Geosmithia argillacea: an Emerging Pathogen in Patients with Cystic Fibrosis

被引:53
作者
Giraud, Sandrine [1 ]
Pihet, Marc [1 ,2 ]
Razafimandimby, Bienvenue [1 ]
Carrere, Jacqueline [3 ]
Degand, Nicolas [3 ]
Mely, Laurent [4 ]
Favennec, Loic [5 ]
Dannaoui, Eric [6 ,7 ]
Bouchara, Jean-Philippe [1 ,2 ]
Calenda, Alphonse [1 ]
机构
[1] CHU Angers, Grp Etud Interact Hote Pathogene, UPRES EA 3142, F-49933 Angers 9, France
[2] CHU Angers, Lab Parasitol Mycol, Angers, France
[3] Hop Renee Sabran, Biol Lab, Giens, France
[4] Hop Renee Sabran, Ctr Ressources & Competences Mucoviscidose, Giens, France
[5] Ctr Hosp Univ Charles Nicolle, Lab Parasitol Mycol, Rouen, France
[6] Inst Pasteur, Ctr Natl Reference Mycol & Antifong, Unite Mycol Mol, CNRS URA3012, Paris, France
[7] Univ Paris 05, Unite Parasitol Mycol, Fac Med, Hop Europeen Georges Pompidou,AP HP, Paris, France
关键词
AIRWAY COLONIZATION; PENICILLIUM; INFECTION; FUNGI; NOV;
D O I
10.1128/JCM.00047-10
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
We report eight cases of airway colonization by Geosmithia argillacea in patients with cystic fibrosis. This filamentous fungus, resembling members of the genera Penicillium and Paecilomyces, was identified by molecular analysis. All patients carried a mutation on each CFTR ( cystic fibrosis transmembrane conductance regulator) allele, with at least one copy of the F508del mutation. The first isolation of this fungus occurred from F508del-homozygous patients at a younger age than in F508del-heterozygous patients. Before recovery of G. argillacea, all patients were treated with itraconazole; two of them had also received voriconazole for an Aspergillus fumigatus infection. However, antifungal susceptibility patterns showed high MICs of voriconazole for all isolates, and high MICs of amphotericin B and itraconazole for the majority of them, but mostly low minimum effective concentrations (MECs) of caspofungin. The appearance and persistence of G. argillacea in the airways were not associated with exacerbation of the disease. However, the clinical implications of G. argillacea, particularly in immunocompromised patients, remain a concern, particularly given recent observations suggesting that this fungus may also cause disseminated infections.
引用
收藏
页码:2381 / 2386
页数:6
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