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6 results on '"MESH: Itraconazole"'

1. Imported African Histoplasmosis in an Immunocompetent Patient 40 Years after Staying in a Disease-Endemic Area

Author

Emilie Catherinot, Olivier Lortholary, C. Richaud, Capucine Picard, Marie-Elisabeth Bougnoux, Dea Garcia-Hermoso, Marie-Olivia Chandesris, Hélène Benzaquen-Forner, Fanny Lanternier, Université Paris Descartes - Paris 5 (UPD5), Université Sorbonne Paris Cité (USPC), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Mycologie moléculaire - Molecular Mycology, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Centre National de Référence Mycoses Invasives et Antifongiques - National Reference Center Invasive Mycoses & Antifungals (CNRMA), Institut Pasteur [Paris] (IP), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre d'étude des Déficits Immunitaires, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), We thank Nicolas Hamilton, Perrine Parize, Blandine Rammaert, Arnaud Hot, and Frédéric Méchai for assistance during the study., Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris], UFR des Sciences de la Santé Simone Veil, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris], Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur [Paris], and Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP]

Subjects
Male, Pediatrics, Endemic Diseases, Disease, MESH: Africa, Histoplasma capsulatum, MESH: Histoplasmosis, Medicine, Histoplasmosis, MESH: Travel, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, MESH: Treatment Outcome, Travel, MESH: Middle Aged, biology, Endemic area, Articles, Middle Aged, MESH: Positron-Emission Tomography, 3. Good health, Treatment Outcome, MESH: Portugal, Infectious Diseases, MESH: Endemic Diseases, African histoplasmosis, Itraconazole, medicine.drug, medicine.medical_specialty, Histoplasma, Amphotericin B, Virology, MESH: Amphotericin B, Humans, MESH: Histoplasma, MESH: Humans, Portugal, business.industry, biology.organism_classification, medicine.disease, MESH: Male, Surgery, Positron-Emission Tomography, Africa, Parasitology, business, MESH: Itraconazole, Rare disease
Abstract

International audience; Histoplasmosis caused by Histoplasma capsulatum var. duboisii is a rare disease outside central and western Africa. In Europe, all cases are imported. We report a case of an African histoplasmosis with isolated pulmonary involvement in a non-immunocompromised patient that occurred 40 years after his stay in a disease-endemic area. The patient was given itraconazole. (18)F-fluoro-2-deoxy-d-glucose positron emission tomography-computed tomography was used to assess evolution during treatment. The outcome for the patient was favorable.

Published
2014

2. High prevalence of triazole resistance in Aspergillus fumigatus, especially mediated by TR/L98H, in a French cohort of patients with cystic fibrosis

Author

Emilie Sacchetto, Alain Haloun, Guillaume Ghislain Aubin, Patrice Le Pape, Dea Garcia-Hermoso, Isabelle Danner-Boucher, Florent Morio, Michel Miegeville, Stéphane Bretagne, Université de Nantes (UN), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre National de Référence des Mycoses invasives et antifongiques - Mycologie moléculaire (CNRMA), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), This study was supported by internal funding., Cibles et Médicaments des Infections et de l'Immunité (IICiMed), Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), and Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, MESH: Sequence Analysis, DNA, Posaconazole, Antifungal Agents, Cystic Fibrosis, MESH: Tubulin, Cystic fibrosis, Aspergillus fumigatus, Tubulin, MESH: Child, Prevalence, Agar, Pharmacology (medical), CFTR, Child, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, MESH: Microbial Sensitivity Tests, 0303 health sciences, multi-azole resistance, MESH: Middle Aged, biology, cyp51A mutations, MESH: Voriconazole, Middle Aged, 3. Good health, Infectious Diseases, MESH: Young Adult, Child, Preschool, France, Itraconazole, MESH: Aspergillus fumigatus, medicine.drug, Adult, Microbiology (medical), food.ingredient, Adolescent, MESH: Cystic Fibrosis, Microbial Sensitivity Tests, In Vitro Techniques, A. fumigatus, MESH: Drug Resistance, Fungal, Microbiology, Agar plate, Young Adult, 03 medical and health sciences, food, Drug Resistance, Fungal, medicine, Aspergillosis, Humans, MESH: Aspergillosis, Gene, MESH: Prevalence, Retrospective Studies, 030304 developmental biology, MESH: Adolescent, MESH: In Vitro Techniques, Pharmacology, Voriconazole, MESH: Humans, 030306 microbiology, MESH: Child, Preschool, MESH: Adult, MESH: Retrospective Studies, Sequence Analysis, DNA, Triazoles, MESH: Antifungal Agents, medicine.disease, biology.organism_classification, MESH: Male, MESH: France, Pyrimidines, MESH: Triazoles, MESH: Pyrimidines, MESH: Itraconazole
Abstract

Part of this work has been presented at the Fifth Congress on Trends in Medical Mycology, Valencia, Spain, 2011 (Abstract no. 308); International audience; OBJECTIVES:Triazole resistance in Aspergillus fumigatus due to a single azole resistance mechanism (TR/L98H) is increasingly reported in European countries. Data from patients with cystic fibrosis (CF) are limited. Our study aimed to investigate the prevalence and molecular mechanisms of azole resistance in A. fumigatus in a cohort of patients with CF.METHODS:Eighty-five A. fumigatus isolates from 50 CF patients, collected between January 2010 and April 2011, were retrospectively analysed for azole resistance using agar plates containing 4 mg/L itraconazole. MICs of itraconazole, voriconazole and posaconazole were determined according to EUCAST methodology for each isolate able to grow on this medium. Species identification was performed by sequencing of the β-tubulin gene. Sequencing analysis of the cyp51A gene and its promoter region was conducted.RESULTS:Nine isolates (four patients, 8% prevalence) were able to grow on itraconazole-containing agar plates. Itraconazole resistance was confirmed by EUCAST methodology (MICs >2 mg/L). All isolates had mutations in the cyp51A gene at residues previously involved in azole resistance: L98H (n = 5), M220T (n = 4) and G54R (n = 1). One patient had three genetically distinct azole-resistant isolates identified during the study. The isolates with L98H that were recovered from three patients (6% prevalence) also had the 34 bp tandem repeat in the promoter region of cyp51A (TR/L98H) and displayed multiazole resistance.CONCLUSIONS:We report an 8% prevalence of itraconazole resistance in CF patients in our centre, mostly driven by TR/L98H (6%). Our data confirm that TR/L98H occurs in France and can be highly prevalent in CF patients.

Published
2012

3. Black grain mycetoma caused byLeptosphaeria tompkinsii

Author

M. Develoux, J. B. Poirat, A. Bazeli, Stéphane Bretagne, H. Machmachi, N. Godineau, Marie Desnos-Ollivier, D. Amsellem, Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre National de Référence Mycologie et Antifongiques-Mycologie Moléculaire (CNRMA), Institut Pasteur [Paris], The authors are grateful to Jeanne Gauthey, Khadidja Kherallah and Hakima Louati for assistance in reviewing the manuscript., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Institut Pasteur [Paris] (IP)

Subjects
Male, Pathology, Veterinary medicine, Antifungal Agents, MESH: Mycology, Mali, West africa, 030207 dermatology & venereal diseases, 0302 clinical medicine, Species identification, Leptosphaeria tompkinsii, Mycetoma, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Microscopy, biology, food and beverages, Agriculture, General Medicine, MESH: Mycetoma, Infectious Diseases, Itraconazole, MESH: Agriculture, medicine.drug, Adult, medicine.medical_specialty, MESH: Microscopy, 030231 tropical medicine, Mycology, MESH: Ascomycota, Fungus, Dematiaceous fungus, MESH: Hand, 03 medical and health sciences, Ascomycota, ascomycetes, medicine, Humans, Internal transcribed spacer, MESH: Debridement, MESH: Humans, MESH: Adult, MESH: Mali, Hand, MESH: Antifungal Agents, biology.organism_classification, black grains mycetoma, MESH: Male, Debridement, Africa, MESH: Itraconazole
Abstract

International audience; Leptosphaeria tompkinsii is a dematiaceous fungus which is rarely reported as an agent of black-grain mycetoma. We present a case involving a mycetoma of the hand of a former farmer from Mali, West Africa, who has been a resident in France for 27 years. The patient was successfully treated with surgery and the use of oral itraconazole for 6 months. Species identification was based on sexual reproductive structures observed on potato-carrot agar media and the use of internal transcribed spacer sequencing.

Published
2011

4. Antifungal drugs during pregnancy: an updated review

Author

Jack D. Sobel, Caroline Charlier, Benoit Pilmis, Olivier Lortholary, Marc Lecuit, Vincent Jullien, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Wayne State University [Detroit], Université Paris Descartes - Paris 5 (UPD5), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des Maladies infectieuses et tropicales [CHU Necker], This study was supported by internal funding, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris], Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP]-Institut des Maladies Génétiques Imagine [Paris]

Subjects
Antifungal Agents, MESH: Administration, Intravenous, [SDV]Life Sciences [q-bio], Antifungal drugs, Administration, Topical, Pharmacology, MESH: Pregnancy, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pregnancy, Medicine, Pharmacology (medical), 030212 general & internal medicine, Pregnancy Complications, Infectious, Fluconazole, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, 030219 obstetrics & reproductive medicine, MESH: Administration, Topical, 3. Good health, fetus, MESH: Teratogens, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Teratogens, fungal infections, MESH: Fluconazole, Liposomal amphotericin, Administration, Intravenous, Female, Itraconazole, Microbiology (medical), placenta, 03 medical and health sciences, Animal data, MESH: Anti-Infective Agents, Local, MESH: Mycoses, Amphotericin B, MESH: Amphotericin B, Humans, MESH: Pregnancy Complications, Infectious, MESH: Humans, business.industry, MESH: Antifungal Agents, bacterial infections and mycoses, antifungal therapy, Mycoses, Anti-Infective Agents, Local, business, MESH: Female, MESH: Itraconazole, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Classics
Abstract

International audience; Antifungal prescription remains a challenge in pregnant women because of uncertainties regarding fetal toxicity and altered maternal pharmacokinetic parameters that may affect efficacy or increase maternal and fetal toxicity. We present updated data reviewing the available knowledge and current recommendations regarding antifungal prescription in pregnancy. Amphotericin B remains the first-choice parenteral drug in spite of its well-established toxicity. Topical drugs are used throughout pregnancy because of limited absorption. Recent data have clarified the teratogenic effect of high-dose fluconazole during the first trimester and provided reassuring cumulative data regarding its use at a single low dose in this key period. Recent data have also provided additional safety data on itraconazole and lipidic derivatives of amphotericin B. Regarding newer antifungal drugs, including posaconazole and echinocandins, clinical data are critically needed before considering prescription in pregnancy.

Published
2014

5. Primary Prophylaxis of Disseminated Histoplasmosis in HIV Patients in French Guiana: Arguments for Cost Effectiveness

Author

Vincent Vantilcke, Célia Basurko, Antoine Adenis, Mathieu Nacher, Christine Aznar, Pierre Couppié, Bernard Carme, Denis Blanchet, ADENIS, ANTOINE, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH Guyane), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Epidémiologie des parasitoses et mycoses tropicales, Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Université des Antilles (UA)-Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Service de Dermatologie et Vénérologie

Subjects
Male, Pediatrics, Antifungal Agents, Cost effectiveness, Cost-Benefit Analysis, HIV Infections, MESH: Hospitalization, Cohort Studies, 0302 clinical medicine, MESH: Immunocompromised Host, MESH: Histoplasmosis, MESH: Incidence, MESH: Cohort Studies, Histoplasmosis, health care economics and organizations, 0303 health sciences, biology, MESH: AIDS-Related Opportunistic Infections, Incidence, MESH: HIV Infections, Articles, 3. Good health, French Guiana, Hospitalization, Infectious Diseases, Cohort, Female, Itraconazole, medicine.drug, medicine.medical_specialty, 030231 tropical medicine, 03 medical and health sciences, Immunocompromised Host, Acquired immunodeficiency syndrome (AIDS), Disseminated histoplasmosis, Virology, MESH: French Guiana, parasitic diseases, medicine, Humans, MESH: Humans, AIDS-Related Opportunistic Infections, 030306 microbiology, business.industry, Euros, MESH: Antifungal Agents, medicine.disease, biology.organism_classification, MESH: Male, Surgery, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Hiv patients, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Parasitology, business, MESH: Itraconazole, MESH: Female, MESH: Cost-Benefit Analysis
Abstract

International audience; Histoplasmosis is the first cause of acquired immunodeficiency syndrome (AIDS) and AIDS-related deaths in French Guiana. Cohort data were used to determine whether primary prophylaxis with 100 mg itraconazole for patients with CD4 counts < 150/mm(3) was cost-effective with different scenarios. For a scenario where 12% of patients died, 60% were aware of their human immunodeficiency virus (HIV) infection and adherence was only 50%, primary prophylaxis would prevent 1 death and 9 cases of histoplasmosis for a cost of 36,792 Euros per averted death, 1,533 per life-year saved, 4,415 Euros per averted case, when only counting the costs of itraconazole prophylaxis. Taking into account the total costs of hospitalization showed that primary prophylaxis would allow a savings of 185,178 Euros per year. Even in a scenario of low adherence, primary prophylaxis would be cost-effective in French Guiana, and presumably in the rest of the Guianas and the Amazon.

Published
2013

6. Molecular Phylogeny and Proposal of Two New Species of the Emerging Pathogenic Fungus Saksenaea

Author

Françoise Dromer, Josep Guarro, Joan Cano, Damien Hoinard, Dea Garcia-Hermoso, Michael G. Rinaldi, A. W. Fothergill, Alberto M. Stchigel, Deanna A. Sutton, Eduardo Alvarez, Universitat Rovira i Virgili, Centre National de Référence des Mycoses invasives et antifongiques - Mycologie moléculaire (CNRMA), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), The University of Texas at San Antonio (UTSA), This work was supported by the Spanish Ministerio de Ciencia y Tecnología grant CGL 2009-08698/BOS, with cofunding from Fondo Europeo de Desarrollo Regional (FEDER)., We thank Catalina Nuñez for technical assistance. The NRCMA gratefully acknowledges the technical help of Laure Diancourt and Coralie Tran at the sequencing facility (PF-8, Genotyping of Pathogens and Public Health, Institut Pasteur)., and Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)

Subjects
MESH: Sequence Analysis, DNA, Antifungal Agents, Saksenaea, 0302 clinical medicine, Peptide Elongation Factor 1, Environmental Microbiology, 030212 general & internal medicine, DNA, Fungal, Mycological Typing Techniques, MESH: Phylogeny, Phylogeny, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, 0303 health sciences, Fungal protein, MESH: Microbial Sensitivity Tests, biology, Sporangium, Temperature, MESH: Environmental Microbiology, MESH: Naphthalenes, Pathogenic fungus, Spores, Fungal, MESH: Temperature, Molecular phylogenetics, Mucorales, MESH: Mucorales, MESH: Fungal Proteins, Itraconazole, Microbiology (medical), MESH: Terbinafine, Molecular Sequence Data, Mycology, Microbial Sensitivity Tests, Naphthalenes, Microbiology, Fungal Proteins, 03 medical and health sciences, MESH: Spores, Fungal, MESH: Mycological Typing Techniques, DNA, Ribosomal Spacer, Humans, Mucormycosis, MESH: Peptide Elongation Factor 1, Internal transcribed spacer, Terbinafine, MESH: DNA, Ribosomal Spacer, MESH: Mucormycosis, MESH: Humans, MESH: Molecular Sequence Data, 030306 microbiology, Saksenaea vasiformis, Sequence Analysis, DNA, Triazoles, biology.organism_classification, MESH: Antifungal Agents, MESH: DNA, Fungal, MESH: Triazoles, MESH: Itraconazole
Abstract

Saksenaea is a monotypic genus belonging to the order Mucorales and capable of producing severe human infections. Through a polyphasic study based on analysis of the sequences of the internal transcribed spacer (ITS) region, domains D1 and D2 of the 28S rRNA gene, and the elongation factor 1α (EF-1α) gene, as well as by evaluation of relevant morphological and physiological characteristics of a set of clinical and environmental strains, we have demonstrated that Saksenaea vasiformis is a complex of species. We propose as new species Saksenaea oblongispora , characterized by oblong sporangiospores and unable to grow at 42°C, and Saksenaea erythrospora , characterized by large sporangiophores and sporangia and by ellipsoid sporangiospores, biconcave in the lateral view. Itraconazole, posaconazole, and terbinafine were active against all isolates included in the study, while amphotericin B, voriconazole, and the echinocandins showed low activity.

Published
2010

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