Pseudozyma and other non-Candida opportunistic yeast bloodstream infections in a large stem cell transplant center

Anupam Pande; Lemuel R Non; Rizwan Romee; Carlos A Q Santos

doi:10.1111/tid.12664

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Pseudozyma and other non-Candida opportunistic yeast bloodstream infections in a large stem cell transplant center

Journal article

Peer reviewed

Pseudozyma and other non-Candida opportunistic yeast bloodstream infections in a large stem cell transplant center

Anupam Pande, Lemuel R Non, Rizwan Romee and Carlos A Q Santos

Transplant infectious disease, Vol.19(2), pp.e12664-n/a

04/2017

DOI: 10.1111/tid.12664

PMID: 28099778

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Abstract

Non-Candida opportunistic yeasts are emerging causes of bloodstream infection (BSI) in immunocompromised hosts. However, their clinical presentation, management, and outcomes in stem cell transplant (SCT) recipients are not well described. We report the first case to our knowledge of Pseudozyma BSI in a SCT recipient. He had evidence of cutaneous involvement, which has not been previously described in the literature. He became infected while neutropenic and receiving empiric micafungin, which is notable because Pseudozyma is reported to be resistant to echinocandins. He was successfully treated with the sequential use of liposomal amphotericin B and voriconazole. A review of the literature revealed nine reported instances of Pseudozyma fungemia. We performed a retrospective review of 3557 SCT recipients at our institution from January 2000 to June 2015 and identified four additional cases of non-Candida yeast BSIs. These include two with Cryptococcus, one with Trichosporon, and one with Saccharomyces. Pseudozyma and other non-Candida yeasts are emerging pathogens that can cause severe and disseminated infections in SCT recipients and other immunocompromised hosts. Clinicians should have a high degree of suspicion for echinocandin-resistant yeasts, if patients develop breakthrough yeast BSIs while receiving echinocandin therapy.

Adult

Amphotericin B - administration & dosage

Amphotericin B - therapeutic use

Antifungal Agents - administration & dosage

Antifungal Agents - therapeutic use

Antineoplastic Combined Chemotherapy Protocols - therapeutic use

Biopsy

Cryptococcus - isolation & purification

Cryptococcus - pathogenicity

Cytarabine - therapeutic use

Dermatomycoses - blood

Dermatomycoses - drug therapy

Dermatomycoses - microbiology

Dermatomycoses - pathology

Echinocandins - administration & dosage

Echinocandins - therapeutic use

Exanthema - blood

Exanthema - drug therapy

Exanthema - microbiology

Exanthema - pathology

Fever - microbiology

Fungemia - drug therapy

Fungemia - microbiology

Granulocyte Colony-Stimulating Factor - therapeutic use

Hematopoietic Stem Cell Transplantation - adverse effects

Humans

Idarubicin - therapeutic use

Immunocompromised Host

Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy

Lipopeptides - administration & dosage

Lipopeptides - therapeutic use

Male

Opportunistic Infections - blood

Opportunistic Infections - drug therapy

Opportunistic Infections - microbiology

Retrospective Studies

Saccharomyces - isolation & purification

Saccharomyces - pathogenicity

Salvage Therapy - methods

Trichosporon - isolation & purification

Trichosporon - pathogenicity

Ustilaginales - isolation & purification

Ustilaginales - pathogenicity

Vidarabine - analogs & derivatives

Vidarabine - therapeutic use

Voriconazole - administration & dosage

Voriconazole - therapeutic use

Yeasts - isolation & purification

Yeasts - pathogenicity

Details

Title: Subtitle: Pseudozyma and other non-Candida opportunistic yeast bloodstream infections in a large stem cell transplant center
Creators: Anupam Pande - Washington University in St. Louis
Lemuel R Non - Washington University in St. Louis
Rizwan Romee - Washington University in St. Louis
Carlos A Q Santos - Rush University Medical Center
Resource Type: Journal article
Publication Details: Transplant infectious disease, Vol.19(2), pp.e12664-n/a
DOI: 10.1111/tid.12664
PMID: 28099778
ISSN: 1398-2273
eISSN: 1399-3062
Language: English
Date published: 04/2017
Academic Unit: Infectious Diseases; Internal Medicine
Record Identifier: 9984359906702771

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