Emerging pan-resistance in Trichosporon species: a case report

Claudy Oliveira dos Santos; Jan G Zijlstra; Robert J Porte; Greetje A Kampinga; Anne D van Diepeningen; Bhanu Sinha; Erik Bathoorn

doi:10.1186/s12879-016-1477-3

Emerging pan-resistance in Trichosporon species: a case report

Claudy Oliveira dos Santos, Jan G Zijlstra, Robert J Porte, Greetje A Kampinga, Anne D van Diepeningen, Bhanu Sinha, Erik Bathoorn

Onderzoeksoutput: Bijdrage aan wetenschappelijk tijdschrift/periodieke uitgave › Artikel › Wetenschappelijk › peer review

16 Citaten (Scopus)

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BACKGROUND: Trichosporon species are ubiquitously spread and known to be part of the normal human flora of the skin and gastrointestinal tract. Trichosporon spp. normally cause superficial infections. However, in the past decade Trichosporon spp. are emerging as opportunistic agents of invasive fungal infections, particularly in severely immunocompromised patients. Clinical isolates are usually sensitive to triazoles, but strains resistant to multiple triazoles have been reported.

CASE PRESENTATION: We report a high-level pan-azole resistant Trichosporon dermatis isolate causing an invasive cholangitis in a patient after liver re-transplantation. This infection occurred despite of fluconazole and low dose amphotericin B prophylaxis, and treatment with combined liposomal amphotericin B and voriconazole failed.

CONCLUSION: This case and recent reports in literature show that not only bacteria are evolving towards pan-resistance, but also pathogenic yeasts. Prudent use of antifungals is important to withstand emerging antifungal resistance.

Originele taal-2	Engels
Pagina's (van-tot)	148
Tijdschrift	BMC Infectious Diseases
Volume	16
DOI's	https://doi.org/10.1186/s12879-016-1477-3
Status	Gepubliceerd - 14 apr. 2016

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10.1186/s12879-016-1477-3

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@article{556c2aa1f1ef45739a5b3e8d2e4bf48f,

title = "Emerging pan-resistance in Trichosporon species: a case report",

abstract = "BACKGROUND: Trichosporon species are ubiquitously spread and known to be part of the normal human flora of the skin and gastrointestinal tract. Trichosporon spp. normally cause superficial infections. However, in the past decade Trichosporon spp. are emerging as opportunistic agents of invasive fungal infections, particularly in severely immunocompromised patients. Clinical isolates are usually sensitive to triazoles, but strains resistant to multiple triazoles have been reported.CASE PRESENTATION: We report a high-level pan-azole resistant Trichosporon dermatis isolate causing an invasive cholangitis in a patient after liver re-transplantation. This infection occurred despite of fluconazole and low dose amphotericin B prophylaxis, and treatment with combined liposomal amphotericin B and voriconazole failed.CONCLUSION: This case and recent reports in literature show that not only bacteria are evolving towards pan-resistance, but also pathogenic yeasts. Prudent use of antifungals is important to withstand emerging antifungal resistance.",

keywords = "Amphotericin B, Antifungal Agents, Cholangitis, Drug Resistance, Fungal, Hepatic Encephalopathy, Humans, Liver Cirrhosis, Liver Transplantation, Male, Microbial Sensitivity Tests, Middle Aged, Peritonitis, Phylogeny, Trichosporon, Trichosporonosis, Voriconazole, Case Reports, Journal Article",

author = "{Oliveira dos Santos}, Claudy and Zijlstra, {Jan G} and Porte, {Robert J} and Kampinga, {Greetje A} and {van Diepeningen}, {Anne D} and Bhanu Sinha and Erik Bathoorn",

year = "2016",

month = apr,

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doi = "10.1186/s12879-016-1477-3",

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pages = "148",

journal = "BMC Infectious Diseases",

issn = "1471-2334",

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TY - JOUR

T1 - Emerging pan-resistance in Trichosporon species

T2 - a case report

AU - Oliveira dos Santos, Claudy

AU - Zijlstra, Jan G

AU - Porte, Robert J

AU - Kampinga, Greetje A

AU - van Diepeningen, Anne D

AU - Sinha, Bhanu

AU - Bathoorn, Erik

PY - 2016/4/14

Y1 - 2016/4/14

N2 - BACKGROUND: Trichosporon species are ubiquitously spread and known to be part of the normal human flora of the skin and gastrointestinal tract. Trichosporon spp. normally cause superficial infections. However, in the past decade Trichosporon spp. are emerging as opportunistic agents of invasive fungal infections, particularly in severely immunocompromised patients. Clinical isolates are usually sensitive to triazoles, but strains resistant to multiple triazoles have been reported.CASE PRESENTATION: We report a high-level pan-azole resistant Trichosporon dermatis isolate causing an invasive cholangitis in a patient after liver re-transplantation. This infection occurred despite of fluconazole and low dose amphotericin B prophylaxis, and treatment with combined liposomal amphotericin B and voriconazole failed.CONCLUSION: This case and recent reports in literature show that not only bacteria are evolving towards pan-resistance, but also pathogenic yeasts. Prudent use of antifungals is important to withstand emerging antifungal resistance.

AB - BACKGROUND: Trichosporon species are ubiquitously spread and known to be part of the normal human flora of the skin and gastrointestinal tract. Trichosporon spp. normally cause superficial infections. However, in the past decade Trichosporon spp. are emerging as opportunistic agents of invasive fungal infections, particularly in severely immunocompromised patients. Clinical isolates are usually sensitive to triazoles, but strains resistant to multiple triazoles have been reported.CASE PRESENTATION: We report a high-level pan-azole resistant Trichosporon dermatis isolate causing an invasive cholangitis in a patient after liver re-transplantation. This infection occurred despite of fluconazole and low dose amphotericin B prophylaxis, and treatment with combined liposomal amphotericin B and voriconazole failed.CONCLUSION: This case and recent reports in literature show that not only bacteria are evolving towards pan-resistance, but also pathogenic yeasts. Prudent use of antifungals is important to withstand emerging antifungal resistance.

KW - Amphotericin B

KW - Antifungal Agents

KW - Cholangitis

KW - Drug Resistance, Fungal

KW - Hepatic Encephalopathy

KW - Humans

KW - Liver Cirrhosis

KW - Liver Transplantation

KW - Male

KW - Microbial Sensitivity Tests

KW - Middle Aged

KW - Peritonitis

KW - Phylogeny

KW - Trichosporon

KW - Trichosporonosis

KW - Voriconazole

KW - Case Reports

KW - Journal Article

U2 - 10.1186/s12879-016-1477-3

DO - 10.1186/s12879-016-1477-3

M3 - Article

C2 - 27074951

SN - 1471-2334

VL - 16

SP - 148

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

ER -

Emerging pan-resistance in Trichosporon species: a case report

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