Abstract
Trichosporon beigelii caused fatal disseminated infections that were resistant to amphotericin B in two granulocytopenic patients. In vitro susceptibility studies demonstrated that both index strains of T. beigelii were inhibited but not killed by amphotericin B at achievable concentrations in serum. The minimum lethal concentration for both isolates was greater than or equal to 18 micrograms/ml. Five of seven other isolates were found to have a similar pattern of amphotericin B resistance. The fact that the minimum lethal concentration of T. beigelii was many times greater than its MIC was consistent with a resistance pattern of tolerance. We concluded that T. beigelii may be resistant in vitro to amphotericin B and that this in vitro resistance was correlated with refractory, disseminated trichosporonosis in granulocytopenic patients. T. beigelii should be included in the expanding list of amphotericin B-resistant fungi.
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- Blinkhorn R. J., Adelstein D., Spagnuolo P. J. Emergence of a new opportunistic pathogen, Candida lusitaniae. J Clin Microbiol. 1989 Feb;27(2):236–240. doi: 10.1128/jcm.27.2.236-240.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burch P. A., Karp J. E., Merz W. G., Kuhlman J. E., Fishman E. K. Favorable outcome of invasive aspergillosis in patients with acute leukemia. J Clin Oncol. 1987 Dec;5(12):1985–1993. doi: 10.1200/JCO.1987.5.12.1985. [DOI] [PubMed] [Google Scholar]
- Dick J. D., Rosengard B. R., Merz W. G., Stuart R. K., Hutchins G. M., Saral R. Fatal disseminated candidiasis due to amphotericin-B-resistant Candida guilliermondii. Ann Intern Med. 1985 Jan;102(1):67–68. doi: 10.7326/0003-4819-102-1-67. [DOI] [PubMed] [Google Scholar]
- Drutz D. J., Lehrer R. I. Development of amphotericin B-resistant Candida tropicalis in a patient with defective leukocyte function. Am J Med Sci. 1978 Jul-Aug;276(1):77–92. [PubMed] [Google Scholar]
- Haupt H. M., Merz W. G., Beschorner W. E., Vaughan W. P., Saral R. Colonization and infection with Trichosporon species in the immunosuppressed host. J Infect Dis. 1983 Feb;147(2):199–203. doi: 10.1093/infdis/147.2.199. [DOI] [PubMed] [Google Scholar]
- Hoy J., Hsu K. C., Rolston K., Hopfer R. L., Luna M., Bodey G. P. Trichosporon beigelii infection: a review. Rev Infect Dis. 1986 Nov-Dec;8(6):959–967. [PubMed] [Google Scholar]
- McManus E. J., Jones J. M. Detection of a Trichosporon beigelii antigen cross-reactive with Cryptococcus neoformans capsular polysaccharide in serum from a patient with disseminated Trichosporon infection. J Clin Microbiol. 1985 May;21(5):681–685. doi: 10.1128/jcm.21.5.681-685.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Melcher G. P., Rinaldi M. G., Frey C. L., Drutz D. J. Demonstration, by immunoelectronmicroscopy, of a cell wall antigen in Trichosporon beigelii that cross-reacts with Cryptococcus neoformans capsular polysaccharide. J Infect Dis. 1988 Oct;158(4):901–902. doi: 10.1093/infdis/158.4.901. [DOI] [PubMed] [Google Scholar]
- Merz W. G. Candida lusitaniae: frequency of recovery, colonization, infection, and amphotericin B resistance. J Clin Microbiol. 1984 Dec;20(6):1194–1195. doi: 10.1128/jcm.20.6.1194-1195.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Merz W. G., Karp J. E., Hoagland M., Jett-Goheen M., Junkins J. M., Hood A. F. Diagnosis and successful treatment of fusariosis in the compromised host. J Infect Dis. 1988 Nov;158(5):1046–1055. doi: 10.1093/infdis/158.5.1046. [DOI] [PubMed] [Google Scholar]
- Powderly W. G., Kobayashi G. S., Herzig G. P., Medoff G. Amphotericin B-resistant yeast infection in severely immunocompromised patients. Am J Med. 1988 May;84(5):826–832. doi: 10.1016/0002-9343(88)90059-9. [DOI] [PubMed] [Google Scholar]
- Safe L. M., Safe S. H., Subden R. E., Morris D. C. Sterol content and polyene antibiotic resistance in isolates of Candida krusei, Candida parakrusei, and Candida tropicalis. Can J Microbiol. 1977 Apr;23(4):398–401. doi: 10.1139/m77-058. [DOI] [PubMed] [Google Scholar]
- Seidenfeld S. M., Cooper B. H., Smith J. W., Luby J. P., Mackowiak P. A. Amphotericin B tolerance: a characteristic of Candida parapsilosis not shared by other Candida species. J Infect Dis. 1983 Jan;147(1):116–119. doi: 10.1093/infdis/147.1.116. [DOI] [PubMed] [Google Scholar]
- Walling D. M., McGraw D. J., Merz W. G., Karp J. E., Hutchins G. M. Disseminated infection with Trichosporon beigelii. Rev Infect Dis. 1987 Sep-Oct;9(5):1013–1019. doi: 10.1093/clinids/9.5.1013. [DOI] [PubMed] [Google Scholar]
- Walsh T. J., Newman K. R., Moody M., Wharton R. C., Wade J. C. Trichosporonosis in patients with neoplastic disease. Medicine (Baltimore) 1986 Jul;65(4):268–279. doi: 10.1097/00005792-198607000-00005. [DOI] [PubMed] [Google Scholar]
- Walsh T. J. Trichosporonosis. Infect Dis Clin North Am. 1989 Mar;3(1):43–52. [PubMed] [Google Scholar]