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Colonization and infection with Trichosporon species in the immunosuppressed host
Abstract:
Trichosporon beigelii and Trichosporon capitatum have recently been recognized as systemic pathogens in the immunosuppressed host. We studied the incidence of colonization and systemic infection with these organisms in 353 highly immunocompromised patients over a 37-month period. Thirteen patients (3.7%) had positive surveillance cultures for Trichosporon species in stool, skin, or urine. Three of the 13 patients developed systemic infections after having positive surveillance cultures. In two of these three patients, urine cultures were positive near the time of systemic infection. The route of entry appeared to have been enteric in two patients and cutaneous in one patient. Both colonizing and infecting organisms showed in vitro susceptibility to amphotericin B and nystatin. This study suggests that positive surveillance cultures for Trichosporon species may correlate with systemic infection in the severely immunocompromised patient and that repeated positive urine cultures may indicate dissemination.
Insights
Positive surveillance cultures for Trichosporon species, particularly in urine, may indicate systemic infection risk in immunocompromised patients. Early detection and monitoring are crucial for managing these fungal pathogens.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Immunocompromised Host Research
Background:
- Trichosporon beigelii and Trichosporon capitatum are emerging systemic pathogens.
- Immunocompromised patients are particularly susceptible to invasive fungal infections.
- Understanding colonization and infection dynamics is critical for patient management.
Purpose of the Study:
- To investigate the incidence of Trichosporon species colonization and systemic infection.
- To determine the correlation between surveillance cultures and invasive disease.
- To identify potential routes of entry and susceptibility patterns.
Main Methods:
- Prospective study of 353 highly immunocompromised patients over 37 months.
- Surveillance cultures (stool, skin, urine) for Trichosporon species.
- Clinical monitoring for systemic infection development.
Main Results:
- Thirteen patients (3.7%) showed positive surveillance cultures for Trichosporon.
- Three of these patients developed systemic infections.
- Positive urine cultures preceded systemic infection in two cases; enteric and cutaneous routes were implicated.
Conclusions:
- Positive surveillance cultures for Trichosporon species may predict systemic infection risk in severely immunocompromised individuals.
- Repeated positive urine cultures could signify dissemination of the fungus.
- Trichosporon isolates demonstrated in vitro susceptibility to amphotericin B and nystatin.