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Trichosporon-Blood Stream Infection
Meera Challapilla1, Kinjal Patel2, Bhargav Patel3
1Consultant,PD Hinduja Hospital, Mumbai, Maharashtra.
The Journal of the Association of Physicians of India
|July 16, 2019
Summary
Trichosporon asahii bloodstream infections in immunocompromised patients are linked to central venous catheters and high mortality. Voriconazole is recommended as the primary treatment, emphasizing species identification and susceptibility testing.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Trichosporon species are emerging opportunistic pathogens.
- These fungi exhibit resistance to conventional antifungals, leading to high mortality rates.
- Bloodstream infections (BSIs) caused by Trichosporon pose a significant clinical challenge, particularly in immunocompromised individuals.
Purpose of the Study:
- To identify risk factors associated with Trichosporon BSIs.
- To evaluate treatment outcomes for these infections.
- To determine the antifungal susceptibility patterns of Trichosporon species.
Main Methods:
- Retrospective analysis of patients with Trichosporon BSIs from January 2012 to August 2016.
- Species identification and antifungal susceptibility testing using the Vitek2 compact automated system and broth microdilution.
- Evaluation of clinical data including central venous catheter use and prior antibiotic exposure.
Main Results:
- Twelve cases of Trichosporon BSI were identified.
- Trichosporon asahii was the predominant species identified in 9 isolates.
- All patients had central venous catheters and received prior antibiotics, with a 50% overall mortality rate.
Conclusions:
- Central venous catheterization is a significant risk factor associated with higher mortality in Trichosporon BSIs.
- Voriconazole is suggested as the drug of choice for treating these infections.
- Accurate species identification, antifungal susceptibility testing, and prompt treatment are crucial for improving patient outcomes.
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