Geosmithia argillacea: an emerging pathogen in patients with cystic fibrosis.
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.
Giraud
Sandrine
S
Groupe d'Etude des Interactions Hôte-Pathogène, UPRES-EA 3142, Université d'Angers, Angers, France. sandrine.giraud@univ-angers.fr
Pihet
Marc
M
Razafimandimby
Bienvenue
B
Carrère
Jacqueline
J
Degand
Nicolas
N
Mely
Laurent
L
Favennec
Loïc
L
Dannaoui
Eric
E
Bouchara
Jean-Philippe
JP
Calenda
Alphonse
A
D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D012634:Bodily Secretions / Q000382:microbiology; D002648:Child; D021821:Communicable Diseases, Emerging / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D003550:Cystic Fibrosis / Q000150:complications*; D032641:Eurotiales / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008168:Lung / Q000382:microbiology; D008172:Lung Diseases, Fungal / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification
D000935:Antifungal Agents
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