Invasive mycoses caused rare yeast fungi in patients in St. Petersburg, Russia, 1998-2007

Klimko1, N.N., Pestova1, L.A., Bogomolova1, T.S., Vybornova1, I.V., Belogurova2, M.B., Saturnov3, A.V., Pryadko3, A.S., Zjuzgin3, I.S., Shnejder3,T.V., Alekseeva2, J.A., Borisov3, M.V., Radulesky2, G.G., Shats2, L.I., Zubarovskaja2, N.I., Palval3,

Author address: 

1 SPb MAPE, ST.PETERSBURG, Russian Federation 2City Hospital #31, ST.PETERSBURG, Russian Federation 3Leningrad Regional Clinical Hospital, ST.PETERSBURG, Russian Federation

Abstract: 

Background: Over the past three decades, the incidence of invasive mycoses has increased substantially. Candida spp. causes the majority of yeast invasive fungal infections (IFI). Other yeast IFI are investigated poor. Objectives: The purpose of this study was to evaluate underlying diseases, clinical manifestation, etiology, treatment and outcomes of invasive mycoses caused rare yeast fungi in patients (pts) in Saint-Petersburg, Russia. Methods: Diagnosis was established on EORTC/MSG 2002 criteria: blood (or peritoneal) culture that yields yeast-like fungi in the context of a compatible infectious disease process. Isolates susceptibility to fluconazole (FLU) was determinated by disk diffusion method according to M-44A CLSI guidelines. Results: During a 9-year period, we diagnosed 20 cases of invasive mycoses caused rare yeast fungi in 5 hospitals. Fifteen pts (75%) were adults and 5 (25%) ' children. Male ' 11, female ' 9. Age: 11 months ' 73 years (median ' 37). Twelve pts (60%) were hospitalized in hematology/oncology units, seven pts (35%) - in ICUs and one (5%) ' in dialysis unit. Underlying diseases in pts were acute leucosis ' 7 (35%), Hodgkin's lymphoma ' 2 (10%), neuroblastoma - 2 (10%), schwannoma ' 1 (5%), brain tumor ' 1 (5%), mechanical asphyxia ' 1 (5%), pancreatitis ' 1 (5%), burn disease ' 1 (5%), hysteromyoma and gallstone disease ' 1 (5%), pneumonia ' 1 (5%), abdominal aortic aneurysm ' 1 (5%), chronic glomerulonephritis ' 1 (5%). Nineteen pts (95%) were diagnosed fungemia and one pt (5%) ' fungal peritonitis. Twenty rare yeast fungal strains were isolated from 20 pts. The most common species were Rhodotorula mucilaginosa ' 50% (10 pts), Trichosporon (asahii, mucoides, cutaneum) - 35% (7 pts), Geotrichum (candidum, capitatum) ' 10% (2 pts) and Malassezia pachydermatis ' 5% (1 pt). In 6 pts (30%) rare yeast fungi were isolated with Candida spp. Eleven rare yeast fungal strains (55%) were tested for susceptibility. Susceptible to FLU were 27% of strains, SDD - 9%, resistant - 64%. All Rhodotorula sp. strains had resistance to FLU, Trichosporon sp. had susceptibility to FLU, Geotrichum sp. ' SDD. In 80% of pts intravenous and/or abdominal catheters were removed/changed. Fourteen pts (70%) received antimycotic therapy: amphotericin B (40%), fluconazole (20%), caspofungin (10%). Mortality rate was 40% in 30 days. Conclusion: Invasive mycoses caused rare yeast fungi developed in hematology/oncology units’, ICUs’ and dialysis units’ pts. Rare yeast fungal strains were low susceptibility to FLU. Those invasive mycoses associated high morbidity and mortality rate.
2007

abstract No: 

P208

Full conference title: 

3rd Trends in Medical Mycology
    • TIMM 3rd (2011)