Journal de mycologie medicale最新文献

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Fatal panresistant Lomentospora prolificans fungemia in a patient with aplastic anemia: First report from Türkiye 再生障碍性贫血患者致死性泛耐药增殖性骆菌菌血症:来自<s:1> rkiye的首次报告
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-04 DOI: 10.1016/j.mycmed.2023.101416
Zeynep Yazgan , Tansu Dündar , Ayşe Barış , Özge Aksu , Ahmet Emre Eşkazan , Fatma Köksal Çakırlar
{"title":"Fatal panresistant Lomentospora prolificans fungemia in a patient with aplastic anemia: First report from Türkiye","authors":"Zeynep Yazgan ,&nbsp;Tansu Dündar ,&nbsp;Ayşe Barış ,&nbsp;Özge Aksu ,&nbsp;Ahmet Emre Eşkazan ,&nbsp;Fatma Köksal Çakırlar","doi":"10.1016/j.mycmed.2023.101416","DOIUrl":"10.1016/j.mycmed.2023.101416","url":null,"abstract":"<div><p><span><em>Lomentospora prolificans</em></span><span><span> is an opportunistic pathogen<span> that can cause invasive lomentosporiosis in immunocompromised patients. Patients with </span></span>hematological malignancies<span> and those who have undergone stem cell or solid organ transplantations are in the highest risk group. In addition to the limitations and delays in diagnostic possibilities, </span></span><em>L. prolificans</em><span><span> has a high mortality due to its resistance to all available antifungal drugs. In a patient diagnosed with </span>aplastic anemia, we described the first case of </span><em>L. prolificans</em> in Türkiye. <em>L. prolificans</em><span> was identified in the blood culture, and despite the initiation of antifungal treatments<span>, the fungemia resulted in mortality on the 7th day of intensive care hospitalization. This case highlights the importance of early recognition and prompt initiation of appropriate antifungal therapy to improve the outcome of patients with rare mold infections.</span></span></p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 4","pages":"Article 101416"},"PeriodicalIF":3.6,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9946295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Withdrawal notice to “Changes in the fungal nomenclature: why and how to manage?” [J Mycol Med 33 (2023) 101387] “真菌命名法的变化:为什么以及如何管理?”的撤回通知[J Mycol Med 33(2023)101387]。
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101405
C. Hennequin , A. Coste , C. Imbert
{"title":"Withdrawal notice to “Changes in the fungal nomenclature: why and how to manage?” [J Mycol Med 33 (2023) 101387]","authors":"C. Hennequin ,&nbsp;A. Coste ,&nbsp;C. Imbert","doi":"10.1016/j.mycmed.2023.101405","DOIUrl":"10.1016/j.mycmed.2023.101405","url":null,"abstract":"","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 3","pages":"Article 101405"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10070316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Four uncommon clinical fungi, Lodderomyces elongisporus, Kodamaea ohmeri, Cyberlindnera fabianii and Wickerhamomyces anomalus, isolated in superficial samples from Côte d'Ivoire 4种罕见的临床真菌,Lodderomyces elongisporus, Kodamaea ohmeri, Cyberlindnera fabianii和Wickerhamomyces anomalus,从Côte d’ivire的表层样品中分离得到
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101410
Ama Valérie Bonouman Ira , Donika Krasteva , Francis Kouadjo , Fréderic Roger , Virginie Bellet , David Koffi , Cyrille Pottier , Offianan André Toure , Pascal Drakulovski , Aliko Joseph Djaman , Stéphane Ranque , Sébastien Bertout
{"title":"Four uncommon clinical fungi, Lodderomyces elongisporus, Kodamaea ohmeri, Cyberlindnera fabianii and Wickerhamomyces anomalus, isolated in superficial samples from Côte d'Ivoire","authors":"Ama Valérie Bonouman Ira ,&nbsp;Donika Krasteva ,&nbsp;Francis Kouadjo ,&nbsp;Fréderic Roger ,&nbsp;Virginie Bellet ,&nbsp;David Koffi ,&nbsp;Cyrille Pottier ,&nbsp;Offianan André Toure ,&nbsp;Pascal Drakulovski ,&nbsp;Aliko Joseph Djaman ,&nbsp;Stéphane Ranque ,&nbsp;Sébastien Bertout","doi":"10.1016/j.mycmed.2023.101410","DOIUrl":"10.1016/j.mycmed.2023.101410","url":null,"abstract":"<div><h3>Aims</h3><p>The rare yeast species <span><em>Lodderomyces elongisporus, Kodamaea ohmeri, </em><em>Cyberlindnera</em><em> fabianii,</em></span> and <span><em>Wickerhamomyces anomalus</em></span><span> are increasingly implicated in severe mycoses<span> in immunocompromised patients. This study aimed to assess the prevalence of uncommon yeast species in Côte d'Ivoire.</span></span></p></div><div><h3>Methods</h3><p>The yeast isolates from superficial samples, mainly vaginal swabs, were collected at the Pasteur Institute of Abidjan in a study on the molecular epidemiology<span> of clinical yeast species. Identification relied on MALDI-TOF MS and ITS sequence analysis. Antifungal susceptibility testing was performed using the CLSI method.</span></p></div><div><h3>Results</h3><p>Of the 315 strains analysed from 227 outpatients, 14 belonged to 4 uncommon species: <em>Lodderomyces elongisporus, Kodamaea ohmeri, Cyberlindnera fabianii,</em> and <em>Wickerhamomyces anomalus</em><span><span><span>. None exhibited elevated fluconazole, </span>amphotericin B, </span>caspofungin, ketoconazole, or flucytosin MIC.</span></p></div><div><h3>Conclusions</h3><p>The presence of these rare yeasts represents a risk in immunocompromised people. Their adequate and timely identification is a priority. Overall, enhancing the mycoses diagnostic capacities in Côte d'Ivoire, and more generally in African clinical laboratories with limited resources is a critical aim.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 3","pages":"Article 101410"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10078344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ibrutinib and tracheal mucormycosis: A case report and systematic review of literature 伊鲁替尼与气管毛霉病:1例报告及文献系统回顾
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101414
Vikram Damaraju , Ritesh Agarwal , Inderpaul Singh Sehgal , Alka Khadwal , Amanjit Bal , Shivaprakash Mandya Rudramurthy , Valliappan Muthu
{"title":"Ibrutinib and tracheal mucormycosis: A case report and systematic review of literature","authors":"Vikram Damaraju ,&nbsp;Ritesh Agarwal ,&nbsp;Inderpaul Singh Sehgal ,&nbsp;Alka Khadwal ,&nbsp;Amanjit Bal ,&nbsp;Shivaprakash Mandya Rudramurthy ,&nbsp;Valliappan Muthu","doi":"10.1016/j.mycmed.2023.101414","DOIUrl":"10.1016/j.mycmed.2023.101414","url":null,"abstract":"<div><p><span><span><span>Ibrutinib, a </span>Bruton tyrosine kinase (BTK) inhibitor, has been approved for various </span>hematological malignancies<span><span>. Invasive aspergillosis is a known complication of ibrutinib, but </span>mucormycosis<span><span> is rare. We describe the case of a 70-year-old man with mantle cell lymphoma<span> infiltrating the trachea, managed with a tracheobronchial stent and ibrutinib. He had improved one month after treatment, and we removed the airway stent. Four months later, he developed tracheal nodules confirmed to be tracheal mucormycosis and responded to liposomal </span></span>amphotericin B (3.5 g) followed by </span></span></span>posaconazole<span>. After transient improvement, the tracheal lesions recurred, the biopsy showed lymphoma (with no evidence of mucormycosis), and he died. A systematic review of the literature identified 20 additional cases of ibrutinib-associated mucormycosis. Most of the 21 patients included were men (95%), and ibrutinib was the only risk factor in 15.7%. The reported mortality was 31.6% (6/19), attributable to mucormycosis in half the cases.</span></p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 3","pages":"Article 101414"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10079438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
COVID-19-associated mucormycosis in India: Why such an outbreak? 印度的covid -19相关毛霉病:为什么会爆发这样的疫情?
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101393
Gregoire Pasquier
{"title":"COVID-19-associated mucormycosis in India: Why such an outbreak?","authors":"Gregoire Pasquier","doi":"10.1016/j.mycmed.2023.101393","DOIUrl":"10.1016/j.mycmed.2023.101393","url":null,"abstract":"<div><p>An unprecedented mucormycosis outbreak occurred in India during the second COVID-19 wave in spring 2021. COVID-19-associated mucormycosis (CAM) was observed, mainly rhino-orbito-cerebral mucormycosis (ROCM), in patients with poorly controlled diabetes and treated with inappropriate doses of glucocorticoids. The aim of this mini-review was to compare the characteristics of the CAM epidemic in India with (i) mucormycosis cases before the COVID-19 pandemic and (ii) CAM in the rest of the world (particularly in France) in order to identify the reasons for this outbreak. In India, the major mucormycosis epidemiologic change during the COVID-19 pandemic was an increase in the percentage of patients treated with corticosteroids who developed CAM. Compared with the rest of the world, India reported a higher mucormycosis incidence even before the COVID-19 pandemic. Moreover, in India, patients with CAM were more likely to have diabetes mellitus and ROCM; conversely, mortality rates were lower. The reasons for such a localized epidemic in India have remained unclear, but some hypotheses can be put forward, particularly the combination of high prevalence of uncontrolled diabetes mellitus and frequent indiscriminate corticosteroid utilization in a country that already had a high mucormycosis burden before the COVID-19 pandemic.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 3","pages":"Article 101393"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10168193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Interest of a metabolic approach using the calScreener™ technology to detect Candida in the peritoneal fluid: A pilot study 利用calScreener™技术检测腹膜液中念珠菌的代谢方法:一项初步研究
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101418
Emmanuel Novy , Marie Collot , Paul Chevallier , Lisiane Cunat , Marie Machouart
{"title":"Interest of a metabolic approach using the calScreener™ technology to detect Candida in the peritoneal fluid: A pilot study","authors":"Emmanuel Novy ,&nbsp;Marie Collot ,&nbsp;Paul Chevallier ,&nbsp;Lisiane Cunat ,&nbsp;Marie Machouart","doi":"10.1016/j.mycmed.2023.101418","DOIUrl":"10.1016/j.mycmed.2023.101418","url":null,"abstract":"","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 4","pages":"Article 101418"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9946297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cryptococcal meningitis in a non-HIV patient with solid organ transplantation 非hiv患者实体器官移植的隐球菌性脑膜炎
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101388
Mediha Ugur , Sinan Cetin , Emel Uzunoglu , Mustafa Saglam , Fatma Mutlu , Ayse Nedret Koc
{"title":"Cryptococcal meningitis in a non-HIV patient with solid organ transplantation","authors":"Mediha Ugur ,&nbsp;Sinan Cetin ,&nbsp;Emel Uzunoglu ,&nbsp;Mustafa Saglam ,&nbsp;Fatma Mutlu ,&nbsp;Ayse Nedret Koc","doi":"10.1016/j.mycmed.2023.101388","DOIUrl":"10.1016/j.mycmed.2023.101388","url":null,"abstract":"<div><p><span>Cryptococcal meningitis (CM) is often associated with human immunodeficiency virus (HIV). Recently, this microorganism has been increasingly identified in HIV-negative patients. CM cases are encountered in HIV-negative individuals, especially secondary to liver disease, </span>solid organ transplantation<span><span> (SOT), tuberculosis, lymphoproliferative diseases with T-cell-mediated immunological disorders, long-term corticosteroid use, </span>malignancies<span>, diabetes mellitus, and sarcoidosis<span>. Our patient is an HIV-negative, SOT case with CM. It should be considered that CM can also occur in HIV-negative patients. As in our case, patients receiving long-term immunosuppressive therapy<span> should be evaluated for CM, and renal functions should be closely monitored during treatment. There is a need for more case reports on the subject, especially in CM detected HIV-negative patients, due to the different treatment protocols and challenging clinical conditions compared to HIV-positive cases.</span></span></span></span></p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 3","pages":"Article 101388"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10067806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fungemia due to rare non-Candida yeasts between 2018 and 2021 in a Greek tertiary care university hospital 2018年至2021年间,希腊一家三级保健大学医院因罕见的非念珠菌酵母菌引起的真菌病
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101386
Anastasia Spiliopoulou , Alexandra Lekkou , Georgia Vrioni , Lydia Leonidou , Massimo Cogliati , Myrto Christofidou , Markos Marangos , Fevronia Kolonitsiou , Fotini Paliogianni
{"title":"Fungemia due to rare non-Candida yeasts between 2018 and 2021 in a Greek tertiary care university hospital","authors":"Anastasia Spiliopoulou ,&nbsp;Alexandra Lekkou ,&nbsp;Georgia Vrioni ,&nbsp;Lydia Leonidou ,&nbsp;Massimo Cogliati ,&nbsp;Myrto Christofidou ,&nbsp;Markos Marangos ,&nbsp;Fevronia Kolonitsiou ,&nbsp;Fotini Paliogianni","doi":"10.1016/j.mycmed.2023.101386","DOIUrl":"10.1016/j.mycmed.2023.101386","url":null,"abstract":"<div><h3>Introduction</h3><p>Non-<em>Candida</em> yeasts, although rare, are increasingly encountered and recognized as a growing threat.</p></div><div><h3>Methods</h3><p>Cases of bloodstream infections (BSIs) due to non-<em>Candida</em> yeasts (NCYs) during the last four years (2018–2021) are presented.</p></div><div><h3>Results</h3><p>During the study period, 16 cases caused by non-<em>Candida</em> yeasts out of 400 cases of yeast BSIs were recorded, corresponding to an incidence of 4%. Yeasts that were isolated included <em>Cryptococcus</em> spp (4 isolates-25%), <em>Rhodotorula mucilaginosa</em> (2 isolates-12.5%), <em>Trichosporon asahii</em> (7 isolates-43.75%) and <em>Saccharomyces cerevisiae</em> (3 isolates-18.75%). Predisposing factors involved mostly hematological malignancies, long term hospitalization or major surgical interventions. Most isolates, 15 out of 16 were susceptible to amphotericin B. Voriconazole was the most active azole in vitro. All isolates, except <em>Saccharomyces</em> spp., were resistant to echinocandins.</p></div><div><h3>Discussion</h3><p>Early recognition of rare yeasts as causative agents of BSIs and prompt initiation of appropriate treatment based on current guidelines and expertise remain crucial in efficient patient management.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 3","pages":"Article 101386"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10077740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fusarium solani species complex infection treated with posaconazole in a liver transplantation patient; a case report 泊沙康唑治疗肝移植患者茄枯菌复合感染1例病例报告
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101382
Vildan Avkan Oguz , Nilgun Karabicak , Caglar Irmak , Tarkan Unek
{"title":"Fusarium solani species complex infection treated with posaconazole in a liver transplantation patient; a case report","authors":"Vildan Avkan Oguz ,&nbsp;Nilgun Karabicak ,&nbsp;Caglar Irmak ,&nbsp;Tarkan Unek","doi":"10.1016/j.mycmed.2023.101382","DOIUrl":"10.1016/j.mycmed.2023.101382","url":null,"abstract":"<div><p>Although <span><em>Fusarium</em></span><span><span><span> spp. rarely cause infections in healthy people, they can cause fusariosis, particularly in neutropenic </span>hematological malignancies<span>, bone marrow transplant<span> patients, and immunocompromised patients<span>, such as those with acquired immune deficiency syndrome (AIDS), and rarely in solid organ transplant recipients. Here, we present a case of a </span></span></span></span>liver transplant recipient with </span><em>F. solani</em><span><span> species complex (FSSC) infection treated with posaconazole<span>. A 61-year-old man presented with multiple itchy, painful, palpable, irregular, subcutaneous nodules on the right leg and total dystrophic </span></span>onychomycosis<span><span> in the right toenails. Incisional skin biopsies<span><span> of the lesions were performed, and the samples were sent to the pathology and mycology laboratories for analysis. The clinical isolate was identified as FSSC using phenotypic, matrix-assisted laser desorption/ionization-time of flight mass spectrometry, and genotypic methods. Liposomal </span>amphotericin B could not be administered owing to the development of side effects; hence, the patient was treated with posaconazole for 4 months. While some nodular lesions disappeared completely under this </span></span>treatment<span>, the others showed dimensional regression. This is the first case of FSSC infection with skin and nail involvement in a non-neutropenic, liver transplant patient in Turkey. Fusariosis may develop with rare species, such as FSSC, as first reported in this case of a liver transplant patient. Regardless of the species, amphotericin B is the first choice for treating fusariosis; however, posaconazole is an effective and safe alternative to amphotericin B.</span></span></span></p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 3","pages":"Article 101382"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10079168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The management and outcome of cryptococcosis in patients with different immune statuses and treatment protocols: A multicenter real-world study in Jiangsu Province - China 不同免疫状态和治疗方案患者隐球菌病的管理和结果:中国江苏省的一项多中心真实世界研究
IF 3.6 4区 医学
Journal de mycologie medicale Pub Date : 2023-08-01 DOI: 10.1016/j.mycmed.2023.101389
Yu Wang , Yu Gu , Kunlu Shen , Xuefan Cui , Rui Min , Siqing Sun , Chunlai Feng , Yanbin Chen , Li Wang , Guoer Ma , Bilin Chen , Yueyan Ni , Huanhuan Zhong , Yi Shi , Xin Su
{"title":"The management and outcome of cryptococcosis in patients with different immune statuses and treatment protocols: A multicenter real-world study in Jiangsu Province - China","authors":"Yu Wang ,&nbsp;Yu Gu ,&nbsp;Kunlu Shen ,&nbsp;Xuefan Cui ,&nbsp;Rui Min ,&nbsp;Siqing Sun ,&nbsp;Chunlai Feng ,&nbsp;Yanbin Chen ,&nbsp;Li Wang ,&nbsp;Guoer Ma ,&nbsp;Bilin Chen ,&nbsp;Yueyan Ni ,&nbsp;Huanhuan Zhong ,&nbsp;Yi Shi ,&nbsp;Xin Su","doi":"10.1016/j.mycmed.2023.101389","DOIUrl":"10.1016/j.mycmed.2023.101389","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;The incidence of cryptococcosis is increasing in non-immunocompromised patients. However, the evidence on proper management is inadequate in this population. We conducted this multi-center real-world study in pulmonary cryptococcosis patients with different immune statuses, so as to provide practical evidence for optimized clinical management of cryptococcosis, especially for mild-to-moderate immunodeficient diseases patients.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This is a prospective observational study. The clinical data of patients with proven cryptococcosis were collected and analyzed from 7 tertiary teaching hospitals in Jiangsu Province, China from January, 2013 to December, 2018. Proven cases include pulmonary cryptococcosis, cryptococcal meningitis, cryptococcemia and cutaneous cryptococcosis. Patients were followed up over 24 months. According to their immune status, patients with cryptococcosis were divided into three groups, namely immunocompetent group (IC), mild-to-moderate immunodeficient diseases group (MID), severe immunodeficient diseases group (SID). Meanwhile, pulmonary crypotococcosis (PC) and extrapulmonary crypotococcosis (EPC) were also classified and analyzed.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;255 proven cases of cryptococcosis were enrolled. Finally, 220 cases completed the follow-up. 143 proven cases (65.0%) were immunocompetent (IC), 41 cases (18.6%) were MID, and 36 cases (16.4%) were SID. 174 cases (79.1%) were PC and 46 cases (20.9%) were EPC. The mortality was significantly higher in SID and MID patients [47.2% (SID) vs. 12.2% (MID) vs. 0.0% (IC), &lt;em&gt;p&lt;/em&gt;&lt;0.001]. The mortality was also significantly higher in EPC patients [45.7% vs. 0.6% (PC), &lt;em&gt;p&lt;/em&gt;&lt;0.001]. Patients with alternative initial antifungal treatment had higher mortality than patients with guideline recommended initial treatment [23.1% vs. 9.5%, &lt;em&gt;p&lt;/em&gt;=0.041]. In MID group, the mortality of receiving alternative initial antifungal treatment was significantly higher than recommended initial treatment [2/3 vs. 3/34(8.8%), &lt;em&gt;p&lt;/em&gt;=0.043]. In pulmonary cryptococcosis patients with MID, the mortality was very similar to IC group [0.0% vs. 0.0% (IC)], lower than SID group [0.0% vs. 11.1% (SID), &lt;em&gt;p&lt;/em&gt;=0.555]. However, in extrapulmonary cryptococcosis patients with MID, the mortality was significantly higher than that in IC [62.5% vs. 0.0% (IC)], and similar to SID patients [62.5% vs. 59.3% (SID)].&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;The immune status exert a significant influence on the management and prognosis of cryptococcosis patients. The mortality of cryptococcosis patients with MID is higher than that of immunocompetent patients. For MID patients with pure pulmonary cryptococcosis, it is acceptable to take the treatment recommended as IC patients. For the MID patients with extrapulmonary cryptococcosis, the mortality is high and the initial treatment should follow the regimen for SID patients. Following the re","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":"33 3","pages":"Article 101389"},"PeriodicalIF":3.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10099949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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