title: Invasive Trichosporon infection in solid organ transplant patients: a report of two cases identified using IGS1 ribosomal DNA sequencing and a review of the literature.
abstract: Trichosporon species are rare etiologic agents of invasive fungal infection in solid organ transplant (SOT) recipients. We report 2 well-documented cases of Trichosporon inkin invasive infection in SOT patients. We also conducted a detailed literature review of Trichosporon species infections in this susceptible population. We gathered a total of 13 cases of Trichosporon species infections. Any type of organ transplantation can be complicated by Trichosporon infection. Bloodstream infections and disseminated infections were the most common clinical presentations. Liver recipients with bloodstream or disseminated infections had poor prognoses. Although the most common species was formerly called Trichosporon beigelii, this species name should no longer be used because of the changes in the taxonomy of this genus resulting from the advent of molecular approaches, which were also used to identify the strains isolated from our patients. Antifungal susceptibility testing highlights the possibility of multidrug resistance. Indeed, Trichosporon has to be considered in cases of breakthrough infection or treatment failure under echinocandins or amphotericin therapy. Voriconazole seems to be the best treatment option.
authors.affiliation: Divisão de Laboratório Central - LIM03, Hospital das Clínicas da FMUSP, São Paulo, Brazil; INSERM, UMRS945, Paris, France.
authors.forename: J N
authors.initials: JN
authors.lastname: Almeida Júnior
authors.forename: A T W
authors.initials: AT
authors.lastname: Song
authors.forename: S V
authors.initials: SV
authors.lastname: Campos
authors.forename: T M V
authors.initials: TM
authors.lastname: Strabelli
authors.forename: G M
authors.initials: GM
authors.lastname: Del Negro
authors.forename: D S Y
authors.initials: DS
authors.lastname: Figueiredo
authors.forename: A L
authors.initials: AL
authors.lastname: Motta
authors.forename: F
authors.initials: F
authors.lastname: Rossi
authors.forename: J
authors.initials: J
authors.lastname: Guitard
authors.forename: G
authors.initials: G
authors.lastname: Benard
authors.forename: C
authors.initials: C
authors.lastname: Hennequin
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D004271:DNA, Fungal / Q000032:analysis*; D021901:DNA, Intergenic / Q000032:analysis; D004275:DNA, Ribosomal / Q000032:analysis; D025141:Drug Resistance, Fungal; D004653:Empyema / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D006084:Graft Rejection / Q000517:prevention & control*; D016027:Heart Transplantation; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D016040:Lung Transplantation; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D008826:Microbial Sensitivity Tests; D010493:Pericarditis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D010996:Pleural Effusion / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D011743:Pyrimidines / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D014230:Triazoles / Q000627:therapeutic use; D014250:Trichosporon / Q000235:genetics*; D060586:Trichosporonosis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D065819:Voriconazole; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D021901:DNA, Intergenic; D004275:DNA, Ribosomal; D007166:Immunosuppressive Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole
keywords: Trichosporon; antifungal susceptibility; invasive infection; solid organ transplant; treatment