1
|
Quindós G, Miranda-Cadena K, San-Millán R, Borroto-Esoda K, Cantón E, Linares-Sicilia MJ, Hamprecht A, Montesinos I, Tortorano AM, Prigitano A, Vidal-García M, Marcos-Arias C, Guridi A, Sanchez-Reus F, Machuca-Bárcena J, Rodríguez-Iglesias MA, Martín-Mazuelos E, Castro-Méndez C, López-Soria L, Ruiz-Gaitán A, Fernandez-Rivero M, Lorenzo D, Capilla J, Rezusta A, Pemán J, Guarro J, Pereira J, Pais C, Romeo O, Ezpeleta G, Jauregizar N, Angulo D, Eraso E. In Vitro Antifungal Activity of Ibrexafungerp (SCY-078) Against Contemporary Blood Isolates From Medically Relevant Species of Candida: A European Study. Front Cell Infect Microbiol 2022; 12:906563. [PMID: 35651755 PMCID: PMC9149255 DOI: 10.3389/fcimb.2022.906563] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/19/2022] [Indexed: 12/18/2022] Open
Abstract
Background Ibrexafungerp (SCY-078) is the newest oral and intravenous antifungal drug with broad activity, currently undergoing clinical trials for invasive candidiasis. Objective The aim of this study was to assess the in vitro activity of ibrexafungerp and comparators against a collection of 434 European blood isolates of Candida. Methods Ibrexafungerp, caspofungin, fluconazole, and micafungin minimum inhibitory concentrations (MICs) were collected from 12 European laboratories for 434 blood isolates, including 163 Candida albicans, 108 Candida parapsilosis, 60 Candida glabrata, 40 Candida tropicalis, 29 Candida krusei, 20 Candida orthopsilosis, 6 Candida guilliermondii, 2 Candida famata, 2 Candida lusitaniae, and 1 isolate each of Candida bracarensis, Candida catenulata, Candida dubliniensis, and Candida kefyr. MICs were determined by the EUCAST broth microdilution method, and isolates were classified according to recommended clinical breakpoints and epidemiological cutoffs. Additionally, 22 Candida auris from different clinical specimens were evaluated. Results Ibrexafungerp MICs ranged from 0.016 to ≥8 mg/L. The lowest ibrexafungerp MICs were observed for C. albicans (geometric MIC 0.062 mg/L, MIC range 0.016–0.5 mg/L) and the highest ibrexafungerp MICs were observed for C. tropicalis (geometric MIC 0.517 mg/L, MIC range 0.06–≥8 mg/L). Modal MICs/MIC50s (mg/L) against Candida spp. were 0.125/0.06 for C. albicans, 0.5/0.5 for C. parapsilosis, 0.25/0.25 for C. glabrata, 0.5/0.5 for C. tropicalis, 1/1 for C. krusei, 4/2 for C. orthopsilosis, and 0.5/0.5 for C. auris. Ibrexafungerp showed activity against fluconazole- and echinocandin-resistant isolates. If adopting wild-type upper limits, a non-wild-type phenotype for ibrexafungerp was only observed for 16/434 (3.7%) isolates: 11 (4.6%) C. parapsilosis, 4 (5%) C. glabrata, and 1 (2.5%) C. tropicalis. Conclusion Ibrexafungerp showed a potent in vitro activity against Candida.
Collapse
Affiliation(s)
- Guillermo Quindós
- Laboratorio de Micología Médica, UFI 11/25, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Bilbao, Spain
- *Correspondence: Guillermo Quindós,
| | - Katherine Miranda-Cadena
- Laboratorio de Micología Médica, UFI 11/25, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Bilbao, Spain
| | - Rosario San-Millán
- Laboratorio de Micología Médica, UFI 11/25, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Bilbao, Spain
| | | | - Emilia Cantón
- Instituto de Investigación Sanitaria, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - María José Linares-Sicilia
- Research Group GC24, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Microbiology, Facultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, Spain
| | - Axel Hamprecht
- University Hospital Cologne, Cologne and Institute for Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany
| | - Isabel Montesinos
- Microbiology Department, LHUB-ULB, Hôpital Erasme, Brussels, Belgium
| | - Anna Maria Tortorano
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Anna Prigitano
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | | | - Cristina Marcos-Arias
- Laboratorio de Micología Médica, UFI 11/25, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Bilbao, Spain
| | - Andrea Guridi
- Laboratorio de Micología Médica, UFI 11/25, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Bilbao, Spain
| | - Ferran Sanchez-Reus
- Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jesús Machuca-Bárcena
- Área de Microbiología, Departamento de Biomedicina, Biotecnología y Salud Pública, Facultad de Medicina, Universidad de Cádiz, Cádiz, Spain
| | - Manuel Antonio Rodríguez-Iglesias
- Área de Microbiología, Departamento de Biomedicina, Biotecnología y Salud Pública, Facultad de Medicina, Universidad de Cádiz, Cádiz, Spain
| | | | | | - Leyre López-Soria
- Servicio de Microbiología, Hospital Universitario de Cruces and BioCruces Bizkaia, Barakaldo, Spain
| | - Alba Ruiz-Gaitán
- Instituto de Investigación Sanitaria, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Marcelo Fernandez-Rivero
- Instituto de Investigación Sanitaria, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Damaris Lorenzo
- Microbiology Unit, Medical School, Universitat Rovira i Virgili, Reus, Spain
| | - Javier Capilla
- Microbiology Unit, Medical School, Universitat Rovira i Virgili, Reus, Spain
| | - Antonio Rezusta
- Servicio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Javier Pemán
- Instituto de Investigación Sanitaria, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Josep Guarro
- Microbiology Unit, Medical School, Universitat Rovira i Virgili, Reus, Spain
| | - Joana Pereira
- Centre of Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
| | - Célia Pais
- Centre of Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
| | - Orazio Romeo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Guillermo Ezpeleta
- Servicio de Microbiología, Complejo Hospitalario de Navarra, Pamplona and Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Bilbao, Spain
| | - Nerea Jauregizar
- Departamento de Farmacología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Bilbao, Spain
| | | | - Elena Eraso
- Laboratorio de Micología Médica, UFI 11/25, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Bilbao, Spain
| |
Collapse
|
2
|
Sprute R, Salmanton-García J, Sal E, Malaj X, Falces-Romero I, Hatvani L, Heinemann M, Klimko N, López-Soria L, Meletiadis J, Shruti M, Steinmann J, Seidel D, Cornely OA, Stemler J. Characterization and outcome of invasive infections due to Paecilomyces variotii: analysis of patients from the FungiScope® registry and literature reports. J Antimicrob Chemother 2021; 76:765-774. [PMID: 33254240 PMCID: PMC7879145 DOI: 10.1093/jac/dkaa481] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/26/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives To provide a basis for clinical management decisions in Paecilomyces variotii infection. Methods Unpublished cases of invasive P. variotii infection from the FungiScope® registry and all cases reported in the literature were analysed. Results We identified 59 cases with P. variotii infection. Main baseline factors were presence of indwelling devices in 29 cases (49.2%), particularly peritoneal catheters (33.9%) and prosthetic heart valves (10.2%), haematological or oncological diseases in 19 (32.2%), major surgery in 11 (18.6%), and diabetes mellitus in 10 cases (16.9%). The most prevalent infection sites were peritoneum (n = 20, 33.3%) and lungs (n = 16, 27.1%). Pain and fever were frequent (n = 35, 59.3% and n = 33, 55.9%, respectively). Diagnosis was established by culture in 58 cases (98.3%). P. variotii caused breakthrough infection in 8 patients. Systemic antifungals were given in 52 patients (88.1%). Amphotericin B was administered in 39, itraconazole in 15, and posaconazole in 8 patients. Clinical isolates were frequently resistant to voriconazole, whereas the above-mentioned antifungals showed good in vitro activity. Infections of the blood and CNS caused high mortality. Overall mortality was 28.8% and death was attributed to P. variotii in 10 cases. Conclusions P. variotii causes life-threatening infections, especially in immunocompromised and critically ill patients with indwelling devices. Patients undergoing peritoneal dialysis are at particular risk. Multidisciplinary management is paramount, including molecular techniques for diagnosis and treatment with efficacious systemic antifungals. Amphotericin B, itraconazole and posaconazole are regarded as treatments of choice. Combination with flucytosine may be considered. Surgical debridement and removal of indwelling devices facilitate favourable outcome.
Collapse
Affiliation(s)
- Rosanne Sprute
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Ertan Sal
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Xhorxha Malaj
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Iker Falces-Romero
- Clinical Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain
| | - Lóránt Hatvani
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Melina Heinemann
- Division of Infectious Diseases, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nikolai Klimko
- Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, St Petersburg, Russia
| | - Leyre López-Soria
- Clinical Microbiology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Malik Shruti
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Joerg Steinmann
- Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Medical University, Nuremberg Hospital, Nuremberg, Germany
| | - Danila Seidel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.,University of Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Jannik Stemler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| |
Collapse
|
3
|
Nucci M, Jenks J, Thompson GR, Hoenigl M, Dos Santos MC, Forghieri F, Rico JC, Bonuomo V, López-Soria L, Lass-Flörl C, Candoni A, Garcia-Vidal C, Cattaneo C, Buil J, Rabagliati R, Roiz MP, Gudiol C, Fracchiolla N, Campos-Herrero MI, Delia M, Farina F, Fortun J, Nadali G, Sastre E, Colombo AL, Pérez Nadales E, Alastruey-Izquierdo A, Pagano L. Do high MICs predict the outcome in invasive fusariosis? J Antimicrob Chemother 2021; 76:1063-1069. [PMID: 33326585 DOI: 10.1093/jac/dkaa516] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/13/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Invasive fusariosis (IF) affects mostly severely immunocompromised hosts and is associated with poor outcome. Since Fusarium species exhibit high MICs for most antifungal agents, this could explain the poor prognosis. However, a clear-cut correlation between MIC and outcome has not been established. OBJECTIVE To evaluate the correlation between MIC and outcome (6 week death rate) in patients with IF. METHODS We performed a multicentre retrospective study of patients with IF who received treatment and had MIC levels determined by EUCAST or CLSI for the drug(s) used during treatment. We compared the MIC50 and MIC distribution among survivors and patients who died within 6 weeks from the diagnosis of IF. RESULTS Among 88 patients with IF, 74 had haematological diseases. Primary treatment was monotherapy in 52 patients (voriconazole in 27) and combination therapy in 36 patients (liposomal amphotericin B + voriconazole in 23). The MIC50 and range for the five most frequent agents tested were: voriconazole 8 mg/L (range 0.5-64), amphotericin B 2 mg/L (range 0.25-64), posaconazole 16 mg/L (range 0.5-64), itraconazole 32 mg/L (range 4-64), and isavuconazole 32 mg/L (range 8-64). There was no difference in MIC50 and MIC distribution among survivors and patients who died. By contrast, persistent neutropenia and receipt of corticosteroids were strong predictors of 6 week mortality. CONCLUSIONS Our study did not show any correlation between MIC and mortality at 6 weeks in patients with IF.
Collapse
Affiliation(s)
- Marcio Nucci
- University Hospital, Universidade Federal do Rio de Janeiro - Rua Prof Rodolpho Paulo Rocco 255, 21941-913 Rio de Janeiro, Brazil
| | - Jeffrey Jenks
- Division of Infectious Diseases and Global Public Health, University of California, San Diego - 9500 Gilman Drive MC 0507 La Jolla, CA, USA
| | - George R Thompson
- Department of Internal Medicine, Division of Infectious Diseases and Department of Medical Microbiology and Immunology, University of California-Davis - 3146 Tupper Hall, 1 Shields Ave., Davis, CA, USA
| | - Martin Hoenigl
- Division of Infectious Diseases and Global Public Health, University of California, San Diego - 9500 Gilman Drive MC 0507 La Jolla, CA, USA.,Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz - Auenbruggerpl. 2, 8036 Graz, Austria
| | - Marielle Camargo Dos Santos
- Division of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de São Paulo - Rua Botucatu, 740, 04023-062 - São Paulo, Brazil
| | - Fabio Forghieri
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia - Via Università, 4, 41121 Modena, Italy
| | - Juan Carlos Rico
- Division of Infectious Diseases, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock - 4301 W Markham St, Little Rock, AR 72205, USA
| | - Valentina Bonuomo
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata di Verona - Piazzale Aristide Stefani, 1, 37126 Verona, Italy
| | - Leyre López-Soria
- Servicio de Microbiología, Hospital Universitario Cruces, Barakaldo - Cruces Plaza, S/N, 48903 Barakaldo, Bizkaia, Spain
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck - Christoph-Probst-Platz 1, Innrain 52, A - 6020 Innsbruck, Austria
| | - Anna Candoni
- Division of Haematology, Santa Maria Della Misericordia University Hospital of Udine - Piazzale Santa Maria Della Misericordia, 15, 33100 Udine, Italy
| | - Carolina Garcia-Vidal
- Infectious Diseases Department, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona - C. de Villarroel, 170, 08036 Barcelona, Spain
| | - Chiara Cattaneo
- Haematology Unit, Spedali Civili di Brescia, Via del Medolo, 2, 25123 Brescia, Italy
| | - Jochem Buil
- Center of Expertise in Mycology Radboud University Medical Center/Canisius-Wilhelmina Hospital - Weg door Jonkerbos 100, 6532 SZ Nijmegen, The Netherlands
| | - Ricardo Rabagliati
- Department of Infectious Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile - Av Libertador Bernardo O'Higgins 340, Santiago, Región Metropolitana, Chile
| | - Maria Pia Roiz
- Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla - Av. de Valdecilla, 25, 39008 Santander, Cantabria, Spain
| | - Carlota Gudiol
- Department of Infectious Diseases, Bellvitge University Hospital - Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Nicola Fracchiolla
- Unità di Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico - Via della Commenda, 10, 20122, Milano, Italy
| | - Maria Isolina Campos-Herrero
- Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria - Calle Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Mario Delia
- Sezione di Ematologia, Dipartimento dell'Emergenza e dei Trapianti d'Organo, Università di Bari - Piazza Umberto I, 1, 70121, Bari, Italy
| | - Francesca Farina
- Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Scientific Institute - Via Olgettina, 60, 20132, Milano, Italy
| | - Jesus Fortun
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal - M-607, km. 9, 100, 28034, Madrid, Spain
| | - Gianpaolo Nadali
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata di Verona - Piazzale Aristide Stefani, 1, 37126 Verona, Italy
| | - Enric Sastre
- Department of Infectious Diseases, Bellvitge University Hospital - Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Arnaldo L Colombo
- Division of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de São Paulo - Rua Botucatu, 740, 04023-062 - São Paulo, Brazil
| | - Elena Pérez Nadales
- Hospital Universitario Reina Sofia, Universidad de Córdoba - Av. Menendez Pidal, s/n, 14004 Córdoba, Spain
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III - Ctra. de Pozuelo, 28, 28222 Majadahonda, Madrid, Spain
| | - Livio Pagano
- Istituto di Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS-Università Cattolica del Sacro Cuore - Largo Francesco Vito, 1, 00168 Roma RM, Italy
| |
Collapse
|
4
|
Escribano P, Rodríguez-Sánchez B, Díaz-García J, Martín-Gómez MT, Ibáñez-Martínez E, Rodríguez-Mayo M, Peláez T, García-Gómez de la Pedrosa E, Tejero-García R, Marimón JM, Reigadas E, Rezusta A, Labayru-Echeverría C, Pérez-Ayala A, Ayats J, Cobo F, Pazos C, López-Soria L, Alastruey-Izquierdo A, Muñoz P, Guinea J. Azole resistance survey on clinical Aspergillus fumigatus isolates in Spain. Clin Microbiol Infect 2020; 27:1170.e1-1170.e7. [PMID: 33010446 DOI: 10.1016/j.cmi.2020.09.042] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/11/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We aimed to assess the percentage of azole resistance in Aspergillus fumigatus in Spain. METHODS Thirty participating Spanish hospitals stored all morphologically identified A. fumigatus sensu lato clinical isolates-regardless their clinical significance-from 15 February to 14 May 2019. Isolates showing azole resistance according to the EUCAST 9.3.2 methodology were molecularly identified and the cyp51A gene was studied in A. fumigatus sensu stricto isolates. RESULTS Eight hundred and forty-seven isolates from 725 patients were collected in 29 hospitals (A. fumigatus sensu stricto (n = 828) and cryptic species (n = 19)). Isolates were mostly from the lower respiratory tract (94.0%; 797/847). Only cryptic species were amphotericin B resistant. Sixty-three (7.4%) out of the 847 isolates were resistant to ≥1 azole(s). Azole resistance was higher in cryptic species than in A. fumigatus sensu stricto (95%, 18/19 vs. 5.5%, 45/828); isavuconazole was associated to the lowest number of non-wild type isolates. The dominant mechanism of resistance was the presence of TR34-L98H substitutions (n = 24 out of 63). Out of the 725 patients, 48 (6.6%) carried either cryptic species (n = 14) or A. fumigatus sensu stricto (n = 34; 4.7%) resistant isolates. Aspergillus fumigatus sensu stricto harbouring either the TR34-L98H (n = 19) or TR46/Y121F/T289A (n = 1) mutations were detected in patients in hospitals located at 7/24 studied cities. DISCUSSION Of the patients, 6.6% carry azole-resistant A. fumigatus sensu lato isolates in Spain. TR34-L98H is the dominant cyp51A gene substitutions, although its presence is not widespread.
Collapse
Affiliation(s)
- Pilar Escribano
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Belén Rodríguez-Sánchez
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
| | - Judith Díaz-García
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | | | - María Rodríguez-Mayo
- Servicio de Microbiología Clínica, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Teresa Peláez
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain; Fundacion para la Investigación y la Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain
| | - Elia García-Gómez de la Pedrosa
- Servicio de Microbiología, Hospital Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Tejero-García
- Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Microbiología Clínica del Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica, Córdoba, Spain
| | - José María Marimón
- Biodonostia, Infectious Diseases Area, Respiratory Infection and Antimicrobial Resistance Group; Donostialdea Integrated Health Organisation, Microbiology Department, Donostia, Spain
| | - Elena Reigadas
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Antonio Rezusta
- Servicio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | | | - Ana Pérez-Ayala
- Servicio de Microbiología, Hospital 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
| | - Josefina Ayats
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain; Microbiology Department, Hospital Universitari de Bellvitge-Universitat de Barcelona-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Fernando Cobo
- Instituto de Investigación Biosanitaria IBS, Granada, Spain; Department of Microbiology, University Hospital Virgen de las Nieves, Granada, Spain
| | - Carmen Pazos
- Servicio de Microbiología Clínica, Complejo Hospitalario Universitario de Cáceres, Cáceres, Spain
| | - Leyre López-Soria
- Servicio de Microbiología, Hospital Universitario Cruces, Barakaldo, Spain; Instituto de Investigación Sanitaria Biocruces Bizkaia, Barakaldo, Spain
| | - Ana Alastruey-Izquierdo
- Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain; Mycology Reference Laboratory, National Centre for Microbiology (ISCIII), Madrid, Spain
| | - Patricia Muñoz
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain; Medicine Department, Faculty of Medicine, Universidad Complutense de Madrid, Spain
| | - Jesús Guinea
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain.
| | | |
Collapse
|
5
|
López-Soria L, Aguirrebengoa Ibarguren K, Ratón Nieto JA, Barrios Andrés JL. Lesión cutánea y linfangitis en paciente inmunocompetente. Enferm Infecc Microbiol Clin 2019; 37:481-482. [DOI: 10.1016/j.eimc.2018.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022]
|
6
|
Rodríguez-Álvarez R, Goikoetxea J, Voces R, López-Soria L, Montejo M. Endocarditis infecciosa (EI) por Candida en un hospital terciario. Cirugía Cardiovascular 2018. [DOI: 10.1016/j.circv.2017.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
7
|
Blanco-Vidal MJ, López-Soria L, Monzón-de la Torre A, Montejo-Baranda JM. Skin nodules in a liver transplant recipient. Enferm Infecc Microbiol Clin 2016; 36:140-141. [PMID: 27771024 DOI: 10.1016/j.eimc.2016.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 11/30/2022]
Affiliation(s)
- María José Blanco-Vidal
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Barakaldo, Bizkaia, España.
| | - Leyre López-Soria
- Servicio de Microbiología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, España
| | | | | |
Collapse
|
8
|
Patiño-Galindo JA, Thomson MM, Pérez-Álvarez L, Delgado E, Cuevas MT, Fernández-García A, Nájera R, Iribarren JA, Cilla G, López-Soria L, Lezaun MJ, Cisterna R, González-Candelas F. Transmission dynamics of HIV-1 subtype B in the Basque Country, Spain. Infect Genet Evol 2016; 40:91-97. [PMID: 26921800 DOI: 10.1016/j.meegid.2016.02.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/15/2016] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
This work was aimed to study the HIV-1 subtype B epidemics in the Basque Country, Spain. 1727 HIV-1 subtype B sequences comprising protease and reverse transcriptase (PR/RT) coding regions, sampled between 2001 and 2008, were analyzed. 156 transmission clusters were detected by means of phylogenetic analyses. Most of them comprised less than 4 individuals and, in total, they included 441 patients. Six clusters comprised 10 or more patients and were further analyzed in order to study their origin and diversification. Four clusters included men who had unprotected homosexual sex (MSM), one group was formed by intravenous drug users (IDUs), and another included both IDUs and people infected through unprotected heterosexual sex (HTs). Most of these clusters originated from the mid-1980s to the mid-1990s. Only one cluster, formed by MSM, originated after 2000. The time between infections was significantly lower in MSM groups than in those containing IDUs (P-value <0.0001). Nucleoside RT and non-nucleoside RT inhibitor (NRTI and NNRTI)-resistance mutations to antiretroviral treatment were found in these six clusters except the most recent MSM group, but only the IDU clusters presented protease inhibitor (PI)-resistance mutations. The most prevalent mutations for each inhibitor class were PI L90M, NRTI T215D/Y/F, and NNRTI K103N, which were also among the most prevalent resistant variants in the whole dataset. In conclusion, while most infections occur as isolated introductions into the population, the number of infections found to be epidemiologically related within the Basque Country is significant. Public health control measures should be reinforced to prevent the further expansion of transmission clusters and resistant mutations occurring within them.
Collapse
Affiliation(s)
- J A Patiño-Galindo
- Joint Research Unit "Infection and Public Health" FISABIO-Universitat de Valencia, Spain; CIBER in Epidemiology and Public Health, Madrid, Spain
| | - Michael M Thomson
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Lucía Pérez-Álvarez
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Elena Delgado
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - María Teresa Cuevas
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Aurora Fernández-García
- CIBER in Epidemiology and Public Health, Madrid, Spain; Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Rafael Nájera
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | | | - Gustavo Cilla
- Hospital Universitario Donostia, San Sebastián, Spain; CIBER for Respiratory Diseases, Madrid, Spain
| | | | | | | | - F González-Candelas
- Joint Research Unit "Infection and Public Health" FISABIO-Universitat de Valencia, Spain; CIBER in Epidemiology and Public Health, Madrid, Spain.
| | | |
Collapse
|
9
|
García-Ruiz JC, Olazábal I, Adán Pedroso RM, López-Soria L, Velasco-Benito V, Sánchez-Aparicio JA, Navajas A, Montejo M, Moragues MD. Disseminated fusariosis and hematologic malignancies, a still devastating association. Report of three new cases. Rev Iberoam Micol 2015; 32:190-6. [PMID: 25936697 DOI: 10.1016/j.riam.2014.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/12/2014] [Accepted: 11/21/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Fungi of the genus Fusarium are primarily plant pathogens and saprobes that produce disseminated infections in immunologically deficient humans. After aspergillosis, disseminated fusariosis is the second most common cause of invasive infection by filamentous fungi in patients with hematologic malignancies or those undergoing transplants of hematopoietic progenitors. AIMS Disseminated fusariosis (DF) is considered an extremely rare infection and has reached a stable incidence rate, but its high mortality rate and the lack of an optimal management protocol have raised increasing interest in this mycosis. METHODS We present three cases of DF produced by Fusarium oxysporum species complex, Fusarium solani species complex and the highly unusual Fusarium dimerum in patients with advanced hematological malignancies diagnosed in our hospital between 2007 and 2011. The species level identification of the Fusarium isolates was established by sequencing their TEF1 gene. RESULTS The isolates showed low susceptibility to most of the antifungal agents analyzed, except that observed for F. dimerum to amphotericin B (AmB) and terbinafine, and F. oxysporum species complex to AmB. Interestingly, the strain of F. solani species complex exhibited high MIC values for AmB and voriconazole, notwithstanding these drugs were used for treatment with good results. Other relevant aspects to be considered in the treatment of DF are surgically cleaning foci of infection, withdrawing presumably contaminated catheters and recovery from neutropenia. CONCLUSIONS The prevention of infection in colonized patients, the maintenance of a high level of diagnostic suspicion for early diagnosis, and the combined, vigorous and prolonged use of L-AmB and voriconazole are essential to decrease the mortality rate of this devastating infection.
Collapse
Affiliation(s)
- Juan Carlos García-Ruiz
- Servicio de Hematología y Hemoterapia, BioCruces Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain
| | - Iñigo Olazábal
- Servicio de Hematología y Hemoterapia, BioCruces Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces s/n, 48903 Barakaldo, Bizkaia, Spain
| | - Rosa María Adán Pedroso
- Servicio de Pediatría, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Leyre López-Soria
- Servicio de Microbiología, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Verónica Velasco-Benito
- Servicio de Anatomía Patológica, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | | | - Aurora Navajas
- Servicio de Pediatría, BioCruces Health Research Institute, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Miguel Montejo
- Unidad de Enfermedades Infecciosas, Hospital Universitario Cruces, BioCruces Health Research Institute, Universidad del País Vasco (UPV/EHU), Barakaldo, Bizkaia, Spain
| | - María-Dolores Moragues
- Departamento de Enfermería, Escuela de Enfermería, Universidad del País Vasco UPV/EHU, Leioa, Bizkaia, Spain.
| |
Collapse
|
10
|
García-Ruiz JC, López-Soria L, Olazábal I, Amutio E, Arrieta-Aguirre I, Velasco-Benito V, Pontón J, Moragues MD. Invasive infections caused by Saprochaete capitata in patients with haematological malignancies: Report of five cases and review of the antifungal therapy. Rev Iberoam Micol 2013; 30:248-55. [DOI: 10.1016/j.riam.2013.02.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 02/22/2013] [Accepted: 02/22/2013] [Indexed: 11/29/2022] Open
|
11
|
Montejo M, Muñiz ML, Zárraga S, Aguirrebengoa K, Amenabar JJ, López-Soria L, Gonzalez R. Case Reports. Infection due to Scedosporium apiospermum in renal transplant recipients: a report of two cases and literature review of central nervous system and cutaneous infections by Pseudallescheria boydii/Sc. apiospermum. Mycoses 2002; 45:418-27. [PMID: 12421295 DOI: 10.1046/j.1439-0507.2002.00790.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Two cases of infections due to Scedosporium apiospermum in renal transplant recipients, one localized in the central nervous system, the other in the skin, are presented, and a literature review of 21 cases of central nervous system and cutaneous infections due to Pseudallescheria boydii/Sc. apiospermum is given.
Collapse
|
12
|
|