Scholars@Duke
John Robert Perfect

John Robert Perfect

James B. Duke Distinguished Professor of Medicine
Medicine, Infectious Diseases
perfe001@mc.duke.edu
Duke Box 102359, Durham, NC 27710
Hanes House Rm 163, Trent Drive, Durham, NC 27710

Selected Publications

Integration of genomic and pharmacokinetic data to predict clinical outcomes in HIV-associated cryptococcal meningitis.

Journal Article mBio · October 16, 2024 UNLABELLED: Cryptococcal meningitis causes an estimated 112,000 global deaths per annum. Genomic and phenotypic features of the infecting strain of Cryptococcus spp. have been associated with outcomes from cryptococcal meningitis. Additionally, population- ... Full text Link to item Cite

Structures of trehalose-6-phosphate synthase, Tps1, from the fungal pathogen Cryptococcus neoformans: A target for antifungals.

Journal Article Proc Natl Acad Sci U S A · August 6, 2024 Invasive fungal diseases are a major threat to human health, resulting in more than 1.5 million annual deaths worldwide. The arsenal of antifungal therapeutics remains limited and is in dire need of drugs that target additional biosynthetic pathways that a ... Full text Link to item Cite

Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM.

Journal Article Lancet Infect Dis · August 2024 Cryptococcosis is a major worldwide disseminated invasive fungal infection. Cryptococcosis, particularly in its most lethal manifestation of cryptococcal meningitis, accounts for substantial mortality and morbidity. The breadth of the clinical cryptococcos ... Full text Link to item Cite

Efficacy of Liposomal Nystatin in a Rabbit Model of Cryptococcal Meningitis.

Journal Article J Fungi (Basel) · July 26, 2024 Cryptococcal meningitis (CM) causes significant global morbidity and mortality. Current therapeutic strategies rely on deoxycholated or liposomal forms of the polyene amphotericin B. Nystatin is also a polyene with broad-spectrum antimicrobial activity. Tr ... Full text Link to item Cite

Donor-derived Mycoplasma and Ureaplasma infections in lung transplant recipients: A prospective study of donor and recipient respiratory tract screening and recipient outcomes.

Journal Article Am J Transplant · July 16, 2024 Mycoplasma hominis and Ureaplasma species are urogenital mollicutes that can cause serious donor-derived infections in lung transplant recipients. Best practices for mollicute screening remain unknown. We conducted a single-center prospective study analyzi ... Full text Link to item Cite

Clinical Mycology Today: Emerging Challenges and Opportunities.

Journal Article Open Forum Infect Dis · July 2024 The Mycoses Study Group Education and Research Consortium is a collective of clinicians, researchers, and educators with the common goal to advance awareness, diagnosis, and management of invasive fungal diseases. Clinical Mycology Today, the Mycoses Study ... Full text Link to item Cite

Fusarium species,Scedosporium species, and Lomentospora prolificans: A systematic review to inform the World Health Organization priority list of fungal pathogens.

Journal Article Med Mycol · June 27, 2024 Recognizing the growing global burden of fungal infections, the World Health Organization established a process to develop a priority list of fungal pathogens (FPPL). In this systematic review, we aimed to evaluate the epidemiology and impact of infections ... Full text Link to item Cite

Mucorales: A systematic review to inform the World Health Organization priority list of fungal pathogens.

Journal Article Med Mycol · June 27, 2024 The World Health Organization, in response to the growing burden of fungal disease, established a process to develop a fungal priority pathogens list (FPPL). This systematic review aimed to evaluate the epidemiology and impact of invasive fungal disease du ... Full text Link to item Cite

Pichia kudriavzevii (Candida krusei): A systematic review to inform the World Health Organisation priority list of fungal pathogens.

Journal Article Med Mycol · June 27, 2024 In response to the growing global threat of fungal infections, in 2020 the World Health Organisation (WHO) established an Expert Group to identify priority fungi and develop the first WHO fungal priority pathogen list (FPPL). The aim of this systematic rev ... Full text Link to item Cite

Aspergillus fumigatus-a systematic review to inform the World Health Organization priority list of fungal pathogens.

Journal Article Med Mycol · June 27, 2024 Recognizing the growing global burden of fungal infections, the World Health Organization established a process to develop a priority list of fungal pathogens (FPPL). In this systematic review, we aimed to evaluate the epidemiology and impact of invasive i ... Full text Link to item Cite

Cryptococcosis-a systematic review to inform the World Health Organization Fungal Priority Pathogens List.

Journal Article Med Mycol · June 27, 2024 Cryptococcosis causes a high burden of disease worldwide. This systematic review summarizes the literature on Cryptococcus neoformans and C. gattii infections to inform the World Health Organization's first Fungal Priority Pathogen List. PubMed and Web of ... Full text Link to item Cite

A ketogenic diet enhances fluconazole efficacy in murine models of systemic fungal infection.

Journal Article mBio · May 8, 2024 Invasive fungal infections are a significant public health concern, with mortality rates ranging from 20% to 85% despite current treatments. Therefore, we examined whether a ketogenic diet could serve as a successful treatment intervention in murine models ... Full text Link to item Cite

Risk factors, management, and clinical outcomes of invasive Mycoplasma and Ureaplasma infections after lung transplantation.

Journal Article Am J Transplant · April 2024 Mollicute infections, caused by Mycoplasma and Ureaplasma species, are serious complications after lung transplantation; however, understanding of the epidemiology and outcomes of these infections remains limited. We conducted a single-center retrospective ... Full text Open Access Link to item Cite

Limitations of antifungal prophylaxis in preventing invasive Candida surgical site infections after liver transplant surgery.

Journal Article Antimicrob Agents Chemother · March 6, 2024 Invasive primary Candida surgical site infections (IP-SSIs) are a common complication of liver transplantation, and targeted antifungal prophylaxis is an efficient strategy to limit their occurrence. We performed a retrospective single-center cohort study ... Full text Link to item Cite

Description of Cryptococcosis Following SARS-CoV-2 Infection: A Disease Survey Through the Mycosis Study Group Education and Research Consortium (MSG-19).

Journal Article Clin Infect Dis · February 17, 2024 BACKGROUND: Invasive fungal infections have been described throughout the COVID-19 pandemic. Cryptococcal disease after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported in several isolated case reports and 1 lar ... Full text Link to item Cite

Hormonal steroids induce multidrug resistance and stress response genes in Neisseria gonorrhoeae by binding to MtrR.

Journal Article Nat Commun · February 7, 2024 Transcriptional regulator MtrR inhibits the expression of the multidrug efflux pump operon mtrCDE in the pathogenic bacterium Neisseria gonorrhoeae. Here, we show that MtrR binds the hormonal steroids progesterone, β-estradiol, and testosterone, which are ... Full text Link to item Cite

Biolistic Transformation of Cryptococcus neoformans.

Journal Article Methods Mol Biol · 2024 Biolistic transformation of Cryptococcus neoformans is used as a molecular tool to genetically alter or delete targeted genes. The DNA is introduced into the yeast on DNA-coated gold beads by a helium shock wave produced using a biolistic particle system. ... Full text Link to item Cite

The Rabbit Model of Cryptococcal Meningitis.

Journal Article Methods Mol Biol · 2024 Cryptococcal meningitis (CM) is a fungal disease caused by the invasion of Cryptococcus yeast cells into the central nervous system. The organism is thought to enter the body through the lungs and then escape due to dysregulation of the immune response. Mu ... Full text Link to item Cite

Cryptococcus neoformans trehalose-6-phosphate synthase (tps1) promotes organ-specific virulence and fungal protection against multiple lines of host defenses.

Journal Article Front Cell Infect Microbiol · 2024 Trehalose-6-phosphate synthase (TPS1) was identified as a virulence factor for Cryptococcus neoformans and a promising therapeutic target. This study reveals previously unknown roles of TPS1 in evasion of host defenses during pulmonary and disseminated pha ... Full text Link to item Cite

Genetic diversity and microevolution in clinical Cryptococcus isolates from Cameroon.

Journal Article Med Mycol · December 1, 2023 Cryptococcal meningitis is the second most common cause of death in people living with HIV/AIDS, yet we have a limited understanding of how cryptococcal isolates change over the course of infection. Cryptococcal infections are environmentally acquired, and ... Full text Link to item Cite

Development and validation of a colorimetric antifungal susceptibility testing method for the dimorphic fungus Talaromyces marneffei.

Journal Article Med Mycol · November 6, 2023 Antifungal drug resistance is an emerging cause of treatment failure in invasive fungal infections, and antifungal susceptibility testing (AFST) may inform treatment decisions. Currently, there are no established AFST guidelines for Talaromyces marneffei ( ... Full text Link to item Cite

HIV and fungal priority pathogens.

Journal Article Lancet HIV · November 2023 The burden of invasive fungal infections associated with opportunistic fungal pathogens is a persistent challenge, particularly among people with advanced HIV disease. In October, 2022, WHO published the Fungal Priority Pathogens List (FPPL)-the first glob ... Full text Link to item Cite

Pharmacodynamics of ATI-2307 in a rabbit model of cryptococcal meningoencephalitis.

Journal Article Antimicrob Agents Chemother · October 18, 2023 Cryptococcal meningoencephalitis (CM) is a devastating fungal disease with high morbidity and mortality. The current regimen that is standard-of-care involves a combination of three different drugs administered for up to one year. There is a critical need ... Full text Link to item Cite

Cryptococcosis

Chapter · September 14, 2023 Cryptococcosis is an infectious disease caused by the encapsulated fungi Cryptococcus neoformans and Cryptococcus gattii. Cryptococcal infection can develop in apparently immunocompetent hosts and these fungi have emerged as important opportunistic pathoge ... Full text Cite

Susceptibility to Cryptococcus neoformans Infection with Bruton's Tyrosine Kinase Inhibition.

Journal Article Infect Immun · August 16, 2023 Patients receiving the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib have an increased likelihood of fungal infections. The objectives of this study were to determine if Cryptococcus neoformans infection severity was isolate dependent with BTK inhibit ... Full text Link to item Cite

C5a-licensed phagocytes drive sterilizing immunity during systemic fungal infection.

Journal Article Cell · June 22, 2023 Systemic candidiasis is a common, high-mortality, nosocomial fungal infection. Unexpectedly, it has emerged as a complication of anti-complement C5-targeted monoclonal antibody treatment, indicating a critical niche for C5 in antifungal immunity. We identi ... Full text Link to item Cite

Efficacy of APX2039 in a Rabbit Model of Cryptococcal Meningitis.

Journal Article mBio · December 20, 2022 Cryptococcal Meningitis (CM) is uniformly fatal if not treated, and treatment options are limited. We previously reported on the activity of APX2096, the prodrug of the novel Gwt1 inhibitor APX2039, in a mouse model of CM. Here, we investigated the efficac ... Full text Link to item Cite

Genomic Variation across a Clinical Cryptococcus Population Linked to Disease Outcome.

Journal Article mBio · December 20, 2022 Cryptococcus neoformans is the causative agent of cryptococcosis, a disease with poor patient outcomes that accounts for approximately 180,000 deaths each year. Patient outcomes may be impacted by the underlying genetics of the infecting isolate; however, ... Full text Link to item Cite

Invasive candidiasis: investigational drugs in the clinical development pipeline and mechanisms of action.

Journal Article Expert Opin Investig Drugs · August 2022 INTRODUCTION: The epidemiology of invasive Candida infections is evolving. Infections caused by non-albicans Candida spp. are increasing; however, the antifungal pipeline is more promising than ever and is enriched with repurposed drugs and agents that hav ... Full text Link to item Cite

The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries.

Journal Article Lancet Microbe · July 2022 Reports of COVID-19-associated mucormycosis have been increasing in frequency since early 2021, particularly among patients with uncontrolled diabetes. Patients with diabetes and hyperglycaemia often have an inflammatory state that could be potentiated by ... Full text Link to item Cite

Noninvasive Testing and Surrogate Markers in Invasive Fungal Diseases.

Journal Article Open Forum Infect Dis · June 2022 Invasive fungal infections continue to increase as at-risk populations expand. The high associated morbidity and mortality with fungal diseases mandate the continued investigation of novel antifungal agents and diagnostic strategies that include surrogate ... Full text Link to item Cite

Another case of cryptococcal meningitis in a person without HIV who injects drugs: A possible risk factor in need of further investigation.

Journal Article Med Mycol Case Rep · June 2022 Cryptococcal meningitis is a fungal central nervous infection typically occurring in patients with severe immunocompromise. We present a case of cryptococcal meningitis occurring in a patient with active injection drug use (IDU) but no immunocompromising c ... Full text Link to item Cite

Transcriptional Profiles Elucidate Differential Host Responses to Infection with Cryptococcus neoformans and Cryptococcus gattii.

Journal Article J Fungi (Basel) · April 22, 2022 Many aspects of the host response to invasive cryptococcal infections remain poorly understood. In order to explore the pathobiology of infection with common clinical strains, we infected BALB/cJ mice with Cryptococcus neoformans, Cryptococcus gattii, or s ... Full text Link to item Cite

The current state of Clinical Mycology in Eastern and South-Eastern Europe.

Journal Article Med Mycol · March 22, 2022 UNLABELLED: The ability of medical centers in Eastern and South-Eastern Europe to diagnose and treat fungal infections remains unknown. In order to investigate that, here we conducted a cross-sectional online survey, released at both The International Soci ... Full text Link to item Cite

Conventional Antifungals for Invasive Infections Delivered by Unconventional Methods; Aerosols, Irrigants, Directed Injections and Impregnated Cement.

Journal Article J Fungi (Basel) · February 21, 2022 The administration of approved antifungals via unapproved formulations or administration routes (such as aerosol, direct injection, irrigation, topical formulation and antifungal-impregnated orthopedic beads or cement) may be resorted to in an attempt to o ... Full text Link to item Cite

A randomized, double-blind, placebo-controlled clinical trial of fluconazole as early empiric treatment of coccidioidomycosis pneumonia (Valley Fever) in adults presenting with community-acquired pneumonia in endemic areas (FLEET-Valley Fever).

Journal Article Contemp Clin Trials Commun · December 2021 INTRODUCTION: Coccidioidomycosis is a fungal infection endemic in the southwestern United States (US). Primary pulmonary coccidioidomycosis (PPC) is a leading cause of community-acquired pneumonia (CAP) in this region, although its diagnosis is often delay ... Full text Open Access Link to item Cite

Inositol Metabolism Regulates Capsule Structure and Virulence in the Human Pathogen Cryptococcus neoformans.

Journal Article mBio · December 2021 The environmental yeast Cryptococcus neoformans is the most common cause of deadly fungal meningitis in primarily immunocompromised populations. A number of factors contribute to cryptococcal pathogenesis. Among them, inositol utilization has been shown to ... Full text Cite

Gene Expression of Diverse Cryptococcus Isolates during Infection of the Human Central Nervous System.

Journal Article mBio · December 2021 Cryptococcus neoformans is a major human central nervous system (CNS) fungal pathogen causing considerable morbidity and mortality. In this study, we provide the widest view to date of the yeast transcriptome directly from the human subarachnoid space and ... Full text Cite

Global guideline for the diagnosis and management of rare yeast infections: an initiative of the ECMM in cooperation with ISHAM and ASM.

Journal Article Lancet Infect Dis · December 2021 Uncommon, or rare, yeast infections are on the rise given increasing numbers of patients who are immunocompromised or seriously ill. The major pathogens include those of the genera Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon (ie, basidiomycete ... Full text Link to item Cite

Reply to Day et al.

Journal Article J Infect Dis · November 16, 2021 Full text Link to item Cite

A global call for talaromycosis to be recognised as a neglected tropical disease.

Journal Article The Lancet. Global health · November 2021 Talaromycosis (penicilliosis) is an invasive mycosis that is endemic in tropical and subtropical Asia. Talaromycosis primarily affects individuals with advanced HIV disease and other immunosuppressive conditions, and the disease disproportionally affects p ... Full text Cite

Curvularia alcornii Aortic Pseudoaneurysm Following Aortic Valve Replacement: Case Report and Review of the Literature.

Journal Article Open Forum Infect Dis · November 2021 We report the first case of Curvularia alcornii aortic pseudoaneurysm following bioprosthetic aortic valve replacement in an immunocompetent host. Infection was complicated by septic emboli to multiple organs. Despite aggressive surgical intervention and a ... Full text Open Access Link to item Cite

Cryptococcus gattii Species Complex as an Opportunistic Pathogen: Underlying Medical Conditions Associated with the Infection.

Journal Article mBio · October 26, 2021 The Cryptococcus gattii species complex has often been referred to as a primary pathogen due to its high infection frequency among apparently immunocompetent patients. In order to scrutinize the immune status of patients and the lineages of etiologic agent ... Full text Link to item Cite

MSG07: An International Cohort Study Comparing Epidemiology and Outcomes of Patients With Cryptococcus neoformans or Cryptococcus gattii Infections.

Journal Article Clin Infect Dis · October 5, 2021 BACKGROUND: Cryptococcosis due to Cryptococcus neoformans and Cryptococcus gattii varies with geographic region, populations affected, disease manifestations, and severity of infection, which impact treatment. METHODS: We developed a retrospective cohort o ... Full text Link to item Cite

Cryptococcal meningoencephalitis: time for action.

Journal Article The Lancet. Infectious diseases · September 2021 Cryptococcal meningoencephalitis was first described over a century ago. This fungal infection is preventable and treatable yet continues to be associated with excessive morbidity and mortality. The largest burden of disease resides in people living with H ... Full text Cite

A link between urease and polyamine metabolism in Cryptococcus neoformans.

Journal Article Microb Pathog · September 2021 The urease enzyme of Cryptococcus neoformans is linked to different metabolic pathways within the yeast cell, several of which are involved in polyamine metabolism. Cryptococcal biogenic amine production is, however, largely unexplored and is yet to be inv ... Full text Link to item Cite

ECMM/ISHAM recommendations for clinical management of COVID-19 associated mucormycosis in low- and middle-income countries.

Journal Article Mycoses · September 2021 Reports are increasing on the emergence of COVID-19-associated mucormycosis (CAM) globally, driven particularly by low- and middle-income countries. The recent unprecedented surge of CAM in India has drawn worldwide attention. More than 28,252 mucormycosis ... Full text Open Access Link to item Cite

Superiority of a Novel Mp1p Antigen Detection Enzyme Immunoassay Compared to Standard BACTEC Blood Culture in the Diagnosis of Talaromycosis.

Journal Article Clin Infect Dis · July 15, 2021 BACKGROUND: Talaromycosis is an invasive mycosis endemic in Southeast Asia and causes substantial morbidity and mortality in individuals with advanced human immunodeficiency virus (HIV) disease. Current diagnosis relies on isolating Talaromyces marneffei i ... Full text Open Access Link to item Cite

Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance.

Journal Article Lancet Infect Dis · June 2021 Severe acute respiratory syndrome coronavirus 2 causes direct damage to the airway epithelium, enabling aspergillus invasion. Reports of COVID-19-associated pulmonary aspergillosis have raised concerns about it worsening the disease course of COVID-19 and ... Full text Open Access Link to item Cite

Fab-dimerized glycan-reactive antibodies are a structural category of natural antibodies.

Journal Article Cell · May 27, 2021 Natural antibodies (Abs) can target host glycans on the surface of pathogens. We studied the evolution of glycan-reactive B cells of rhesus macaques and humans using glycosylated HIV-1 envelope (Env) as a model antigen. 2G12 is a broadly neutralizing Ab (b ... Full text Open Access Link to item Cite

Amoeba Predation of Cryptococcus neoformans Results in Pleiotropic Changes to Traits Associated with Virulence.

Journal Article mBio · April 27, 2021 Amoeboid predators, such as amoebae, are proposed to select for survival traits in soil microbes such as Cryptococcus neoformans; these traits can also function in animal virulence by defeating phagocytic immune cells, such as macrophages. Consistent with ... Full text Link to item Cite

Cryptococcal Antigen in Serum and Cerebrospinal Fluid for Detecting Cryptococcal Meningitis in Adults Living With Human Immunodeficiency Virus: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies.

Journal Article Clin Infect Dis · April 8, 2021 Cryptococcal antigen (CrAg) detection could direct the timely initiation of antifungal therapy. We searched MEDLINE and Embase for studies where CrAg detection in serum/cerebrospinal fluid (CSF) and CSF fungal culture were done on adults living with human ... Full text Link to item Cite

Outcomes and Health Care Resource Utilization of Adult Bacterial Meningitis in the United States.

Journal Article Neurol Clin Pract · April 2021 OBJECTIVE: To examine the longitudinal health care resource utilization, in-hospital mortality, and incidence of downstream complications of bacterial meningitis in the United States. METHODS: Using IBM MarketScan, we retrieved data on adult patients with ... Full text Link to item Cite

Associations between Cryptococcus Genotypes, Phenotypes, and Clinical Parameters of Human Disease: A Review.

Journal Article J Fungi (Basel) · March 30, 2021 The genus Cryptococcus contains two primary species complexes that are significant opportunistic human fungal pathogens: C. neoformans and C. gattii. In humans, cryptococcosis can manifest in many ways, but most often results in either pulmonary or central ... Full text Link to item Cite

Paediatric bacterial meningitis in the USA: outcomes and healthcare resource utilization of nosocomial versus community-acquired infection.

Journal Article J Med Microbiol · January 2021 Introduction. Paediatric bacterial meningitis remains a costly disease, both financially and clinically.Hypothesis/Gap Statement. Previous epidemiological and cost studies of bacterial meningitis (BM) have largely focused on adult populations or single pat ... Full text Link to item Cite

Comparison of Cryptococcus gattii/neoformans Species Complex to Related Genera (Papiliotrema and Naganishia) Reveal Variances in Virulence Associated Factors and Antifungal Susceptibility.

Journal Article Frontiers in cellular and infection microbiology · January 2021 Cryptococcosis is an infectious disease of worldwide distribution, caused by encapsulated yeasts belonging to the phylum Basidiomycota. The genus Cryptococcus includes several species distributed around the world. The C. gattii/neoformans< ... Full text Cite

Fungal Infections of the Central Nervous System

Chapter · January 1, 2021 Fungal infections of the central nervous system (CNS) are life-threatening conditions that generally involve an immunosuppressive event. Many of these infections occur sporadically in the course of a serious underlying disease. However, outbreaks of CNS fu ... Full text Cite

Uncommon Yeasts and Molds Causing Human Disease

Chapter · January 1, 2021 With advances in modern medicine, patients are now living with increasingly complex medical comorbidities, and often with increasingly fragile immunity. As a result, larger populations are susceptible to infections from once infrequently seen fungal opport ... Full text Cite

Emerging Issues in Antifungal Resistance.

Journal Article Infect Dis Clin North Am · December 2020 Invasive fungal diseases continue to cause substantial mortality in the enlarging immunocompromised population. It is fortunate that the field has moved past amphotericin B deoxycholate as the only available antifungal drug but despite new classes of antif ... Full text Link to item Cite

Assessing the virulence of Cryptococcus neoformans causing meningitis in HIV infected and uninfected patients in Vietnam.

Journal Article Med Mycol · November 10, 2020 We previously observed a substantial burden of cryptococcal meningitis in Vietnam atypically arising in individuals who are uninfected with human immunodeficiency virus (HIV). This disease was associated with a single genotype of Cryptococcus neoformans (s ... Full text Link to item Cite

Occult Talaromyces marneffei Infection Unveiled by the Novel Mp1p Antigen Detection Assay.

Journal Article Open Forum Infect Dis · November 2020 Talaromyces marneffei causes fatal invasive mycosis in Southeast Asia. Diagnosis by culture has limited sensitivity and can result in treatment delay. We describe the use of a novel Mp1p enzyme immunoassay (EIA) to identify blood culture-negative talaromyc ... Full text Open Access Link to item Cite

Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium.

Journal Article Clin Infect Dis · September 12, 2020 BACKGROUND: Invasive fungal diseases (IFDs) remain important causes of morbidity and mortality. The consensus definitions of the Infectious Diseases Group of the European Organization for Research and Treatment of Cancer and the Mycoses Study Group have be ... Full text Open Access Link to item Cite

Black mold takes hold and story told.

Journal Article Med Mycol Case Rep · September 2020 We present a case of an invasive Curvularia infection in a patient who developed following bilateral orthotopic lung transplantation despite receiving post-transplant antifungal prophylaxis. This infection presented as mold colonies studding the interior s ... Full text Link to item Cite

Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research Consortium.

Journal Article J Infect Dis · August 5, 2020 In recent years, the global public health community has increasingly recognized the importance of antimicrobial stewardship (AMS) in the fight to improve outcomes, decrease costs, and curb increases in antimicrobial resistance around the world. However, th ... Full text Link to item Cite

The virulence factor urease and its unexplored role in the metabolism of Cryptococcus neoformans.

Journal Article FEMS Yeast Res · June 1, 2020 Cryptococcal urease is believed to be important for the degradation of exogenous urea that the yeast encounters both in its natural environment and within the human host. Endogenous urea produced by the yeast's own metabolic reactions, however, may also se ... Full text Link to item Cite

A case of CNS aspergillosis in a patient with chronic lymphocytic leukemia on first-line ibrutinib therapy.

Journal Article Med Mycol Case Rep · March 2020 Ibrutinib has revolutionized the treatment of chronic lymphoid malignancies. Despite its success, ibrutinib has been linked with several reports of invasive fungal infections. We present a case of CNS aspergillosis in a CLL patient on first line ibrutinib ... Full text Link to item Cite

Combination Therapy for Invasive Fungal Infections

Journal Article Current Fungal Infection Reports · March 1, 2020 Purpose of the Review: The purpose of this review is to summarize and evaluate relevant literature on combination antifungal therapy for invasive fungal infections (IFIs). Recent Findings: Cryptococcal meningitis has the largest body and highest quality in ... Full text Cite

The robust and rapid role of molecular testing in precision fungal diagnostics: A case report.

Journal Article Med Mycol Case Rep · March 2020 Diagnosis of invasive fungal disease remains an ongoing challenge for clinicians, while continuously evolving treatment regimens increase patient risk for invasive infection. This case highlights how molecular testing led to the diagnosis of co-infection w ... Full text Link to item Cite

The longitudinal health economic impact of viral encephalitis in the United States.

Journal Article J Med Microbiol · February 2020 Introduction. Previous studies of viral encephalitis have focused on acute costs, estimating incidence at 7.3 per 100 000 and total US annual charges at $2 billion in 2010.Aim. We aim to quantify the most updated longitudinal health economic impact of vira ... Full text Link to item Cite

Complete Genome Sequences for Two Talaromyces marneffei Clinical Isolates from Northern and Southern Vietnam.

Journal Article Microbiol Resour Announc · January 9, 2020 Talaromyces marneffei is a thermally dimorphic fungus endemic in China and Southeast Asia that causes fatal infections in immunocompromised individuals, particularly in patients with advanced HIV disease. Here, we report the complete genome sequences of tw ... Full text Open Access Link to item Cite

Invasive Fungal Infection After Lung Transplantation: Epidemiology in the Setting of Antifungal Prophylaxis.

Journal Article Clin Infect Dis · January 1, 2020 BACKGROUND: Lung transplant recipients commonly develop invasive fungal infections (IFIs), but the most effective strategies to prevent IFIs following lung transplantation are not known. METHODS: We prospectively collected clinical data on all patients who ... Full text Link to item Cite

Landscape of gene expression variation of natural isolates of Cryptococcus neoformans in response to biologically relevant stresses.

Journal Article Microb Genom · January 2020 Cryptococcus neoformans is an opportunistic fungal pathogen that at its peak epidemic levels caused an estimated million cases of cryptococcal meningitis per year worldwide. This species can grow in diverse environmental (trees, soil and bird excreta) and ... Full text Link to item Cite

Fluconazole Monotherapy Is a Suboptimal Option for Initial Treatment of Cryptococcal Meningitis Because of Emergence of Resistance.

Journal Article mBio · December 3, 2019 Cryptococcal meningitis is a lethal disease with few therapeutic options. Induction therapy with fluconazole has been consistently demonstrated to be associated with suboptimal microbiological and clinical outcomes. Exposure to fluconazole causes dynamic c ... Full text Link to item Cite

Regulatory Mechanism of the Atypical AP-1-Like Transcription Factor Yap1 in Cryptococcus neoformans.

Journal Article mSphere · November 20, 2019 AP-1-like transcription factors play evolutionarily conserved roles as redox sensors in eukaryotic oxidative stress responses. In this study, we aimed to elucidate the regulatory mechanism of an atypical yeast AP-1-like protein, Yap1, in the stress respons ... Full text Link to item Cite

Pharmacodynamics of Isavuconazole in a Rabbit Model of Cryptococcal Meningoencephalitis.

Journal Article Antimicrob Agents Chemother · September 2019 Cryptococcus spp., important fungal pathogens, are the leading cause of fungus-related mortality in human immunodeficiency virus-infected patients, and new therapeutic options are desperately needed. Isavuconazonium sulfate, a newer triazole antifungal age ... Full text Link to item Cite

Correction: Cryptococcus neoformans resists to drastic conditions by switching to viable but non-culturable cell phenotype.

Journal Article PLoS Pathog · September 2019 [This corrects the article DOI: 10.1371/journal.ppat.1007945.]. ... Full text Link to item Cite

A Genome-Wide Functional Genomics Approach Identifies Susceptibility Pathways to Fungal Bloodstream Infection in Humans.

Journal Article J Infect Dis · July 31, 2019 BACKGROUND: Candidemia, one of the most common causes of fungal bloodstream infection, leads to mortality rates up to 40% in affected patients. Understanding genetic mechanisms for differential susceptibility to candidemia may aid in designing host-directe ... Full text Link to item Cite

Cryptococcus neoformans resists to drastic conditions by switching to viable but non-culturable cell phenotype.

Journal Article PLoS Pathog · July 2019 Metabolically quiescent pathogens can persist in a viable non-replicating state for months or even years. For certain infectious diseases, such as tuberculosis, cryptococcosis, histoplasmosis, latent infection is a corollary of this dormant state, which ha ... Full text Link to item Cite

Performance of the T2Bacteria Panel for Diagnosing Bloodstream Infections: A Diagnostic Accuracy Study.

Journal Article Ann Intern Med · June 18, 2019 BACKGROUND: Blood cultures, the gold standard for diagnosing bloodstream infections (BSIs), are insensitive and limited by prolonged time to results. The T2Bacteria Panel (T2 Biosystems) is a direct-from-blood, nonculture test that identifies the most comm ... Full text Link to item Cite

Three phylogenetic groups have driven the recent population expansion of Cryptococcus neoformans.

Journal Article Nat Commun · May 2, 2019 Cryptococcus neoformans (C. neoformans var. grubii) is an environmentally acquired pathogen causing 181,000 HIV-associated deaths each year. We sequenced 699 isolates, primarily C. neoformans from HIV-infected patients, from 5 countries in Asia and Africa. ... Full text Link to item Cite

How Clean Is the Linen at My Hospital? The Mucorales on Unclean Linen Discovery Study of Large United States Transplant and Cancer Centers.

Journal Article Clin Infect Dis · February 15, 2019 Mucormycosis outbreaks have been linked to contaminated linen. We performed fungal cultures on freshly-laundered linens at 15 transplant and cancer hospitals. At 33% of hospitals, the linens were visibly unclean. At 20%, Mucorales were recovered from >10% ... Full text Link to item Cite

Management of Phaeohyphomycosis

Chapter · February 13, 2019 This new edition of Antifungal Therapy aims at providing concise, practical, need-to-know information for busy physicians dealing with fungal infections, such as infectious disease physicians, transplant surgeons, dermatologists, and ... ... Cite

Management of Mucormycoses

Chapter · February 13, 2019 This new edition of Antifungal Therapy aims at providing concise, practical, need-to-know information for busy physicians dealing with fungal infections, such as infectious disease physicians, transplant surgeons, dermatologists, and ... ... Cite

Population Pharmacodynamics of Amphotericin B Deoxycholate for Disseminated Infection Caused by Talaromyces marneffei.

Journal Article Antimicrob Agents Chemother · February 2019 Amphotericin B deoxycholate (DAmB) is a first-line agent for the initial treatment of talaromycosis. However, little is known about the population pharmacokinetics and pharmacodynamics of DAmB for talaromycosis. Pharmacokinetic data were obtained from 78 p ... Full text Open Access Link to item Cite

Real-world implications of QT prolongation in patients receiving voriconazole and amiodarone.

Journal Article J Antimicrob Chemother · January 1, 2019 OBJECTIVES: Voriconazole, a triazole antifungal, is frequently prescribed in a complex patient population with comorbidities that require concomitant administration of QT interval-prolonging medications. We sought to evaluate QT interval prolongation in pa ... Full text Link to item Cite

Genotypic diversity and clinical outcome of cryptococcosis in renal transplant recipients in Brazil.

Journal Article Emerg Microbes Infect · 2019 Genotypic diversity and fluconazole susceptibility of 82 Cryptococcus neoformans and Cryptococcus gattii isolates from 60 renal transplant recipients in Brazil were characterized. Clinical characteristics of the patients and prognostic factors were analyse ... Full text Link to item Cite

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications.

Journal Article Br J Anaesth · December 2018 BACKGROUND: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes ... Full text Link to item Cite

Phenotypic Variability Correlates with Clinical Outcome in Cryptococcus Isolates Obtained from Botswanan HIV/AIDS Patients.

Journal Article mBio · October 23, 2018 Pathogenic species of Cryptococcus cause hundreds of thousands of deaths annually. Considerable phenotypic variation is exhibited during infection, including increased capsule size, capsule shedding, giant cells (≥15 μm), and micro cells (≤1 μm). We examin ... Full text Link to item Cite

Genomic characterization of recurrent mold infections in thoracic transplant recipients.

Journal Article Transpl Infect Dis · October 2018 Invasive mold disease in thoracic organ transplant recipients is a well-recognized complication, but the long-term persistence of molds within the human body and evasion of host defenses has not been well-described. We present 2 cases of invasive mold dise ... Full text Link to item Cite

Novel Treatment of Cryptococcal Meningitis via Neurapheresis Therapy.

Journal Article J Infect Dis · August 24, 2018 Cryptococcal meningitis (CM) has emerged as the most common life-threatening fungal meningitis worldwide. Current management involves a sequential, longitudinal regimen of antifungals; despite a significant improvement in survival compared with uniform mor ... Full text Open Access Link to item Cite

Isavuconazole for treatment of rare invasive fungal diseases.

Journal Article Mycoses · August 2018 Data regarding treatment of rare invasive fungal diseases (IFDs) are scarce. We documented the efficacy and safety of isavuconazole for treatment of uncommonly diagnosed IFDs. VITAL was a single-arm, international, open-label study evaluating the efficacy ... Full text Link to item Cite

Outcomes of cryptococcosis in renal transplant recipients in a less-resourced health care system.

Journal Article Transpl Infect Dis · August 2018 BACKGROUND: Cryptococcosis is the second most common cause of invasive fungal infections in renal transplant recipients in many countries, and data on graft outcome after treatment for this infection is lacking in less-resourced health care settings. METHO ... Full text Link to item Cite

In Vitro and In Vivo Evaluation of APX001A/APX001 and Other Gwt1 Inhibitors against Cryptococcus.

Journal Article Antimicrob Agents Chemother · August 2018 Cryptococcal meningitis (CM), caused primarily by Cryptococcus neoformans, is uniformly fatal if not treated. Treatment options are limited, especially in resource-poor geographical regions, and mortality rates remain high despite current therapies. Here w ... Full text Link to item Cite

Pulmonary blastomycosis presenting as primary lung cancer.

Journal Article BMC Infect Dis · July 18, 2018 BACKGROUND: Blastomycosis is an endemic mycosis in North America that is caused by the dimorphic fungus Blastomyces dermatitidis. The illness is a systemic disease with a wide variety of pulmonary and extra-pulmonary manifestations. The initial presentatio ... Full text Open Access Link to item Cite

Present and Future Therapy of Cryptococcus Infections.

Journal Article J Fungi (Basel) · July 3, 2018 Cryptococcal infections burden the immunocompromised population with unacceptably high morbidity and mortality. This population includes HIV-infected individuals and those undergoing organ transplants, as well as seemingly immunocompetent patients (non-HIV ... Full text Link to item Cite

Isavuconazole treatment for rare fungal diseases and for invasive aspergillosis in patients with renal impairment: Challenges and lessons of the VITAL trial.

Journal Article Mycoses · July 2018 Invasive fungal disease (IFD) confers a substantial risk for morbidity and mortality to immunocompromised patients. Invasive aspergillosis (IA) is the most common IFD caused by moulds but the prevalence of other rare mould diseases, such as mucormycosis, h ... Full text Link to item Cite

Isavuconazole for treatment of invasive fungal diseases caused by more than one fungal species.

Journal Article Mycoses · July 2018 The optimal approach to treat invasive fungal disease (IFD) caused by more than one fungal species is unknown. We documented the efficacy and safety of isavuconazole for treatment of IFDs caused by more than one fungal species. VITAL was a single-arm, inte ... Full text Link to item Cite

On-demand release of Candida albicans biofilms from urinary catheters by mechanical surface deformation.

Journal Article Biofouling · July 2018 Candida albicans is a leading cause of catheter-associated urinary tract infections and elimination of these biofilm-based infections without antifungal agents would constitute a significant medical advance. A novel urinary catheter prototype that utilizes ... Full text Link to item Cite

Genome-wide analysis of the regulation of Cu metabolism in Cryptococcus neoformans.

Journal Article Mol Microbiol · June 2018 The ability of the human fungal pathogen Cryptococcus neoformans to adapt to variable copper (Cu) environments within the host is key for successful dissemination and colonization. During pulmonary infection, host alveolar macrophages compartmentalize Cu i ... Full text Link to item Cite

Titan cells formation in Cryptococcus neoformans is finely tuned by environmental conditions and modulated by positive and negative genetic regulators.

Journal Article PLoS Pathog · May 2018 The pathogenic fungus Cryptococcus neoformans exhibits morphological changes in cell size during lung infection, producing both typical size 5 to 7 μm cells and large titan cells (> 10 μm and up to 100 μm). We found and optimized in vitro conditions that p ... Full text Link to item Cite

Management of an Outbreak of Exophiala dermatitidis Bloodstream Infections at an Outpatient Oncology Clinic.

Journal Article Clin Infect Dis · March 5, 2018 We report the presentation and management of 17 cases of Exophiala dermatitidis and Rhodotorula mucilaginosa bloodstream infections caused by a compounded parenteral medication at an oncology clinic. Twelve patients were asymptomatic. All central venous ca ... Full text Link to item Cite

Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States.

Journal Article J Med Microbiol · February 2018 PURPOSE: Previous epidemiological and cost studies of fungal meningitis have largely focused on single pathogens, leading to a poor understanding of the disease in general. We studied the largest and most diverse group of fungal meningitis patients to date ... Full text Link to item Cite

Tolerability profile of the current antifungal armoury.

Journal Article J Antimicrob Chemother · January 1, 2018 The tolerability of available antifungal agents is essential to the final outcome of the management of invasive mycoses. There are limited classes of antifungal agents for use, and they can have serious direct toxicities and/or drug-drug interactions. In t ... Full text Link to item Cite

The war on cryptococcosis: A Review of the antifungal arsenal.

Journal Article Mem Inst Oswaldo Cruz · 2018 Cryptococcal meningitis is the most common central nervous system infection in the world today. It occurs primarily, but not exclusively, in immunocompromised individuals and despite substantial improvement in management of clinical events like AIDS, the n ... Full text Link to item Cite

Fungi that infect humans

Chapter · September 5, 2017 In its short history of a century and a half, of which the last half-century brought the most dramatic advances, scientific medicine has found ways to cure or to treat millions of ill people who 200 years ago would have died early. Paradoxically, these suc ... Full text Cite

The antifungal pipeline: a reality check.

Journal Article Nat Rev Drug Discov · September 2017 Invasive fungal infections continue to appear in record numbers as the immunocompromised population of the world increases, owing partially to the increased number of individuals who are infected with HIV and partially to the successful treatment of seriou ... Full text Link to item Cite

Emergence of the Molds Other than Aspergillus in Immunocompromised Patients.

Journal Article Clin Chest Med · September 2017 Immunocompromised patients are at high risk for invasive fungal infections (IFIs); although Aspergillus remains the most common IFI caused by molds, other fungi, such as Mucorales, dematiaceous molds, and Fusarium spp, are being seen with increasing freque ... Full text Link to item Cite

Tracing Genetic Exchange and Biogeography of Cryptococcus neoformans var. grubii at the Global Population Level.

Journal Article Genetics · September 2017 Cryptococcus neoformans var. grubii is the causative agent of cryptococcal meningitis, a significant source of mortality in immunocompromised individuals, typically human immunodeficiency virus/AIDS patients from developing countries. Despite the worldwide ... Full text Link to item Cite

Novel Agents and Drug Targets to Meet the Challenges of Resistant Fungi.

Journal Article The Journal of infectious diseases · August 2017 The emergence of drug-resistant fungi poses a major threat to human health. Despite advances in preventive, diagnostic, and therapeutic interventions, resistant fungal infections continue to cause significant morbidity and mortality in patients with compro ... Full text Cite

Structural and In Vivo Studies on Trehalose-6-Phosphate Synthase from Pathogenic Fungi Provide Insights into Its Catalytic Mechanism, Biological Necessity, and Potential for Novel Antifungal Drug Design.

Journal Article mBio · July 25, 2017 The disaccharide trehalose is critical to the survival of pathogenic fungi in their human host. Trehalose-6-phosphate synthase (Tps1) catalyzes the first step of trehalose biosynthesis in fungi. Here, we report the first structures of eukaryotic Tps1s in c ... Full text Link to item Cite

Population genomics and the evolution of virulence in the fungal pathogen Cryptococcus neoformans.

Journal Article Genome Res · July 2017 Cryptococcus neoformans is an opportunistic fungal pathogen that causes approximately 625,000 deaths per year from nervous system infections. Here, we leveraged a unique, genetically diverse population of C. neoformans from sub-Saharan Africa, commonly iso ... Full text Link to item Cite

Central Role of the Trehalose Biosynthesis Pathway in the Pathogenesis of Human Fungal Infections: Opportunities and Challenges for Therapeutic Development.

Journal Article Microbiol Mol Biol Rev · June 2017 Invasive fungal infections cause significant morbidity and mortality in part due to a limited antifungal drug arsenal. One therapeutic challenge faced by clinicians is the significant host toxicity associated with antifungal drugs. Another challenge is the ... Full text Link to item Cite

Experimental Models of Short Courses of Liposomal Amphotericin B for Induction Therapy for Cryptococcal Meningitis.

Journal Article Antimicrob Agents Chemother · June 2017 Cryptococcal meningoencephalitis is a rapidly lethal infection in immunocompromised patients. Induction regimens are usually administered for 2 weeks. The shortest effective period of induction therapy with liposomal amphotericin B (LAMB) is unknown. The p ... Full text Link to item Cite

Fungi that Infect Humans.

Journal Article Microbiol Spectr · June 2017 Fungi must meet four criteria to infect humans: growth at human body temperatures, circumvention or penetration of surface barriers, lysis and absorption of tissue, and resistance to immune defenses, including elevated body temperatures. Morphogenesis betw ... Full text Link to item Cite

What Can the Clinical Mycology Laboratory Do for Clinicians Today and Tomorrow?

Journal Article Current Clinical Microbiology Reports · June 1, 2017 Purpose of Review: In this review, we discuss the old and new tools available to the clinical mycology laboratory, the “growing pains” in their use, and how they impact patient care and aim to recommend what clinical mycology laboratories need to do to suc ... Full text Cite

Microevolution of Serial Clinical Isolates of Cryptococcus neoformans var. grubii and C. gattii.

Journal Article mBio · March 7, 2017 The pathogenic species of Cryptococcus are a major cause of mortality owing to severe infections in immunocompromised as well as immunocompetent individuals. Although antifungal treatment is usually effective, many patients relapse after treatment, and in ... Full text Open Access Link to item Cite

Trehalose pathway as an antifungal target.

Journal Article Virulence · February 17, 2017 With an increasing immunocompromised population which is linked to invasive fungal infections, it is clear that our present 3 classes of antifungal agents may not be sufficient to provide optimal management to these fragile patients. Furthermore, with wide ... Full text Link to item Cite

Reply to Argüelles.

Journal Article Virulence · February 17, 2017 Full text Link to item Cite

Comparing outcomes of early, late, and non-surgical management of intraspinal abscess.

Journal Article J Clin Neurosci · February 2017 Intraspinal abscesses (ISAs) are rare lesions that are often neurologically devastating. Current treatment paradigms vary widely including early surgical decompression, drainage, and systemic antibiotics, delayed surgery, and sole medical management. The N ... Full text Link to item Cite

Risk factors for group B streptococcal disease in neonates of mothers with negative antenatal testing.

Journal Article J Perinatol · February 2017 OBJECTIVE: The aim of this study was to identify risk factors for early-onset group B Streptococcus (EOGBS) disease in neonates of mothers with negative antenatal screening. STUDY DESIGN: We performed a retrospective cohort study of neonates born to mother ... Full text Link to item Cite

Efficient, Cost-Effective, High-Throughput, Multilocus Sequencing Typing (MLST) Method, NGMLST, and the Analytical Software Program MLSTEZ.

Journal Article Methods Mol Biol · 2017 Multilocus sequence typing (MLST) has become the preferred method for genotyping many biological species. It can be used to identify major phylogenetic clades, molecular groups, or subpopulations of a species, as well as individual strains or clones. Howev ... Full text Link to item Cite

Disseminated Cryptococcosis With Brain Involvement in Patients With Chronic Lymphoid Malignancies on Ibrutinib.

Journal Article Open Forum Infect Dis · 2017 We report 2 cases of disseminated cryptococcosis with central nervous system involvement in patients with chronic lymphoid malignancies occurring within 1 month of starting on ibrutinib. Characteristically, in both cases, no inflammation was seen in the ce ... Full text Link to item Cite

The Case for Adopting the "Species Complex" Nomenclature for the Etiologic Agents of Cryptococcosis.

Journal Article mSphere · 2017 Cryptococcosis is a potentially lethal disease of humans/animals caused by Cryptococcus neoformans and Cryptococcus gattii. Distinction between the two species is based on phenotypic and genotypic characteristics. Recently, it was proposed that C. neoforma ... Full text Link to item Cite

Disseminated cryptococcosis with brain involvement in patients with chronic lymphoid malignancies on ibrutinib

Journal Article Open Forum Infectious Diseases · January 1, 2017 We report 2 cases of disseminated cryptococcosis with central nervous system involvement in patients with chronic lymphoid malignancies occurring within 1 month of starting on ibrutinib. Characteristically, in both cases, no inflammation was seen in the ce ... Full text Cite

An integrative genomics approach identifies novel pathways that influence candidaemia susceptibility.

Journal Article PLoS One · 2017 Candidaemia is a bloodstream infection caused by Candida species that primarily affects specific groups of at-risk patients. Because only small candidaemia patient cohorts are available, classical genome wide association cannot be used to identify Candida ... Full text Link to item Cite

Simple Strategy for Taming Membrane-Disrupting Antibiotics.

Journal Article Bioconjug Chem · December 21, 2016 A strategy has been devised for increasing the cellular selectivity of membrane-disrupting antibiotics based on the attachment of a facially amphiphilic sterol. Using Amphotericin B (AmB) as a prototype, covalent attachment of cholic acid bound to a series ... Full text Link to item Cite

Vav Proteins Are Key Regulators of Card9 Signaling for Innate Antifungal Immunity.

Journal Article Cell Rep · December 6, 2016 Fungal infections are major causes of morbidity and mortality, especially in immunocompromised individuals. The innate immune system senses fungal pathogens through Syk-coupled C-type lectin receptors (CLRs), which signal through the conserved immune adapt ... Full text Link to item Cite

Repeated therapeutic lumbar punctures in cryptococcal meningitis - necessity and/or opportunity?

Journal Article Curr Opin Infect Dis · December 2016 PURPOSE OF REVIEW: Overall, 50-70% of patients with cryptococcal meningitis have raised intracranial pressure (ICP). Multiple international treatment guidelines recommend repeated therapeutic lumbar punctures as adjunctive management. Here, we review the r ... Full text Link to item Cite

Cases of disseminated cryptococcosis in intravenous drug abusers without HIV infection: A new risk factor?

Journal Article Medical Mycology Case Reports · December 1, 2016 Cryptococcosis is a fungal disease which has been characterized by its identified risk groups. There are many risk factors identified. We present a surprising four cases of disseminated cryptococcosis in intravenous drug abuse (IVDA) patients in a short pe ... Full text Cite

The current treatment landscape: other fungal diseases (cryptococcosis, fusariosis and mucormycosis).

Journal Article J Antimicrob Chemother · November 2016 Compared with major invasive mycoses such as aspergillosis and candidiasis, the antifungal stewardship management strategies of other fungal diseases have different opportunities and considerations. Cryptococcosis, fusariosis and mucormycosis are globally ... Full text Link to item Cite

Short-term risk of liver and renal injury in hospitalized patients using micafungin: a multicentre cohort study.

Journal Article J Antimicrob Chemother · October 2016 BACKGROUND: Although echinocandins are generally well tolerated, there is little information on the frequency with which renal and hepatic adverse effects occur during use of micafungin or other parenteral antifungal (PAF) agents in clinical practice. METH ... Full text Link to item Cite

Cardiovascular Disease and HIV: Pathophysiology, Treatment Considerations, and Nursing Implications.

Journal Article Crit Care Nurse · October 2016 HIV infection has progressed from an acute, terminal disease to a chronic illness with cardiovascular disease as the leading cause of death among persons living with HIV. As persons living with HIV infection continue to become older, traditional risk facto ... Full text Link to item Cite

Copy number variation contributes to cryptic genetic variation in outbreak lineages of Cryptococcus gattii from the North American Pacific Northwest.

Journal Article BMC Genomics · September 2, 2016 BACKGROUND: Copy number variants (CNVs) are a class of structural variants (SVs) and are defined as fragments of DNA that are present at variable copy number in comparison with a reference genome. Recent advances in bioinformatics methodologies and sequenc ... Full text Link to item Cite

Isavuconazole Treatment of Cryptococcosis and Dimorphic Mycoses.

Journal Article Clin Infect Dis · August 1, 2016 BACKGROUND: Invasive fungal diseases (IFD) caused by Cryptococcus and dimorphic fungi are associated with significant morbidity and mortality. Isavuconazole (ISAV) is a novel, broad-spectrum, triazole antifungal agent (IV and by mouth [PO]) developed for t ... Full text Link to item Cite

Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis.

Journal Article Lancet Infect Dis · July 2016 BACKGROUND: Mucormycosis is an uncommon invasive fungal disease with high mortality and few treatment options. Isavuconazole is a triazole active in vitro and in animal models against moulds of the order Mucorales. We assessed the efficacy and safety of is ... Full text Link to item Cite

Structures of trehalose-6-phosphate phosphatase from pathogenic fungi reveal the mechanisms of substrate recognition and catalysis.

Journal Article Proc Natl Acad Sci U S A · June 28, 2016 Trehalose is a disaccharide essential for the survival and virulence of pathogenic fungi. The biosynthesis of trehalose requires trehalose-6-phosphate synthase, Tps1, and trehalose-6-phosphate phosphatase, Tps2. Here, we report the structures of the N-term ... Full text Link to item Cite

Intracellular Action of a Secreted Peptide Required for Fungal Virulence.

Journal Article Cell Host Microbe · June 8, 2016 Quorum sensing (QS) is a bacterial communication mechanism in which secreted signaling molecules impact population function and gene expression. QS-like phenomena have been reported in eukaryotes with largely unknown contributing molecules, functions, and ... Full text Link to item Cite

"Is there an emerging need for new antifungals?".

Journal Article Expert Opin Emerg Drugs · June 2016 Full text Link to item Cite

Genetic Susceptibility to Fungal Infections: What is in the Genes?

Journal Article Curr Clin Microbiol Rep · June 2016 The development of severe fungal infections has long been associated with traditional risk factors such as profound immunosuppression, yet it remains challenging to understand why under similar conditions only some patients will develop these infections wh ... Full text Link to item Cite

Cryptococcosis.

Journal Article Infect Dis Clin North Am · March 2016 Cryptococcosis is an invasive mycosis caused by pathogenic encapsulated yeasts in the genus Cryptococcus. Cryptococcus gained prominence as a pathogen capable of widespread disease outbreaks in vulnerable populations. We have gained insight into the pathob ... Full text Link to item Cite

CXCR1-mediated neutrophil degranulation and fungal killing promote Candida clearance and host survival.

Journal Article Sci Transl Med · January 20, 2016 Systemic Candida albicans infection causes high morbidity and mortality and is now the leading cause of nosocomial bloodstream infection in the United States. Neutropenia is a major risk factor for poor outcome in infected patients; however, the molecular ... Full text Link to item Cite

The Zinc Finger Protein Mig1 Regulates Mitochondrial Function and Azole Drug Susceptibility in the Pathogenic Fungus Cryptococcus neoformans.

Journal Article mSphere · 2016 The opportunistic pathogen Cryptococcus neoformans causes fungal meningoencephalitis in immunocompromised individuals. In previous studies, we found that the Hap complex in this pathogen represses genes encoding mitochondrial respiratory functions and tric ... Full text Link to item Cite

Familial Adenomatous Polyposis Manifesting as Lactococcus Endocarditis: A Case Report and Review of the Association of Lactococcus with Underlying Gastrointestinal Disease.

Journal Article Case Rep Infect Dis · 2016 A 45-year-old male with a prosthetic aortic valve presented to the hospital with several months of generalized malaise. On admission, he was noted to have anemia of unclear etiology and subsequently became febrile with multiple blood cultures growing Lacto ... Full text Link to item Cite

Taming Amphotericin B.

Journal Article Bioconjug Chem · October 21, 2015 A strategy is introduced for enhancing the cellular selectivity of Amphotericin B (AmB) and other classes of membrane-disrupting agents. This strategy involves attaching the agent to a molecular umbrella to minimize the disruptive power of aggregated forms ... Full text Link to item Cite

Live Imaging of Host-Parasite Interactions in a Zebrafish Infection Model Reveals Cryptococcal Determinants of Virulence and Central Nervous System Invasion.

Journal Article mBio · September 29, 2015 UNLABELLED: The human fungal pathogen Cryptococcus neoformans is capable of infecting a broad range of hosts, from invertebrates like amoebas and nematodes to standard vertebrate models such as mice and rabbits. Here we have taken advantage of a zebrafish ... Full text Open Access Link to item Cite

Scedosporium apiosermum infection of the "Native" valve: Fungal endocarditis in an orthotopic heart transplant recipient.

Journal Article Med Mycol Case Rep · September 2015 Scedosporium apiospermum is an increasingly appreciated pathogen in immunosuppressed patients. We present a case of S. apiospermum endocarditis in a 70-year-old male who had undergone orthotopic heart transplant. Echocardiogram demonstrated a 1.4 cm tricus ... Full text Link to item Cite

Comparative analyses of clinical and environmental populations of Cryptococcus neoformans in Botswana.

Journal Article Mol Ecol · July 2015 Cryptococcus neoformans var. grubii (Cng) is the most common cause of fungal meningitis, and its prevalence is highest in sub-Saharan Africa. Patients become infected by inhaling airborne spores or desiccated yeast cells from the environment, where the fun ... Full text Open Access Link to item Cite

AMBITION-cm: intermittent high dose AmBisome on a high dose fluconazole backbone for cryptococcal meningitis induction therapy in sub-Saharan Africa: study protocol for a randomized controlled trial.

Journal Article Trials · June 17, 2015 BACKGROUND: Cryptococcal meningitis (CM) is a leading cause of mortality among HIV-infected individuals in Africa. Poor outcomes from conventional antifungal therapies, unavailability of flucytosine, and difficulties administering 14 days of amphotericin B ... Full text Link to item Cite

Azole antifungals: 35 years of invasive fungal infection management.

Journal Article Expert Rev Anti Infect Ther · June 2015 Prior to 1981, treatment options for invasive fungal infections were limited and associated with significant toxicities. The introduction of ketoconazole marked the beginning of an era of dramatic improvements over previous therapies for non-life-threateni ... Full text Link to item Cite

Cryptococcosis diagnosis and treatment: What do we know now.

Journal Article Fungal Genet Biol · May 2015 Cryptococcosis has evolved into a major invasive fungal disease over the last century. Its primary epidemiology has been focused on three major outbreaks of disease that reflects both changing environmental exposures and growth of host risk factors. The mo ... Full text Link to item Cite

The RIG-I-like helicase receptor MDA5 (IFIH1) is involved in the host defense against Candida infections.

Journal Article Eur J Clin Microbiol Infect Dis · May 2015 The induction of host defense against Candida species is initiated by recognition of the fungi by pattern recognition receptors and activation of downstream pathways that produce inflammatory mediators essential for infection clearance. In this study, we p ... Full text Link to item Cite

Mucormycosis Rhinosinusitis at Diagnosis of Acute Lymphoblastic Leukemia: Diagnostics and Management Challenges in a Low-Middle-income Country.

Journal Article J Pediatr Hematol Oncol · April 2015 We present the case of an adolescent with mucor rhinosinusitis diagnosed concomitantly with acute lymphoblastic leukemia at a hospital in Tegucigalpa, Honduras. We also discuss the challenges faced in the dual management of hematologic malignancies and inv ... Full text Link to item Cite

Candida infective endocarditis: an observational cohort study with a focus on therapy.

Journal Article Antimicrob Agents Chemother · April 2015 Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and u ... Full text Link to item Cite

Name changes in medically important fungi and their implications for clinical practice.

Journal Article J Clin Microbiol · April 2015 Recent changes in the Fungal Code of Nomenclature and developments in molecular phylogeny are about to lead to dramatic changes in the naming of medically important molds and yeasts. In this article, we present a widely supported and simple proposal to pre ... Full text Link to item Cite

Collaborative drug therapy management and comprehensive medication management-2015.

Journal Article Pharmacotherapy · April 2015 The American College of Clinical Pharmacy (ACCP) previously published position statements on collaborative drug therapy management (CDTM) in 1997 and 2003. Since 2003, significant federal and state legislation addressing CDTM has evolved and expanded throu ... Full text Link to item Cite

A case of cryptococcus gattii in Western Florida: An aggressive pathogen in an immunocompetent host

Journal Article Infectious Diseases in Clinical Practice · March 12, 2015 Background Cryptococcus gattii is an environmental pathogenic yeast that produces disease in the skin, the respiratory tract, and the central nervous system of both immunocompromised and immunocompetent hosts. The incidence of C. gattii disease is increasi ... Full text Cite

Predictors of glycaemic control among HIV-positive veterans with diabetes.

Conference Int J STD AIDS · March 2015 Antiretroviral therapy has decreased HIV-related mortality. However, the incidence of diabetes as a co-morbidity is increasing as HIV-positive patients age. The purpose of this study was to assess the correlation between markers of HIV-infection and diabet ... Full text Link to item Cite

Next generation multilocus sequence typing (NGMLST) and the analytical software program MLSTEZ enable efficient, cost-effective, high-throughput, multilocus sequencing typing.

Journal Article Fungal Genet Biol · February 2015 Multilocus sequence typing (MLST) has become the preferred method for genotyping many biological species, and it is especially useful for analyzing haploid eukaryotes. MLST is rigorous, reproducible, and informative, and MLST genotyping has been shown to i ... Full text Open Access Link to item Cite

AMBITION-cm: Intermittent high dose AmBisome on a high dose fluconazole backbone for cryptococcal meningitis induction therapy in sub-Saharan Africa: Study protocol for a randomized controlled trial

Journal Article Trials · 2015 © 2015 Molefi et al.Background: Cryptococcal meningitis (CM) is a leading cause of mortality among HIV-infected individuals in Africa. Poor outcomes from conventional antifungal therapies, unavailability of flucytosine, and difficulties administering 14 da ... Full text Cite

Cryptococcosis

Chapter · January 1, 2015 Cryptococcosis is an infectious disease caused by the encapsulated fungi Cryptococcus neoformans and Cryptococcus gattii Once a relatively uncommon cause of human disease, cryptococcal infection can develop in apparently immunocompetent hosts and has emerg ... Full text Cite

The discriminative capacity of soluble Toll-like receptor (sTLR)2 and sTLR4 in inflammatory diseases.

Journal Article BMC Immunol · November 19, 2014 BACKGROUND: The extracellular domains of cytokine receptors are released during inflammation, but little is known about the shedding of Toll-like receptors (TLR) and whether they can be used as diagnostic biomarkers. METHODS: The release of sTLR2 and sTLR4 ... Full text Link to item Cite

Update on epidemiology of and preventive strategies for invasive fungal infections in cancer patients.

Journal Article Clin Infect Dis · November 15, 2014 Changes in antineoplastic treatments and transplant practices are driving shifts in the epidemiology of invasive fungal diseases (IFDs). Patients with acute myelogenous leukemia (AML) and those undergoing bone marrow transplant (BMT) are at greatest risk f ... Full text Link to item Cite

Black Molds and Melanized Yeasts Pathogenic to Humans.

Journal Article Cold Spring Harb Perspect Med · November 10, 2014 A review is given of melanized fungi involved in human infection, including species forming budding cells and strictly filamentous representatives. Classically, they are known as "phaeoid" or "dematiaceous" fungi, and, today, agents are recognized to belon ... Full text Link to item Cite

The spectrum of fungi that infects humans.

Journal Article Cold Spring Harb Perspect Med · November 3, 2014 Few among the millions of fungal species fulfill four basic conditions necessary to infect humans: high temperature tolerance, ability to invade the human host, lysis and absorption of human tissue, and resistance to the human immune system. In previously ... Full text Link to item Cite

Phase 1b study of new posaconazole tablet for prevention of invasive fungal infections in high-risk patients with neutropenia.

Journal Article Antimicrob Agents Chemother · October 2014 Posaconazole tablets, a new oral formulation of posaconazole, can be effective when given as antifungal prophylaxis to neutropenic patients at high risk for invasive fungal infection (e.g., those with acute myelogenous leukemia or myelodysplastic syndrome) ... Full text Link to item Cite

Phase 1b study of new posaconazole tablet for prevention of invasive fungal infections in high-risk patients with neutropenia

Journal Article Antimicrobial Agents and Chemotherapy · October 1, 2014 Posaconazole tablets, a new oral formulation of posaconazole, can be effective when given as antifungal prophylaxis to neutropenic patients at high risk for invasive fungal infection (e.g., those with acute myelogenous leukemia or myelodysplastic syndrome) ... Full text Cite

Immunochip SNP array identifies novel genetic variants conferring susceptibility to candidaemia.

Journal Article Nat Commun · September 8, 2014 Candidaemia is the fourth most common cause of bloodstream infection, with a high mortality rate of up to 40%. Identification of host genetic factors that confer susceptibility to candidaemia may aid in designing adjunctive immunotherapeutic strategies. He ... Full text Link to item Cite

Molecular umbrella-amphotericin B conjugates.

Journal Article Bioconjug Chem · August 20, 2014 A tetrawalled and an octawalled molecular umbrella conjugate of amphotericin B (AmB) have been synthesized. Both conjugates exhibit high water solubility, a low tendency to aggregate, negligible hemolytic activity at 100 μM, and an ability to release a der ... Full text Link to item Cite

Very low levels of 25-hydroxyvitamin D are not associated with immunologic changes or clinical outcome in South African patients with HIV-associated cryptococcal meningitis.

Journal Article Clin Infect Dis · August 15, 2014 BACKGROUND: Vitamin D deficiency is associated with impaired immune responses and increased susceptibility to a number of intracellular pathogens in individuals infected with human immunodeficiency virus (HIV). It is not known whether such an association e ... Full text Link to item Cite

Antifungal catheter lock therapy for the management of a persistent Candida albicans bloodstream infection in an adult receiving hemodialysis.

Journal Article Pharmacotherapy · July 2014 Antifungal catheter lock therapy (AfLT) with liposomal amphotericin B has been used in the treatment of pediatric central line infections caused by Candida species; however, reports describing the use of liposomal amphotericin B lock therapy in the adult h ... Full text Link to item Cite

Clinical effectiveness of posaconazole versus fluconazole as antifungal prophylaxis in hematology-oncology patients: a retrospective cohort study.

Journal Article Cancer Med · June 2014 In preventing invasive fungal disease (IFD) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS), clinical trials demonstrated efficacy of posaconazole over fluconazole and itraconazole. However, effectiveness of posaconazole ... Full text Open Access Link to item Cite

Role of autophagy genetic variants for the risk of Candida infections.

Journal Article Med Mycol · May 2014 Candida albicans can cause candidemia in neutropenic and critically ill patients and oropharyngeal candidiasis in human immunodeficiency virus (HIV)-positive patients with low CD4(+) counts. Because all patients at risk do not develop Candida infections, i ... Full text Link to item Cite

Cryptococcosis: a model for the understanding of infectious diseases.

Journal Article J Clin Invest · May 2014 The increase in immunosuppressed patient populations has correlated with a rise in clinical fungal infections, including cryptococcosis. Patient outcome following Cryptococcus infection is linked to initial fungal burden in cerebrospinal fluid (CSF) and fu ... Full text Link to item Cite

Autophagy is redundant for the host defense against systemic Candida albicans infections.

Journal Article Eur J Clin Microbiol Infect Dis · May 2014 Autophagy has been demonstrated to play an important role in the immunity against intracellular pathogens, but very little is known about its role in the host defense against fungal pathogens such as Candida albicans. Therefore, the role of autophagy for t ... Full text Link to item Cite

Fungal meningitis

Chapter · April 21, 2014 Cite

T cells down-regulate macrophage TNF production by IRAK1-mediated IL-10 expression and control innate hyperinflammation.

Journal Article Proc Natl Acad Sci U S A · April 8, 2014 Endotoxemia is caused by excessive inflammation, but the immune system has various mechanisms to avoid collateral organ damage in endotoxemia. A handful of reports have shown that innate immune responses are suppressed by the adaptive immune system. Howeve ... Full text Link to item Cite

Predictors and outcomes of Candida bloodstream infection: eight-year surveillance, western Saudi Arabia.

Journal Article Int J Infect Dis · April 2014 OBJECTIVES: To assess the epidemiological pattern of Candida bloodstream infection (BSI) over an 8-year period (2002-2009) in King Abdulaziz Medical City, western Saudi Arabia. METHOD: A retrospective chart review was performed. RESULTS: A total of 258 BSI ... Full text Link to item Cite

Analysis of the genome and transcriptome of Cryptococcus neoformans var. grubii reveals complex RNA expression and microevolution leading to virulence attenuation.

Journal Article PLoS Genet · April 2014 Cryptococcus neoformans is a pathogenic basidiomycetous yeast responsible for more than 600,000 deaths each year. It occurs as two serotypes (A and D) representing two varieties (i.e. grubii and neoformans, respectively). Here, we sequenced the genome and ... Full text Open Access Link to item Cite

The Cryptococcus neoformans transcriptome at the site of human meningitis.

Journal Article mBio · February 4, 2014 UNLABELLED: Cryptococcus neoformans is the leading cause of fungal meningitis worldwide. Previous studies have characterized the cryptococcal transcriptome under various stress conditions, but a comprehensive profile of the C. neoformans transcriptome in t ... Full text Open Access Link to item Cite

The Cryptococcus neoformans transcriptome at the site of human meningitis

Journal Article mBio · February 4, 2014 Cryptococcus neoformans is the leading cause of fungal meningitis worldwide. Previous studies have characterized the cryptococcal transcriptome under various stress conditions, but a comprehensive profile of the C. neoformans transcriptome in the human hos ... Full text Cite

Impact of surfactant protein D, interleukin-5, and eosinophilia on Cryptococcosis.

Journal Article Infect Immun · February 2014 Cryptococcus neoformans is an opportunistic fungal pathogen that initiates infection following inhalation. As a result, the pulmonary immune response provides a first line of defense against C. neoformans. Surfactant protein D (SP-D) is an important regula ... Full text Link to item Cite

Efficacy of an abbreviated induction regimen of amphotericin B deoxycholate for cryptococcal meningoencephalitis: 3 days of therapy is equivalent to 14 days.

Journal Article mBio · January 28, 2014 UNLABELLED: Cryptococcal meningoencephalitis is an urgent global health problem. Induction regimens using 14 days of amphotericin B deoxycholate (dAmB) are considered the standard of care but may not be suitable for resource-poor settings. We investigated ... Full text Link to item Cite

Efficacy of an abbreviated induction regimen of amphotericin B deoxycholate for cryptococcal meningoencephalitis: 3 days of therapy is equivalent to 14 days

Journal Article mBio · January 28, 2014 Cryptococcal meningoencephalitis is an urgent global health problem. Induction regimens using 14 days of amphotericin B deoxycholate (dAmB) are considered the standard of care but may not be suitable for resource-poor settings. We investigated the efficacy ... Full text Cite

Future strategies for the treatment of cryptococcal meningoencephalitis in pediatric patients

Journal Article Expert Opinion on Orphan Drugs · January 1, 2014 Introduction: Cryptococcal meningoencephalitis (CM) is a rare infection in pediatric patients, which is associated with substantial morbidity and mortality. Since symptoms of this infection are nonspecific, the diagnosis relies on risk assessment and labor ... Full text Cite

Fungal Infections of the Central Nervous System

Journal Article · January 1, 2014 Fungal infections of the central nervous system (CNS) are life-threatening conditions that generally involve an immunosuppressive event. Many of these infections occur sporadically in the course of a serious underlying disease. However, outbreaks of CNS fu ... Full text Cite

Circulating galectin-3 in infections and non-infectious inflammatory diseases.

Journal Article Eur J Clin Microbiol Infect Dis · December 2013 Recent studies point to a dual role for galectin-3 as both a circulating damage-associated molecular pattern and a cell membrane-associated pattern recognition receptor. The aim of this study was to assess the potential of circulating galectin-3 for discri ... Full text Link to item Cite

Recent advances in the treatment of life-threatening, invasive fungal infections.

Journal Article Expert Opin Pharmacother · December 2013 INTRODUCTION: Invasive fungal infections (IFIs) pose significant morbidity and are often life-threatening to many high-risk patients. Timely diagnosis and treatment of these infections with optimal therapy is imperative. AREAS COVERED: Advances have been m ... Full text Link to item Cite

CX3CR1-dependent renal macrophage survival promotes Candida control and host survival.

Journal Article J Clin Invest · December 2013 Systemic Candida albicans infection causes high morbidity and mortality and is associated with neutropenia; however, the roles of other innate immune cells in pathogenesis are poorly defined. Here, using a mouse model of systemic candidiasis, we found that ... Full text Link to item Cite

Nitrogen source-dependent capsule induction in human-pathogenic cryptococcus species.

Journal Article Eukaryot Cell · November 2013 Cryptococcus neoformans and C. gattii cause meningoencephalitis and are an increasing human health threat. These pathogenic Cryptococcus species are neurotropic and persist in the cerebrospinal fluid (CSF) of the mammalian host during infection. In order t ... Full text Link to item Cite

Pericarditis mediated by respiratory syncytial virus in a hematopoietic stem cell transplant patient.

Journal Article Transpl Infect Dis · August 2013 We describe a case of pericarditis and large pericardial effusion in a 63-year-old African-American man undergoing autologous hematopoietic stem cell transplant for multiple myeloma. Pericardial tissue biopsy demonstrated fibrinous pericarditis, and immuno ... Full text Link to item Cite

Pharmacodynamics of liposomal amphotericin B and flucytosine for cryptococcal meningoencephalitis: safe and effective regimens for immunocompromised patients.

Journal Article J Infect Dis · July 15, 2013 BACKGROUND: Cryptococcal meningoencephalitis is a lethal infection with relatively few therapeutic options. The optimal dosage of liposomal amphotericin B (LAmB) alone or in combination with flucytosine is not known. METHODS: A murine model of cryptococcal ... Full text Link to item Cite

Increasing echinocandin resistance in Candida glabrata: clinical failure correlates with presence of FKS mutations and elevated minimum inhibitory concentrations.

Journal Article Clin Infect Dis · June 2013 BACKGROUND: Fluconazole (FLC) resistance is common in C. glabrata and echinocandins are often used as first-line therapy. Resistance to echinocandin therapy has been associated with FKS1 and FKS2 gene alterations. METHODS: We reviewed records of all patien ... Full text Link to item Cite

Approaches to antifungal therapies and their effectiveness among patients with cryptococcosis.

Journal Article Antimicrob Agents Chemother · June 2013 The goal of this study was to determine the degree to which the persistence of cryptococcosis, overall 1-year mortality, and 1-year mortality due to cryptococcosis were influenced by initial antifungal treatment regimen in a cohort of adults with cryptococ ... Full text Link to item Cite

Pharmacokinetics and pharmacodynamics of fluconazole for cryptococcal meningoencephalitis: implications for antifungal therapy and in vitro susceptibility breakpoints.

Journal Article Antimicrob Agents Chemother · June 2013 Fluconazole is frequently the only antifungal agent that is available for induction therapy for cryptococcal meningitis. There is relatively little understanding of the pharmacokinetics and pharmacodynamics (PK-PD) of fluconazole in this setting. PK-PD rel ... Full text Link to item Cite

Efficiently killing a sugar-coated yeast.

Journal Article N Engl J Med · April 4, 2013 Full text Link to item Cite

Pharmacological considerations in human immunodeficiency virus-infected adults in the intensive care unit.

Journal Article Crit Care Nurse · April 2013 According to estimates, 1.2 million Americans are infected with human immuno deficiency virus (HIV). Because of antiretroviral therapy, persons who have HIV infection or have progressed to AIDS are living longer. As a result, the likelihood that they will ... Full text Link to item Cite

Inkjet printing of amphotericin B onto biodegradable microneedles using piezoelectric inkjet printing

Journal Article JOM · April 1, 2013 The delivery of amphotericin B, a pharmacologic agent with activity against a broad spectrum of fungi as well as against parasitic protozoa, has been complicated by the fact that amphotericin B exhibits poor solubility in aqueous solutions at physiologic p ... Full text Cite

Fungal diagnosis: how do we do it and can we do better?

Journal Article Curr Med Res Opin · April 2013 BACKGROUND: Morbidity and mortality remain high for patients with invasive fungal infections (IFIs) despite an increasing number of antifungals and other treatments. Many studies indicate that delayed or inaccurate diagnosis and treatment are major causes ... Full text Link to item Cite

Antifungal therapy: current concepts and evidence-based management.

Journal Article Curr Med Res Opin · January 22, 2013 Program overview The clinical care of seriously ill patients can often be complicated by invasive fungal infections that substantially increase morbidity and mortality. Early identification of these infections is paramount to successful clinical outcomes. ... Full text Link to item Cite

Dematiaceous fungi mimicking a conjunctival melanoma.

Journal Article Ophthalmic Plast Reconstr Surg · 2013 An 85-year-old, immunocompetent man was referred to the authors due to the presence of an enlarging, pigmented mass of the conjunctiva concerning for a conjunctival melanoma. Wide excision of the mass revealed a pigmented or "dematiaceous" fungus. He was t ... Full text Link to item Cite

Functional genomics identifies type I interferon pathway as central for host defense against Candida albicans.

Journal Article Nat Commun · 2013 Candida albicans is the most common human fungal pathogen causing mucosal and systemic infections. However, human antifungal immunity remains poorly defined. Here by integrating transcriptional analysis and functional genomics, we identified Candida-specif ... Full text Link to item Cite

Posaconazole exhibits in vitro and in vivo synergistic antifungal activity with caspofungin or FK506 against Candida albicans.

Journal Article PLoS One · 2013 The object of this study was to test whether posaconazole, a broad-spectrum antifungal agent inhibiting ergosterol biosynthesis, exhibits synergy with the β-1,3 glucan synthase inhibitor caspofungin or the calcineurin inhibitor FK506 against the human fung ... Full text Link to item Cite

Brain inositol is a novel stimulator for promoting Cryptococcus penetration of the blood-brain barrier.

Journal Article PLoS Pathog · 2013 Cryptococcus neoformans is the most common cause of fungal meningitis, with high mortality and morbidity. The reason for the frequent occurrence of Cryptococcus infection in the central nervous system (CNS) is poorly understood. The facts that human and an ... Full text Link to item Cite

Iatrogenic fungal meningitis: tragedy repeated.

Journal Article Ann Intern Med · December 4, 2012 Full text Link to item Cite

Human genetic susceptibility to Candida infections.

Journal Article Med Mycol · November 2012 Infections with Candida spp. have different manifestations in humans, ranging from mucosal to bloodstream and deep-seated disseminated infections. Immunocompromised patients have increased susceptibility to these types of infections, due to reduced capacit ... Full text Link to item Cite

Cost of invasive fungal infections in the era of new diagnostics and expanded treatment options.

Journal Article Pharmacotherapy · October 2012 STUDY OBJECTIVE: To determine the true institutional cost of treating invasive fungal infections in light of recent advances in diagnostic techniques and antifungal therapies for both treatment and prophylaxis of these infections. DESIGN: Economic analysis ... Full text Link to item Cite

Cryptococcus neoformans phospholipase B1 activates host cell Rac1 for traversal across the blood-brain barrier.

Journal Article Cell Microbiol · October 2012 Cryptococcus neoformans penetration into the central nervous system (CNS) requires traversal of the blood-brain barrier that is composed of a single layer of human brain microvascular endothelial cells (HBMEC), but the underlying mechanisms of C. neoforman ... Full text Link to item Cite

Virulence factors identified by Cryptococcus neoformans mutant screen differentially modulate lung immune responses and brain dissemination.

Journal Article Am J Pathol · October 2012 Deletions of cryptococcal PIK1, RUB1, and ENA1 genes independently rendered defects in yeast survival in human CSF and within macrophages. We evaluated virulence potential of these genes by comparing wild-type Cryptococcus neoformans strain H99 with deleta ... Full text Link to item Cite

Evaluation of a digital microfluidic real-time PCR platform to detect DNA of Candida albicans in blood.

Journal Article Eur J Clin Microbiol Infect Dis · September 2012 Species of Candida frequently cause life-threatening infections in neonates, transplant and intensive care unit (ICU) patients, and others with compromised host defenses. The successful management of systemic candidiasis depends upon early, rapid diagnosis ... Full text Open Access Link to item Cite

Risk factors for mortality in patients with mucormycosis.

Journal Article Med Mycol · August 2012 Optimal clinical care and clinical investigation of patients with mucormycosis are limited by absence of controlled trials, and absence of well-defined predictors of mortality or clinical response. The Deferasirox-AmBisome Therapy for mucormycosis (DEFEAT ... Full text Link to item Cite

Surfactant protein D facilitates Cryptococcus neoformans infection.

Journal Article Infect Immun · July 2012 Concurrent with the global escalation of the AIDS pandemic, cryptococcal infections are increasing and are of significant medical importance. Furthermore, Cryptococcus neoformans has become a primary human pathogen, causing infection in seemingly healthy i ... Full text Link to item Cite

A chronological history of the International Conference on Cryptococcus and Cryptococcosis (ICCC), an invaluable forum for growth of the cryptococcal research field and clinical practice.

Journal Article Mycopathologia · June 2012 Cryptococcologists meet every 3 years to present their new research data and discuss the current state of cryptococcosis therapy at the International Conference on Cryptococcus and Cryptococcosis (ICCC). The ICCC has served as a unique forum where mycologi ... Full text Link to item Cite

Toll-like receptor 1 polymorphisms increase susceptibility to candidemia.

Journal Article J Infect Dis · March 15, 2012 BACKGROUND: Candidemia is a severe invasive fungal infection with high mortality. Recognition of Candida species is mediated through pattern recognition receptors such as Toll-like receptors (TLRs). This study assessed whether genetic variation in TLR sign ... Full text Link to item Cite

The impact of caspase-12 on susceptibility to candidemia.

Journal Article Eur J Clin Microbiol Infect Dis · March 2012 Candida is one of the leading causes of sepsis, and an effective host immune response to Candida critically depends on the cytokines IL-1β and IL-18, which need caspase-1 cleavage to become bioactive. Caspase-12 has been suggested to inhibit caspase-1 acti ... Full text Open Access Link to item Cite

IRIS and fungal infections: What have we learned?

Journal Article Current Fungal Infection Reports · March 1, 2012 Restoration of pathogen-specific immunity as a result of highly active antiretroviral therapy or reduction of immunosuppression in solid-organ transplant recipients can result in a destructive inflammatory response known as the immune reconstitution inflam ... Full text Cite

The Deferasirox-AmBisome Therapy for Mucormycosis (DEFEAT Mucor) study: a randomized, double-blinded, placebo-controlled trial.

Journal Article J Antimicrob Chemother · March 2012 OBJECTIVES: Host iron availability is fundamental to mucormycosis pathogenesis. The combination of liposomal amphotericin B (LAmB) and deferasirox iron chelation therapy synergistically improved survival in diabetic mice with mucormycosis. To determine the ... Full text Link to item Cite

Cytokine gene polymorphisms and the outcome of invasive candidiasis: a prospective cohort study.

Journal Article Clin Infect Dis · February 15, 2012 BACKGROUND:  Candida bloodstream infections cause significant morbidity and mortality among hospitalized patients. Although clinical and microbiological factors affecting prognosis have been identified, the impact of genetic variation in the innate immune ... Full text Open Access Link to item Cite

Cost-effectiveness of posaconazole versus fluconazole for prevention of invasive fungal infections in U.S. patients with graft-versus-host disease.

Journal Article Am J Health Syst Pharm · January 15, 2012 PURPOSE: The results of a pharmacoeconomic study of the cost-effectiveness of posaconazole versus fluconazole in preventing invasive fungal infections (IFIs) in patients with graft-versus-host disease (GVHD) are reported. METHODS: The results of a randomiz ... Full text Link to item Cite

β-D-glucan surveillance with preemptive anidulafungin for invasive candidiasis in intensive care unit patients: a randomized pilot study.

Journal Article PLoS One · 2012 BACKGROUND: Invasive candidiasis (IC) is a devastating disease. While prompt antifungal therapy improves outcomes, empiric treatment based on the presence of fever has little clinical impact. Β-D-Glucan (BDG) is a fungal cell wall component detectable in t ... Full text Open Access Link to item Cite

The Hsp90 co-chaperone Sgt1 governs Candida albicans morphogenesis and drug resistance.

Journal Article PLoS One · 2012 The molecular chaperone Hsp90 orchestrates regulatory circuitry governing fungal morphogenesis, biofilm development, drug resistance, and virulence. Hsp90 functions in concert with co-chaperones to regulate stability and activation of client proteins, many ... Full text Open Access Link to item Cite

Identification of genes from the fungal pathogen Cryptococcus neoformans related to transmigration into the central nervous system.

Journal Article PLoS One · 2012 BACKGROUND: A mouse brain transmigration assessment (MBTA) was created to investigate the central nervous system (CNS) pathogenesis of cryptococcal meningoencephalitis. METHODOLOGY/PRINCIPAL FINDINGS: Two cryptococcal mutants were identified from a pool of ... Full text Link to item Cite

Comparison and temporal trends of three groups with cryptococcosis: HIV-infected, solid organ transplant, and HIV-negative/non-transplant.

Journal Article PLoS One · 2012 BACKGROUND: The Infectious Disease Society of America (IDSA) 2010 Clinical Practice Guidelines for the management of cryptococcosis outlined three key populations at risk of disease: (1) HIV-infected, (2) transplant recipient, and (3) HIV-negative/non-tran ... Full text Link to item Cite

The triple threat of cryptococcosis: it's the body site, the strain, and/or the host.

Journal Article mBio · 2012 Cryptococcosis is the leading invasive fungal infection in the world today. Over the past century, the causative agents, Cryptococcus neoformans and Cryptococcus gattii, have risen from the status of medical curiosities to common but life-threatening centr ... Full text Link to item Cite

Pleiotropic effects of deubiquitinating enzyme Ubp5 on growth and pathogenesis of Cryptococcus neoformans.

Journal Article PLoS One · 2012 Ubiquitination is a reversible protein modification that influences various cellular processes in eukaryotic cells. Deubiquitinating enzymes remove ubiquitin, maintain ubiquitin homeostasis and regulate protein degradation via the ubiquitination pathway. C ... Full text Link to item Cite

The impact of the host on fungal infections.

Journal Article Am J Med · January 2012 Outcomes of fungal infections in immunocompromised individuals depend on a complex interplay between host and pathogen factors, as well as treatment modalities. Problems occur when host responses to an infection are either too weak to effectively help erad ... Full text Link to item Cite

Cryptococcus gattii genotype VGI infection in New England.

Journal Article Pediatr Infect Dis J · December 2011 Cryptococcus gattii is a known, emerging infectious disease pathogen predominantly in the Pacific Northwest, the United States, and British Columbia, Canada. We report a case of an immunocompetent adolescent from New England who had severe pulmonary and ce ... Full text Link to item Cite

Ertapenem for treatment of osteomyelitis: a case series.

Journal Article BMC Res Notes · November 2, 2011 BACKGROUND: Ertapenem is a once-daily broad spectrum carbapenem that is increasingly used to treat polymicrobial osteomyelitis due to diabetic foot and traumatic wound infections. However, limited data exists on ertapenem use for osteomyelitis. This study ... Full text Link to item Cite

Deletion of Cryptococcus neoformans AIF ortholog promotes chromosome aneuploidy and fluconazole-resistance in a metacaspase-independent manner.

Journal Article PLoS Pathog · November 2011 Apoptosis is a form of programmed cell death critical for development and homeostasis in multicellular organisms. Apoptosis-like cell death (ALCD) has been described in several fungi, including the opportunistic human pathogen Cryptococcus neoformans. In a ... Full text Link to item Cite

Variation in chromosome copy number influences the virulence of Cryptococcus neoformans and occurs in isolates from AIDS patients.

Journal Article BMC Genomics · October 27, 2011 BACKGROUND: The adaptation of pathogenic fungi to the host environment via large-scale genomic changes is a poorly characterized phenomenon. Cryptococcus neoformans is the leading cause of fungal meningoencephalitis in HIV/AIDS patients, and we recently di ... Full text Open Access Link to item Cite

Genetic variation in the dectin-1/CARD9 recognition pathway and susceptibility to candidemia.

Journal Article J Infect Dis · October 1, 2011 BACKGROUND: Candidemia is an important cause of morbidity and mortality in critically ill patients or patients undergoing invasive treatments. Dectin-1 is the main β-glucan receptor, and patients with a complete deficiency of either dectin-1 or its adaptor ... Full text Link to item Cite

Cryptococcus gattii: an emerging fungal pathogen infecting humans and animals.

Journal Article Microbes Infect · October 2011 Infectious fungi are among a broad group of microbial pathogens that has and continues to emerge concomitantly due to the global AIDS pandemic as well as an overall increase of patients with compromised immune systems. In addition, many pathogens have been ... Full text Link to item Cite

Polyhexamethylene biguanide and calcineurin inhibitors as novel antifungal treatments for Aspergillus keratitis.

Journal Article Invest Ophthalmol Vis Sci · September 21, 2011 PURPOSE: To establish polyhexamethylene biguanide (PHMB) as an effective treatment for Aspergillus keratitis in a novel murine model. To determine the ability of the calcineurin inhibitors tacrolimus (FK506) and cyclosporine A (CSA) to enhance the activity ... Full text Link to item Cite

Addressing current medical needs in invasive fungal infection prevention and treatment with new antifungal agents, strategies and formulations.

Journal Article Expert Opin Emerg Drugs · September 2011 Introduction: Morbidity and mortality associated with invasive fungal infections (IFIs) remains unacceptably high. Such diseases represent a substantial burden to the healthcare system. New options are needed to address antifungal resistance in existing an ... Full text Link to item Cite

Quantitation of Candida CFU in initial positive blood cultures.

Journal Article J Clin Microbiol · August 2011 One potential limitation of DNA-based molecular diagnostic tests for Candida bloodstream infection (BSI) is organism burden, which is not sufficiently characterized. We hypothesized that the number of CFU per milliliter (CFU/ml) present in an episode of Ca ... Full text Link to item Cite

Azoles: Back to the future

Journal Article Current Opinion in Infectious Diseases · August 1, 2011 Purpose of review Azoles are among the oldest class of antifungals, and they continue to be integral to the treatment of invasive fungal infections. This review examines the place of azoles in the treatment of invasive candidiasis and aspergillosis, and th ... Full text Cite

Immune reconstitution syndrome in a patient with disseminated histoplasmosis and steroid taper: maintaining the perfect balance.

Journal Article Mycoses · May 2011 Immune reconstitution syndrome (IRS) is an increasingly common condition that has been described in immunosuppressed individuals once immune function is restored. In this case, we describe a patient who had a renal transplant and subsequently developed pul ... Full text Link to item Cite

The economic costs to United States hospitals of invasive fungal infections in transplant patients.

Journal Article Am J Infect Control · May 2011 BACKGROUND: Patients with a solid organ transplant (SOTs) and hematopoietic stem cell or bone marrow transplants (HSC/BMTs) are at risk of contracting invasive fungal infections (IFIs). Data on the economic burden of IFIs in the United States are sparse. M ... Full text Link to item Cite

Early treatment of candidemia in adults: a review.

Journal Article Med Mycol · February 2011 Invasive candidiasis is associated with high mortality, particularly in adults. Retrospective studies show that shorter times to treatment are correlated with a lower risk of death. A number of factors can be used to predict which patients would benefit fr ... Full text Link to item Cite

Strategies to manage antifungal drug resistance.

Journal Article Expert Opin Pharmacother · February 2011 INTRODUCTION: Invasive fungal infections continue to cause significant morbidity and mortality in immunocompromised hosts. From more than half a million deaths from cryptococcosis in sub-Saharan Africa to an unchanging death rate from invasive candidiasis, ... Full text Link to item Cite

Cryptococcus gattii virulence composite: candidate genes revealed by microarray analysis of high and less virulent Vancouver island outbreak strains.

Journal Article PLoS One · January 13, 2011 Human and animal cryptococcosis due to an unusual molecular type of Cryptococcus gattii (VGII) emerged recently on Vancouver Island, Canada. Unlike C. neoformans, C. gattii causes disease mainly in immunocompetent hosts, despite producing a similar suite o ... Full text Link to item Cite

Phaeohyphomycoses (brown-black moulds)

Chapter · January 1, 2011 Phaeohyphomycosis, a term first introduced by Ajello and colleagues [1], is an encompassing clinical designation for a spectrum of infections caused by darkly pigmented moulds [2, 3]. In its simplest definition, phaeohyphomycosis is an infection caused by ... Full text Cite

Combination antifungal therapy

Journal Article · January 1, 2011 Invasive fungal infections continue to cause significant morbidity and mortality among hospitalized patients. In particular, recent studies indicate an increase in the incidence of mould infections among transplant recipients, and Candida species have rise ... Full text Cite

Tourism implications of cryptococcus gattii in the southeastern USA

Chapter · January 1, 2011 In 2007, the first confirmed case of Cryptococcus gattii was reported in the state of North Carolina, USA. An otherwise healthy human immunodeficiency virus (HIV) negative male patient presented with a large upper thigh cryptococcoma in February, which was ... Cite

Cryptococcus neoformans requires a functional glycolytic pathway for disease but not persistence in the host.

Journal Article mBio · 2011 Cryptococcus neoformans is an important fungal pathogen of immunocompromised individuals, with a close relative, Cryptococcus gattii, emerging as a serious threat for the immunocompetent. During initial infection, C. neoformans colonizes the airspaces of t ... Full text Link to item Cite

Host defenses against cryptococcosis.

Journal Article Immunol Invest · 2011 The interaction of pathogenic Cryptococcus species with their various hosts is somewhat unique compared to other fungal pathogens such as Aspergillus fumigatus and Candida albicans. Cryptococcus shares an intimate association with host immune cells, leadin ... Full text Link to item Cite

Cryptococcus neoformans requires a functional glycolytic pathway for disease but not persistence in the host

Journal Article mBio · January 1, 2011 Cryptococcus neoformans is an important fungal pathogen of immunocompromised individuals, with a close relative, Cryptococcus gattii, emerging as a serious threat for the immunocompetent. During initial infection, C. neoformans colonizes the airspaces of t ... Full text Cite

An official American Thoracic Society statement: Treatment of fungal infections in adult pulmonary and critical care patients.

Journal Article Am J Respir Crit Care Med · January 1, 2011 With increasing numbers of immune-compromised patients with malignancy, hematologic disease, and HIV, as well as those receiving immunosupressive drug regimens for the management of organ transplantation or autoimmune inflammatory conditions, the incidence ... Full text Link to item Cite

Host Genomics and Bacterial Infections

Journal Article · December 1, 2010 This chapter focuses on host genomics, highlighting examples of studies aimed at unraveling the complex nature of immune response to infection. Bacterial pathogens are known to cause infectious diseases in humans. Many of these pathogens are commensal orga ... Full text Cite

The (1,3){beta}-D-glucan test as an aid to early diagnosis of invasive fungal infections following lung transplantation.

Journal Article J Clin Microbiol · November 2010 The Fungitell assay for (1,3)β-D-glucan (BG) detection in serum has been evaluated in patients with invasive fungal infections (IFIs) and healthy controls and for the early diagnosis of IFI in cancer patients. We evaluated the BG assay for the detection of ... Full text Link to item Cite

Survival defects of Cryptococcus neoformans mutants exposed to human cerebrospinal fluid result in attenuated virulence in an experimental model of meningitis.

Journal Article Infect Immun · October 2010 Cryptococcus neoformans is a fungal pathogen that encounters various microenvironments during growth in the mammalian host, including intracellular vacuoles, blood, and cerebrospinal fluid (CSF). Because the CSF is isolated by the blood-brain barrier, we h ... Full text Link to item Cite

PKC signaling regulates drug resistance of the fungal pathogen Candida albicans via circuitry comprised of Mkc1, calcineurin, and Hsp90.

Journal Article PLoS Pathog · August 26, 2010 Fungal pathogens exploit diverse mechanisms to survive exposure to antifungal drugs. This poses concern given the limited number of clinically useful antifungals and the growing population of immunocompromised individuals vulnerable to life-threatening fun ... Full text Open Access Link to item Cite

Trehalose 6-phosphate phosphatase is required for cell wall integrity and fungal virulence but not trehalose biosynthesis in the human fungal pathogen Aspergillus fumigatus.

Journal Article Mol Microbiol · August 2010 The trehalose biosynthesis pathway is critical for virulence in human and plant fungal pathogens. In this study, we tested the hypothesis that trehalose 6-phosphate phosphatase (T6PP) is required for Aspergillus fumigatus virulence. A mutant of the A. fumi ... Full text Link to item Cite

Breakthrough invasive candidiasis in patients on micafungin.

Journal Article J Clin Microbiol · July 2010 For Candida species, a bimodal wild-type MIC distribution for echinocandins exists, but resistance to echinocandins is rare. We characterized isolates from patients with invasive candidiasis (IC) breaking through >or=3 doses of micafungin therapy during th ... Full text Link to item Cite

Microfluidic platform versus conventional real-time polymerase chain reaction for the detection of Mycoplasma pneumoniae in respiratory specimens.

Journal Article Diagn Microbiol Infect Dis · May 2010 Rapid, accurate diagnosis of community-acquired pneumonia (CAP) due to Mycoplasma pneumoniae is compromised by low sensitivity of culture and serology. Polymerase chain reaction (PCR) has emerged as a sensitive method to detect M. pneumoniae DNA in clinica ... Full text Open Access Link to item Cite

Use of Antifungal Combination Therapy: Agents, Order, and Timing.

Journal Article Curr Fungal Infect Rep · May 1, 2010 Given the substantial morbidity and mortality related to invasive fungal infections, treatment with a combination of antifungal agents is often considered. A growing body of literature from in vitro studies, animal models, and clinical experience provides ... Full text Link to item Cite

Transcriptional regulation of chitin synthases by calcineurin controls paradoxical growth of Aspergillus fumigatus in response to caspofungin.

Journal Article Antimicrob Agents Chemother · April 2010 Attenuated activity of echinocandin antifungals at high concentrations, known as the "paradoxical effect," is a well-established phenomenon in Candida albicans and Aspergillus fumigatus. In the yeast C. albicans, upregulation of chitin biosynthesis via the ... Full text Link to item Cite

Blood gene expression signatures predict invasive candidiasis.

Journal Article Sci Transl Med · March 3, 2010 Candidemia is the fourth most common bloodstream infection, with Candida albicans being the most common causative species. Success in reducing the associated morbidity and mortality has been limited by the inadequacy and time delay of currently available d ... Full text Link to item Cite

Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america.

Journal Article Clin Infect Dis · February 1, 2010 Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. These guidelines for its management have been built on the previous Infectious Diseases Society of America guidelines from 2000 and include new sections. There ... Full text Open Access Link to item Cite

Incidence of Severe Hepatotoxicity Related to Antiretroviral Therapy in HIV/HCV Coinfected Patients.

Journal Article AIDS Res Treat · 2010 Introduction. Hepatotoxicity is a concern in HIV/hepatitis C virus (HCV) coinfected patients due to their underlying liver disease. This study assessed the incidence of hepatotoxicity in HIV/HCV co-infected patients in two outpatient infectious diseases cl ... Full text Link to item Cite

Antifungal therapy for invasive fungal diseases in allogeneic stem cell transplant recipients: an update.

Journal Article Mycopathologia · December 2009 Invasive fungal diseases (IFDs) remain a major cause of morbidity and mortality in allogeneic stem cell transplant (SCT) recipients. While the most common pathogens are Candida spp. and Aspergillus spp., the incidence of infections caused by non-albicans C ... Full text Link to item Cite

Host Genomics and Bacterial Infections

Journal Article · December 1, 2009 Full text Cite

Human dectin-1 deficiency and mucocutaneous fungal infections.

Journal Article N Engl J Med · October 29, 2009 Mucocutaneous fungal infections are typically found in patients who have no known immune defects. We describe a family in which four women who were affected by either recurrent vulvovaginal candidiasis or onychomycosis had the early-stop-codon mutation Tyr ... Full text Link to item Cite

Mortality, length of hospitalization, and costs associated with invasive fungal infections in high-risk patients.

Journal Article Am J Health Syst Pharm · October 1, 2009 PURPOSE: The mortality, length of hospitalization, and costs associated with invasive fungal infections (IFIs) in hospitalized patients were studied. METHODS: This retrospective database study used data from the 2004 Healthcare Cost and Utilization Project ... Full text Link to item Cite

The trehalose synthesis pathway is an integral part of the virulence composite for Cryptococcus gattii.

Journal Article Infect Immun · October 2009 The trehalose pathway is essential for stress tolerance and virulence in fungi. We investigated the importance of this pathway for virulence of the pathogenic yeast Cryptococcus gattii using the highly virulent Vancouver Island, Canada, outbreak strain R26 ... Full text Link to item Cite

Hsp90 governs echinocandin resistance in the pathogenic yeast Candida albicans via calcineurin.

Journal Article PLoS Pathog · July 2009 Candida albicans is the leading fungal pathogen of humans, causing life-threatening disease in immunocompromised individuals. Treatment of candidiasis is hampered by the limited number of antifungal drugs whose efficacy is compromised by host toxicity, fun ... Full text Link to item Cite

Surfactant protein D increases phagocytosis of hypocapsular Cryptococcus neoformans by murine macrophages and enhances fungal survival.

Journal Article Infect Immun · July 2009 Cryptococcus neoformans is a facultative intracellular opportunistic pathogen and the leading cause of fungal meningitis in humans. In the absence of a protective cellular immune response, the inhalation of C. neoformans cells or spores results in pulmonar ... Full text Link to item Cite

Pharmacokinetics of posaconazole administered orally or by nasogastric tube in healthy volunteers.

Journal Article Antimicrob Agents Chemother · July 2009 The use of a nasogastric tube is one means of administering antifungal therapy to critically ill patients unable to receive medication via the oral route. This was a phase 1, open-label, single-center, randomized, crossover study of posaconazole administer ... Full text Link to item Cite

First reported case of Cryptococcus gattii in the Southeastern USA: implications for travel-associated acquisition of an emerging pathogen.

Journal Article PLoS One · June 10, 2009 In 2007, the first confirmed case of Cryptococcus gattii was reported in the state of North Carolina, USA. An otherwise healthy HIV negative male patient presented with a large upper thigh cryptococcoma in February, which was surgically removed and the pat ... Full text Link to item Cite

Pharmacogenomics of systemic antifungal agents

Journal Article Current Fungal Infection Reports · June 1, 2009 The genomic era offers a multitude of new technologies that may make the promise of personalized medicine a reality for patients in this century. Numerous new antifungal agents have been developed over the past two decades, but use of these agents requires ... Full text Cite

Molds: hyalohyphomycosis, phaeohyphomycosis, and zygomycosis.

Journal Article Clin Chest Med · June 2009 Emerging fungi previously thought to be nonpathogenic are now recognized as playing a significant role in the increased incidence of invasive fungal disease. This change in the epidemiology of invasive fungal infections (IFIs) has occurred in the era of ag ... Full text Link to item Cite

Hsp90 orchestrates temperature-dependent Candida albicans morphogenesis via Ras1-PKA signaling.

Journal Article Curr Biol · April 28, 2009 BACKGROUND: Hsp90 is an environmentally contingent molecular chaperone that influences the form and function of diverse regulators of cellular signaling. Hsp90 potentiates the evolution of fungal drug resistance by enabling crucial cellular stress response ... Full text Link to item Cite

Aspergillus fumigatus calcipressin CbpA is involved in hyphal growth and calcium homeostasis.

Journal Article Eukaryot Cell · April 2009 Calcineurin is a conserved protein phosphatase that plays a critical role in Ca(2+) signaling and stress responses. Previously, a new class of conserved calcineurin-binding proteins, the calcipressins, was identified. However, the role of these proteins re ... Full text Link to item Cite

Assessing the antimicrobial activity of zinc oxide thin films using disk diffusion and biofilm reactor

Journal Article Applied Surface Science · March 15, 2009 The electronic and chemical properties of semiconductor materials may be useful in preventing growth of microorganisms. In this article, in vitro methods for assessing microbial growth on semiconductor materials will be presented. The structural and biolog ... Full text Cite

Mortality and time to extubation in severe hospital-acquired pneumonia.

Journal Article Am J Infect Control · March 2009 BACKGROUND: This study examined predictors of in-hospital mortality and time to extubation among patients with acute, severe hospital-acquired pneumonia (HAP) managed in the intensive care unit (ICU). METHODS: Patients with HAP prospectively identified bet ... Full text Link to item Cite

Candida glabrata endophthalmitis following penetrating keratoplasty.

Journal Article J Cataract Refract Surg · March 2009 We report a case of Candida glabrata endophthalmitis following penetrating keratoplasty in a 57-year-old man. The infection was thought to be treated successfully with intravitreal amphotericin B but flared 7 months later following cataract extraction and ... Full text Link to item Cite

Posaconazole's impact on prophylaxis and treatment of invasive fungal infections: an update.

Journal Article Expert Rev Anti Infect Ther · March 2009 Owing to the morbidity and mortality associated with invasive fungal infections, particularly in the immunocompromised host, development of new agents for both prevention and treatment is essential. Posaconazole is a recently approved extended-spectrum tri ... Full text Link to item Cite

Candida pneumonia: What we know and what we don't

Journal Article Current Fungal Infection Reports · March 1, 2009 The diagnosis of Candida pneumonia is a difficult one to make, and some experts often question whether the entity truly exists. This article assimilates the information currently available regarding Candida pulmonary infection to elucidate the presentation ... Full text Cite

Harnessing Hsp90 function as a powerful, broadly effective therapeutic strategy for fungal infectious disease.

Journal Article Proc Natl Acad Sci U S A · February 24, 2009 Invasive fungal infections are a leading cause of mortality among immunocompromised individuals. Treatment is notoriously difficult with the limited armamentarium of antifungal drugs, whose efficacy is compromised by host toxicity, a limited activity spect ... Full text Link to item Cite

Differential effects of inhibiting chitin and 1,3-{beta}-D-glucan synthesis in ras and calcineurin mutants of Aspergillus fumigatus.

Journal Article Antimicrob Agents Chemother · February 2009 Aspergillus fumigatus must be able to properly form hyphae and maintain cell wall integrity in order to establish invasive disease. Ras proteins and calcineurin each have been implicated as having roles in these processes. Here, we further delineate the ro ... Full text Link to item Cite

Toll like receptor 1 polymorphisms and susceptibility to invasive candidiasis.

Journal Article Critical care (London, England) · January 2009 Full text Cite

Cost-effectiveness of posaconazole versus fluconazole or itraconazole in the prevention of invasive fungal infections among neutropenic patients in the United States.

Journal Article Value Health · 2009 OBJECTIVES: Clinical trial data indicate that posaconazole is superior to fluconazole (FLU) or itraconazole (ITRA) in preventing invasive fungal infections (IFIs) among neutropenic patients. Our objective was to assess the cost-effectiveness of posaconazol ... Full text Link to item Cite

Invasive mould infections: a multi-disciplinary update.

Journal Article Med Mycol · 2009 Systemic fungal infections remain a significant cause of mortality in neutropenic and immunocompromised patients, despite advances in their diagnosis and treatment. The incidence of such infections is rising due to the use of intensive chemotherapy regimen ... Full text Link to item Cite

Posaconazole as salvage treatment of invasive fungal infections in patients with underlying renal impairment.

Journal Article J Antimicrob Chemother · December 2008 OBJECTIVES: The aim of this study is to determine the efficacy and safety of posaconazole in patients with underlying renal impairment. Patients and methods We analysed the efficacy and safety of posaconazole in patients with renal impairment in a post hoc ... Full text Link to item Cite

Cryptococcosis in solid organ transplant recipients: current state of the science.

Journal Article Clin Infect Dis · November 15, 2008 Cryptococcosis remains a significant opportunistic infection in solid organ transplant recipients. Disease presentation and outcomes may be affected by, among other factors, the use of calcineurin inhibitor immunosuppressive agents. It is being increasingl ... Full text Link to item Cite

Pulmonary cryptococcosis in patients without HIV infection: factors associated with disseminated disease.

Journal Article Eur J Clin Microbiol Infect Dis · October 2008 Cryptococcus neoformans is an uncommonly recognized cause of pneumonia in HIV-negative patients. Because of its propensity to disseminate to the meninges and other sites, a lumbar puncture is recommended for patients with pulmonary cryptococcosis, regardle ... Full text Link to item Cite

Posaconazole as salvage therapy in patients with invasive fungal infections after solid organ transplant.

Journal Article Transplantation · September 27, 2008 BACKGROUND: The incidence of invasive fungal infections (IFIs) in solid organ transplant (SOT) recipients has increased during the past 20 years and is associated with significant morbidity and mortality. In this post hoc analysis of a large, open-label, m ... Full text Link to item Cite

Metabolic adaptation in Cryptococcus neoformans during early murine pulmonary infection.

Journal Article Mol Microbiol · September 2008 The pathogenic fungus Cryptococcus neoformans generally initiates infection in mammalian lung tissue and subsequently disseminates to the brain. We performed serial analysis of gene expression (SAGE) on C. neoformans cells recovered from the lungs of mice ... Full text Link to item Cite

Defining responses to therapy and study outcomes in clinical trials of invasive fungal diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer consensus criteria.

Journal Article Clin Infect Dis · September 1, 2008 Invasive fungal diseases (IFDs) have become major causes of morbidity and mortality among highly immunocompromised patients. Authoritative consensus criteria to diagnose IFD have been useful in establishing eligibility criteria for antifungal trials. There ... Full text Link to item Cite

Calcineurin target CrzA regulates conidial germination, hyphal growth, and pathogenesis of Aspergillus fumigatus.

Journal Article Eukaryot Cell · July 2008 The calcineurin pathway is a critical signal transduction pathway in fungi that mediates growth, morphology, stress responses, and pathogenicity. The importance of the calcineurin pathway in fungal physiology creates an opportunity for the development of n ... Full text Link to item Cite

Plasminogen alleles influence susceptibility to invasive aspergillosis.

Journal Article PLoS Genet · June 20, 2008 Invasive aspergillosis (IA) is a common and life-threatening infection in immunocompromised individuals. A number of environmental and epidemiologic risk factors for developing IA have been identified. However, genetic factors that affect risk for developi ... Full text Link to item Cite

Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.

Journal Article Clin Infect Dis · June 15, 2008 BACKGROUND: Invasive fungal diseases are important causes of morbidity and mortality. Clarity and uniformity in defining these infections are important factors in improving the quality of clinical studies. A standard set of definitions strengthens the cons ... Full text Link to item Cite

Current options in antifungal pharmacotherapy.

Journal Article Pharmacotherapy · May 2008 Infections caused by yeasts and molds continue to be associated with high rates of morbidity and mortality in both immunocompromised and immunocompetent patients. Many antifungal drugs have been developed over the past 15 years to aid in the management of ... Full text Link to item Cite

When primary antifungal therapy fails.

Journal Article Clin Infect Dis · May 1, 2008 The prognosis for persons with invasive fungal infections has improved over the past 2 decades because of the development of new diagnostic tools, a better understanding of the epidemiology and prognostic factors of these infections, and the availability o ... Full text Link to item Cite

Rare and emerging fungal pulmonary infections.

Journal Article Semin Respir Crit Care Med · April 2008 The frequency and diversity of serious fungal infections are increasing. Persons who are severely immunocompromised are particularly vulnerable to infection from unusual molds and yeasts that are often found naturally in the environment. Clinical manifesta ... Full text Link to item Cite

Analysis of two- and three-year trends in antimicrobial resistance in intensive care units using unit-specific antibiograms.

Journal Article Scand J Infect Dis · 2008 Unit-specific antibiograms serve as useful guides to clinicians and infection control personnel. We compared trends in antimicrobial resistance in intensive care units using traditional 2-y unit-specific antibiogram data and 3 y of data. Three-y unit-speci ... Full text Link to item Cite

Antimicrobial resistance: resistance to antifungal agents: mechanisms and clinical impact.

Journal Article Clin Infect Dis · January 1, 2008 Despite advances in preventive, diagnostic, and therapeutic interventions, invasive fungal infections cause significant morbidity and mortality in immunocompromised patients. The burden of antifungal resistance in such high-risk patients is becoming a majo ... Full text Link to item Cite

Cryptococcus neoformans is resistant to surfactant protein A mediated host defense mechanisms.

Journal Article PLoS One · December 26, 2007 Initiation of a protective immune response to infection by the pathogenic fungus Cryptococcus neoformans is mediated in part by host factors that promote interactions between immune cells and C. neoformans yeast. Surfactant protein A (SP-A) contributes pos ... Full text Link to item Cite

A comparison of the effectiveness of lipid-lowering therapy between HIV- and non-HIV-infected subjects with hyperlipidaemia.

Journal Article Int J STD AIDS · December 2007 This retrospective cohort study conducted at the Durham Veterans Affairs Medical Center evaluated the effectiveness and safety of lipid-lowering therapy (LLT) in a HIV-infected population as compared with a general population with hyperlipidaemia. Fifty-th ... Full text Link to item Cite

Immune reconstitution syndrome and exacerbation of infections after pregnancy.

Journal Article Clin Infect Dis · November 1, 2007 Pregnancy is a state of subtle immunosuppression characterized by physiologic suppression of proinflammatory host responses that are meant to promote embryonic implantation. Rapid reversal of these changes and a rebound of inflammatory responses during the ... Full text Link to item Cite

Fungal infections of the bones and joints.

Journal Article Curr Infect Dis Rep · October 2007 Osteoarticular complications may occur with a variety of invasive fungal infections, and seem to be increasing with growing use of prosthetic joints and as the immunosuppressed patient population increases. Epidemiology, pathogenesis, presentation, and man ... Full text Link to item Cite

Targeting the calcineurin pathway enhances ergosterol biosynthesis inhibitors against Trichophyton mentagrophytes in vitro and in a human skin infection model.

Journal Article Antimicrob Agents Chemother · October 2007 Fluconazole-FK506 or fluconazole-cyclosporine drug combinations were tested in an ex vivo Trichophyton mentagrophytes human skin infection model. Conidia colonization was monitored by scanning electron microscopy over a 7-day treatment period. The fluconaz ... Full text Link to item Cite

Fatty acid synthesis is essential for survival of Cryptococcus neoformans and a potential fungicidal target.

Journal Article Antimicrob Agents Chemother · October 2007 Fatty acid synthase in the yeast Cryptococcus neoformans is composed of two subunits encoded by FAS1 and FAS2 genes. We inserted a copper-regulated promoter (P(CTR4-2)) to regulate FAS1 and FAS2 expression in Cryptococcus neoformans (strains P(CTR4-2)/FAS1 ... Full text Link to item Cite

Reply to Baden and Marty [2]

Journal Article Clinical Infectious Diseases · September 1, 2007 Full text Cite

Calcineurin inhibition or mutation enhances cell wall inhibitors against Aspergillus fumigatus.

Journal Article Antimicrob Agents Chemother · August 2007 Calcineurin mutation or inhibition enhanced the antifungal morphological effect of cell wall inhibitors caspofungin or nikkomycin Z against Aspergillus fumigatus. Quantification of 1,3-beta-d-glucan revealed decreased amounts in the calcineurin A (Deltacna ... Full text Link to item Cite

Combination antifungal therapy: what can and should we expect?

Journal Article Bone Marrow Transplant · August 2007 Invasive fungal infections are associated with significant morbidity and mortality among immunocompromised patients. Recent advances in antifungal development have afforded us more pharmacologic compounds to choose from when managing these fungal infection ... Full text Link to item Cite

Prospective Aspergillus galactomannan antigen testing in pediatric hematopoietic stem cell transplant recipients.

Journal Article Pediatr Infect Dis J · July 2007 BACKGROUND: The galactomannan (GM) assay is an approved noninvasive test for detection of invasive aspergillosis (IA) that has been validated in adult patients with hematologic malignancies who are undergoing bone marrow transplantation. There have been fe ... Full text Link to item Cite

Quantification of 1,3-beta-D-glucan levels in children: preliminary data for diagnostic use of the beta-glucan assay in a pediatric setting.

Journal Article Clin Vaccine Immunol · July 2007 1,3-Beta-D-Glucan serum levels have demonstrated good diagnostic sensitivity and specificity for the diagnosis of candidiasis in adult patients, but normal levels for children have not been established. We found higher 1,3-beta-D-glucan levels in children ... Full text Link to item Cite

Candida endophthalmitis: Who is looking?

Journal Article Infectious Diseases in Clinical Practice · July 1, 2007 Full text Cite

Harnessing calcineurin as a novel anti-infective agent against invasive fungal infections.

Journal Article Nat Rev Microbiol · June 2007 The number of immunocompromised patients with invasive fungal infections continues to increase and new antifungal therapies are not keeping pace with the growing incidence of these infections and their associated mortality. Calcineurin inhibition is curren ... Full text Link to item Cite

Immune reconstitution syndrome associated with opportunistic mycoses.

Journal Article Lancet Infect Dis · June 2007 Host immunity is essential in facilitating the eradication of infection. However, immunological recovery and an imbalance characterised by either suboptimum or excessive expression of immune responses can also be harmful to the host. Inflammatory responses ... Full text Link to item Cite

Pulmonary fungal infections: Making the diagnosis

Journal Article Infections in Medicine · April 1, 2007 Since endemic mycoses can be contracted during a brief travel exposure, it is important to inquire about travel when a patient presents with symptoms of a respiratory infection. Most patients with blastomycosis present in the chronic phase, with cough, wei ... Cite

Comparative pharmacokinetics of voriconazole administered orally as either crushed or whole tablets.

Journal Article Antimicrob Agents Chemother · March 2007 Voriconazole is a triazole antifungal agent used to treat serious, invasive fungal infections including aspergillosis and candidemia. Limitations with existing formulations of voriconazole including restricted utility in patients with renal dysfunction (in ... Full text Link to item Cite

Protection against cryptococcosis by using a murine gamma interferon-producing Cryptococcus neoformans strain.

Journal Article Infect Immun · March 2007 We evaluated cell-mediated immune (CMI) responses in mice given a pulmonary infection with a Cryptococcus neoformans strain engineered to produce the Th1-type cytokine gamma interferon (IFN-gamma). Mice given a pulmonary infection with an IFN-gamma-produci ... Full text Link to item Cite

Comparative evaluation of Etest and sensititre yeastone panels against the Clinical and Laboratory Standards Institute M27-A2 reference broth microdilution method for testing Candida susceptibility to seven antifungal agents.

Journal Article J Clin Microbiol · March 2007 To assess their utility for antifungal susceptibility testing in our clinical laboratory, the Etest and Sensititre methods were compared with the Clinical and Laboratory Standards Institute (CLSI) M27-A2 reference broth microdilution method. Fluconazole (F ... Full text Link to item Cite

Caspofungin for the treatment of azole resistant candidemia in a premature infant.

Journal Article J Perinatol · February 2007 Candidemia is common in extremely low birth weight infants and is associated with substantial mortality and morbidity. Treatment options have traditionally been limited to amphotericin B deoxycholate or fluconazole. We present a case of a premature infant ... Full text Link to item Cite

Management of cryptococcosis: how are we doing?

Journal Article PLoS Med · February 2007 Perfect discusses the implications of a national prospective study (the "CryptoA/D" study) of the factors influencing clinical presentation and outcome of patients with cryptococcosis. ... Full text Link to item Cite

Prevention and early treatment of invasive fungal infection in patients with cancer and neutropenia and in stem cell transplant recipients in the era of newer broad-spectrum antifungal agents and diagnostic adjuncts.

Journal Article Clin Infect Dis · February 1, 2007 Invasive fungal infection (IFI) is a leading cause of infection-related mortality among patients with cancer and prolonged neutropenia and among allogeneic hematopoietic stem cell transplant recipients with graft-versus-host disease. Invasive candidiasis w ... Full text Link to item Cite

Management of cryptococcosis: How are we doing?

Journal Article PLOS MEDICINE · February 1, 2007 Full text Link to item Cite

Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia.

Journal Article N Engl J Med · January 25, 2007 BACKGROUND: Patients with neutropenia resulting from chemotherapy for acute myelogenous leukemia or the myelodysplastic syndrome are at high risk for difficult-to-treat and often fatal invasive fungal infections. METHODS: In this randomized, multicenter st ... Full text Link to item Cite

Diagnosis of cryptococcosis

Chapter · January 1, 2007 Cryptococcus neoformans is an encapsulated yeast that can cause life-threatening infectious diseases in both apparently immunocompetent and immunocompromised hosts in all areas of the world. This pathogenic yeast consists of four serotypes (A, B, C, and D) ... Cite

Peroxisome function regulates growth on glucose in the basidiomycete fungus Cryptococcus neoformans.

Journal Article Eukaryot Cell · January 2007 The function of the peroxisomes was examined in the pathogenic basidiomycete Cryptococcus neoformans. Recent studies reveal the glyoxylate pathway is required for virulence of diverse microbial pathogens of plants and animals. One exception is C. neoforman ... Full text Link to item Cite

Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial.

Journal Article Clin Infect Dis · January 1, 2007 BACKGROUND: Invasive aspergillosis is an important cause of morbidity and mortality in immunocompromised patients. Current treatments provide limited benefit. Posaconazole is an extended-spectrum triazole with in vitro and in vivo activity against Aspergil ... Full text Link to item Cite

Cost-Effectiveness of Posaconazole Versus Standard Azole Therapy in the Prevention of Invasive Fungal Infections among High-Risk Neutropenic Patients in the U.S.

Conference Blood · November 16, 2006 AbstractIn a recent clinical trial, posaconazole was found to be superior to standard azole therapy (i.e., fluconazole or itraconazole) in preventing both invasive fungal infections (IFIs) and in reducing ov ... Full text Cite

Phylogenomic analysis of non-ribosomal peptide synthetases in the genus Aspergillus.

Journal Article Gene · November 15, 2006 Fungi from the genus Aspergillus are important saprophytes and opportunistic human fungal pathogens that contribute in these and other diverse ways to human well-being. Part of their impact on human well-being stems from the production of small molecular w ... Full text Link to item Cite

Caspofungin for invasive candidiasis at a tertiary care medical center.

Journal Article Am J Med · November 2006 BACKGROUND: Caspofungin is emerging as first-line therapy for invasive candidiasis. Data on the use of caspofungin for treatment for invasive candidiasis are limited to clinical trials and case reports. We report a single-center experience with 104 consecu ... Full text Link to item Cite

Characterization and regulation of the trehalose synthesis pathway and its importance in the pathogenicity of Cryptococcus neoformans.

Journal Article Infect Immun · October 2006 The disaccharide trehalose has been found to play diverse roles, from energy source to stress protectant, and this sugar is found in organisms as diverse as bacteria, fungi, plants, and invertebrates but not in mammals. Recent studies in the pathobiology o ... Full text Link to item Cite

The Cryptococcus neoformans catalase gene family and its role in antioxidant defense.

Journal Article Eukaryot Cell · September 2006 In the present study, we sought to elucidate the contribution of the Cryptococcus neoformans catalase gene family to antioxidant defense. We employed bioinformatics techniques to identify four members of the C. neoformans catalase gene family and created m ... Full text Link to item Cite

Cryptococcosis.

Journal Article Infect Dis Clin North Am · September 2006 In the past 2 decades, Cryptococcus has emerged in its clinical significance and as a model yeast for understanding molecular pathogenesis. C neoformans and C gattii are currently considered major primary and secondary pathogens in a wide array of hosts th ... Full text Link to item Cite

Calcineurin controls growth, morphology, and pathogenicity in Aspergillus fumigatus.

Journal Article Eukaryot Cell · July 2006 Calcineurin is implicated in a myriad of human diseases as well as homeostasis and virulence in several major human pathogenic microorganisms. The fungus Aspergillus fumigatus is a leading cause of infectious death in the rapidly expanding immunocompromise ... Full text Link to item Cite

Safety of long-term oral posaconazole use in the treatment of refractory invasive fungal infections.

Journal Article Clin Infect Dis · June 15, 2006 BACKGROUND: Invasive fungal infections are found most frequently in immunosuppressed and critically ill hospitalized patients. Antifungal therapy is often required for long periods. Safety data from the clinical development program of the triazole antifung ... Full text Link to item Cite

Disruption of a nonribosomal peptide synthetase in Aspergillus fumigatus eliminates gliotoxin production.

Journal Article Eukaryot Cell · June 2006 The fungal secondary metabolite gliotoxin produced by Aspergillus fumigatus has been hypothesized to be important in the development of invasive aspergillosis. In this study, we addressed this hypothesis by disrupting a nonribosomal peptide synthetase (NRP ... Full text Link to item Cite

Cryptococcus neoformans: the yeast that likes it hot.

Journal Article FEMS Yeast Res · June 2006 The ability of fungi to grow well at mammalian body temperatures is a fundamental characteristic of invasive human fungal pathogens. Cryptococcus neoformans, with its genetics, molecular biology, robust animal models and clinical importance, has become a p ... Full text Link to item Cite

Emerging echinocandins for treatment of invasive fungal infections.

Journal Article Expert Opin Emerg Drugs · May 2006 The echinocandins are a new class of antifungals, developed in response to the need for safe and effective antifungals for the treatment of invasive fungal infections. These agents work by inhibiting 1,3-beta-d-glucan synthase, an enzyme essential for prod ... Full text Link to item Cite

Zygomycosis: the re-emerging fungal infection.

Journal Article Eur J Clin Microbiol Infect Dis · April 2006 Invasive fungal infections are major medical complications in immunocompromised patients. The recent rise in the incidence of cancer and the increased use of newer medical treatment modalities, including organ transplantations, have resulted in growing num ... Full text Link to item Cite

Non-comparative evaluation of the safety of aerosolized amphotericin B lipid complex in patients undergoing allogeneic hematopoietic stem cell transplantation.

Journal Article Transpl Infect Dis · March 2006 Allogeneic hematopoietic stem cell transplant (HSCT) recipients are at increased risk for invasive fungal infections (IFIs) over prolonged periods of time. Aerosolized amphotericin B lipid complex (ABLC) has shown promise in lung transplant recipients as a ... Full text Link to item Cite

Pharmacotherapy for human immunodeficiency virus-associated nephropathy.

Journal Article Pharmacotherapy · December 2005 Approximately 10% of adult patients with human immunodeficiency virus (HIV) infection have HIV-associated nephropathy (HIVAN). This condition, a leading cause of renal failure, is characterized by damage to specific areas of the renal filtration system. It ... Full text Link to item Cite

Pharmacoeconomics of antifungal pharmacotherapy--challenges and future directions.

Journal Article Expert Opin Pharmacother · December 2005 The frequency and severity of invasive fungal infections have been increasingly recognised and new antifungal therapies have expanded the therapeutic armamentarium available to manage such infections. Antifungal agents comprise a significant portion of ant ... Full text Link to item Cite

Carbonic anhydrase and CO2 sensing during Cryptococcus neoformans growth, differentiation, and virulence.

Journal Article Curr Biol · November 22, 2005 The gas carbon dioxide (CO2) plays a critical role in microbial and mammalian respiration, photosynthesis in algae and plants, chemoreception in insects, and even global warming . However, how CO2 is transported, sensed, and metabolized by microorganisms i ... Full text Link to item Cite

Phenotypic and genotypic evaluation of fluconazole resistance in vaginal Candida strains isolated from HIV-infected women from Brazil.

Journal Article Med Mycol · November 2005 We conducted a study to determine the antifungal susceptibility of vaginal Candida isolates from HIV-infected Brazilian women. Among 127 women enrolled, positive cultures for yeast were obtained from 31 of 38 (81%) women with symptomatic vulvovaginitis, an ... Full text Link to item Cite

Same-sex mating and the origin of the Vancouver Island Cryptococcus gattii outbreak.

Journal Article Nature · October 27, 2005 Genealogy can illuminate the evolutionary path of important human pathogens. In some microbes, strict clonal reproduction predominates, as with the worldwide dissemination of Mycobacterium leprae, the cause of leprosy. In other pathogens, sexual reproducti ... Full text Link to item Cite

A meta-analysis of medical versus surgical therapy for Candida endocarditis.

Journal Article J Infect · October 2005 OBJECTIVES: The optimal management of Candida infective endocarditis (IE) is unknown. METHODS: We reviewed all 879 cases of Candida IE reported from 1966-2002 in the peer-reviewed literature to better understand the role of medical and surgical therapies. ... Full text Link to item Cite

Reply to Wise

Journal Article Clinical Infectious Diseases · October 1, 2005 Full text Cite

Candida glabrata fungemia in transplant patients receiving voriconazole after fluconazole.

Journal Article Transplantation · September 27, 2005 The clinical impact of voriconazole resistance in Candida glabrata is not well described. Five hematopoietic stem cell transplant recipients that developed breakthrough Candida glabrata bloodstream infections while receiving voriconazole are described and ... Full text Link to item Cite

Weird fungi

Journal Article ASM News · September 1, 2005 Cite

Cryptococcus neoformans: a sugar-coated killer with designer genes.

Journal Article FEMS Immunol Med Microbiol · September 1, 2005 Cryptococcus neoformans has become a common central nervous system pathogen as the immunocompromised populations enlarge world-wide. This encapsulated yeast has significant advantages for the study of fungal pathogenesis and these include: (1) a clinically ... Full text Link to item Cite

Cryptococcus neoformans {alpha} strains preferentially disseminate to the central nervous system during coinfection.

Journal Article Infect Immun · August 2005 Cryptococcus neoformans is a fungal pathogen that has evolved over the past 40 million years into three distinct varieties or sibling species (gattii, grubii, and neoformans). Each variety manifests differences in epidemiology and disease, and var. grubii ... Full text Link to item Cite

Identification and characterization of an SKN7 homologue in Cryptococcus neoformans.

Journal Article Infect Immun · August 2005 Cryptococcus neoformans is an encapsulated fungal pathogen that primarily infects the central nervous system of immunocompromised individuals, causing life-threatening meningoencephalitis. The capacity of C. neoformans to subvert host defenses and dissemin ... Full text Link to item Cite

Novel use of a swimming pool biocide in the treatment of a rare fungal mastoiditis.

Journal Article Laryngoscope · June 2005 OBJECTIVE: To describe an extremely rare fungal mastoiditis caused by Lecythophora hoffmannii, its recalcitrant behavior to therapy, and eventual successful treatment with adjunctive therapy using polyhexamethylene biguanide (a common swimming pool biocide ... Full text Link to item Cite

Is it time to abandon the use of amphotericin B bladder irrigation?

Journal Article Clin Infect Dis · May 15, 2005 In this article, we review the issues surrounding funguria and its management. With this background, the value of bladder irrigation with amphotericin B for the management of funguria is directly examined. Amphotericin B bladder irrigation is used frequent ... Full text Link to item Cite

Successful use of amphotericin B lipid complex in the treatment of cryptococcosis.

Journal Article Clin Infect Dis · May 1, 2005 The efficacy and renal safety of amphotericin B lipid complex (ABLC) injection were assessed in 106 patients with cryptococcal infection. Eighty-three patients (78%) had a central nervous system (CNS) infection. Of these patients, 20 initiated azole therap ... Full text Link to item Cite

Treatment of non-Aspergillus moulds in immunocompromised patients, with amphotericin B lipid complex.

Journal Article Clin Infect Dis · May 1, 2005 An assessment was made of the efficacy and renal safety of amphotericin B lipid complex (ABLC) in the treatment of patients with invasive fungal infections caused by moulds other than Aspergillus species, on the basis of a retrospective analysis of data fr ... Full text Link to item Cite

Nuances of new anti-Aspergillus antifungals.

Journal Article Med Mycol · May 2005 Invasive aspergillosis (IA) is a serious complication of immunosuppression, and has become more widespread as the immunocompromised population has increased as a result of new treatment strategies and diseases. This paper identifies and discusses seven iss ... Full text Link to item Cite

Liposomal amphotericin B: clinical experience and perspectives.

Journal Article Expert Rev Anti Infect Ther · April 2005 While amphotericin B deoxycholate (Fungizone, Apothecon Pharmaceuticals) has been considered by many to be the gold standard for the treatment for numerous invasive fungal infections for over 45 years, toxicities associated with its use often necessitate t ... Full text Link to item Cite

Phase I evaluation of the safety and pharmacokinetics of murine-derived anticryptococcal antibody 18B7 in subjects with treated cryptococcal meningitis.

Journal Article Antimicrob Agents Chemother · March 2005 A promising approach to improving outcomes in patients with cryptococcal meningitis is to use adjunctive passive immunotherapy with a monoclonal antibody (MAb) directed against the capsular polysaccharide of Cryptococcus neoformans. This is the first appli ... Full text Link to item Cite

Eight years of Drug Resistance Updates

Journal Article Drug Resistance Updates · February 1, 2005 Full text Cite

Evaluation of host immune responses to pulmonary cryptococcosis using a temperature-sensitive C. neoformans calcineurin A mutant strain.

Journal Article Microb Pathog · 2005 Cryptococcus neoformans is an opportunistic fungal pathogen that threatens individuals with impaired cell-mediated immunity (CMI). Presently, there are no standardized vaccines available to prevent cryptococcal infections and conventional anti-fungal drug ... Full text Link to item Cite

Cytochrome c peroxidase contributes to the antioxidant defense of Cryptococcus neoformans.

Journal Article Fungal Genet Biol · January 2005 Cryptococcus neoformans is an opportunistic pathogen and the leading cause of fungal meningitis. To survive within the host, this organism must be able to protect itself from oxidative stress. Cytochrome c peroxidase (Ccp1) is a mitochondrial antioxidant t ... Full text Link to item Cite

Cryptococcus neoformans mitochondrial superoxide dismutase: an essential link between antioxidant function and high-temperature growth.

Journal Article Eukaryot Cell · January 2005 Manganese superoxide dismutase is an essential component of the mitochondrial antioxidant defense system of most eukaryotes. In the present study, we used a reverse-genetics approach to assess the contribution of the Cryptococcus neoformans manganese super ... Full text Link to item Cite

Immunology of infection caused by Cryptococcus neoformans.

Journal Article Methods Mol Med · 2005 Cryptococcus neoformans is an opportunistic fungal pathogen that may lead to life-threatening meningoencephalitis and pulmonary infections in immunosuppressed hosts. The lack of an effective fungicidal regimen and the development of antifungal resistant st ... Full text Link to item Cite

Liposomal amphotericin B: Clinical experience and perspectives

Journal Article Expert Review of Anti-Infective Therapy · 2005 While amphotericin B deoxycholate (Fungizone®, Apothecon Pharmaceuticals) has been considered by many to be the gold standard for the treatment for numerous invasive fungal infections for over 45 years, toxicities associated with its use often necessitate ... Full text Cite

Evaluation and management of fungal infections in immunocompromised patients.

Journal Article Dermatol Ther · 2005 As the population of chronically immunosuppressed individuals continues to grow, the prevalence of fungal infections is increasing. Fungal infections in this patient population represent challenges in diagnosis and management. This article will review the ... Full text Link to item Cite

Posaconazole: A viewpoint

Journal Article Drugs · January 1, 2005 Full text Cite

Posaconazole

Journal Article Drugs · 2005 Full text Cite

In vitro interactions between antifungals and immunosuppressants against Aspergillus fumigatus isolates from transplant and nontransplant patients.

Journal Article Antimicrob Agents Chemother · December 2004 We performed in vitro antifungal checkerboard testing on 12 Aspergillus fumigatus clinical isolates (6 transplant recipients and 6 nontransplant patients) with three antifungal agents (amphotericin B, voriconazole, and caspofungin) and three immunosuppress ... Full text Link to item Cite

The calcineurin target, Crz1, functions in azole tolerance but is not required for virulence of Candida albicans.

Journal Article Infect Immun · December 2004 In Candida albicans, calcineurin is essential for virulence and survival during membrane perturbation by azoles. Crz1 is a proposed downstream target of calcineurin based on studies of Saccharomyces cerevisiae. However, the in vitro phenotypes of C. albica ... Full text Link to item Cite

Antifungal resistance: the clinical front.

Journal Article Oncology (Williston Park) · December 2004 The emergence of resistance and changes in the spectrum of Candida infections have led to an increased interest in susceptibility testing of antifungal drugs. Such testing may be particularly useful in patients with invasive candidiasis who have been previ ... Link to item Cite

Use of newer antifungal therapies in clinical practice: what do the data tell us?

Journal Article Oncology (Williston Park) · November 2004 Considering the significant morbidity and mortality associated with invasive fungal infections in immunocompromised patients, it is particularly important to make the diagnosis as early as possible and to make best use of the available antifungal drugs for ... Link to item Cite

Management of invasive mycoses in hematology patients: current approaches.

Journal Article Oncology (Williston Park) · November 2004 Candidiasis and aspergillosis are the most common fungal infections in hematopoietic stem cell transplant recipients and other hematology/oncology patients. Strategies for reducing the morbidity and mortality associated with these infections include antifu ... Link to item Cite

Design of aerosolized amphotericin b formulations for prophylaxis trials among lung transplant recipients.

Journal Article Clin Infect Dis · October 15, 2004 BACKGROUND: Emphasis has been placed on the need for antifungal prophylaxis when transplanted organs are directly exposed to the environment. In lung transplantation, one strategy for prevention has been aerosolization of polyenes into the lung. Despite wi ... Full text Link to item Cite

Native valve endocarditis due to Candida glabrata treated without valvular replacement: a potential role for caspofungin in the induction and maintenance treatment.

Journal Article Clin Infect Dis · October 1, 2004 Conventional antifungal therapy for fungal endocarditis has been associated with a poor cure rate. Therefore, combined medical and surgical therapy has been recommended. However, new potent antifungal agents, such as echinocandins, could increase the medic ... Full text Link to item Cite

Value of an inhalational model of invasive aspergillosis.

Journal Article Med Mycol · October 2004 Animal models of invasive aspergillosis have been used for virulence studies and antifungal efficacy evaluations but results have been inconsistent. In an attempt to reproduce human infection, many Aspergillus animal models have utilized a 'pulmonary route ... Full text Link to item Cite

Identification of Cryptococcus neoformans temperature-regulated genes with a genomic-DNA microarray.

Journal Article Eukaryot Cell · October 2004 The ability to survive and proliferate at 37 degrees C is an essential virulence attribute of pathogenic microorganisms. A partial-genome microarray was used to profile gene expression in the human-pathogenic fungus Cryptococcus neoformans during growth at ... Full text Link to item Cite

Cryptococcus neoformans mitochondrial genomes from serotype A and D strains do not influence virulence.

Journal Article Curr Genet · October 2004 Cryptococcus neoformans is an encapsulated pathogenic yeast producing meningoencephalitis. Two primary strains in genetic studies, serotype A H99 and serotype D JEC21, possess dramatic differences in virulence. Since it has been shown that mitochondrial ge ... Full text Link to item Cite

Novel modes of antifungal drug administration.

Journal Article Expert Opin Investig Drugs · August 2004 Administration of antifungals by routes other than that for which the agent was designed or approved have been utilised in attempts to provide directed therapy, reduce adverse effects and improve drug penetration into selected infection sites, such as the ... Full text Link to item Cite

Gpr1, a putative G-protein-coupled receptor, regulates morphogenesis and hypha formation in the pathogenic fungus Candida albicans.

Journal Article Eukaryot Cell · August 2004 In response to various extracellular signals, the morphology of the human fungal pathogen Candida albicans switches from yeast to hypha form. Here, we report that GPR1 encoding a putative G-protein-coupled receptor and GPA2 encoding a Galpha subunit are re ... Full text Link to item Cite

Interlaboratory comparison of results of susceptibility testing with caspofungin against Candida and Aspergillus species.

Journal Article J Clin Microbiol · August 2004 Seventeen laboratories participated in a study of interlaboratory reproducibility with caspofungin microdilution susceptibility testing against panels comprising 30 isolates of Candida spp. and 20 isolates of Aspergillus spp. The laboratories used material ... Full text Link to item Cite

Infections due to Aspergillus terreus: a multicenter retrospective analysis of 83 cases.

Journal Article Clin Infect Dis · July 15, 2004 Current in vitro and in vivo data indicate that invasive aspergillosis due to Aspergillus terreus is resistant to treatment with amphotericin B. Because little clinical data are available to guide therapy, we performed a retrospective cohort study of cases ... Full text Link to item Cite

In vitro interactions between antifungals and immunosuppressants against Aspergillus fumigatus.

Journal Article Antimicrob Agents Chemother · May 2004 The optimal treatment for invasive aspergillosis remains elusive, despite the increased efficacy of newer agents. The immunosuppressants cyclosporine (CY), tacrolimus (FK506), and sirolimus (formerly called rapamycin) exhibit in vitro and in vivo activity ... Full text Link to item Cite

Urease expression by Cryptococcus neoformans promotes microvascular sequestration, thereby enhancing central nervous system invasion.

Journal Article Am J Pathol · May 2004 Our objective was to determine the role of the cryptococcal virulence factor urease in pulmonary-to-central nervous system, dissemination, invasion, and growth. C. neoformans H99, the urease knockout strain (ure1) derived from H99, and the urease restored ... Full text Link to item Cite

Recent advances in antifungal pharmacotherapy for invasive fungal infections.

Journal Article Expert Rev Anti Infect Ther · April 2004 Invasive fungal infections carry significant morbidity and mortality. Candida species have become one of the most frequent causes of bloodstream infections, and infections caused by molds such as Aspergillus are becoming more frequent in immunocompromised ... Full text Link to item Cite

Our current understanding of therapies for invasive fungal infections

Journal Article Advanced Studies in Medicine · April 1, 2004 This article provides an update on the current state of the art for treating invasive fungal infections, with insights, based on the experience of the author, into future directions for antifungal treatment strategies. Amphotericin B deoxycholate (amBd) is ... Cite

Combination antifungal therapy.

Journal Article Antimicrob Agents Chemother · March 2004 Full text Link to item Cite

Aspergillus fumigatus empyema, arthritis, and calcaneal osteomyelitis in a lung transplant patient successfully treated with posaconazole.

Journal Article J Clin Microbiol · March 2004 A 64-year-old male with Aspergillus fumigatus infection that had disseminated from the lung to the ankle and adjacent bone was treated successfully with posaconazole after therapy with itraconazole and amphotericin B lipid complex failed. Marked clinical i ... Full text Link to item Cite

In vitro and in vivo efficacies of the new triazole albaconazole against Cryptococcus neoformans.

Journal Article Antimicrob Agents Chemother · February 2004 The activity of albaconazole (UR-9825; J. Uriach & Cía. S.A., Barcelona, Spain) was compared to that of fluconazole against 12 isolates of Cryptococcus neoformans in vitro and against 1 isolate in vivo in a rabbit model of cryptococcal meningitis. Albacona ... Full text Link to item Cite

Comparative safety of amphotericin B lipid complex and amphotericin B deoxycholate as aerosolized antifungal prophylaxis in lung-transplant recipients.

Journal Article Transplantation · January 27, 2004 BACKGROUND: Aerosolized administrations of amphotericin B deoxycholate (AmBd) and amphotericin B lipid complex (ABLC) in lung transplant recipients were compared for safety and tolerability. The incidence of invasive fungal infections in patients receiving ... Full text Link to item Cite

Rational use of antifungals for invasive fungal infections in the institutional setting

Chapter · January 1, 2004 The incidence of invasive fungal infections (IFIs) is increasing at an alarming rate. In the past decade alone, Candida spp. have become the fourth leading cause of nosocomial bloodstream infections in the United States (1). The incidence of Aspergillus in ... Cite

Fungal infections in cancer patients

Chapter · January 1, 2004 Cite

Candida endocarditis: contemporary cases from the International Collaboration of Infectious Endocarditis Merged Database (ICE-mD).

Journal Article Scand J Infect Dis · 2004 Candida infective endocarditis (IE) is increasingly common, yet most reports have been single-center reviews. We evaluated 16 patients with Candida IE nested within a cohort of 2,022 patients with IE. Prosthetic valve IE was more common in patients with Ca ... Full text Link to item Cite

Status of medical mycology education.

Journal Article Med Mycol · December 2003 The number of immunocompromised patients and subsequent invasive fungal infections continues to rise. However, the education of future medical mycologists to engage this growing problem is diminishing. While there are an increasing number of publications a ... Full text Link to item Cite

Cryptococcus neoformans gene expression during experimental cryptococcal meningitis.

Journal Article Eukaryot Cell · December 2003 Cryptococcus neoformans, an encapsulated basidiomycete fungus of medical importance, is capable of crossing the blood-brain barrier and causing meningitis in both immunocompetent and immunocompromised individuals. To gain insight into the adaptation of the ... Full text Link to item Cite

Risk of fungemia due to Rhodotorula and antifungal susceptibility testing of Rhodotorula isolates.

Journal Article J Clin Microbiol · November 2003 Rhodotorula infections occur among patients with immunosuppression and/or central venous catheters. Using standardized methods (NCCLS M27-A), we determined the antifungal susceptibilities of 10 Rhodotorula bloodstream infection isolates. Patient informatio ... Full text Link to item Cite

Scedosporium species infections and treatments.

Journal Article J Chemother · November 2003 Scedosporium species are now increasingly isolated from immunocompromised and immunocompetent patients. Unfortunately, Scedosporium species infections are generally resistant to amphotericin B, and S. prolificans strains are particularly resistant to prese ... Full text Link to item Cite

Identification of App1 as a regulator of phagocytosis and virulence of Cryptococcus neoformans.

Journal Article J Clin Invest · October 2003 Cryptococcus neoformans is a fungal pathogen that, after inhalation, can disseminate to the brain. Host alveolar macrophages (AMs) represent the first defense against the fungus. Once phagocytosed by AMs, fungal cells are killed by a concerted mechanism, i ... Full text Link to item Cite

Role of alternative oxidase gene in pathogenesis of Cryptococcus neoformans.

Journal Article Infect Immun · October 2003 We identified a homologue of the alternative oxidase gene in a screen to identify genes that are preferentially transcribed in response to a shift to 37 degrees C in the human-pathogenic yeast Cryptococcus neoformans. Alternative oxidases are nucleus-encod ... Full text Link to item Cite

Pulmonary fungal infections: Making the diagnosis

Journal Article Journal of Respiratory Diseases · October 1, 2003 Since endemic mycoses can be contracted during a brief travel exposure, it is important to inquire about travel when a patient presents with symptoms of a respiratory infection. Most patients with blastomycosis present in the chronic phase, with cough, wei ... Cite

Sexual cycle of Cryptococcus neoformans var. grubii and virulence of congenic a and alpha isolates.

Journal Article Infect Immun · September 2003 Cryptococcus neoformans is a human-pathogenic fungus that has evolved into three distinct varieties that infect most prominently the central nervous system. A sexual cycle involving haploid cells of a and alpha mating types has been reported for two variet ... Full text Link to item Cite

Cerebral phaeohyphomycosis in an immunodeficient child treated medically with combination antifungal therapy.

Journal Article Med Mycol · August 2003 Cerebral phaeohyphomycosis is a rare fungal infection with a poor prognosis when using conventional antifungal therapy in the absence of neurosurgical intervention. We present a case of a pediatric patient with inoperable Cladophialophora bantiana cerebral ... Full text Link to item Cite

Scedosporium prolificans osteomyelitis in an immunocompetent child treated with voriconazole and caspofungin, as well as locally applied polyhexamethylene biguanide.

Journal Article J Clin Microbiol · August 2003 Scedosporium species are increasingly isolated from immunocompromised and immunocompetent patients. Unfortunately, Scedosporium infections are generally resistant to amphotericin B, and Scedosporium prolificans strains are particularly resistant to the ant ... Full text Link to item Cite

Global distribution and outcomes for Candida species causing invasive candidiasis: results from an international randomized double-blind study of caspofungin versus amphotericin B for the treatment of invasive candidiasis.

Journal Article Eur J Clin Microbiol Infect Dis · August 2003 In a randomized study, caspofungin was compared with amphotericin B for the treatment of invasive candidiasis in a total of 239 adults from 56 sites in 20 countries. This study provided a unique opportunity to assess the frequency and outcome of invasive c ... Full text Link to item Cite

A MAP kinase cascade composed of cell type specific and non-specific elements controls mating and differentiation of the fungal pathogen Cryptococcus neoformans.

Journal Article Mol Microbiol · July 2003 Cryptococcus neoformans is an opportunistic fungal pathogen with a defined sexual cycle in which the alpha allele of the mating type locus is linked to virulence and haploid differentiation. Here we analysed a conserved MAP kinase cascade composed of matin ... Full text Link to item Cite

Candidemia in women with breast carcinoma treated with high-dose chemotherapy and autologous bone marrow transplantation.

Journal Article Cancer · July 1, 2003 BACKGROUND: Invasive fungal infections, including candidemia, pose a major threat to patients with impaired immune defenses, including bone marrow transplantation (BMT) recipients. During 1992-1997, 845 women with multiple lymph node positive or metastatic ... Full text Link to item Cite

Calcineurin is essential for Candida albicans survival in serum and virulence.

Journal Article Eukaryot Cell · June 2003 Calcineurin is a calcium-activated protein phosphatase that is the target of the immunosuppressants cyclosporin A and FK506. In T cells, calcineurin controls nuclear import of the NF-AT transcription factor and gene activation. In plants and fungi, calcine ... Full text Link to item Cite

Caspofungin: first approved agent in a new class of antifungals.

Journal Article Expert Opin Pharmacother · May 2003 Caspofungin (Cancidas, Merck & Co. Inc.) is the first echinocandin antifungal agent to gain FDA-approval for use in the US. It has excellent clinical activity against Candida spp. and Aspergillus spp. but lacks significant activity against Cryptococcus neo ... Full text Link to item Cite

Voriconazole treatment for less-common, emerging, or refractory fungal infections.

Journal Article Clin Infect Dis · May 1, 2003 Treatments for invasive fungal infections remain unsatisfactory. We evaluated the efficacy, tolerability, and safety of voriconazole as salvage treatment for 273 patients with refractory and intolerant-to-treatment fungal infections and as primary treatmen ... Full text Link to item Cite

Regulation of cytochrome c oxidase subunit 1 (COX1) expression in Cryptococcus neoformans by temperature and host environment.

Journal Article Microbiology (Reading) · April 2003 In the study of differential gene expression of Cryptococcus neoformans, a transcript of COX1 (cytochrome oxidase c subunit 1) was identified in a serotype A strain. The transcript was upregulated at 37 degrees C compared to 30 degrees C and expressed by y ... Full text Link to item Cite

Role of PLB1 in pulmonary inflammation and cryptococcal eicosanoid production.

Journal Article Infect Immun · March 2003 Cryptococcal phospholipase (PLB1) is a secreted enzyme with lysophospholipase hydrolase and lysophospholipase transacylase activities. To investigate the role of PLB1 in the evasion of host immune responses, we characterized pulmonary immune responses to t ... Full text Link to item Cite

Newer antifungal therapy for emerging fungal pathogens.

Journal Article Int J Infect Dis · March 2003 As the number of immunocompromised patients increases, there is a concomitant increase in the number and diversity of fungal infections. Fungi that were once considered harmless or contaminants are now pathogenic in the immunocompromised host. Often these ... Full text Link to item Cite

Teaching old drugs new tricks: reincarnating immunosuppressants as antifungal drugs.

Journal Article Curr Opin Investig Drugs · February 2003 Invasive fungal infections are rising worldwide as the number of immunocompromised patients increases. Unfortunately, our armamentarium of antifungal drugs is limited. Although current therapies are effective in treating some of the most prevalent infectio ... Link to item Cite

Antifungal pharmacotherapy for invasive mould infections.

Journal Article Expert Opin Pharmacother · February 2003 The incidence of invasive mould infections is increasing and is associated with significant morbidity and mortality. Among the most prevalent of these infections are those caused by Aspergillus and Fusarium species. Invasive disease caused by moulds freque ... Full text Link to item Cite

A randomized comparative study to determine the effect of omeprazole on the peak serum concentration of itraconazole oral solution.

Journal Article J Antimicrob Chemother · February 2003 To determine the effect of omeprazole on peak serum concentrations (C(max)) of itraconazole oral solution (IOS), we carried out a randomized, open-label, prospective, crossover study. Fifteen healthy, non-pregnant adults received a single dose of IOS 400 m ... Full text Link to item Cite

Superoxide dismutase influences the virulence of Cryptococcus neoformans by affecting growth within macrophages.

Journal Article Infect Immun · January 2003 Superoxide dismutase (SOD) is an enzyme that converts superoxide radicals into hydrogen peroxide and molecular oxygen and has been shown to contribute to the virulence of many human-pathogenic bacteria through its ability to neutralize toxic levels of reac ... Full text Link to item Cite

Comparison of caspofungin and amphotericin B for invasive candidiasis.

Journal Article N Engl J Med · December 19, 2002 BACKGROUND: Caspofungin is an echinocandin agent with fungicidal activity against candida species. We performed a double-blind trial to compare caspofungin with amphotericin B deoxycholate for the primary treatment of invasive candidiasis. METHODS: We enro ... Full text Link to item Cite

Cryptococcosis.

Journal Article Infect Dis Clin North Am · December 2002 Cryptococcus neoformans has risen to a worldwide highly recognizable major opportunistic pathogen with deadly consequences. It has become a model fungus to study a variety of paradigms in the host-fungus relationships. Genomic studies are advancing knowled ... Full text Link to item Cite

Killing of Caenorhabditis elegans by Cryptococcus neoformans as a model of yeast pathogenesis.

Journal Article Proc Natl Acad Sci U S A · November 26, 2002 We found that the well-studied nematode Caenorhabditis elegans can use various yeasts, including Cryptococcus laurentii and Cryptococcus kuetzingii, as a sole source of food, producing similar brood sizes compared with growth on its usual laboratory food s ... Full text Link to item Cite

Relationship of the glyoxylate pathway to the pathogenesis of Cryptococcus neoformans.

Journal Article Infect Immun · October 2002 Functional genomics has become a major focus in the study of microbial pathogenesis. This study used a functional genomic tool, differential display reverse transcription-PCR, to identify a transcriptional profile of Cryptococcus neoformans cells as they p ... Full text Link to item Cite

Safety and efficacy of quinupristin/dalfopristin for treatment of invasive Gram-positive infections in pediatric patients.

Journal Article Pediatr Infect Dis J · October 2002 BACKGROUND: Antibiotic-resistant Gram-positive pathogens are an increasingly common cause of serious pediatric infections. Although quinupristin/dalfopristin demonstrates favorable activity against resistant Gram-positive pathogens (including many vancomyc ... Full text Link to item Cite

Steady-state pharmacokinetics of lamivudine in human immunodeficiency virus-infected patients with end-stage renal disease receiving chronic dialysis.

Journal Article Antimicrob Agents Chemother · August 2002 The steady-state pharmacokinetics of lamivudine were evaluated in 11 subjects with human immunodeficiency virus infection and end-stage renal disease, 9 of whom were receiving hemodialysis and 2 of whom were receiving chronic ambulatory peritoneal dialysis ... Full text Link to item Cite

New antifungal agents.

Journal Article Semin Respir Infect · June 2002 Treatment of fungal infections is an area of increasing concern. This is because of the complexity of underlying illness in affected patients as well as the limited number of antifungal agents available for use. Current strategies focus on prevention of th ... Full text Link to item Cite

Mating-type-specific and nonspecific PAK kinases play shared and divergent roles in Cryptococcus neoformans.

Journal Article Eukaryot Cell · April 2002 Cryptococcus neoformans is an opportunistic fungal pathogen with a defined sexual cycle involving fusion of haploid MATalpha and MATa cells. Virulence has been linked to the mating type, and MATalpha cells are more virulent than congenic MATa cells. To stu ... Full text Link to item Cite

Recent advances in the epidemiology, prevention, diagnosis, and treatment of fungal pneumonia.

Journal Article Curr Opin Infect Dis · April 2002 Although pneumonia caused by fungi is not a common occurrence in the general population, disease in an enlarging immunocompromised population is encountered with increasing frequency. Fungal pneumonias are most frequently caused by Aspergillus spp., dimorp ... Full text Link to item Cite

Voriconazole in the treatment of aspergillosis, scedosporiosis and other invasive fungal infections in children.

Journal Article Pediatr Infect Dis J · March 2002 OBJECTIVE: To describe the safety and efficacy of voriconazole in children treated within the compassionate release program. METHODS: Children received voriconazole on a compassionate basis for treatment of an invasive fungal infection if they were refract ... Full text Link to item Cite

Calcineurin is essential for survival during membrane stress in Candida albicans.

Journal Article EMBO J · February 15, 2002 The immunosuppressants cyclosporin A (CsA) and FK506 inhibit the protein phosphatase calcineurin and block T-cell activation and transplant rejection. Calcineurin is conserved in microorganisms and plays a general role in stress survival. CsA and FK506 are ... Full text Link to item Cite

An auxotrophic pigmented Cryptococcus neoformans strain causing infection of the bone marrow.

Journal Article Med Mycol · February 2002 Cryptococcosis, caused by an encapsulated fungus, Cryptococcus neoformans, has emerged as a life-threatening infection in HIV-positive individuals and other immunocompromised hosts. This report describes an unusual strain of C. neoformans isolated from an ... Full text Link to item Cite

Adenylyl cyclase functions downstream of the Galpha protein Gpa1 and controls mating and pathogenicity of Cryptococcus neoformans.

Journal Article Eukaryot Cell · February 2002 The signaling molecule cyclic AMP (cAMP) is a ubiquitous second messenger that enables cells to detect and respond to extracellular signals. cAMP is generated by the enzyme adenylyl cyclase, which is activated or inhibited by the Galpha subunits of heterot ... Full text Link to item Cite

Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever.

Journal Article N Engl J Med · January 24, 2002 BACKGROUND: Patients with neutropenia and persistent fever are often treated empirically with amphotericin B or liposomal amphotericin B to prevent invasive fungal infections. Antifungal triazoles offer a potentially safer and effective alternative. METHOD ... Full text Link to item Cite

Outcome of lung transplantation in patients with mycetomas.

Journal Article Chest · January 2002 BACKGROUND: Lung transplantation has become an acceptable treatment option for many end-stage lung diseases. Pulmonary mycetomas are found in patients with end-stage lung diseases, especially sarcoidosis. The clinical course and long-term outcome of these ... Full text Link to item Cite

Antisense repression in Cryptococcus neoformans as a laboratory tool and potential antifungal strategy.

Journal Article Microbiology (Reading) · January 2002 Antisense repression was used as a method to alter gene function in the human-pathogenic fungus Cryptococcus neoformans. The calcineurin A gene (CNA1) and the laccase gene (LAC1) were targeted since disruption of these loci results in phenotypes that are e ... Full text Link to item Cite

New antifungal agents.

Journal Article Transpl Infect Dis · 2002 Full text Link to item Cite

Antisense repression in Cryptococcus neoformans as a laboratory tool and potential antifungal strategy

Journal Article Microbiology · 2002 Antisense repression was used as a method to alter gene function in the human-pathogenic fungus Cryptococcus neoformans. The calcineurin A gene (CNA1) and the laccase gene (LAC1) were targeted since disruption of these loci results in phenotypes that are e ... Cite

The impact of culture isolation of Aspergillus species: a hospital-based survey of aspergillosis.

Journal Article Clin Infect Dis · December 1, 2001 The term "aspergillosis" comprises several categories of infection: invasive aspergillosis; chronic necrotizing aspergillosis; aspergilloma, or fungus ball; and allergic bronchopulmonary aspergillosis. In 24 medical centers, we examined the impact of a cul ... Full text Link to item Cite

Fungal phospholipase activity and susceptibility to lipid preparations of amphotericin B.

Journal Article Antimicrob Agents Chemother · November 2001 It has been postulated that phospholipases of fungal origin can affect in vitro susceptibility testing of amphotericin B lipid complex (ABLC). We used specific phospholipase-deficient mutants of Candida albicans and Cryptococcus neoformans in susceptibilit ... Full text Link to item Cite

Rapamycin and less immunosuppressive analogs are toxic to Candida albicans and Cryptococcus neoformans via FKBP12-dependent inhibition of TOR.

Journal Article Antimicrob Agents Chemother · November 2001 Candida albicans and Cryptococcus neoformans cause both superficial and disseminated infections in humans. Current antifungal therapies for deep-seated infections are limited to amphotericin B, flucytosine, and azoles. A limitation is that commonly used az ... Full text Link to item Cite

Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy.

Journal Article Clin Infect Dis · September 1, 2001 We conducted a case study of human immunodeficiency virus (HIV)-negative patients with cryptococcosis at 15 United States medical centers from 1990 through 1996 to understand the demographics, therapeutic approach, and factors associated with poor prognosi ... Full text Link to item Cite

Safety of aerosolized amphotericin B lipid complex in lung transplant recipients.

Journal Article Transplantation · August 15, 2001 BACKGROUND: Fungal infections remain an important cause of morbidity and mortality in lung transplant recipients. Aerosolized amphotericin B lipid complex (ABLC) may be more efficacious than conventional amphotericin B in the prevention of fungal infection ... Full text Link to item Cite

Two cyclophilin A homologs with shared and distinct functions important for growth and virulence of Cryptococcus neoformans.

Journal Article EMBO Rep · June 2001 Cyclophilin A is the target of the immunosuppressant cyclosporin A (CsA) and is encoded by a single unique gene conserved from yeast to humans. In the pathogenic fungus Cryptococcus neoformans, two homologous linked genes, CPA1 and CPA2, were found to enco ... Full text Link to item Cite

Diguanidino and "reversed" diamidino 2,5-diarylfurans as antimicrobial agents.

Journal Article J Med Chem · May 24, 2001 Dicationic 2,5-bis(4-guanidinophenyl)furans 5a-5f, 2,5-bis[4-(arylimino)aminophenyl]furans 6a-6b and 6e-6k, and 2,5-bis[4-(alkylimino)aminophenyl]furans 6c-6d have been synthesized starting from 2,5-bis[tri-n-butylstannyl]furan. Thermal melting studies wit ... Full text Link to item Cite

Identification and characterization of the Cryptococcus neoformans phosphomannose isomerase-encoding gene, MAN1, and its impact on pathogenicity.

Journal Article Mol Microbiol · May 2001 The polysaccharide capsule surrounding Cryptococcus neoformans comprises manose, xylose and glucuronic acid, of which mannose is the major constituent. The GDP-mannose biosynthesis pathway is highly conserved in fungi and consists of three key enzymes: pho ... Full text Link to item Cite

Cyclic AMP-dependent protein kinase controls virulence of the fungal pathogen Cryptococcus neoformans.

Journal Article Mol Cell Biol · May 2001 Cryptococcus neoformans is an opportunistic fungal pathogen that infects the human central nervous system. This pathogen elaborates two specialized virulence factors: the antioxidant melanin and an antiphagocytic immunosuppressive polysaccharide capsule. A ... Full text Link to item Cite

Roles for inositol-phosphoryl ceramide synthase 1 (IPC1) in pathogenesis of C. neoformans.

Journal Article Genes Dev · January 15, 2001 Cryptococcus neoformans is a leading cause of life-threatening fungal infection in immunocompromised patients. Inositol-phosphoryl ceramide synthase 1 (Ipc1) is a fungus-specific enzyme, encoded by the essential IPC1 gene, that catalyzes the formation of c ... Full text Link to item Cite

Extracellular phospholipase activity is a virulence factor for Cryptococcus neoformans.

Journal Article Mol Microbiol · January 2001 The human pathogenic fungus Cryptococcus neoformans secretes a phospholipase enzyme that demonstrates phospholipase B (PLB), lysophospholipase hydrolase and lysophospholipase transacylase activities. This enzyme has been postulated to be a cryptococcal vir ... Full text Link to item Cite

Identification of the MATa mating-type locus of Cryptococcus neoformans reveals a serotype A MATa strain thought to have been extinct.

Journal Article Proc Natl Acad Sci U S A · December 19, 2000 Cryptococcus neoformans is an opportunistic fungal pathogen with a defined sexual cycle involving mating between haploid MATa and MATalpha cells. Here we describe the isolation of part of the MATa mating-type locus encoding a Ste20 kinase homolog, Ste20a. ... Full text Link to item Cite

Treatment of methicillin-resistant staphylococcus aureus infections with quinupristin-dalfopristin in patients intolerant of or failing prior therapy. For the Synercid Emergency-Use Study Group.

Journal Article J Antimicrob Chemother · November 2000 Safety and efficacy of quinupristin-dalfopristin (an injectable streptogramin antibiotic) were evaluated in the treatment of a variety of infections due to methicillin-resistant Staphylococcus aureus (MRSA) in patients either intolerant of or failing prior ... Full text Link to item Cite

Antifungal pharmacodynamics: review of the literature and clinical applications.

Journal Article Pharmacotherapy · November 2000 Invasive fungal infections are seen with growing frequency, likely due to increases in numbers of patients at risk of infection. Optimal selection and dosing of antifungal agents are important, as these infections are often refractory to available therapy. ... Full text Link to item Cite

Virulence mechanisms for fungi, Part II

Journal Article Clinical Microbiology Newsletter · August 15, 2000 With the molecular tools available for gene manipulation in pathogenic fungi and the rapid development of functional genomics and genome sequencing, the potential to understand the virulence composite of fungal pathogens has never been greater. Virulence g ... Full text Cite

Virulence mechanisms for fungi, Part I

Journal Article Clinical Microbiology Newsletter · August 1, 2000 In this first of a two-part article, the authors begin by discussing the general concepts of fungal virulence as well as host factors and fungal-specific factors that may contribute to the development of human disease. This discussion is followed by a desc ... Full text Cite

Identification and characterization of a highly conserved calcineurin binding protein, CBP1/calcipressin, in Cryptococcus neoformans.

Journal Article EMBO J · July 17, 2000 Calcineurin is the conserved target of the immunosuppressants cyclosporin A and FK506. Using the yeast two-hybrid system, we identified a novel calcineurin binding protein, CBP1, from the pathogenic fungus Cryptococcus neoformans. We show that CBP1 binds t ... Full text Link to item Cite

Voriconazole for salvage treatment of invasive aspergillosis

Conference CLINICAL INFECTIOUS DISEASES · July 1, 2000 Link to item Cite

New potential targets for antifungal development

Journal Article Expert Opinion on Therapeutic Targets · June 1, 2000 With the increasing number of immunocompromised hosts and advances in medical technology there has been a concomitant rise in the number of cases of invasive fungal infections. Novel approaches for the discovery of new antifungal targets and their inhibito ... Full text Cite

RAS1 regulates filamentation, mating and growth at high temperature of Cryptococcus neoformans.

Journal Article Mol Microbiol · April 2000 Cryptococcus neoformans is a basidiomycete yeast and opportunistic human pathogen of increasing clinical importance due to the increasing population of immunocompromised patients. To further investigate signal transduction cascades regulating fungal pathog ... Full text Link to item Cite

Agents for treatment of invasive fungal infections.

Journal Article Otolaryngol Clin North Am · April 2000 The incidence of fungal infections continues to rise as the population of immunocompromised individuals increases. Despite the enlarging numbers of infections, there are only a few antifungal agents for treatment of deep-seated, invasive infections. These ... Full text Link to item Cite

Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America.

Journal Article Clin Infect Dis · April 2000 An 8-person subcommittee of the National Institute of Allergy and Infectious Diseases (NIAID) Mycoses Study Group evaluated available data on the treatment of cryptococcal disease. Opinion regarding optimal treatment was based on personal experience and in ... Full text Link to item Cite

Synergistic antifungal activities of bafilomycin A(1), fluconazole, and the pneumocandin MK-0991/caspofungin acetate (L-743,873) with calcineurin inhibitors FK506 and L-685,818 against Cryptococcus neoformans.

Journal Article Antimicrob Agents Chemother · March 2000 Cryptococcus neoformans is an opportunistic fungal pathogen that causes life-threatening infections of the central nervous system. Existing therapies include amphotericin B, fluconazole, and flucytosine, which are limited by toxic side effects and the emer ... Full text Link to item Cite

Urease as a virulence factor in experimental cryptococcosis.

Journal Article Infect Immun · February 2000 Urease catalyzes the hydrolysis of urea to ammonia and carbamate and has been found to be an important pathogenic factor for certain bacteria. Cryptococcus neoformans is a significant human pathogenic fungus that produces large amounts of urease; thus we w ... Full text Link to item Cite

Reply.

Other J Infect Dis · February 2000 Full text Link to item Cite

Immunosuppressive and nonimmunosuppressive cyclosporine analogs are toxic to the opportunistic fungal pathogen Cryptococcus neoformans via cyclophilin-dependent inhibition of calcineurin.

Journal Article Antimicrob Agents Chemother · January 2000 Cyclosporine (CsA) is an immunosuppressive and antimicrobial drug which, in complex with cyclophilin A, inhibits the protein phosphatase calcineurin. We recently found that Cryptococcus neoformans growth is resistant to CsA at 24 degrees C but sensitive at ... Full text Link to item Cite

The G-protein beta subunit GPB1 is required for mating and haploid fruiting in Cryptococcus neoformans.

Journal Article Mol Cell Biol · January 2000 Cryptococcus neoformans is an opportunistic fungal pathogen with a defined sexual cycle. The gene encoding a heterotrimeric G-protein beta subunit, GPB1, was cloned and disrupted. gpb1 mutant strains are sterile, indicating a role for this gene in mating. ... Full text Link to item Cite

Anastomotic infections in lung transplant recipients.

Journal Article Ann Transplant · 2000 OBJECTIVES: Anastomotic infections are an uncommon but potentially devastating complication after lung transplantation. The incidence, microbiology, predisposing factors, and clinical outcomes of anastomotic infections have not been well described. METHODS ... Link to item Cite

Tuberculous pseudoaneurysm of the thoracoabdominal aorta: Case and review

Journal Article Infectious Diseases in Clinical Practice · January 1, 2000 Full text Cite

Knockout mice as experimental models of virulence.

Journal Article Med Mycol · 2000 Infection models with animals whose immune systems have been selectively altered by neutralization of endogenous cytokines or by deletion of a gene have provided a valuable means to study the function of cells or cytokines in the context of complex multidi ... Link to item Cite

Fungal meningitis.

Journal Article Semin Neurol · 2000 Fungi provide many benefits to humans. However, some of these fungi have the ability to become human pathogens. All the major fungal pathogens can produce meningitis. From the common cryptococcal meningitis to the rare fungal meningitis caused by a dimorph ... Full text Link to item Cite

Oropharyngeal candidiasis in patients with HIV: suggested guidelines for therapy.

Journal Article AIDS Res Hum Retroviruses · December 10, 1999 The high frequency of oropharyngeal candidiasis in immunocompromised patients has led many institutions to develop protocols to guide the use of antifungal agents in the treatment of this opportunistic infection. However, few specific recommendations have ... Full text Link to item Cite

Comparison of in vitro activities of camptothecin and nitidine derivatives against fungal and cancer cells.

Journal Article Antimicrob Agents Chemother · December 1999 The activities of a series of camptothecin and nitidine derivatives that might interact with topoisomerase I were compared against yeast and cancer cell lines. Our findings reveal that structural modifications to camptothecin derivatives have profound effe ... Full text Link to item Cite

The STE12alpha homolog is required for haploid filamentation but largely dispensable for mating and virulence in Cryptococcus neoformans.

Journal Article Genetics · December 1999 Cryptococcus neoformans is a fungal pathogen that causes meningitis in immunocompromised hosts. The organism has a known sexual cycle, and strains of the MATalpha mating type are more virulent than isogenic MATa strains in mice, and they are more common in ... Full text Link to item Cite

Diagnosis and treatment of oropharyngeal candidiasis in patients infected with HIV: a critical reassessment.

Journal Article AIDS Res Hum Retroviruses · November 1, 1999 Oropharyngeal candidiasis is the most common opportunistic infection seen in patients infected with the human immunodeficiency virus (HIV). As HIV disease progresses and immunosuppression worsens, the incidence and severity of oropharyngeal candidiasis inc ... Full text Link to item Cite

Antifungal activities of antineoplastic agents: Saccharomyces cerevisiae as a model system to study drug action.

Journal Article Clin Microbiol Rev · October 1999 Recent evolutionary studies reveal that microorganisms including yeasts and fungi are more closely related to mammals than was previously appreciated. Possibly as a consequence, many natural-product toxins that have antimicrobial activity are also toxic to ... Full text Link to item Cite

Drug resistance in Cryptococcus neoformans.

Journal Article Drug Resist Updat · August 1999 Cryptococcus neoformans has become a major opportunistic fungal pathogen worldwide. Successful treatment of invasive disease with this fungus has used amphotericin B, flucytosine and various azoles. However, treatment failures continue to occur for a varie ... Full text Link to item Cite

Association of plasma levels of human immunodeficiency virus type 1 RNA and oropharyngeal Candida colonization.

Journal Article J Infect Dis · August 1999 The pathophysiology of oropharyngeal candidiasis in patients infected with human immunodeficiency virus (HIV) type 1 is poorly understood. Association between oropharyngeal yeast carriage and various clinical factors in HIV-1-infected patients was studied ... Full text Link to item Cite

In-vitro activity of dicationic aromatic compounds and fluconazole against Cryptococcus neoformans and Candida spp.

Journal Article J Antimicrob Chemother · August 1999 We investigated the in-vitro activity of three selected dicationic aromatic compounds for nine clinical isolates of Cryptococcus neoformans and 93 clinical isolates of Candida spp., representing 12 different species, using a broth macrodilution method foll ... Full text Link to item Cite

Rapamycin antifungal action is mediated via conserved complexes with FKBP12 and TOR kinase homologs in Cryptococcus neoformans.

Journal Article Mol Cell Biol · June 1999 Cryptococcus neoformans is a fungal pathogen that causes meningitis in patients immunocompromised by AIDS, chemotherapy, organ transplantation, or high-dose steroids. Current antifungal drug therapies are limited and suffer from toxic side effects and drug ... Full text Link to item Cite

Topoisomerase I is essential in Cryptococcus neoformans: role In pathobiology and as an antifungal target.

Journal Article Genetics · May 1999 Topisomerase I is the target of several toxins and chemotherapy agents, and the enzyme is essential for viability in some organisms, including mice and drosophila. We have cloned the TOP1 gene encoding topoisomerase I from the opportunistic fungal pathogen ... Full text Link to item Cite

Formation of azole-resistant Candida albicans by mutation of sterol 14-demethylase P450.

Journal Article Antimicrob Agents Chemother · May 1999 The sterol 14-demethylase P450 (CYP51) of a fluconazole-resistant isolate of Candida albicans, DUMC136, showed reduced susceptibility to this azole but with little change in its catalytic activity. Twelve nucleotide substitutions, resulting in four amino a ... Full text Link to item Cite

Cryptococcus neoformans differential gene expression detected in vitro and in vivo with green fluorescent protein.

Journal Article Infect Immun · April 1999 Synthetic green fluorescent protein (GFP) was used as a reporter to detect differential gene expression in the pathogenic fungus Cryptococcus neoformans. Promoters from the C. neoformans actin, GAL7, or mating-type alpha pheromone (MFalpha1) genes were fus ... Full text Link to item Cite

The Cryptococcus neoformans genome sequencing project.

Journal Article Mycopathologia · 1999 Cryptococcus neoformans is a basidiomycete that can cause life-threatening meningoencephalitis in patients with and without impaired immune function. Cryptococcosis is usually an opportunistic infection in patients with compromised immunity as a consequenc ... Full text Link to item Cite

Use of antifungal agents in the intensive care unit

Journal Article Current Opinion in Critical Care · January 1, 1999 Invasive fungal infections in severely ill hospitalized patients are increasing prevalent. Intense efforts are focused on the development of novel antifungal agents as well as improvements in the safety profile of pre-existing agents. New antifungal agents ... Full text Cite

A glucan synthase FKS1 homolog in cryptococcus neoformans is single copy and encodes an essential function.

Journal Article J Bacteriol · January 1999 Cryptococcal meningitis is a fungal infection, caused by Cryptococcus neoformans, which is prevalent in immunocompromised patient populations. Treatment failures of this disease are emerging in the clinic, usually associated with long-term treatment with e ... Full text Link to item Cite

Cryptococcus neoformans: Virulence and host defences

Journal Article Journal of Medical and Veterinary Mycology · December 1, 1998 Cryptococcus neoformans represents a model organism for the study of virulence and the host response. In this discussion, there is a focus on the genetic, molecular, and biochemical aspects of C. neoformans as it interacts with the host. Investigations int ... Cite

Molecular methods for epidemiological and diagnostic studies of fungal infections.

Journal Article Pathology · November 1998 Over the past two decades there has been a remarkable increase in the incidence of invasive fungal infections. Molecular methods, such as karyotyping, restriction analysis and polymerase chain reaction (PCR), have now been applied to improve our current un ... Full text Link to item Cite

Signal transduction pathways regulating differentiation and pathogenicity of Cryptococcus neoformans.

Journal Article Fungal Genet Biol · October 1998 The basidiomycetous yeast Cryptococcus neoformans is a human pathogen. Several phenotypes of this organism are defined as virulence traits including the polysaccharide capsule, melanin, and the ability to grow at 37 degreesC. The signaling pathways regulat ... Full text Link to item Cite

Candidal anastomotic infection in lung transplant recipients: successful treatment with a combination of systemic and inhaled antifungal agents.

Journal Article J Heart Lung Transplant · October 1998 Anastomotic infection is an uncommon but potentially life-threatening complication after lung transplantation. We recently encountered three lung transplant recipients with invasive candidal anastomotic infection. Two patients were admitted with dyspnea an ... Link to item Cite

In vitro and in vivo efficacy of the triazole TAK-187 against Cryptococcus neoformans.

Journal Article Antimicrob Agents Chemother · October 1998 Multiple isolates of Cryptococcus neoformans, including those with fluconazole resistance, were tested to assess the in vitro activity of the new triazole TAK-187. MICs of TAK-187 were at least eightfold lower than those of fluconazole, and fungicidal conc ... Full text Link to item Cite

Structure-in vitro activity relationships of pentamidine analogues and dication-substituted bis-benzimidazoles as new antifungal agents.

Journal Article Antimicrob Agents Chemother · October 1998 Twenty analogues of pentamidine, 7 primary metabolites of pentamidine, and 30 dicationic substituted bis-benzimidazoles were screened for their inhibitory and fungicidal activities against Candida albicans and Cryptococcus neoformans. A majority of the com ... Full text Link to item Cite

In vitro antifungal activities of a series of dication-substituted carbazoles, furans, and benzimidazoles.

Journal Article Antimicrob Agents Chemother · October 1998 Aromatic dicationic compounds possess antimicrobial activity against a wide range of eucaryotic pathogens, and in the present study an examination of the structures-functions of a series of compounds against fungi was performed. Sixty-seven dicationic mole ... Full text Link to item Cite

The Phenomenon of Adventitious Sporulation

Journal Article American Journal of Clinical Pathology · July 1, 1998 Full text Cite

Amphotericin B lipid complex for invasive fungal infections: analysis of safety and efficacy in 556 cases.

Journal Article Clin Infect Dis · June 1998 The safety and antifungal efficacy of amphotericin B lipid complex (ABLC) were evaluated in 556 cases of invasive fungal infection treated through an open-label, single-patient, emergency-use study of patients who were refractory to or intolerant of conven ... Full text Link to item Cite

Biochemical role of the Cryptococcus neoformans ADE2 protein in fungal de novo purine biosynthesis.

Journal Article Arch Biochem Biophys · March 1, 1998 Comparative studies of 5-aminoimidazole ribonucleotide (AIR) carboxylases from Escherichia coli and Gallus gallus have identified this central step in de novo purine biosynthesis as a case for unusual divergence in primary metabolism. Recent discoveries es ... Full text Link to item Cite

Morphologic criteria for the preliminary identification of Fusarium, Paecilomyces, and Acremonium species by histopathology.

Journal Article Am J Clin Pathol · January 1998 Nontraditional human pathogenic fungi, including Fusarium, Paecilomyces, and Acremonium species, have been increasingly documented as agents of infection in immunocompromised patients and, occasionally, in normal hosts. Although definitive identification o ... Full text Link to item Cite

Chest discomfort associated with liposomal amphotericin B: report of three cases and review of the literature.

Journal Article Pharmacotherapy · 1998 Liposomal formulations of amphotericin B are designed to maintain therapeutic efficacy of amphotericin B deoxycholate while reducing its associated toxicities. In three patients chest discomfort occurred during planned 1-hour infusions of liposomal amphote ... Link to item Cite

Cryptococcus neoformans: virulence and host defences.

Journal Article Med Mycol · 1998 Cryptococcus neoformans represents a model organism for the study of virulence and the host response. In this discussion, there is a focus on the genetic, molecular, and biochemical aspects of C. neoformans as it interacts with the host. Investigations int ... Link to item Cite

Cryptococcus neoformans mating and virulence are regulated by the G-protein alpha subunit GPA1 and cAMP.

Journal Article Genes Dev · December 1, 1997 This study explores signal transduction pathways that function during mating and infection in the opportunistic, human fungal pathogen Cryptococcus neoformans. The gene encoding a G-protein alpha subunit homolog, GPA1, was disrupted by homologous recombina ... Full text Link to item Cite

Cryptococcosis in non-HIV infected patients: A multicemer survey

Journal Article Clinical Infectious Diseases · December 1, 1997 Cryptococcosis (crypto) is an important invasive fungal pathogen among HIV infected pts. Since the development of fluconazole (Flu) and itraconazole (Itra), the treatment of crypto has evolved, largely based on studies in these pts. In an effort to better ... Cite

GPA1 regulates capsule formation, melanin production, mating, and virulence in Cryptococcus neoformans

Journal Article Clinical Infectious Diseases · December 1, 1997 Virulence of the pathogenic fungus Cryptococcus neoformans is determined by several factors, including the production of a polysaccharide capsule, the elaboration of melanin within the cell wall, and growth at 37°. A gene encoding a cryptococcal G-protein ... Cite

A successful program to optimize use of Amphotericin B Lipid Complex (ABLC) at an academic medical center

Journal Article Clinical Infectious Diseases · December 1, 1997 Lipid-based antifungal products have been developed, and some may reduce nephrotoxicily and infusion-related side-effects, compared to standard amphotericin B (AmB). However, questions remain about optimal daily and cumulative dosing strategies, and no pub ... Cite

Study of Cryptococcus neoformans actin gene regulation with a β-galactosidase-actin fusion

Journal Article Journal of Medical and Veterinary Mycology · November 24, 1997 An expression plasmid carrying a heterologous gene fusion between the Cryptococcus neoformans actin promoter and the Escherichia coli reporter gene, LACZ, was constructed to study actin regulation in C. neoformans. Two randomly stable transformants, design ... Cite

Antifungal resistance trends towards the year 2000. Implications for therapy and new approaches.

Journal Article Drugs · November 1997 Medical advances have led to increased numbers of immunocompromised patients living longer. Coinciding with this increase in the immunocompromised patient population is an increase in the number of clinically significant fungal infections. Unfortunately, w ... Full text Link to item Cite

In vitro antifungal activity of pneumocandin L-743,872 against a variety of clinically important molds.

Journal Article Antimicrob Agents Chemother · August 1997 The in vitro activity of the new antifungal drug pneumocandin L-743,872 against 55 isolates of clinically important molds was examined by an adapted macrobroth dilution method for yeasts. Pneumocandin L-743,872 exhibited in vitro antifungal activity agains ... Full text Link to item Cite

Calcineurin is required for virulence of Cryptococcus neoformans.

Journal Article EMBO J · May 15, 1997 Cyclosporin A (CsA) and FK506 are antimicrobial, immunosuppressive natural products that inhibit signal transduction. In T cells and Saccharomyces cerevisiae, CsA and FK506 bind to the immunophilins cyclophilin A and FKBP12 and the resulting complexes inhi ... Full text Link to item Cite

The immunosuppressant FK506 and its nonimmunosuppressive analog L-685,818 are toxic to Cryptococcus neoformans by inhibition of a common target protein.

Journal Article Antimicrob Agents Chemother · January 1997 The immunosuppressant FK506 (tacrolimus) is an antifungal natural product macrolide that suppresses the immune system by blocking T-cell activation. In complex with the intracellular protein FKBP12, FK506 inhibits calcineurin, a Ca(2+)-calmodulin-dependent ... Full text Link to item Cite

Infections due to zygomycetes and other rare fungal opportunists

Journal Article Seminars in Respiratory and Critical Care Medicine · January 1, 1997 In this article we review the salient features of several invasive mycoses seen with increasing frequency in this age of immunocompromised hosts. Included are descriptions of zygomycosis, trichosporonosis, and fusariosis. Invasive disease due to the pigmen ... Full text Cite

Study of Cryptococcus neoformans actin gene regulation with a beta-galactosidase-actin fusion.

Journal Article J Med Vet Mycol · 1997 An expression plasmid carrying a heterologous gene fusion between the Cryptococcus neoformans actin promoter and the Escherichia coli reporter gene, LACZ, was constructed to study actin regulation in C. neoformans. Two randomly stable transformants, design ... Link to item Cite

Orbitofascial conidiobolomycosis in a child.

Journal Article Pediatr Infect Dis J · December 1996 Full text Link to item Cite

Identification of a Cryptococcus neoformans gene that directs expression of the cryptic Saccharomyces cerevisiae mannitol dehydrogenase gene.

Journal Article J Bacteriol · September 1996 The Mtl gene from Cryptococcus neoformans, which confers the ability of Saccharomyces cerevisiae Sc4l YJO to grow on mannitol with substantial NAD-dependent mannitol dehydrogenase activity, was identified. Purifications and characterizations of this enzyme ... Full text Link to item Cite

In vitro and in vivo efficacies of the azole SCH56592 against Cryptococcus neoformans.

Journal Article Antimicrob Agents Chemother · August 1996 Multiple isolates of Cryptococcus neoformans were tested to compare the in vitro activity of a new triazole, SCH56592, with those of amphotericin B, fluconazole, and itraconazole, MICs of each drug were determined, and minimum fungicidal concentrations of ... Full text Link to item Cite

Effect of the laccase gene CNLAC1, on virulence of Cryptococcus neoformans.

Journal Article J Exp Med · August 1, 1996 To assess the relationship between melanin production by Cryptococcus neoformans and virulence on a molecular basis, we asked: (a) is CNLAC1, the laccase structural gene of C. neoformans, expressed in vivo?; (b) can mouse virulence be restored to cnlac1 (M ... Full text Link to item Cite

Fungal virulence genes as targets for antifungal chemotherapy.

Journal Article Antimicrob Agents Chemother · July 1996 Fungal virulence genes have now met the age of molecular pathogenesis. The definition of virulence genes needs to be broad so that it encompasses the focus on molecular antifungal targets and vaccine epitopes. However, in the broad but simple definition of ... Full text Link to item Cite

Soft-tissue fungal infections: surgical management of 12 immunocompromised patients.

Journal Article Plast Reconstr Surg · June 1996 Isolated fungal soft-tissue infections are uncommon but may cause severe morbidity or mortality among transplant recipients and other immunosuppressed patients. Twelve immunocompromised patients illustrating three patterns of infection were treated recentl ... Full text Link to item Cite

The significance of microbial cultures of the hematopoietic support for patients receiving high-dose chemotherapy.

Journal Article J Hematother · June 1996 The use of hematopoietic support for patients receiving high-dose chemotherapy has increased over the past 10 years. Various quality controls are performed on the hematopoietic cells, including microbiologic cultures. There is considerable expense associat ... Full text Link to item Cite

Fungal infections in lung and heart-lung transplant recipients. Report of 9 cases and review of the literature.

Journal Article Medicine (Baltimore) · May 1996 We reviewed the pattern and incidence of fungal infections in patients undergoing lung and heart-lung transplantation at Duke University Medical Center from September 1992 until August 1995, and present here 9 illustrative cases. Of the 73 lung and heart-l ... Full text Link to item Cite

The new fungal opportunists are coming.

Journal Article Clin Infect Dis · May 1996 Frequent and prolonged exposure of immunocompromised patients to a variety of environmental conditions has resulted in the recognition of infections with new fungal opportunists. Infections with fungi such as Fusarium species, Paecilomyces lilacinus, Acrem ... Full text Link to item Cite

Fatal, disseminated Acremonium strictum infection in a neutropenic host.

Journal Article J Clin Microbiol · May 1996 Disseminated Acremonium strictum infection in a neutropenic patient is reported. Positive fecal cultures preceded positive cutaneous and blood cultures by 18 and 21 days, respectively, which suggests gastrointestinal colonization and invasion as initiating ... Full text Link to item Cite

Oropharyngeal yeast flora and fluconazole resistance in HIV-infected patients receiving long-term continuous versus intermittent fluconazole therapy.

Journal Article AIDS · March 1996 OBJECTIVE: To examine the impact of continuous versus intermittent fluconazole therapy on fungal colonization and fluconazole resistance in the oropharynx of HIV-infected patients. DESIGN: Case-control study. SETTING: Duke University Adult Infectious Disea ... Full text Link to item Cite

Dominant selection system for use in Cryptococcus neoformans.

Journal Article J Med Vet Mycol · 1996 Present transformation systems for Cryptococcus neoformans depend on complementation of auxotrophic mutants. We have developed a dominant selection system for transformation of wild-type strains of cryptococci in which resistance to the antibiotic hygromyc ... Link to item Cite

Treatment of vancomycin-resistant enterococci, with a focus on quinupristin-dalfopristin.

Journal Article Pharmacotherapy · 1996 Enterococci are the second most common cause of hospital-acquired infections, and drug resistance among these organisms is a growing problem. Vancomycin-resistant enterococci (VRE) now account for 7.9% of the nosocomial enterococcal infections. There is no ... Link to item Cite

Treatment of lymphocutaneous and visceral sporotrichosis with fluconazole.

Journal Article Clin Infect Dis · January 1996 Thirty patients with documented sporotrichosis were treated with 200-800 mg of fluconazole daily. Fourteen patients had lymphocutaneous infection; only five (36%) of these patients had any underlying illnesses. Sixteen patients had osteoarticular or viscer ... Full text Link to item Cite

Dominant selection system for use in Cryptococcus neoformans

Journal Article Journal of Medical and Veterinary Mycology · January 1, 1996 Present transformation systems for Cryptococcus neoformans depend on complementation of auxotrophic mutants. We have developed a dominant selection system for transformation of wild-type strains of cryptococci in which resistance to the antibiotic hygromyc ... Full text Cite

Molecular targets for new antifungal drugs

Journal Article Canadian Journal of Botany · December 31, 1995 Fungal infections in man and animals have a significant impact on health. However, there are only a few antifungal agents available for treatment of invasive mycoses. Further understanding of fungal molecular pathogenesis in collaboration with bioc ... Full text Cite

Cryptococcosis in the era of AIDS--100 years after the discovery of Cryptococcus neoformans.

Journal Article Clin Microbiol Rev · October 1995 Although Cryptococcus neoformans and cryptococcosis have existed for several millennia, a century has passed since the discovery of this encapsulated yeast and its devastating disease. With the advent of the AIDS pandemic, cryptococcal meningitis has emerg ... Full text Link to item Cite

Alopecia associated with fluconazole therapy.

Journal Article Ann Intern Med · September 1, 1995 OBJECTIVE: To describe the association between fluconazole and reversible alopecia. DESIGN: A retrospective survey of 1) patients enrolled in NIAID Mycoses Study Group (MSG) protocols involving the long-term use of fluconazole for treatment of endemic myco ... Full text Link to item Cite

Cutaneous infection caused by Curvularia pallescens: a case report and review of the spectrum of disease.

Journal Article J Am Acad Dermatol · February 1995 A 75-year-old woman being treated with prednisone and methotrexate had a 5.5 x 2.2 cm ulcer on the leg. A biopsy specimen revealed suppurative, granulomatous dermal inflammation with necrotic areas of septate, branching hyphae containing brown pigment. Cul ... Full text Link to item Cite

The actin gene from Cryptococcus neoformans: structure and phylogenetic analysis.

Journal Article J Med Vet Mycol · 1995 Using heterologous probing of a genomic library, we have cloned and sequenced the actin gene from the pathogenic yeast Cryptococcus neoformans. The actin gene is 1371 bp in length, and exists as a single copy, as is the case for all fungi studied to date. ... Full text Link to item Cite

Targeted gene replacement demonstrates that myristoyl-CoA: protein N-myristoyltransferase is essential for viability of Cryptococcus neoformans.

Journal Article Proc Natl Acad Sci U S A · December 6, 1994 Cryptococcus neoformans is a major cause of systemic fungal infection in immunocompromised patients. Myristoyl-CoA:protein N-myristoyltransferase (Nmt) catalyzes the transfer of myristate (C14:0) from myristoyl-CoA to the N-terminal glycine of a subset of ... Full text Link to item Cite

Management of injuries caused by Cryptococcus neoformans--contaminated needles.

Journal Article Clin Infect Dis · November 1994 This report describes four skin-puncture accidents with needles that were heavily contaminated with Cryptococcus neoformans. In one accident, delayed administration of antifungal drugs resulted in a granuloma of the finger. In the other three accidents, no ... Full text Link to item Cite

First report of involvement of Nodulisporium species in human disease.

Journal Article J Clin Microbiol · September 1994 Allergic fungal sinusitis is a common disease that results from a hypersensitivity reaction mounted by the host against fungi living in the paranasal sinuses. We have recently treated a patient with allergic fungal sinusitis due to a Nodulisporium species. ... Full text Link to item Cite

NIAID Mycoses Study Group Multicenter Trial of Oral Itraconazole Therapy for Invasive Aspergillosis.

Journal Article Am J Med · August 1994 BACKGROUND: Invasive aspergillosis is the most common invasive mould infection and a major cause of mortality in immunocompromised patients. Response to amphotericin B, the only antifungal agent licensed in the United States for the treatment of aspergillo ... Full text Link to item Cite

Sequential prophylactic oral and empiric once-daily parenteral antibiotics for neutropenia and fever after high-dose chemotherapy and autologous bone marrow support.

Journal Article J Clin Oncol · May 1994 PURPOSE: We studied the effectiveness of prophylactic oral ciprofloxacin and rifampin on fever prevention in patients undergoing autologous bone marrow transplantation (ABMT) for breast cancer. Furthermore, we evaluated the toxicity and efficacy of empiric ... Full text Link to item Cite

Amphotericin B lipid complex in the treatment of experimental cryptococcal meningitis and disseminated candidosis.

Journal Article J Antimicrob Chemother · January 1994 In the quest for safer and more effective antifungal agents, amphotericin B (AMB) has been placed in a variety of lipid preparations. In this study, we examined the efficacy of amphotericin B lipid complex (ABLC) on experimental cryptococcal meningitis and ... Full text Link to item Cite

Role of classic dimorphic pathogens in contemporary mycoses

Journal Article Infectious Diseases in Clinical Practice · January 1, 1994 Full text Cite

[Epidemiology of chemoresistant Plasmodium falciparum].

Journal Article Ann Med Interne (Paris) · 1994 Link to item Cite

Karyotyping of Cryptococcus neoformans as an epidemiological tool.

Journal Article J Clin Microbiol · December 1993 Karyotyping of Cryptococcus neoformans var. neoformans can be used as an epidemiological tool for C. neoformans infections. In this study of over 40 isolates from both clinical and environmental sources, 90% had a unique chromosome banding by pulsed-field ... Full text Link to item Cite

Cryptococcal ventricular-peritoneal shunt infection: clinical and epidemiological evaluation of two closely associated cases.

Journal Article Infect Control Hosp Epidemiol · December 1993 OBJECTIVE: To determine the cause of meningitis associated with Cryptococcus neoformans in two patients with recent ventricular-peritoneal (VP) shunt placement. DESIGN: A retrospective review of materials, records, and concurrent cases of VP shunt procedur ... Full text Link to item Cite

Correlation of in vitro fluconazole resistance of Candida isolates in relation to therapy and symptoms of individuals seropositive for human immunodeficiency virus type 1.

Journal Article Antimicrob Agents Chemother · November 1993 Yeast strains isolated from the oropharynx of 87 consecutive patients infected with human immunodeficiency virus type 1 were examined for in vitro susceptibility to fluconazole. Candida albicans was isolated from 73 patients. Fifty-one patients had receive ... Full text Link to item Cite

The gene encoding phosphoribosylaminoimidazole carboxylase (ADE2) is essential for growth of Cryptococcus neoformans in cerebrospinal fluid.

Journal Article Infect Immun · October 1993 A cryptococcal meningitis model in corticosteroid-treated rabbits was used to assess the requirement for the phosphoribosylaminoimidazole gene (ADE2) for virulence of Cryptococcus neoformans. A wild-type strain (H99), an ade2 auxotroph of H99 (M001), and a ... Full text Link to item Cite

Treatment of sporotrichosis with itraconazole. NIAID Mycoses Study Group.

Journal Article Am J Med · September 1993 PURPOSE: To describe the clinical presentation and outcomes of treatment with itraconazole in patients with sporotrichosis. METHODS: A culture for Sporothrix schenckii or compatible histopathology was required for inclusion in the study. Patients with both ... Full text Link to item Cite

Uptake of itraconazole by alveolar macrophages.

Journal Article Antimicrob Agents Chemother · April 1993 Itraconazole is a broad-spectrum potent triazole antifungal agent. Its efficacy in treatment cannot always be explained by body fluid drug levels. In this study, itraconazole was shown to accumulate into host cells. Its intracellular accumulation in cells ... Full text Link to item Cite

Gene transfer in Cryptococcus neoformans by use of biolistic delivery of DNA.

Journal Article J Bacteriol · March 1993 A transformation scheme for Cryptococcus neoformans to yield high-frequency, integrative events was developed. Adenine auxotrophs from a clinical isolate of C. neoformans serotype A were complemented by the cryptococcal phosphoribosylaminoimidazole carboxy ... Full text Link to item Cite

Fungal infections

Journal Article Current Opinion in Infectious Diseases · January 1, 1993 Fungi are important infectious agents in the immunocompromised population. The increasing number of patients with fungal infections has led to a reevaluation of the epidemiology and treatment of these pathogens. Recently we have seen the emergence of sever ... Cite

Uncommon invasive fungal pathogens in the acquired immunodeficiency syndrome.

Journal Article J Med Vet Mycol · 1993 This communication lists fungi reported to cause invasive infection in patients with AIDS. It excludes the well known and common fungi that infect these patients such as Candida, Cryptococcus, Histoplasma, Coccidioides and Aspergillus. It is likely that th ... Full text Link to item Cite

Uptake of itraconazole by alveolar macrophages

Journal Article Antimicrob Agents Chemother · 1993 Cite

Cloning the Cryptococcus neoformans TRP1 gene by complementation in Saccharomyces cerevisiae.

Journal Article Gene · December 1, 1992 We have cloned the phosphoribosyl anthranilate isomerase (PRAI)-encoding gene (TRP1) of Cryptococcus neoformans by genetic complementation in Saccharomyces cerevisiae. Sequence analysis of this gene revealed it to be 939 bp in length, and without known pro ... Full text Link to item Cite

Fungal infections

Journal Article Current Opinion in Infectious Diseases · June 19, 1992 Fungal infections remain important opportunistic pathogens, particularly in immunocompromised individuals. A variety of fungal pathogens have been identified that cause infection in the growing population of immunocompromised patients. Over the last year, ... Full text Cite

Prophylactic intravenous amphotericin B in neutropenic autologous bone marrow transplant recipients.

Journal Article J Infect Dis · May 1992 This study assessed the efficacy, toxicity, and pharmacology of low-dose amphotericin B given prophylactically to patients (serum concentrations of 0.2-0.4 microgram/ml) undergoing bone marrow transplantation. Yeast isolates from patients' oropharyngeal ar ... Full text Link to item Cite

Fungal scleritis after cataract surgery. Successful outcome using itraconazole.

Journal Article Cornea · March 1992 We report the development of fungal scleritis in a 53-year-old man after uncomplicated cataract surgery. Histopathology and culture identified the organism as Aspergillus flavus. Clinically, the patient worsened on treatment with oral ketoconazole and topi ... Full text Link to item Cite

Adverse drug reactions to systemic antifungals. Prevention and management.

Journal Article Drug Saf · 1992 Systemic administration of antifungal agents for invasive mycoses has dramatically increased over the past 10 years in many fields of medicine. The increase has been due both to an increasing immune compromised population and to potent antibacterial agents ... Full text Link to item Cite

A nationwide survey of clinical laboratory methodologies for fungal infections.

Journal Article J Med Vet Mycol · 1992 Many hospitalized patients are at risk for fungal infections. In order to characterize present clinical laboratory experience and facilities for diagnosis and management of fungal infections, a nationwide survey of laboratory diagnostic methodologies was c ... Full text Link to item Cite

SYNERGISTIC INTERACTION OF NIKKOMYCIN AND CILOFUNGIN AGAINST DIVERSE FUNGI

Conference RECENT PROGRESS IN ANTIFUNGAL CHEMOTHERAPY · January 1, 1992 Link to item Cite

CILOFUNGIN

Conference RECENT PROGRESS IN ANTIFUNGAL CHEMOTHERAPY · January 1, 1992 Link to item Cite

Fluconazole and Candida krusei fungemia.

Journal Article N Engl J Med · October 31, 1991 Link to item Cite

FUNGAL-INFECTIONS IN THE IMMUNOCOMPROMISED HOST - DISCUSSION

Journal Article REVIEWS OF INFECTIOUS DISEASES · May 1, 1991 Link to item Cite

The use of amphotericin B in nosocomial fungal infection.

Journal Article Rev Infect Dis · 1991 The use of potent broad-spectrum antibacterial agents, the increasing number of immunocompromised hosts, and the use of invasive treatment modalities have exacerbated the problems involved in the management of nosocomial fungal infection. The hospital reco ... Full text Link to item Cite

Discussion: Fungal infections in the immunocompromised host

Journal Article Reviews of Infectious Diseases · January 1, 1991 Cite

The pharmacokinetics of BAY R3783 and its efficacy in the treatment of experimental cryptococcal meningitis.

Journal Article J Antimicrob Chemother · September 1990 We studied the pharmacokinetics and efficacy of BAY R3783, a new antifungal azole compound, in rabbits and compared it with fluconazole and itraconazole. BAY R3783 has at least two active metabolites, BAY U3624 and BAY U3625. We measured serum concentratio ... Full text Link to item Cite

Opsonic activity of cerebrospinal fluid in experimental cryptococcal meningitis.

Journal Article Infect Immun · July 1990 The role of antibody in protection against infection with Cryptococcus neoformans is undefined. In this paper we describe the development of opsonic activity in the cerebrospinal fluid (CSF) of rabbits in response to cryptococcal meningitis. The opsonin ap ... Full text Link to item Cite

Production of the hexitol D-mannitol by Cryptococcus neoformans in vitro and in rabbits with experimental meningitis.

Journal Article Infect Immun · June 1990 We studied the ability of Cryptococcus neoformans to produce the hexitol D-mannitol in vitro and in rabbits with experimental meningitis. Twelve of twelve human isolates of C. neoformans produced D-mannitol in yeast nitrogen base plus 1% glucose and releas ... Full text Link to item Cite

Antifungal therapy and its use in surgical treatment.

Journal Article Surg Gynecol Obstet · 1990 Modern surgery continues to make significant therapeutic advances, and a major component in the adjunctive care allowing these improved procedures is the successful use of broad-spectrum antibacterials. However, the widespread administration of potent anti ... Link to item Cite

Fluconazole therapy for experimental cryptococcosis and candidiasis in the rabbit.

Journal Article Rev Infect Dis · 1990 Fluconazole is a second-generation azole compound with broad-spectrum antifungal activity. It has been examined in several animal models emphasizing important clinical sites of infection with common yeast pathogens. The drug has an excellent pharmacokineti ... Full text Link to item Cite

Antifungal therapy for infections of the compromised host

Journal Article Current Opinion in Infectious Diseases · January 1, 1990 Full text Cite

Metabolic fate of L-arginine in relation to microbiostatic capability of murine macrophages.

Journal Article J Clin Invest · January 1990 L-arginine is required for the fungistatic action of murine macrophages in vitro. To further investigate this requirement, L-arginine metabolism by macrophages was measured under conditions where fungistasis either succeeded or failed. Macrophage fungistas ... Full text Link to item Cite

MACROPHAGE OXIDATION OF L-ARGININE IS LINKED TO FUNGISTATIC CAPABILITY

Conference MICROBIAL DETERMINANTS OF VIRULENCE AND HOST RESPONSE · January 1, 1990 Link to item Cite

Treatment of experimental cryptococcal meningitis and disseminated candidiasis with SCH39304.

Journal Article Antimicrob Agents Chemother · October 1989 We studied the pharmacokinetics and in vivo antifungal action of SCH39304, a new antifungal azole compound, in rabbits. It crossed the blood-cerebrospinal fluid barrier in the presence or absence of meningeal inflammation, reaching approximately 60% of the ... Full text Link to item Cite

Treatment of experimental disseminated candidiasis with cilofungin.

Journal Article Antimicrob Agents Chemother · October 1989 The efficacy of cilofungin treatment of experimental disseminated candidiasis in rabbits was examined. Cilofungin treatment reduced yeast counts, especially in the kidney, with activity comparable to that of amphotericin B. The peak level of cilofungin in ... Full text Link to item Cite

Separation of chromosomes of Cryptococcus neoformans by pulsed field gel electrophoresis.

Journal Article Infect Immun · September 1989 Chromosomes from Cryptococcus neoformans, an encapsulated yeast pathogen, were separated by contour-clamped homogeneous field gel electrophoresis. Seven strains representing all four serotypes were studied. It was found that each strain had a unique, repro ... Full text Link to item Cite

Cryptococcosis.

Journal Article Infect Dis Clin North Am · March 1989 Cryptococcosis emphasizes the importance of the host-parasite interaction. C. neoformans has developed factors to invade the host but generally requires host immune dysfunction to establish infection. Cryptococcal infection has increased as our immunocompr ... Link to item Cite

Intervertebral diskitis due to Candida tropicalis.

Journal Article South Med J · February 1989 This report describes a case of Candida tropicalis intervertebral diskitis successfully treated with a brief course of amphotericin B followed by a longer course of ketoconazole. Candida tropicalis is an increasingly frequent pathogen in immunocompromised ... Full text Link to item Cite

Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review.

Journal Article Rev Infect Dis · 1989 Actinobacillus actinomycetemcomitans is a small fastidious gram-negative coccobacillus that fails to grow on MacConkey's agar. Slow growth in broth may lead to delays in diagnosis. First described in 1912, A. actinomycetemcomitans has been recognized since ... Full text Link to item Cite

Infection and cyclosporine.

Journal Article Rev Infect Dis · 1989 Cyclosporine is a potent immunosuppressive agent that selectively impairs T cell function. The steady growth of its importance makes knowledge of its activity and effects clinically relevant. The intrinsic antibiotic activity of cyclosporine is limited; al ... Full text Link to item Cite

Disseminated zygomycosis: report of four cases and review.

Journal Article Rev Infect Dis · 1989 We present four cases of disseminated zygomycosis that illustrate the characteristic clinical syndromes and natural history of this infection. The zygomycetes affect individuals immunosuppressed by age, drug therapy, or underlying disease. A previous splen ... Full text Link to item Cite

Antifungal therapy 1989

Journal Article Current Opinion in Infectious Diseases · January 1, 1989 Full text Cite

Successful treatment of cryptococcal ventriculoatrial shunt infection with systemic therapy alone.

Journal Article Neurosurgery · September 1988 We report successful treatment of a cryptococcal ventriculoatrial shunt infection with antifungal therapy without shunt removal. ... Full text Link to item Cite

Cerebrospinal fluid macrophage response to experimental cryptococcal meningitis: relationship between in vivo and in vitro measurements of cytotoxicity.

Journal Article Infect Immun · April 1988 The functional abilities of macrophages from cerebrospinal fluid (CSF) have so far been little studied. We examined the acquisition of activation characteristics by CSF macrophages during the course of experimental cryptococcal meningitis. CSF macrophages ... Full text Link to item Cite

Specific amino acid (L-arginine) requirement for the microbiostatic activity of murine macrophages.

Journal Article J Clin Invest · April 1988 The microbiostatic action of macrophages was studied in vitro employing peritoneal cytotoxic macrophages (CM) from mice acting against Cryptococcus neoformans cultured in Dulbecco's medium with 10% dialyzed fetal bovine serum. Fungistasis was measured usin ... Full text Link to item Cite

Evaluation of in vitro antifungal activity of LY121019.

Journal Article Eur J Clin Microbiol Infect Dis · February 1988 LY121019 is a new semisynthetic lipopeptide antifungal agent with potent in vitro fungicidal activity against multiple clinical strains of Candida albicans and Candida tropicalis but is 10-100 fold less active against Torulopsis glabrata and Candida paraps ... Full text Link to item Cite

Antifungal therapy

Journal Article Current Opinion in Infectious Diseases · January 1, 1988 Full text Cite

Mycobacterium avium-intracellulare complex infections in the acquired immunodeficiency syndrome.

Journal Article J Electron Microsc Tech · January 1988 This review examines an important bacterial infection in acquired immunodeficiency syndrome (AIDS). Despite occasional infections with bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, Salmonella, and Nocardia in patients with AIDS, the pr ... Full text Link to item Cite

Effects of antifungal agents and gamma interferon on macrophage cytotoxicity for fungi and tumor cells.

Journal Article J Infect Dis · August 1987 The activated macrophage may play a central role in host effector mechanisms against invading fungi. Here we demonstrate the importance of the activation state of murine macrophages for both fungistatic and fungicidal activity. Host factors such as gamma i ... Full text Link to item Cite

Retrospective review of amphotericin B use in a tertiary-care medical center.

Journal Article Am J Hosp Pharm · June 1987 A retrospective review of amphotericin B use in a tertiary-care medical center was conducted, and use patterns were evaluated. The pharmacy department audited the medical records of all patients who received amphotericin B during 1983. Of 179 patients who ... Link to item Cite

Efficacy of immune therapy in early experimental Naegleria fowleri meningitis.

Journal Article Infect Immun · May 1987 Naegleria fowleri meningoencephalitis is usually fatal in humans despite treatment. As a new approach, we tested intracisternal passive immune therapy in rabbits with amebic meningoencephalitis by using antinaegleria immune serum, an immunoglobulin G fract ... Full text Link to item Cite

Penetration of new azole compounds into the eye and efficacy in experimental Candida endophthalmitis.

Journal Article Antimicrob Agents Chemother · January 1987 We studied the penetration of three azole compounds, ketoconazole, itraconazole, and fluconazole, into the ocular tissues and fluids of rabbits in the presence and absence of ocular inflammation. Drug concentrations were compared with those found in serum ... Full text Link to item Cite

REQUIREMENTS FOR THE EXPRESSION OF THE MICROBIOSTATIC ACTION OF MACROPHAGES

Conference JOURNAL OF CELLULAR BIOCHEMISTRY · January 1, 1987 Link to item Cite

Macrophage-mediated fungistasis: requirement for a macromolecular component in serum.

Journal Article J Immunol · July 15, 1986 Peritoneal macrophages from Mycobacterium bovis- or Toxoplasma gondii-infected mice cultured in vitro in Dulbecco's medium containing 10% fetal bovine serum (FBS) and endotoxin stopped replication of Cryptococcus neoformans for 30 hr, whereas yeast cells c ... Link to item Cite

INHIBITION OF FUNGAL CELL REPLICATION BY MACROPHAGES - REQUIREMENT FOR SERUM FACTOR(S)

Conference ZENTRALBLATT FUR BAKTERIOLOGIE MIKROBIOLOGIE UND HYGIENE SERIES A-MEDICAL MICROBIOLOGY INFECTIOUS DISEASES VIROLOGY PARASITOLOGY · July 1, 1986 Link to item Cite

THE ANTIFUNGAL ACTIVITY OF THE TRIANGLE UK-49,858 IN THE TREATMENT OF EXPERIMENTAL CANDIDA PYELONEPHRITIS AND CRYPTOCOCCAL MENINGITIS

Conference ZENTRALBLATT FUR BAKTERIOLOGIE MIKROBIOLOGIE UND HYGIENE SERIES A-MEDICAL MICROBIOLOGY INFECTIOUS DISEASES VIROLOGY PARASITOLOGY · July 1, 1986 Link to item Cite

Comparison of itraconazole and fluconazole in treatment of cryptococcal meningitis and candida pyelonephritis in rabbits.

Journal Article Antimicrob Agents Chemother · April 1986 Itraconazole and fluconazole, two new triazoles, were examined for their antifungal activity in rabbits. Fluconazole easily crossed the blood-cerebrospinal fluid barrier, and active drug was eliminated in high concentrations in the urine. On the other hand ... Full text Link to item Cite

Macrophage-mediated fungistasis in vitro: requirements for intracellular and extracellular cytotoxicity.

Journal Article J Immunol · January 1986 Macrophage cytotoxicity for Cryptococcus neoformans was investigated by culturing mouse peritoneal macrophages with a thin-capsuled clone of cryptococcus under conditions permitting efficient phagocytosis. Yeast replication was quantitated by electronic pa ... Link to item Cite

Comparison of amphotericin B and N-D-ornithyl amphotericin B methyl ester in experimental cryptococcal meningitis and Candida albicans endocarditis with pyelonephritis.

Journal Article Antimicrob Agents Chemother · December 1985 Amphotericin B and N-D-ornithyl amphotericin B methyl ester were compared for therapeutic efficacies against experimentally induced cryptococcal meningitis and Candida albicans endocarditis with pyelonephritis in rabbits. Antifungal activity of the two pol ... Full text Link to item Cite

Effects of cyclosporine in experimental cryptococcal meningitis.

Journal Article Infect Immun · October 1985 We studied the effects of cyclosporine on experimental cryptococcal meningitis. Like cortisone, cyclosporine depressed the highly effective defense mechanisms of normal rabbits against inoculated Cryptococcus neoformans, causing them to develop progressive ... Full text Link to item Cite

Virulence of Cryptococcus neoformans. Regulation of capsule synthesis by carbon dioxide.

Journal Article J Clin Invest · August 1985 Cryptococcus neoformans is variably encapsulated in vitro, whereas in tissues it develops a large capsule. We observed that cells of a strain with thin capsules, when growing in a standard fungal culture medium, became heavily encapsulated when incubated i ... Full text Link to item Cite

Penetration of imidazoles and triazoles into cerebrospinal fluid of rabbits.

Journal Article J Antimicrob Chemother · July 1985 We studied the penetration of two imidazoles (ketoconazole and vibunazole) and two triazoles (itraconazole and UK-49,858) into cerebrospinal fluid (CSF) of rabbits with and without meningitis. There were wide differences in degree of penetration of these d ... Full text Link to item Cite

Penile cryptococcosis with review of mycotic infections of penis.

Journal Article Urology · May 1985 A recurrence of cryptococcosis sixteen years after the primary infection as a penile ulcer is reported. The clinical manifestations of genitourinary and skin involvement by cryptococci are discussed. The epidemiology, pathogenesis, diagnosis, and treatment ... Full text Link to item Cite

Chemotactic activity of cerebrospinal fluid in experimental cryptococcal meningitis.

Journal Article Sabouraudia · February 1985 Cerebrospinal fluid from rabbits with chronic cryptococcal meningitis was tested for its chemotactic activity towards polymorphonuclear cells and monocytes. CSF chemotactic activity was present; it peaked 5-8 days after infection, coinciding with the time ... Full text Link to item Cite

SERUM THERAPY OF EXPERIMENTAL NAEGLERIA FOWLERI MENINGITIS

Conference CLINICAL RESEARCH · January 1, 1985 Link to item Cite

SERUM FACTOR(S) WHICH PROMOTES MACROPHAGE FUNGISTATIC ACTION

Conference JOURNAL OF LEUKOCYTE BIOLOGY · January 1, 1985 Link to item Cite

Combined therapy with amphotericin B and 5-fluorocytosine for Candida meningitis.

Journal Article Rev Infect Dis · 1984 The course and outcome of combined treatment with amphotericin B and 5-fluorocytosine were analyzed in 17 patients with candida meningitis. Eleven patients were twelve months of age or younger; seven of these were neonates. All but two patients had underly ... Full text Link to item Cite

Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis.

Journal Article Ann Intern Med · September 1983 Fungal peritonitis is a rare complication in patients on continuous ambulatory peritoneal dialysis. We report five recent cases and their management. The fungi isolated were Candida albicans, C. parapsilosis, Exophiala jeanselmei, Drechslera spicifera, and ... Full text Link to item Cite

Pharmacokinetics of N-formimidoyl thienamycin and influence of a renal dipeptidase inhibitor in experimental meningitis.

Journal Article J Antimicrob Chemother · July 1983 We studied the pharmacokinetics of N-formimidoyl thienamycin with and without a renal dipeptidase inhibitor in plasma and cerebrospinal fluid (CSF) of rabbits. Thienamycin reached a maximal concentration of 0.6 +/- 0.06 mg/l in the CSF of normal rabbits. W ... Full text Link to item Cite

Brain abscess caused by a variety of cladosporium trichoides.

Journal Article Am J Clin Pathol · June 1983 A brain abscess caused by a new variety of Cladosporium trichoides occurred in a previously healthy man. A reversed T-suppressor/helper cell ratio was noted as the only immunologic abnormality. He required three surgical procedures, the last an occipital l ... Full text Link to item Cite

Cryptococcemia.

Journal Article Medicine (Baltimore) · March 1983 Previous reports have emphasized that cryptococcemia is almost uniformly fatal. To define the clinical course and prognostic and therapeutic implications of cryptococcemia, we studied 15 patients treated at this medical center over the past 7 years. Crypto ... Full text Link to item Cite

Leukocyte subpopulations in cerebrospinal fluid of normal rabbits.

Journal Article Lab Anim Sci · December 1982 Cerebrospinal fluid leukocytes from 48 apparently healthy New Zealand white rabbits were examined to define the number and types of cells present. The cerebrospinal fluid contained 0 to 7 leukocytes/mm3 (median 3/mm3). This small pool of mononuclear cells ... Link to item Cite

Treatment of experimental cryptococcal meningitis with amphotericin B, 5-fluorocytosine, and ketoconazole.

Journal Article J Infect Dis · September 1982 Ketoconazole, amphotericin B, 5-fluorocytosine, and combinations of these drugs were compared as therapy for chronic cryptococcal meningitis in steroid-treated rabbits. Two hours after treatment of rabbits with meningitis with single drugs the mean cerebro ... Full text Link to item Cite

Cryptococcosis and the basidiospore.

Journal Article Lancet · June 5, 1982 Full text Link to item Cite

Method for the purification of filobasidiella neoformans basidiospores by flow cytometry

Journal Article Medical Mycology · January 1, 1982 A procedure is described for the purification of basidiospores of Filobasidiella neoformans. The method involves the use of flow cytometry, and yields a suspension containing approximately 4 × 104 infective particles ml-1, of which greater than 95% are bas ... Full text Cite

Trimethoprim-sulfamethoxazole vs. ampicillin in the treatment of experimental meningitis due to Streptococcus pneumoniae.

Journal Article Rev Infect Dis · 1982 When given in combination, both trimethoprim and sulfamethoxazole penetrated well into the cerebrospinal fluid of rabbits with experimental pneumococcal meningitis, reaching concentrations that should have been adequate for synergistic killing of Streptoco ... Full text Link to item Cite

Influence of agglutinating antibody in experimental cryptococcal meningitis.

Journal Article Br J Exp Pathol · December 1981 A model for chronic Cryptococcus neoformans meningitis in corticosteroid-treated rabbits was used to determine the influence of pre-formed agglutinating antibody to cryptococcal polysaccharide on the progress of this infection. Immunized rabbits developed ... Link to item Cite

Potential value of cefoperazone in bacterial meningitis: experimental studies.

Journal Article Drugs · 1981 To assess the potential value of cefoperazone in treating bacterial meningitis, its pharmacokinetics in the cerebrospinal fluid of rabbits were studied. Cefoperazone penetrated poorly into the cerebrospinal fluid of rabbits with uninflamed meninges, but in ... Full text Link to item Cite

CRYPTOCOCCEMIA

Conference CLINICAL RESEARCH · January 1, 1981 Link to item Cite

Mediastinitis complicating cellulitis of the head and neck.

Journal Article South Med J · October 1980 A patient with mediastinitis caused by Streptococcus pyogenes and/or Staphylococcus aureus responded to antibiotic therapy without surgical intervention, although fever was prolonged and recovery slow. The medical and surgical management of mediastinitis i ... Full text Link to item Cite

Chronic cryptococcal meningitis: a new experimental model in rabbits.

Journal Article Am J Pathol · October 1980 This paper describes the salient features of a new model for chronic cryptococcal meningitis in cortisone-treated rabbits. Normal rabbits soon recovered after intracisternal inoculation of Cryptococcus neoformans, but cortisone-treated animals developed ch ... Link to item Cite

Comparison of cotrimoxazole, ampicillin, and chloramphenicol in treatment of experimental Haemophilus influenzae type B meningitis.

Journal Article Antimicrob Agents Chemother · January 1980 To evaluate cotrimoxazole in the treatment of bacterial meningitis, we compared its action with that of ampicillin and chloramphenicol in experimental Haemophilus influenzae type b meningitis. Both trimethoprim and sulfamethoxazole penetrated well into the ... Full text Link to item Cite