Hemodynamic changes in surgical intensive care unit patients undergoing echinocandin treatment

AbstractBackground Echinocandins are well-established agents for the treatment of patients with fungal infections, but growing evidence questions their safety in special patient populations prone to systemic inflammatory responses.Objective The study aimed to analyse early hemodynamic changes during echinocandin therapy in critically ill surgical patients.Setting The study was conducted at the surgical intensive care unit at the University Hospital of Giessen, Germany.Methods This single-centre retrospective study includes data from critically ill patients who underwent primary antifungal treatment during 2009 –2013.Main outcome measures Hemodynamic parameters, need for vasopressor/inotropic therapy, and dose of vasopressor/inotropic therapy were recorded 2  h before and 2 h after the onset of antifungal treatment. Comparisons of echinocandins to azoles and analysis of a combined endpoint (decrease of mean arterial pressure  ≥ 10 mmHg and/or new or increased dosages of norepinephrine, epinephrine, or dobutamine) were performed.Results We found 342 episodes of intravenous antifungal treatment (33 [9.6%] anidulafungin, 116 [33.9%] caspofungin, 132 [38.6%] fluconazole, 17 [5%] micafungin, 44 [12.9%] voriconazole). Group comparisons revealed no significant differences of hemodynamic parameters, need for vasopressor/inotropic therapy, and dose of vasopressor/inotropic therapy, expect for a decreased dose of norepinephrine in the fluconazole gr...
Source: International Journal of Clinical Pharmacy - Category: Drugs & Pharmacology Source Type: research

Related Links:

Authors: Koch B, Traven A Abstract Proper structure and function of the fungal cell wall are controlled by metabolic processes, as well as an interplay between a range of cellular organelles. Somewhat surprisingly, mitochondrial function has been shown to be important for proper cell wall biogenesis and integrity. Mitochondria also play a role in the susceptibility of fungi to cell wall-targeting drugs. This is true in a range of fungal species, including important human fungal pathogens. The biochemical mechanisms that explain the roles of mitochondria in cell wall biology have remained elusive, but studies to dat...
Source: Current Topics in Microbiology and Immunology - Category: Microbiology Tags: Curr Top Microbiol Immunol Source Type: research
Conclusions: Given the significant risk of Cryptococcus species for susceptible humans, mainly HIV-infected patients, it seems quite necessary to adopt concrete preventive strategies to pinpoint the environmental habitats of this yeast.
Source: Journal of Medical Mycology - Category: Biology Source Type: research
Publication date: Available online 6 December 2019Source: Wilderness &Environmental MedicineAuthor(s): James H. DiazCryptococcus neoformans, a soil-dwelling fungus found worldwide, can cause cryptococcosis, an opportunistic fungal infection of the lungs and central nervous system. One former member of the C neoformans complex, Cryptococcus gattii, has caused meningitis in immunosuppressed and immunocompetent persons in endemic regions in Africa and Asia. Between 1999 and 2004, C gattii caused outbreaks of human cryptococcosis in unexpected, nonendemic, nontropical regions on Vancouver Island, Canada, and throughout the...
Source: Wilderness and Environmental Medicine - Category: Environmental Health Source Type: research
We present a case of CNS aspergillosis in a CLL patient on first line ibrutinib therapy. We summarize existing case reports and case series of invasive aspergillosis in patients on ibrutinib, the pathogenesis of invasive aspergillosis, and discuss the clinical controversies regarding anti-fungal prophylaxis in this population.
Source: Medical Mycology Case Reports - Category: Biology Source Type: research
Conference abstracts
Source: The Aspergillus Website - updates - Category: Respiratory Medicine Authors: Source Type: news
Conference abstracts
Source: The Aspergillus Website - updates - Category: Respiratory Medicine Authors: Source Type: news
In this study, a peptide analog from the mastoparan class of wasps (MK58911) was tested against Cryptococcus spp. and Paracoccidioides spp. In addition, peptide toxicity tests on lung fibroblasts (MRC5) and glioblastoma cells (U87) were performed. Subsequent tests related to drug interaction and mechanism of action were also performed, and efficacy and toxicity of the peptide were evaluated in vivo using the G. mellonella model. Our results reveal promising activity of the peptide, with an MIC in the range of 7.8–31.2 μg/mL, and low toxicity in MRC and U87 cells (IC50> 500 μg/mL). Taken together, these resul...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Conference abstracts
Source: The Aspergillus Website - updates - Category: Respiratory Medicine Authors: Source Type: news
AbstractTo study the clinical presentation and management outcomes in a series of patients with invasive rhino-orbital-cerebral mucormycosis presenting to a tertiary care center in central India. Medical records of eleven consecutive cases of invasive rhino-orbital –cerebral mucormycosis were reviewed. All clinically diagnosed cases, confirmed on microbiological examination were included. Their demographic data, clinical manifestations, underlying systemic conditions, microbiological and radiological reports, medical treatments, and surgical interventions we re recorded and analyzed. There were nine male and two fema...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research
In this study, we show that puupehenone (PUUP), a marine sponge-derived sesquiterpene quinone potentiates the echinocandin drug, caspofungin (CAS) in CAS-resistant fungal pathogens. We have conducted RNA-Seq analysis, followed by genetic and molecular studies, to elucidate PUUP ’s CAS-potentiating mechanism. We found that the combination of CAS and PUUP blocked the induction of CAS-responding genes required for the adaptation to cell wall stress through the cell wall integrity (CWI) pathway. Further analysis showed that PUUP inhibited the activation of Slt2 (Mpk1), the t erminal MAP kinase in this pathway. We also fo...
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by high throughput sequencing Saccharomyces cerevisiae Source Type: research
More News: Cancidas | Caspofungin | Drugs & Pharmacology | Fluconazole | Fungal Infections | Germany Health | Intensive Care | Study