603 research outputs found
Chemotherapy induced intestinal mucosal barrier damage: a cause of falsely elevated serum 1.3-beta-d-glucan levels?
No full textBlood citrulline and intestinal fatty acid binding protein were determined as biomarkers for intestinal mucositis. Biomarker levels were correlated with corresponding serum 1,3-beta-d-glucan levels in 56 samples obtained from 33 cases with underlying hematological malignancies receiving induction chemotherapy. No correlation between biomarkers of intestinal mucositis and BDG levels was observed.sponsorship: Merck Investigators Studies Program provided funding to Martin Hoenigl under grant number 39543. Oesterreichische Nationalbank (OeNB) provided funding to Martin Hoenigl under grant number 15346. (Merck Investigators Studies Program|39543, Oesterreichische Nationalbank (OeNB)|15346)status: Publishe
VMJ789783_Supplementary_Table_1 – Supplemental material for Association of HIV infection with age and symptomatic carotid atherosclerotic disease at the time of carotid intervention in the United States
No full textSupplemental material, VMJ789783_Supplementary_Table_1 for Association of HIV infection with age and symptomatic carotid atherosclerotic disease at the time of carotid intervention in the United States by Timothy C Lin, Brittany N Burton, Andrew Barleben, Martin Hoenigl and Rodney A Gabriel in Vascular Medicine</p
Exploring European Consensus About the Remaining Treatment Challenges and Subsequent Opportunities to Improve the Management of Invasive Fungal Infection (IFI) in the Intensive Care Unit
No full textBackground: The global prevalence of invasive fungal infections (IFI) is increasing, particularly within Intensive Care Units (ICU), where Candida spp. and Aspergillus spp. represent the most important pathogens. Diagnosis and management of IFIs becomes progressively challenging, with increasing antifungal resistance and the emergence of rare fungal species. Through a consensus survey focused on assessing current views on how IFI should be managed, the aim of this project was to identify challenges around diagnosing and managing IFIs in the ICU. The current status in different countries and perceived challenges to date amongst a multidisciplinary cohort of healthcare professionals involved in the care of IFI in the ICU was assessed. Methods: Using a modified Delphi approach, an expert panel developed 44 Likert-scale statements across 6 key domains concerning patient screening and minimal standards for diagnosis of IFIs in ICU; initiation and termination of antifungal treatments and how to minimise their side effects and insights for future research on this topic. These were used to develop an online survey which was distributed on a convenience sampling basis utilising the subscriber list held by an independent provider (M3 Global). This survey was distributed to intensivists, infectious disease specialists, microbiologists and antimicrobial/ICU pharmacists within the UK, Germany, Spain, France and Italy. The threshold for consensus was set at 75%. Results: A total of 335 responses were received during the five-month collection period. From these, 29/44 (66%) statements attained very high agreement (≥ 90%), 11/44 (25%) high agreement (< 90% and ≥ 75%), and 4/44 (9%) did not meet threshold for consensus (< 75%). Conclusion: The results outline the need for physicians to be aware of the local incidence of IFI and the associated rate of azole resistance in their ICUs. Where high clinical suspicion exists, treatment should start immediately and prior to receiving the results from any diagnostic test. Beta-D-glucan testing should be available to all ICU centres, with results available within 48 h to inform the cessation of empirical antifungal therapy. These consensus statements and proposed measures may guide future areas for further research to optimise the management of IFIs in the ICU
Diagnostic Approaches for Aspergillus Infections
No full textThis eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contac
Diagnostic Approaches for Aspergillus Infections
No full textThis eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contac
Salvage Treatment for Invasive Aspergillosis and Mucormycosis: Challenges, Recommendations and Future Considerations
No full textMatthias Egger,1,2 Romuald Bellmann,3 Robert Krause,1,2 Johannes Boyer,1 Daniela Jakšić,4 Martin Hoenigl1,2,5,6 1Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria; 2Biotechmed-Graz, Graz, Austria; 3Clinical Pharmacokinetics Unit, Division of Intensive Care and Emergency Medicine, Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria; 4Department of Microbiology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia; 5Clinical and Translational Fungal-Working Group, University of California San Diego, San Diego, CA, USA; 6Translational Medical Mycology Research Unit, ECMM Excellence Center for Medical Mycology, Medical University of Graz, Graz, AustriaCorrespondence: Martin Hoenigl, Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz, 8036, Austria, Tel +43 31638531425, Email [email protected]: Invasive mold diseases are devastating systemic infections which demand meticulous care in selection, dosing, and therapy monitoring of antifungal drugs. Various circumstances regarding PK/PD properties of the applied drug, resistance/tolerance of the causative pathogen or host intolerability can lead to failure of the initial antifungal therapy. This necessitates treatment adaption in the sense of switching antifungal drug class or potentially adding another drug for a combination therapy approach. In the current state of drastically limited options of antifungal drug classes adaption of therapy remains challenging. Current guidelines provide restricted recommendations only and emphasize individual approaches. However, novel antifungals, incorporating innovative mechanisms of action, show promising results in late stage clinical development. These will expand options for salvage therapy in the future potentially as monotherapy or in combination with conventional or other novel antifungals. We outline current recommendations for salvage therapy including PK/PD considerations as well as elucidate possible future treatment options for invasive aspergillosis and mucormycosis.Keywords: invasive fungal infections, aspergillosis, mucormycosis, salvage therap
Fungal Infections Complicating COVID-19
No full textCoronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread globally to pandemic proportions. Although the majority of cases have asymptomatic or mild infections, a significant proportion of cases progress to severe pneumonia and acute respiratory distress syndrome requiring critical care. Opportunistic infections following severe respiratory viral infections have been recognized since the 1918 influenza pandemic. Among critically ill patients with COVID-19, secondary fungal infections caused by Aspergillus and Candida spp. are increasingly described, affecting up to 30% of COVID-19 patients requiring intensive care treatment. This collection of manuscripts focuses on fungal infections complicating COVID-19, including immunological mechanisms and pathogenesis, diagnosis, and treatment
IDIM: ECMM Webinar - COVID19 associated Aspergillosis
No full textThis online Webinar about the COVID-19 associated Aspergillosis, was hosted by the ECMM (European Confederation of Medical Mycology) at Thursday 30 July 2020. The list of talks is listed as below:; 1_Dr. Carolina Garcia-Vidal, Spain: Immunology of COVID19 associated aspergillosis; 2_Prof. Paul E. Verweij, Netherlands: COVID19 associated pulmonary aspergillosis (CAPA) definitions; 3_Dr. Jon Salmanton-Garcia, Germany: Epidemiology in Europe and beyond; 4_Eelco F.J. Meijer, Netherlands: Azole resistance in CAPA; 5_Prof. Jean-Pierre Gangneux, France: Diagnosis of CAPA; how it’s done now; 6_Dr. Lewis White, UK: Point of Care diagnosis – soon reality?; 7_Prof. Martin Hoenigl, Austria: Point of Care Diagnosis from BALF; other patient groups & treatment; 8_Dr. Philip Köhler: CAPA Management Guidance // Dieses Online-Webinar über die COVID19-assoziierte Aspergillose wurde von der ECMM (European Confederation of Medical Mycology) am Donnerstag, dem 30. Juli 2020, veranstaltet. Die Liste der Vorträge ist unten aufgeführt:; 1_Dr. Carolina Garcia-Vidal, Spanien: Immunologie der COVID19-assoziierten Aspergillose; 2_Prof. Paul E. Verweij, Niederlande: COVID19-assoziierte pulmonale Aspergillose (CAPA)-Definitionen; 3_Dr. Jon Salmanton-Garcia, Deutschland: Epidemiologie in Europa und darüber hinaus; 4_Eelco F.J. Meijer, Niederlande: Azol-Resistenz bei CAPA; 5_Prof. Jean-Pierre Gangneux, Frankreich: Diagnose von CAPA; derzeitiger Standard; 6_Dr. Lewis White, UK: Point of Care-Diagnose - bald Realität?; 7_Prof. Martin Hoenigl, Österreich: Point-of-Care-Diagnose des BALF; andere Patientengruppen & Behandlun
Comparative efficacy and safety of treatment regimens for Pneumocystis jirovecii pneumonia in people living with HIV: a systematic review and network meta-analysis of randomized controlled trials
No full textBackground: Pneumocystis jirovecii pneumonia (PCP) is a serious opportunistic infection in people living with HIV (PWH) who have low CD4 counts. Despite its side effects, trimethoprim–sulfamethoxazole (TMP-SMX) is currently considered the primary treatment for PCP. Objectives: The objectives of this study are to compare the efficacy (treatment failure and mortality) and tolerability (treatment change) of PCP treatment regimens with a frequentist network meta-analysis. Data sources: Data sources include Embase, Medline, and CENTRAL from inception to 3 February 2024. Study eligibility criteria: Study eligibility criteria include comparative randomized controlled trials (RCTs) of at least two PCP treatment regimens. Participants: Participants include PWH. Interventions: Interventions include treatment regimens for PCP compared head-to-head. Assessment of risk of bias: Assessment of risk of bias includes Cochrane Risk-of-bias tool for RCTs (Cochrane Risk-of-Bias 2). Methods of data synthesis: Title, abstract, and full-text screening, along with data extraction, were conducted by two independent reviewers. Data on PCP treatment failure, all-cause mortality, and discontinuation because of toxicity were pooled and ranked. Results: Fourteen RCTs conducted between 1983 and 1996 included 1788 participants across 27 treatment arms. No regimen showed statistically significant superiority over TMP-SMX in direct comparison. In the network meta-analysis, clindamycin/primaquine was ranked the best (surface under the cumulative ranking curve, 0.8), followed by intravenous pentamidine (0.8) and TMP-SMX (0.8) regarding treatment failure. Regarding all-cause mortality, TMP-SMX was superior to atovaquone in direct comparison, but no treatment was superior in the full network analysis. Dapsone–TMP (0.7) and intravenous pentamidine (0.8) were ranked the highest for mortality reduction. For safety and tolerability, comparator drugs consistently outperformed TMP-SMX, with significant reductions in toxicity observed for dapsone–TMP, inhaled pentamidine, and atovaquone. Inhaled pentamidine (0.9) was the best tolerated, followed by trimetrexate (0.8) and atovaquone (0.8). Conclusions: We conclude that TMP-SMX should be reassessed as the standalone first-line therapy for PCP in PWH, given the better tolerability and comparable efficacy of other treatments. In places with access to alternative drugs for PCP treatment, our analysis suggests that alternative regimens may offer comparable effectiveness, providing flexibility to use alternative treatments when comorbidities necessitate it
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