We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Saprochaete clavata infections in patients undergoing treatment for haematological malignancies: A report of a monocentric outbreak and review of the literature.
- Authors
Stanzani, Marta; Cricca, Monica; Sassi, Claudia; Sutto, Emanuele; De Cicco, Gabriella; Bonifazi, Francesca; Bertuzzi, Clara; Bacci, Francesco; Paolini, Stefania; Cavo, Michele; Lewis, Russell E.
- Abstract
Summary: Saprochaete clavata is a rare cause of fungaemia with deep organ involvement in patients with haematological malignancies with reported mortality rates of 60%‐80%. We describe four cases of S clavata infection in a haematology unit over several months that were treated with voriconazole‐based regimens. We also review the literature on factors that could contribute to earlier recognition and effective treatment of S clavata. We included all cases of culture‐positive S clavata from sterile sites with associated signs of infection in patients undergoing treatment for a haematological malignancy. Isolates were identified by MALDI‐TOF MS, and spectrum profiles were used to prepare clustering analysis of isolates. Susceptibility testing was performed using a commercial microtitre methods. Saprochaete clavata was isolated from the bloodstream in three cases and bronchial alveolar lavage (BAL) fluid in one case. Clustering analysis suggested strains of S clavata were clonal without evidence of divergence although a common source was not identified. Susceptibility testing yielded elevated MICs to fluconazole (8 mg/L) and echinocandins (>1‐8 mg/L). All patients were treated with voriconazole‐based regimens resulting in survival of 3/4 patients, who continued chemotherapy for their underlying malignancy without evidence of relapse. Saprochaete clavata is a rare but aggressive cause of breakthrough yeast infection in patients undergoing treatment for haematological malignancies, particularly patients with a prior history of echinocandin treatment. Timely initiation of appropriate treatment, aided by more rapid identification in microbiology laboratory, can reduce the risk of deep organ dissemination and patient death.
- Subjects
LITERATURE reviews; BRONCHOALVEOLAR lavage; FUNGEMIA; INFECTION
- Publication
Mycoses, 2019, Vol 62, Issue 12, p1100
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/myc.12978