https://scholars.lib.ntu.edu.tw/handle/123456789/528679
標題: | Invasive trichosporonosis caused by Trichosporon asahii and other unusual Trichosporon species at a medical center in taiwan | 作者: | SHENG-YUAN RUAN JUNG-YIEN CHIEN PO-REN HSUEH |
公開日期: | 2009 | 卷: | 49 | 期: | 1 | 起(迄)頁: | e11-e17 | 來源出版物: | Clinical Infectious Diseases | 摘要: | Background. During the past 2 decades, invasive trichosporonosis has emerged as an opportunistic infectious disease in immunocompromised patients. However, no case series have been reported recently. Methods. All patients with a culture that was positive for Trichosporon species from May 2000 through May 2008 at a medical center were evaluated. The identity of all Trichosporon species was confirmed by analysis of the intergenic spacer 1 region of the fungal ribosomal RNA gene. In vitro susceptibility testing was performed using the reference broth microdilution method. Results. Forty-three patients were found to have a culture that was positive for Trichosporon species. T. asahii was the most frequently isolated species (32 isolates; 74%), followed by T. dermatis (5; 12%), T. montevideense (2; 5%), and T. asteroides (1; 2%), T. cutaneum (1; 2%), T. faecale (1; 2%), and T. ovoides (1; 2%). Nineteen patients had invasive infections; 16 (84%) were caused by T. asahii, and 1 (5%) each was caused by T. dermatis, T. montevideense, and T. asteroides. Of the 19 episodes of invasive trichosporonosis, 14 (74%) were fungemia, 3 (16%) were pulmonary infection, and 1 (5%) each was soft-tissue infection and meningitis. Most invasive infections were associated with prior antibiotic therapy (95%), use of a central catheter (90%), malignancy (58%), and intensive care unit admission (47%). Azoles had good in vitro activity, whereas amphotericin B and echinocandins were not active against Trichosporon isolates. The 30-day all-cause mortality rate was 42% and was higher among patients with a malignancy (55%) than among those without an underlying malignancy (25%). Conclusions. Invasive trichosporonosis tended to develop in patients with an underlying malignancy and to be associated with higher mortality. T. asahii and other unusual Trichosporon species may cause invasive trichosporonosis. ? 2009 by the Infectious Diseases Society of America. All rights reserved. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/528679 | ISSN: | 1058-4838 | DOI: | 10.1086/599614 | SDG/關鍵字: | adolescent; adult; aged; antibiotic therapy; article; child; clinical article; controlled study; female; fungus isolation; human; male; meningitis; minimum inhibitory concentration; mortality; mycosis; nucleotide sequence; preschool child; priority journal; school child; soft tissue infection; Taiwan; Trichosporon asahii; trichosporonosis; Academic Medical Centers; Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents; Child; Child, Preschool; DNA, Fungal; DNA, Ribosomal Spacer; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Mycoses; Sequence Analysis, DNA; Taiwan; Trichosporon; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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