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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Microbiol. | doi: 10.3389/fmicb.2019.02196

Saprochaete clavata invasive infections – a new threat to hemato-oncological patients

  • 1Faculty of Medicine in Hradec Králové, Charles University, Czechia
  • 2University Hospital Hradec Kralove, Czechia
  • 3University of Cologne, Germany

Background: Saprochaete clavata (Magnusiomyces clavatus) is a filamentous yeast-like fungus that has recently been described as a newly emerging pathogen mostly in patients with acute leukemia. The diagnosis of this mycosis is very difficult and an optimal treatment regimen has yet to be established.
Methods: Retrospective study that includes cases of proven and probable S. clavata infection, including epidemiological data, which were diagnosed at the University Hospital, Hradec Kralove, Czech Republic between March 2005 and December 2017. Review of literature and FungiScope™database of documented cases of S. clavata infection.
Results: Six cases (5 females, 1 male) of blood-stream S. clavata infections at the hemato-oncological department of a large hospital were described. Overall, 116 strains of S. clavata were isolated from clinical specimens of 54 patients; most of them belonged to the respiratory tract (60.3%). Saprochaete clavata was the most frequently recovered species among arthroconidial yeasts (Trichosporon, Galactomyces, Magnusiomyces) from the blood. All patients with S. clavata infection had profound neutropenia, a central venous catheter, broad-spectrum antibiotics and antifungal prophylaxis; four had a history of a biliary tract system disease. The diagnosis was based on a positive blood culture in all patients. Four patients died of multiorgan failure and sepsis despite treatment with lipid-based amphotericin B and/or voriconazole.
Conclusions: Saprochaete clavata infection represents a new life-threatening mycosis in severely immunocompromised patients. The successful outcome of treatment seems to be critically dependent on the early diagnosis and the recovery of underlying conditions associated with immune dysfunction or deficiency.

Keywords: Saprochaete, Magnusiomyces, Geotrichum, Epidemiology, Leukemia, diagnosis, FungiScope™, therapy, arthroconidial yeasts , Fungemia, haematological patients

Received: 06 May 2019; Accepted: 09 Sep 2019.

Copyright: © 2019 Buchta, Bolehovska, hovorkova, Cornely, Seidel and Žák. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD, PhD. Pavel Žák, Faculty of Medicine in Hradec Králové, Charles University, Hradec Kralove, Czechia, zak.pce@email.cz