Global guideline for the diagnosis and management of rare yeast infections: an initiative of the ECMM in cooperation with ISHAM and ASM - 25/11/21
Doi : 10.1016/S1473-3099(21)00203-6
Sharon C-A Chen, ProfPhD a, b, †, ⁎ 
, John Perfect, ProfMD c, †, Arnaldo L Colombo, ProfMD d, †, Oliver A Cornely, ProfMD e, f, g, †, Andreas H Groll, ProfMD h, Danila Seidel, PhD e, f, Kerstin Albus, PhD e, f, Joao N de Almedia, MD i, j, Guillermo Garcia-Effron, ProfPhD k, l, Nicole Gilroy, MBBS b, Cornelia Lass-Flörl, ProfMD m, Luis Ostrosky-Zeichner, ProfMD n, Livio Pagano, ProfMD o, Tamas Papp, ProfDSc p, Riina Rautemaa-Richardson, FRCPath q, r, Jon Salmanton-García, PhD e, f, Andrej Spec, MD s, Joerg Steinmann, ProfMD t, u, Sevtap Arikan-Akdagli, ProfMD v, Dorothee E Arenz, PhD e, w, Rosanne Sprute, MD e, w, Luisa Duran-Graeff, MD x, Tomas Freiberger, ProfMD z, aa, Corrado Girmenia, MD ab, Michelle Harris c, Souha S Kanj, ProfMD ac, Maryam Roudbary, PhD ad, Olivier Lortholary, ProfMD ae, Joseph Meletiadis, PhD af, Esther Segal, ProfPhD ah, Felipe Francisco Tuon, ProfPhD ai, Nathan Wiederhold, ProfPharmD aj, Tihana Bicanic, MD ak, Jagdish Chander, ProfMD al, Yee-Chun Chen, ProfMD am, an, Po-Ren Hsueh, ProfMD am, ao, Margaret Ip, ProfMD ap, Patricia Munoz, ProfMD aq, Isabel Spriet, ProfMD ar, as, Elvis Temfack, MD at, au, Luis Thompson, ProfMD y, Anna Maria Tortorano, ProfPhD av, Aristea Velegraki, PhD ag, Nelesh P Govender, ProfMBBCh aw, ax, †
, John Perfect, ProfMD c, †, Arnaldo L Colombo, ProfMD d, †, Oliver A Cornely, ProfMD e, f, g, †, Andreas H Groll, ProfMD h, Danila Seidel, PhD e, f, Kerstin Albus, PhD e, f, Joao N de Almedia, MD i, j, Guillermo Garcia-Effron, ProfPhD k, l, Nicole Gilroy, MBBS b, Cornelia Lass-Flörl, ProfMD m, Luis Ostrosky-Zeichner, ProfMD n, Livio Pagano, ProfMD o, Tamas Papp, ProfDSc p, Riina Rautemaa-Richardson, FRCPath q, r, Jon Salmanton-García, PhD e, f, Andrej Spec, MD s, Joerg Steinmann, ProfMD t, u, Sevtap Arikan-Akdagli, ProfMD v, Dorothee E Arenz, PhD e, w, Rosanne Sprute, MD e, w, Luisa Duran-Graeff, MD x, Tomas Freiberger, ProfMD z, aa, Corrado Girmenia, MD ab, Michelle Harris c, Souha S Kanj, ProfMD ac, Maryam Roudbary, PhD ad, Olivier Lortholary, ProfMD ae, Joseph Meletiadis, PhD af, Esther Segal, ProfPhD ah, Felipe Francisco Tuon, ProfPhD ai, Nathan Wiederhold, ProfPharmD aj, Tihana Bicanic, MD ak, Jagdish Chander, ProfMD al, Yee-Chun Chen, ProfMD am, an, Po-Ren Hsueh, ProfMD am, ao, Margaret Ip, ProfMD ap, Patricia Munoz, ProfMD aq, Isabel Spriet, ProfMD ar, as, Elvis Temfack, MD at, au, Luis Thompson, ProfMD y, Anna Maria Tortorano, ProfPhD av, Aristea Velegraki, PhD ag, Nelesh P Govender, ProfMBBCh aw, ax, † a Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, NSW, Australia
b Centre for Infectious Diseases and Microbiology, Westmead Hospital, The University of Sydney, Sydney, NSW, Australia
c Duke University Medical Center, Durham, NC, USA
d Division of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
e Department I of Internal Medicine, Excellence Center for Medical Mycology, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
f Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany
g Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
h Infectious Disease Research Program, Centre for Bone Marrow Transplantation and Department of Paediatric Hematology and Oncology, University Children’s Hospital Münster, Münster, Germany
i Central Laboratory Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
j Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
k Laboratorio de Micología y Diagnóstico Molecular, Cátedra de Parasitología y Micología, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina
l Consejo Nacional de Investigaciones Científicas y Tecnológicas, CCT Santa Fe, Santa Fe, Argentina
m Institute of Hygiene and Medical Microbiology, ECMM Excellence Centre, Medical University of Innsbruck, Innsbruck, Austria
n Division of Infectious Diseases, McGovern Medical School, Houston, TX, USA
o Fondazione Policlinico Universitario A Gemelli—IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
p Fungal Pathogenicity Mechanisms Research Group, Department of Microbiology, University of Szeged, Szeged, Hungary
q Wythenshawe Hospital, ECMM Excellence Centre, Manchester University NHS Foundation Trust, Manchester, UK
r Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
s Division of Infectious Disease, School of Medicine, Washington University in St Louis, St Louis, MO, USA
t Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Nuremberg, Germany
u Institute of Medical Microbiology, University Hospital Essen, Essen, Germany
v Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey
w German Centre for Infection Research, Partner Site Bonn-Cologne, Cologne, Germany
x Clínica Las Condes, Departamento de Medicina Interna, Unidad de Infectología, Santiago, Chile
y Clinica Alemana–Universidad del Desarrollo, Departamento de Medicina Interna, Unidad de Infectología, Santiago, Chile
z Centre for Cardiovascular Surgery and Transplantation, Brno, Czech Republic
aa Medical Faculty, Masaryk University, Brno, Czech Republic
ab Department of Hematology, Umberto I Policlinico di Roma, Rome, Italy
ac Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Centre, Beirut, Lebanon
ad Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
ae Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants malades, Université Paris V, Paris, France
af Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
ag Mycology Research Laboratory and UOA/HCPF Culture Collection, Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
ah Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
ai Laboratory of Emerging Infectious Diseases, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
aj Fungus Testing Laboratory, University of Texas Health Science Center, San Antonio, TX, USA
ak Institute of Infection and Immunity, St George’s University of London, London, UK
al Department of Microbiology, Government Medical College Hospital, Chandigarh, India
am Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University College of Medicine, Taipeh, Taiwan
an Department of Medicine, National Taiwan University College of Medicine, Taipeh, Taiwan
ao Department of Laboratory Medicine, National Taiwan University College of Medicine, Taipeh, Taiwan
ap Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
aq Infectious Diseases and Clinical Microbiology Department, Hospital General Universitario Gregorio Marañón, Servicio de Microbiología-Enfermedades Infecciosas, Madrid, Spain
ar Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
as Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
at Internal Medicine Unit, Douala General Hospital, Douala, Cameroon
au National Public Health Laboratory, Yaounde, Cameroon
av Department of Biomedical Science for Research, Universita degli Studi di Milano, Milan, Italy
aw National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa
ax School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
* Correspondence to: Prof Sharon C-A Chen, Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Sydney, NSW 214, Australia Centre for Infectious Diseases and Microbiology Laboratory Services Institute of Clinical Pathology and Medical Research New South Wales Health Pathology Sydney NSW 214 Australia
Summary |
Uncommon, or rare, yeast infections are on the rise given increasing numbers of patients who are immunocompromised or seriously ill. The major pathogens include those of the genera Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon (ie, basidiomycetes) and Kodamaea, Malassezia, Pseudozyma (ie, now Moesziomyces or Dirkmeia), Rhodotorula, Saccharomyces, and Sporobolomyces (ie, ascomycetes). A considered approach to the complex, multidisciplinary management of infections that are caused by these pathogens is essential to optimising patient outcomes; however, management guidelines are either region-specific or require updating. In alignment with the One World–One Guideline initiative to incorporate regional differences, experts from diverse geographical regions analysed publications describing the epidemiology and management of the previously mentioned rare yeasts. This guideline summarises the consensus recommendations with regards to the diagnostic and therapeutic options for patients with these rare yeast infections, with the intent of providing practical assistance in clinical decision making. Because there is less clinical experience of patients with rare yeast infections and studies on these patients were not randomised, nor were groups compared, most recommendations are not robust in their validation but represent insights by use of expert opinions and in-vitro susceptibility results. In this Review, we report the key features of the epidemiology, diagnosis, antifungal susceptibility, and treatment outcomes of patients with Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon spp infections.
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Elsevier Ltd. Tous droits réservés.
Vol 21 - N° 12
P. e375-e386 - décembre 2021 Retour au numéro
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