis recommendations of the German Society of Haematology and Medical Oncology (DGHO). The strong recommendation to administer antifungal prophylaxis in patients with HM with long-lasting neutropenia, i.e. 7 days remains unchanged. Posaconazole remains the drug of choice for mould-active prophylaxis in these patients. Novel treatment options in HM, such as

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… Caspofungin Since 2017, one multi-centre, randomized, open-label trial compared caspofungin versus fluconazole for prophylaxis in children, adolescents and young adults with newly diagnosed de novo , relapsed or secondary AML during neutropenia following induction and consolidation chemotherapy. … The 5-month cumulative incidence of IFD was 3.1% in the caspofungin group versus 7.2% in the fluconazole group, and for invasive aspergillosis, it was 0.5% with caspofungin versus 3.1% with fluconazole. …

Antifungal prophylaxis in chemotherapy-associated neutropenia: a retrospective, observational study.

BackgroundIn August 2002, the antifungal prophylaxis algorithm for neutropenic hematology/oncology (NHO) patients at the Medical Center was changed from conventional amphotericin (AMB) to an azole (AZ) based regimen (fluconazole [FLU] in low-risk and voriconazole [VOR] in high-risk patients). The aim of our study was to compare outcomes associated with the two regimens, including breakthrough fungal infection, adverse drug events, and costs.MethodsAdult, non-febrile, NHO patients who received prophylactic AMB from 01 August 2001-30 July 2002 or AZ from 01 August 2002-30 July 2003 were retrospe

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… In addition to the increased cost associated with FLU and VOR, a $157,490 increased total cost associated with greater use of caspofungin was observed during the AZ period. … When this cost of caspofungin was removed from the analysis, the increased mean antifungal cost of the AZ period further decreased to $476/hospitalization. …

Management of Invasive Fungal Infections in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: The Turin Experience.

BACKGROUND: Allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients are exposed to an increased risk of invasive fungal infecti … s the drug used in the majority of patients receiving diagnostic-driven therapy (30/79, 38%), while caspofungin was administered more frequently in patients who received a fever-driven strategy (27/63, 42.9%). CONCLUSION: According to our experience, a non-mold active prophylaxis in patients undergoing allo-HSCT is feasible when combined with an intensive di …

Breakthrough pulmonary Aspergillus fumigatus infection with multiple triazole resistance in a Spanish patient with chronic myeloid leukemia.

BACKGROUND: An allogeneic hematopoietic cell transplantation (allo-HCT) patient presented with chronic pulmonary aspergillosis associated to pulmonary graft versus host disease (GVHD) and was treated for a long time with several antifungal agents that were administered as prophylaxis, combination therapies, and maintenance treatment. The patient suffered from a breakthrough invasive pulmonary aspergillosis due to Aspergillus fumigatus after long-term antifungal therapy. MATERIAL AND METHODS: Several isolates were analyzed. First isolates were susceptible in vitro to all azole agents. However,

Empirical antimicrobial treatment in haemato-/oncological patients with neutropenic sepsis.

Neutropenic sepsis in haemato-/oncological patients is a medical emergency, as infections may show a fulminant clinical course. Early differentiation between sepsis and febrile neutropenic response often proves to be challenging. To assess the severity of the illness, different tools, which are discussed in this article, are available. Once the diagnosis has been established, the correct use of early empirical antibiotic and antifungal treatment is key in improving patient survival. Therefore, profound knowledge of local resistance patterns is mandatory and carefully designed antibiotic regime

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… Groetzner J , Kaczmarek I , Wittwer T , et al Caspofungin as first-line therapy for the treatment of invasive aspergillosis after thoracic organ transplantation . J Heart Lung Transplant 2008 ; 27 : 1 – 6 . 10.1016/j.healun.2007.10.002 18187079 52. … Heinz WJ , Einsele H Caspofungin for treatment of invasive aspergillus infections . Mycoses 2008 ; 51 ( Suppl 1 ): 47 – 57 . 10.1111/j.1439-0507.2008.01528.x 18471161 53. Marr KA , Schlamm HT , Herbrecht R , et al Combination antifungal therapy for invasive aspergillosis: a randomized trial . …

Drug Repurposing Approaches towards Defeating Multidrug-Resistant Gram-Negative Pathogens: Novel Polymyxin/Non-Antibiotic Combinations.

Multidrug-resistant (MDR) Gram-negative pathogens remain an unmet public health threat. In recent times, increased rates of resistance have been reported not only to commonly used antibiotics, but also to the last-resort antibiotics, such as polymyxins. More worryingly, despite the current trends in resistance, there is a lack of new antibiotics in the drug-discovery pipeline. Hence, it is imperative that new strategies are developed to preserve the clinical efficacy of the current antibiotics, particularly the last-line agents. Combining conventional antibiotics such as polymyxins with non-an

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… Antifungal Drugs Caspofungin is an antifungal drug that operates by inhibiting the enzyme (1→3)-β-D-glucan synthase, destabilizing fungal cell wall integrity. Caspofungin serves as a therapeutic agent against Aspergillus and Candida fungal infections [ 106 ]. … Intriguingly, caspofungin was observed to exert antibacterial activity by inhibiting biofilms [ 80 ]. …

Management of Invasive Pulmonary Aspergillosis in Intensive Care Units: Guidelines From the Fungal Infection Network of Switzerland (FUNGINOS).

Invasive pulmonary aspergillosis (IPA) is increasingly recognised in intensive care units (ICU) affecting not only patients with classical immunosuppressive conditions but also other severely ill patients, including those with respiratory viral infections (influenza, COVID-19), advanced chronic obstructive pulmonary disease or acute and chronic liver diseases. Several expert panels have proposed definitions of IPA in different ICU settings. However, practical recommendations for its diagnostic and therapeutic approaches are scarce. Moreover, these approaches can be influenced by different para

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… Echinocandins (mainly caspofungin) have been used with variable success rates (30%–50%) for the treatment of IPA but comparative trials, as well as specific ICU data, are lacking [ 126 , 127 , 154 , 176 ]. … Among echinocandins, some decrease in caspofungin clearance has been observed in patients with moderate/severe liver impairment, but the need for dosing adjustment is debated [ 201 , 202 ]. An alternative echinocandin (e.g., anidulafungin) should be considered in this setting. …

Navigating Trichosporon Asahii Infections in Pediatric Leukemia: First Reported Case in Central and Eastern Europe Case Report and Literature Review.

Invasive fungal infections pose significant challenges in the management of immunocompromised patients, particularly those undergoing treatment for hematologic malignancies. Trichosporon asahii is a rare but severe cause of invasive trichosporonosis, associated with mortality rates. Effective management is complicated by its resistance to echinocandins and reduced susceptibility to polyenes, necessitating azole-based therapy. This paper aims to illustrate the diagnostic challenges associated with Trichosporon infections, analyze the complexities of treatment, review and synthesize known risk f

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… One of them was treated with caspofungin, and six, including our patient, received micafungin. For the remaining eight cases, the antifungal agent used was unspecified. … Trichosporon asahii infection treated with caspofungin combined with liposomal amphotericin B. J Antimicrob Chemother . 2004;54(2):575–577. doi: 10.1093/jac/dkh337 55. Hu L, Liu G, Chen X. …

[Expert consensus on diagnosis and treatment of severe COVID-19 associated pulmonary aspergillosis and mucormycosis].

The incidence and mortality of COVID-19 associated pulmonary aspergillosis (CAPA) are high in critically ill patients. Although COVID-19 ass … CAPA, but may be used as a salvage therapy strategy. Triazole or amphotericin B in combination with caspofungin or micafungin is recommended; whereas amphotericin B in combination with triazole is not recommended. For CAPM patients with extensive lesions, rapid progression or poor general condition, a combination of amphotericin B liposome with isavuconazole …