Objectives: To compare groups of etiologic agents for neonatal fungemia based on previously published case reports with regard to case outcomes. Methods: Secondary analysis of data from case reports published in scien...Objectives: To compare groups of etiologic agents for neonatal fungemia based on previously published case reports with regard to case outcomes. Methods: Secondary analysis of data from case reports published in scientific literature indexed in Medline, Scopus and LILACS databases, and starting from the year, full texts were registered until the year 2010. Results: Thirty-four species of fungi were isolated in 252 cases reported over a 40-year period. The distribution of fungal groups according to the development level of a case’s region of origin was very uneven (p Aspergillus sp.) in more developed countries. However, 73% of the chi-squared distribution corresponded to differences observed in the frequency of Candida sp. and non-albicans Candida. While the frequency of candidemia by C. albicans was progressively declining in the period from 1966 to 2010, reports of non-albicans candidemia and other non-Candida fungi became significantly (p albicans Candida or non-Candida fungi were isolated. Conclusion: fungi of the genera Candida and Aspergillus were the etiologic agents most frequently identified in published cases of neonatal fungemia;the outcome of death was more often related to cases where non-albicans Candida or non-Candida fungi were isolated.展开更多
Invasive trichosporonosis is an extremely rare mycosis, but Trichosporon fungemia (TF) in patients with hematologic malignancies has been increasingly recognized to be a fulminant and highly lethal infection. Although...Invasive trichosporonosis is an extremely rare mycosis, but Trichosporon fungemia (TF) in patients with hematologic malignancies has been increasingly recognized to be a fulminant and highly lethal infection. Although the utility of azole therapy has been demonstrated in several observations, little is known about the efficacy of one of azoles, miconazole (MCZ). To assess its therapeutic role, we retrospectively investigated 6 cases of TF in patients with acute leukemia receiving MCZ containing regimens. Successful outcome was obtained in 4 patients [MCZ + amphotericin B (AmB) in 2, MCZ only and MCZ + fluconazole (FLCZ) + AmB in one each], but not in 2 (MCZ + FLCZ + AmB and MCZ + FLCZ in one each). Although MCZ and AmB exhibited good in vitro activities against isolates from all patients, FLCZ had such finding from only one patient. Considering the reportedly limited utility of AmB, MCZ seemed to play a critical role even in the combination therapies for TF. Despite the release of newer azoles and other classes of antifungals, the use of MCZ remains a potential therapeutic approach for TF in patients with acute leukemia.展开更多
文摘Objectives: To compare groups of etiologic agents for neonatal fungemia based on previously published case reports with regard to case outcomes. Methods: Secondary analysis of data from case reports published in scientific literature indexed in Medline, Scopus and LILACS databases, and starting from the year, full texts were registered until the year 2010. Results: Thirty-four species of fungi were isolated in 252 cases reported over a 40-year period. The distribution of fungal groups according to the development level of a case’s region of origin was very uneven (p Aspergillus sp.) in more developed countries. However, 73% of the chi-squared distribution corresponded to differences observed in the frequency of Candida sp. and non-albicans Candida. While the frequency of candidemia by C. albicans was progressively declining in the period from 1966 to 2010, reports of non-albicans candidemia and other non-Candida fungi became significantly (p albicans Candida or non-Candida fungi were isolated. Conclusion: fungi of the genera Candida and Aspergillus were the etiologic agents most frequently identified in published cases of neonatal fungemia;the outcome of death was more often related to cases where non-albicans Candida or non-Candida fungi were isolated.
文摘Invasive trichosporonosis is an extremely rare mycosis, but Trichosporon fungemia (TF) in patients with hematologic malignancies has been increasingly recognized to be a fulminant and highly lethal infection. Although the utility of azole therapy has been demonstrated in several observations, little is known about the efficacy of one of azoles, miconazole (MCZ). To assess its therapeutic role, we retrospectively investigated 6 cases of TF in patients with acute leukemia receiving MCZ containing regimens. Successful outcome was obtained in 4 patients [MCZ + amphotericin B (AmB) in 2, MCZ only and MCZ + fluconazole (FLCZ) + AmB in one each], but not in 2 (MCZ + FLCZ + AmB and MCZ + FLCZ in one each). Although MCZ and AmB exhibited good in vitro activities against isolates from all patients, FLCZ had such finding from only one patient. Considering the reportedly limited utility of AmB, MCZ seemed to play a critical role even in the combination therapies for TF. Despite the release of newer azoles and other classes of antifungals, the use of MCZ remains a potential therapeutic approach for TF in patients with acute leukemia.