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Browsing by Author "Klingspor, Lena"

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  • Azole-Resistance in Aspergillus terreus and Related Species: An Emerging Problem or a Rare Phenomenon?
    Publication . Zoran, Tamara; Sartori, Bettina; Sappl, Laura; Aigner, Maria; Sánchez-Reus, Ferran; Rezusta, Antonio; Chowdhary, Anuradha; Taj-Aldeen, Saad J.; Arendrup, Maiken C.; Oliveri, Salvatore; Kontoyiannis, Dimitrios P.; Alastruey-Izquierdo, Ana; Lagrou, Katrien; Cascio, Giuliana Lo; Meis, Jacques F.; Buzina, Walter; Farina, Claudio; Drogari-Apiranthitou, Miranda; Grancini, Anna; Tortorano, Anna M.; Willinger, Birgit; Hamprecht, Axel; Johnson, Elizabeth; Klingspor, Lena; Arsic-Arsenijevic, Valentina; Cornely, Oliver A.; Meletiadis, Joseph; Prammer, Wolfgang; Tullio, Vivian; Vehreschild, Jörg-Janne; Trovato, Laura; Lewis, Russell E.; Segal, Esther; Rath, Peter-Michael; Hamal, Petr; Rodriguez-Iglesias, Manuel; Roilides, Emmanuel; Arikan-Akdagli, Sevtap; Chakrabarti, Arunaloke; Colombo, Arnaldo L.; Fernández, Mariana S.; Martin-Gomez, M. Teresa; Badali, Hamid; Petrikkos, Georgios; Klimko, Nikolai; Heimann, Sebastian M.; Uzun, Omrum; Roudbary, Maryam; de la Fuente, Sonia; Houbraken, Jos; Risslegger, Brigitte; Lass-Flörl, Cornelia; Lackner, Michaela
    Objectives: Invasive mold infections associated with Aspergillus species are a significant cause of mortality in immunocompromised patients. The most frequently occurring aetiological pathogens are members of the Aspergillus section Fumigati followed by members of the section Terrei. The frequency of Aspergillus terreus and related (cryptic) species in clinical specimens, as well as the percentage of azole-resistant strains remains to be studied. Methods: A global set (n = 498) of A. terreus and phenotypically related isolates was molecularly identified (beta-tubulin), tested for antifungal susceptibility against posaconazole, voriconazole, and itraconazole, and resistant phenotypes were correlated with point mutations in the cyp51A gene. Results: The majority of isolates was identified as A. terreus (86.8%), followed by A. citrinoterreus (8.4%), A. hortai (2.6%), A. alabamensis (1.6%), A. neoafricanus (0.2%), and A. floccosus (0.2%). One isolate failed to match a known Aspergillus sp., but was found most closely related to A. alabamensis. According to EUCAST clinical breakpoints azole resistance was detected in 5.4% of all tested isolates, 6.2% of A. terreus sensu stricto (s.s.) were posaconazole-resistant. Posaconazole resistance differed geographically and ranged from 0% in the Czech Republic, Greece, and Turkey to 13.7% in Germany. In contrast, azole resistance among cryptic species was rare 2 out of 66 isolates and was observed only in one A. citrinoterreus and one A. alabamensis isolate. The most affected amino acid position of the Cyp51A gene correlating with the posaconazole resistant phenotype was M217, which was found in the variation M217T and M217V. Conclusions:Aspergillus terreus was most prevalent, followed by A. citrinoterreus. Posaconazole was the most potent drug against A. terreus, but 5.4% of A. terreus sensu stricto showed resistance against this azole. In Austria, Germany, and the United Kingdom posaconazole-resistance in all A. terreus isolates was higher than 10%, resistance against voriconazole was rare and absent for itraconazole.
    2018-03-28Journal article Open access Show more
  • ECMM CandiReg - A ready to use platform for outbreaks and epidemiological studies
    Publication . Koehler, Philipp; Arendrup, Maiken Cavling; Arikan‐Akdagli, Sevtap; Bassetti, Matteo; Bretagne, Stéphane; Klingspor, Lena; Lagrou, Katrien; Meis, Jacques F.; Rautemaa‐Richardson, Riina; Schelenz, Silke; Hamprecht, Axel; Koehler, Felix C.; Kurzai, Oliver; Salmanton‐García, Jon; Vehreschild, Jörg‐Janne; Alanio, Alexandre; Alastruey‐Izquierdo, Ana; Arsic Arsenijevic, Valentina; Gangneux, Jean‐Pierre; Gow, Neil A. R.; Hadina, Suzana; Hamal, Petr; Johnson, Elizabeth; Klimko, Nikolay; Lass‐Flörl, Cornelia; Mares, Mihai; Özenci, Volkan; Papp, Tamas; Roilides, Emmanuel; Sabino, Raquel; Segal, Esther; Talento, Alida Fe; Tortorano, Anna Maria; Verweij, Paul E.; Hoenigl, Martin; Cornely, Oliver A.; European Confederation of Medical Mycology (ECMM)
    Background: Recent outbreaks of Candida auris further exemplify that invasive Candida infections are a substantial threat to patients and healthcare systems. Even short treatment delays are associated with higher mortality rates. Epidemiological shifts towards more resistant Candida spp. require careful surveillance. Objectives: Triggered by the emergence of C auris and by increasing antifungal resistance rates the European Confederation of Medical Mycology developed an international Candida Registry (FungiScope™ CandiReg) to allow contemporary multinational surveillance. Methods: CandiReg serves as platform for international cooperation to enhance research regarding invasive Candida infections. CandiReg uses the General Data Protection Regulation compliant data platform ClinicalSurveys.net that holds the electronic case report forms (eCRF). Data entry is supported via an interactive macro created by the software that can be accessed via any Internet browser. Results: CandiReg provides an eCRF for invasive Candida infections that can be used for a variety of studies from cohort studies on attributable mortality to evaluations of guideline adherence, offering to the investigators of the 28 ECMM member countries the opportunity to document their cases of invasive Candida infection. CandiReg allows the monitoring of epidemiology of invasive Candida infections, including monitoring of multinational outbreaks. Here, we describe the structure and management of the CandiReg platform. Conclusion: CandiReg supports the collection of clinical information and isolates to improve the knowledge on epidemiology and eventually to improve management of invasive Candida infections. CandiReg promotes international collaboration, improving the availability and quality of evidence on invasive Candida infection and contributes to improved patient management.
    2019-08-01Journal article Restricted access Show more
  • Invasive pulmonary aspergillosis treatment duration in haematology patients in Europe: An EFISG, IDWP‐EBMT, EORTC‐IDG and SEIFEM survey
    Publication . Lanternier, Fanny; Seidel, Danila; Pagano, Livio; Styczynski, Jan; Mikulska, Malgorzata; Pulcini, Celine; Maertens, Johan; Munoz, Patricia; Garcia‐Vidal, Carol; Rijnders, Bart; Arendrup, Maiken Cavling; Sabino, Raquel; Verissimo, Cristina; Gaustad, Peter; Klimko, Nikolay; Arikan‐Akdagli, Sevtap; Arsic, Valentina; Barac, Aleksandra; Skiada, Anna; Klingspor, Lena; Herbrecht, Raoul; Donnelly, Peter; Cornely, Oliver A.; Lass‐Flörl, Cornelia; Lortholary, Olivier
    Invasive pulmonary aspergillosis (IPA) optimal duration of antifungal treatment is not known. In a joint effort, four international scientific societies/groups performed a survey to capture current practices in European haematology centres regarding management of IPA. We conducted a cross-sectional internet-based questionnaire survey in 2017 to assess practices in sixteen European countries concerning IPA management in haematology patients including tools to evaluate treatment response, duration and discontinuation. The following four groups/societies were involved in the project: European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fungal Infection Study Group (EFISG), Infectious Diseases Working Party-European Society for Blood and Bone Marrow Transplantation (IDWP-EBMT), European Organisation for Research and Treatment-Infectious Disease group (EORTC-IDG) and Sorveglianza Epidemiologica Infezioni nelle Emopatie (SEIFEM). A total of 112 physicians from 14/16 countries answered the survey. Galactomannan antigen was available in serum and bronchoalveolar lavage in most centres (106/112 [95%] and 97/112 [87%], respectively), quantitative Aspergillus PCR in 27/112 (24%) centres, β-D-glucan in 24/112 (21%) and positron emission tomography in 50/112 (45%). Treatment duration differed between haematological malignancies, with a median duration of 6 weeks [IQR 3-12] for patients with AML, 11 [4-12] for patients with allogenic stem cell transplantation and GvHD and 6 [3-12] for patients with lymphoproliferative disease. Treatment duration significantly differed according to country. Essential IPA biomarkers are not available in all European countries, and treatment duration is highly variable according to country. It will be important to provide guidelines to help with IPA treatment cessation with algorithms according to biomarker availability.
    2020-05Journal article Restricted access Show more
  • Knowledge and regulation on fungal contamination of sand and water: progress report and perspectives
    Publication . Gangneux, Jean-Pierre; Brandão, João; Segal, Ester; Arikan-Akdagli, Sevtap; Barac, Aleksandra; Bertout, Sébastien; Bostanaru, Andra-Cristina; Brito, Sara; Bull, Michelle; Çerikçioğlu, Nilgün; Chapman, Belinda; Delhaes, Laurence; Efstratiou, Maria; Ergin, Çagri; Frenkel, Michael; Guerra, Alexis Danielle; Gitto, Aurora; Gonçalves, Cláudia Isabel; Guegan, Hélène; Gunde-Cimerman, Nina; Güran, Mümtaz; Irinyi, Laszlo; Jiang, Sunny; Jonikaitė, Egle; Jozić, Slaven; Kataržytė, Marija; Klingspor, Lena; Mares, Mihai; Meijer, Wim; Melchers, Willem; Meletiadis, Joseph; Meyer, Wieland; Nastasa, Valentin; Novak-Babič, Monika; Ogunc, Dilara; Ozhak, Betil; Prigitano, Anna; Ranque, Stéphane; Richardson, Malcolm; Roger, Frédéric; Rusu, Raluca-Oana; Sabino, Raquel; Sampaio, Ana; Silva, Susana; Solo-gabriele, Helena; Stephens, Jayne; Tehupeiory-Kooreman, Marlou; Tortorano, Anna-Maria; Velegraki, Aristea; Veríssimo, Cristina; Vukić Lušić, Darija; Wunderlich, Georgoa
    Fungal flora in coastal/inland beach sand and recreational water is a neglected field of study, despite its potential impact on human health. A joint International Society for Human and Animal Mycology/European Confederation for Medical Mycology (ISHAM/ECMM) working group was formed in 2019 with the task to set up a vast international initiative aimed at studying the fungal contamination of beaches and bathing waters. Here we review the importance of the topic, and list the main results and achievements from 12 scientific publications. Fungal contamination exists at different levels, and the genera most frequently found were Aspergillus spp., Candida spp., Fusarium spp., and Cryptococcus spp., both in sand and in water. A site-blind median was found to be 89 colony-forming units of fungi per gram of sand in coastal/inland freshwaters. This threshold has been used for the sand quality criterion of the blue flag in Portugal. Additionally, our data were considered pivotal and therefore used for the first inclusion of fungi as a biological taxon of interest in water quality and sand monitoring recommendations of the World Health Organization's new guidelines on recreational water quality (Vol.1-Chap7). The findings of the consortium also suggest how environmental conditions (climate, salinity, soil pH, nitrogen, etc.) influence microbial communities in different regions, and that yeast species like Candida glabrata, Clavispora lusitaniae, and Meyerozyma guilliermondii have been identified as potential fungal indicators of fecal contamination. Climate change and natural disasters may affect fungal populations in different environments, and because this is still a field of study under exploration, we also propose to depict the future challenges of research and unmet needs.
    2024-01-27Journal article Open access Show more