Trichosporon asahii superinfections in critically ill COVID-19 patients overexposed to antimicrobials and corticosteroids.
Mycoses
; 64(8): 817-822, 2021 Aug.
Article
in English
| MEDLINE | ID: covidwho-1258972
ABSTRACT
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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Basidiomycota
/
Superinfection
/
Adrenal Cortex Hormones
/
Trichosporonosis
/
COVID-19
/
Antifungal Agents
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Mycoses
Journal subject:
Microbiology
Year:
2021
Document Type:
Article
Affiliation country:
Myc.13333
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