title: Trichosporon beigelii, an emerging pathogen resistant to amphotericin B.
abstract: Trichosporon beigelii caused fatal disseminated infections that were resistant to amphotericin B in two granulocytopenic patients. In vitro susceptibility studies demonstrated that both index strains of T. beigelii were inhibited but not killed by amphotericin B at achievable concentrations in serum. The minimum lethal concentration for both isolates was greater than or equal to 18 micrograms/ml. Five of seven other isolates were found to have a similar pattern of amphotericin B resistance. The fact that the minimum lethal concentration of T. beigelii was many times greater than its MIC was consistent with a resistance pattern of tolerance. We concluded that T. beigelii may be resistant in vitro to amphotericin B and that this in vitro resistance was correlated with refractory, disseminated trichosporonosis in granulocytopenic patients. T. beigelii should be included in the expanding list of amphotericin B-resistant fungi.
authors.affiliation: Infectious Diseases Section, National Cancer Institute, Bethesda, Maryland 20892.
authors.forename: T J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: G P
authors.initials: GP
authors.lastname: Melcher
authors.forename: M G
authors.initials: MG
authors.lastname: Rinaldi
authors.forename: J
authors.initials: J
authors.lastname: Lecciones
authors.forename: D A
authors.initials: DA
authors.lastname: McGough
authors.forename: P
authors.initials: P
authors.lastname: Kelly
authors.forename: J
authors.initials: J
authors.lastname: Lee
authors.forename: D
authors.initials: D
authors.lastname: Callender
authors.forename: M
authors.initials: M
authors.lastname: Rubin
authors.forename: P A
authors.initials: PA
authors.lastname: Pizzo
mesh_terms: D000293:Adolescent; D000368:Aged; D000380:Agranulocytosis / Q000150:complications; D000666:Amphotericin B / Q000494:pharmacology*; D000741:Anemia, Aplastic / Q000150:complications; D004352:Drug Resistance, Microbial; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D003904:Mitosporic Fungi / Q000187:drug effects*; D009181:Mycoses / Q000150:complications / Q000188:drug therapy*; D009894:Opportunistic Infections / Q000150:complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications; D014250:Trichosporon / Q000187:drug effects* / Q000472:pathogenicity
chemical_list: D000666:Amphotericin B