Rapid diagnosis of Aspergillus flavus infection in acute very severe aplastic anemia with metagenomic next-generation sequencing: a case report and literature review DOI Creative Commons
Kang Ying, Xiaojing Zhang,

Qin Cao

et al.

Frontiers in Medicine, Journal Year: 2024, Volume and Issue: 11

Published: Sept. 23, 2024

Infection remains the leading cause of mortality in severe aplastic anemia (SAA) patients, with invasive fungal infections being great threat. Aspergillus fumigatus accounts for most reported infection cases. Here, we present a case A. flavus patient acute very (VSAA) despite persistently negative clinical tests. The was admitted to hospital due pancytopenia presisting over month and intermittent fever 10 days. Elevated inflammatory indicators abnormal lung imaging suggested infection, prompting consideration involvement. Despite results from multiple blood, sputum cultures serum (1,3)-β-D-glucan/galactomannan Metagenomic next-generation sequencing (mNGS) on blood samples, alongside symptoms, confirmed infection. Targeted antifungal treatment liposomal amphotericin B voriconazole significantly ameliorated pulmonary symptoms. Additionally, this study reviewed compared diagnostic approaches, treatments prior AA patients. It emphasizes critical role early mNGS utilization diagnosing managing infectious diseases, offering insights treating VSAA.

Language: Английский

Novel antifungals and treatment approaches to tackle resistance and improve outcomes of invasive fungal disease DOI
Martin Hoenigl, Amir Arastehfar, Maiken Cavling Arendrup

et al.

Clinical Microbiology Reviews, Journal Year: 2024, Volume and Issue: 37(2)

Published: April 11, 2024

SUMMARYFungal infections are on the rise, driven by a growing population at risk and climate change. Currently available antifungals include only five classes, their utility efficacy in antifungal treatment limited one or more of innate acquired resistance some fungi, poor penetration into "sequestered" sites, agent-specific side effect which require frequent patient reassessment monitoring. Agents with novel mechanisms, favorable pharmacokinetic (PK) profiles including good oral bioavailability, fungicidal mechanism(s) urgently needed. Here, we provide comprehensive review agents, both improved known mechanisms actions new currently clinical development for treating invasive yeast, mold (filamentous fungi),

Language: Английский

Citations

33
Influenza-associated and COVID-19-associated pulmonary aspergillosis in critically ill patients DOI
Simon Feys, Agostinho Carvalho, Cornelius J. Clancy

et al.

The Lancet Respiratory Medicine, Journal Year: 2024, Volume and Issue: 12(9), P. 728 - 742

Published: July 15, 2024

Language: Английский

Citations

17
Epidemiology of Invasive Candidiasis DOI Creative Commons
Derek J. Bays, Emily N Jenkins, Meghan Lyman

et al.

Clinical Epidemiology, Journal Year: 2024, Volume and Issue: Volume 16, P. 549 - 566

Published: Aug. 1, 2024

Invasive candidiasis (IC) is an increasingly prevalent, costly, and potentially fatal infection brought on by the opportunistic yeast,

Language: Английский

Citations

11
Invasive Aspergillosis in the Intensive Care Unit DOI Creative Commons

Anna Zubovskaia,

José A. Vázquez

Journal of Fungi, Journal Year: 2025, Volume and Issue: 11(1), P. 70 - 70

Published: Jan. 17, 2025

Invasive aspergillosis (IA) is a fungal infection, which has traditionally been associated with neutropenia and immunosuppressive therapies. Our understanding of invasive evolving and, in the past few decades, IA among ICU patients recognized as common infection become more widely recognized. The diagnosis management particularly challenging, due to unstable clinical condition patients, lack diagnostic markers, increased risk further deterioration, multiple comorbidities, need for early assessment treatment. In this article, we will discuss challenges pitfalls an setting, along review current literature that pertinent specific population.

Language: Английский

Citations

1
Serial Quantitation of Plasma Microbial Cell-Free DNA Before and After Diagnosis of Pulmonary Invasive Mold Infections After Hematopoietic Cell Transplant DOI
Madeleine R. Heldman, Asim A. Ahmed, Winnie Liu

et al.

The Journal of Infectious Diseases, Journal Year: 2023, Volume and Issue: 229(2), P. 576 - 587

Published: July 5, 2023

Abstract Background Plasma microbial cell-free DNA sequencing (mcfDNA-Seq) is a noninvasive test for diagnosis of invasive mold infection (IMI). The utility mcfDNA-Seq predicting IMI onset and the clinical implications mcfDNA concentrations are unknown. Methods We retrospectively tested plasma from hematopoietic cell transplant (HCT) recipients with pulmonary ≥1 identified by in collected within 14 days diagnosis. Samples up to 4 weeks before after were evaluated using mcfDNA-Seq. Results Thirty-five HCT 39 IMIs (16 Aspergillus 23 non-Aspergillus infections) included. Pathogenic molds detected 38%, 26%, 11%, 0% samples during first, second, third, fourth week diagnosis, respectively. In infections, median 3 higher infections versus without extrapulmonary spread (4.3 vs 3.3 log10 molecules per microliter [mpm], P = .02), all patients (8/8) >4.0 mpm died 42 Conclusions can identify pathogenic IMI. may correlate mortality

Language: Английский

Citations

22
Treatment of Fusarium Infection of the Central Nervous System: A Review of Past Cases to Guide Therapy for the Ongoing 2023 Outbreak in the United States and Mexico DOI Creative Commons
Martin Hoenigl, Jeffrey D. Jenks, Matthias Egger

et al.

Mycopathologia, Journal Year: 2023, Volume and Issue: 188(6), P. 973 - 981

Published: Aug. 31, 2023

Abstract Introduction Fusariosis of the central nervous system (CNS) is extremely uncommon. Treatment and outcome data from previously published cases may provide some guidance in light ongoing fungal meningitis outbreak 2023 involving Fusarium spp. United States Mexico. Methods We reviewed literature describing invasive fusariosis that included on patient demographic characteristics, treatment, outcome. Results Twenty-six met inclusion criteria. The mean age was 36 years, 55% involved females, 60% had underlying hematologic malignancy, another 16% were immunosuppressants. majority infections solani species complex. Overall 72% patients died. received monotherapy with amphotericin B, although voriconazole or combination therapy B plus without adjuvant surgery. Among survivors, 3 monotherapy, 2 1 both, one surgery only. Conclusion overall mortality rate CNS high, although—unlike during current outbreak—the preponderance severely immunocompromised. While historically treated recent voriconazole. Current guidelines recommend lipid formulations both for treatment fusariosis, which line findings our review should be considered outbreak.

Language: Английский

Citations

22
An update on current and novel molecular diagnostics for the diagnosis of invasive fungal infections DOI
Jeffrey D. Jenks, P. Lewis White, Sarah Kidd

et al.

Expert Review of Molecular Diagnostics, Journal Year: 2023, Volume and Issue: 23(12), P. 1135 - 1152

Published: Oct. 6, 2023

Invasive fungal infections cause millions of annually, but diagnosis remains challenging. There is an increased need for low-cost, easy to use, highly sensitive and specific molecular assays that can differentiate between colonized pathogenic organisms from different clinical specimens.

Language: Английский

Citations

19
Point-of-care testing for viral-associated pulmonary aspergillosis DOI
Robina Aerts, Brice Autier,

Maximilian Gornicec

et al.

Expert Review of Molecular Diagnostics, Journal Year: 2023, Volume and Issue: 24(3), P. 231 - 243

Published: Sept. 9, 2023

Over the last years, severe respiratory viral infections, particularly those caused by acute syndrome coronavirus 2 (SARS-CoV-2) and influenza virus, have emerged as risk factor for viral-associated pulmonary aspergillosis (VAPA) among critically ill patients. Delays in diagnosis of VAPA are associated with increased mortality. Point-of-care-tests may play an important role earlier thus improve patient outcomes.

Language: Английский

Citations

18
Nucleic-Acid-Based Molecular Fungal Diagnostics: A Way to a Better Future DOI Creative Commons

Rajendra Gudisa,

Ritika Harchand, Shivaprakash M. Rudramurthy

et al.

Diagnostics, Journal Year: 2024, Volume and Issue: 14(5), P. 520 - 520

Published: Feb. 29, 2024

The world has seen a tremendous increase in the number of fungal infections during past two decades. Recently, World Health Organisation released pathogen priority list for infections, signifying importance these fields research and public health. Microbiology laboratories demand an upgrade diagnostic system to keep up with increased burden infections. Diagnosis using conventional techniques always faced limitations terms specificity, sensitivity, turnaround time. Although methods are core pillars diagnosis, there is need molecular approaches. Molecular have revolutionised field diagnostics. diverse array techniques, including like Polymerase Chain Reaction (PCR), emerged as cornerstone transformed diagnostics, providing powerful tools rapid accurate identification pathogens. As technologies continue evolve, their integration into routine clinical practice holds promise improving patient outcomes through timely targeted antifungal interventions. This review will cover approaches involved moving from basic advanced-level nucleic-acid-based high throughput decreased time diagnosis serious

Language: Английский

Citations

8
Diagnostic Value of Microbial Cell-free DNA Sequencing for Suspected Invasive Fungal Infections: A Retrospective Multicenter Cohort Study DOI Creative Commons
Sammy Huygens, Alexander Schauwvlieghe, Nick Wlazlo

et al.

Open Forum Infectious Diseases, Journal Year: 2024, Volume and Issue: 11(6)

Published: May 3, 2024

An early diagnosis and treatment of invasive fungal disease (IFD) is associated with improved outcome, but the moderate sensitivity noninvasive diagnostic tests makes this challenging. Invasive procedures such as bronchoalveolar lavage (BAL) have a higher yield are not without risk. The detection sequencing microbial cell-free DNA (mcfDNA) may facilitate diagnosis. In prospective observational study, we collected plasma in 120 hours preceding or following BAL patients hematological malignancies suspected for pulmonary IFD. EORTC/MSGERC2020 criteria were used IFD classification. Sequencing was performed by Karius (Redwood City, CA) using their Test (KT) on "research use only test" fluid if available. Cases probable/proven identified based standard serum (microscopy, polymerase chain reaction, galactomannan, culture) to calculate sensitivity, specificity, additional value KT. Of 106 enrolled, 39 (37%) had proven/probable aspergillosis, 7 (7%) non-Aspergillus IFD, 4 (4%) mixed KT detected mcfDNA 29 (28%) patients. Compared usual tests, specificity 44.0% (95% confidence interval [CI], 31.2-57.7) 96.6% CI, 88.5%-99.1%). Sensitivity (Mucorales:2/3, Pneumocystis jirovecii: 3/5). On BAL, 72.2% 62.1-96.3), 83.3% 49.1-87.5). particular However, similar currently available diagnostics, it cannot be "rule-out" test.

Language: Английский

Citations

8