Trichosporon asahii superinfections in critically ill COVID-19 patients overexposed to antimicrobials and corticosteroids

Autor(es)

de Almeida Jr, Joao Nobrega ; Moreno, Lis ^[1] ; Francisco, Elaine Cristina ^[2] ; Marques, Gabriela Noronha ^[1] ; Mendes, Ana Verena ^[1] ; Barberino, Maria Goreth ^[1] ; Colombo, Arnaldo Lopes ^[2]

Afiliação do(s) autor(es)

^[1] Hosp Sao Rafael, Salvador, BA - Brazil

^[2] de Almeida Jr, Jr., Joao Nobrega, Univ Fed Sao Paulo, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: MYCOSES; v. 64, n. 8, p. 817-822, AUG 2021.
• Citações Web of Science: 2

Resumo

Objectives To investigate the occurrence of Trichosporon asahii fungemia among critically ill COVID-19 patients. Methods From 1 July to 30 September 2020, cases of T asahii fungemia (TAF) in a Brazilian COVID-19 referral centre were investigated. The epidemiology and clinical courses were detailed, along with a mycological investigation that included molecular species identification, haplotype diversity analysis and antifungal susceptibility testing. Results Five critically ill COVID-19 patients developed TAF in the period. All five patients had common risk conditions for TAF: central venous catheter at fungemia, previous exposure to broad-spectrum antibiotics, prior echinocandin therapy and previous prolonged corticosteroid therapy. The average time of intensive care unit hospitalisation previous to the TAF episode was 23 days. All but one patient had voriconazole therapy, and TAF 30-day mortality was 80%. The five T asahii strains from the COVID-19 patients belonged to 4 different haplotypes, mitigating the possibility of skin origin and cross-transmission linking the 5 reported episodes. The antifungal susceptibility testing revealed low minimal inhibitory concentrations for azole derivatives. Conclusions Judicious prescription of antibiotics, corticosteroids and antifungals needs to be discussed in critically ill COVID-19 patients to prevent infections by hard-to-treat fungi like T asahii. (AU)

• Processo FAPESP: 18/19347-4 - Caracterização de mecanismos moleculares associados à resistência aos derivados azólicos em cepas clínicas de Trichosporon asahii
• Beneficiário: João Nóbrega de Almeida Júnior
• Modalidade de apoio: Bolsas no Exterior - Pesquisa