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Case Reports
. 2016 Apr 14:16:148.
doi: 10.1186/s12879-016-1477-3.

Emerging pan-resistance in Trichosporon species: a case report

Claudy Oliveira dos Santos  1 , Jan G Zijlstra  2 , Robert J Porte  3 , Greetje A Kampinga  4 , Anne D van Diepeningen  5 , Bhanu Sinha  4 , Erik Bathoorn  4
Affiliations
Case Reports

Emerging pan-resistance in Trichosporon species: a case report

Claudy Oliveira dos Santos et al. BMC Infect Dis. .

Erratum in

Abstract

Background: Trichosporon species are ubiquitously spread and known to be part of the normal human flora of the skin and gastrointestinal tract. Trichosporon spp. normally cause superficial infections. However, in the past decade Trichosporon spp. are emerging as opportunistic agents of invasive fungal infections, particularly in severely immunocompromised patients. Clinical isolates are usually sensitive to triazoles, but strains resistant to multiple triazoles have been reported.

Case presentation: We report a high-level pan-azole resistant Trichosporon dermatis isolate causing an invasive cholangitis in a patient after liver re-transplantation. This infection occurred despite of fluconazole and low dose amphotericin B prophylaxis, and treatment with combined liposomal amphotericin B and voriconazole failed.

Conclusion: This case and recent reports in literature show that not only bacteria are evolving towards pan-resistance, but also pathogenic yeasts. Prudent use of antifungals is important to withstand emerging antifungal resistance.

Keywords: Antifungal stewardship; Disseminated trichosporonosis; Invasive fungal disease; Liver transplant; Trichosporon dermatis.

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Figures

Fig. 1
Fig. 1
Rooted phylogenetic tree of the Trichosporon isolate based on confidently aligned ITS and cytB sequences, obtained by maximum parsimony cluster analysis and 1000 bootstrap simulations
See this image and copyright information in PMC

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