INFECTIONS IN ONCOHEMATOLOGY

Aureobasidium pullulans-Associated Invasive Mycosis in a Child with Acute Myeloblastic Leukemia: A Case Report

INFECTIONS IN ONCOHEMATOLOGY ,

NS Bagirova1, AV Popa1, ТS Bogomolova2, NA Batmanova1, NV Dmitrieva1, IN Petukhova1, EN Sokolova1

1 NN Blokhin National Medical Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

2 II Mechnikov North-Western State Medical University, 41 Kirochnaya str., Saint Petersburg, Russian Federation, 191015

For correspondence: Nataliya Sergeevna Bagirova, MD, PhD, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: 8(499)324-18-60; e-mail: nbagirova@mail.ru

For citation: Bagirova NS, Popa AV, Bogomolova ТS, et al. Aureobasidium pullulans-Associated Invasive Mycosis in a Child with Acute Myeloblastic Leukemia: A Case Report. Clinical oncohematology. 2018;11(3):259–64.

DOI: 10.21320/2500-2139-2018-11-3-259-264

ABSTRACT

Severe mycotic infection occurring mainly in immunocompromised patients often exacerbates the progression of the primary oncohematological disease. It is the first attempt in Russian literature to present clinical and microbiological characteristics of invasive mycosis caused by Aureobasidium pullulans in a child with acute myeloblastic leukemia after receiving cytoreductive and antifungal treatment with favourable outcome.

Keywords: Aureobasidium pullulans, acute myeloblastic leukemia, invasive mycosis.

Received: January 15, 2018

Accepted: April 8, 2018

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REFERENCES

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  3. Salkin IF, Martinez JA, Kemna ME. Opportunistic infection of the spleen caused by Aureobasidium pullulans. J Clin Microbiol. 1986;23(5):828–31.
  4. Najafzadeh MJ, Sutton DA, Keisari MS, et al. In Vitro Activities of Eight Antifungal Drugs against 104 Environmental and Clinical Isolates of Aureobasidium pullulans. Agents Chemother. 2014;58(9):5629–31. doi: 10.1128/AAC.03095-14.

Invasive Zygomycosis: Epidemiology and Clinical Features (Review)

INFECTIONS IN ONCOHEMATOLOGY ,

NS Bagirova

N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Nataliya Sergeevna Bagirova, DSci, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-18-60; e-mail: nbagirova@mail.ru

For citation: Bagirova NS. Invasive Zygomycosis: Epidemiology and Clinical Features (Review). Clinical oncohematology. 2016;9(1):84–9 (In Russ).

DOI: 10.21320/2500-2139-2016-9-1-84-89

ABSTRACT

The invasive zygomycosis is the third most common mycosis following invasive candidiasis and aspergillosis. Patients with hematological malignancies and patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are two main risk groups for the disease. In addition, zygomycosis is important for patients with diabetes. The review presents detailed description of epidemiology, risk factors, clinical types of zygomycosis, and features of therapy.

Keywords: zygomycosis, invasive zygomycosis, Zygomycetes.

Received: October 9, 2015

Accepted: November 1, 2015

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REFERENCES

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  15. Lewis RE, Liao G, Hou J, et al. Comparative analysis of amphotericin B lipid complex and liposomal amphotericin B kinetics of lung accumulation and fungal clearance in a murine model of acute invasive pulmonary aspergillosis. Antimicrob Agents Chemother. 2007;51:1253–8. doi: 10.1128/aac.01449-06.
  16. Lewis RE, Albert ND, Liao G, et al. Comparative pharmacodynamics of amphotericin B lipid complex and liposomal amphotericin B in a murine model of pulmonary mucormycosis. Antimicrob Agents Chemother. 2010;54:1298–304. doi: 10.1128/aac.01222-09.
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  18. Walsh TJ, Gamaletsou MN, McGinnis MR, et al. Early clinical and laboratory diagnosis of invasive pulmonary, extrapulmonary, and disseminated mucormycosis (zygomycosis). Clin Infect Dis. 2012;54(Suppl. 1):S55–60. doi: 10.1093/cid/cir868.
  19. Lewis RE, Lortholary O, Spellberg B, et al. How does antifungal pharmacology differ for mucormycosis versus aspergillosis? Clin Infect Dis. 2012;54(Suppl. 1):S67–72. doi: 10.1093/cid/cir884.

Diagnostic Value of C-Reactive Protein as Marker of Infections in Patients with De Novo Acute Myeloid Leukemias

INFECTIONS IN ONCOHEMATOLOGY , , , , ,

L.N. Tarasova1, S.G. Vladimirova1, V.V. Cherepanova2

1 Kirov Scientific Research Institute for Hematology and Blood Transfusion under the Federal Medico-Biological Agency of Russia, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027

2 Municipal Hospital No. 33, 54 pr-t Lenina, Nizhny Novgorod, Russian Federation, 603122

For correspondence: Lyudmila Nikolaevna Tarasova, DSci, Professor, 72 Krasnoarmeiskaya str., Kirov, Russian Federation, 610027; Tel.: +7(8332)67-57-00; e-mail: vlsg@mail.ru

For citation: Tarasova LN, Vladimirova SG, Cherepanova VV. Diagnostic Value of C-Reactive Protein as Marker of Infections in Patients with De Novo Acute Myeloid Leukemias. Clinical oncohematology. 2015;8(4):442–446 (In Russ).

DOI: 10.21320/2500-2139-2015-8-4-442-446

ABSTRACT

Aim. To determine diagnostically relevant C-protein levels (CRP) as an early infection marker in patients with de novo acute myeloid leukemias (AML), to evaluate the dependence of CRP concentrations on the WBC count and leukemic blast cells in the peripheral blood.

Methods. CRP was tested in 39 patients with de novo AML (17 males and 22 females) at the age of 20 to 76 years (median age is 49). AML types according to the FAB grading were as follows: М0 — 2, М1 — 4, М2 — 23, М4 — 8, and М5 — 2 patients.

Results. CRP concentrations in patients without symptoms of an infection (n = 16) were within the range from 0 to 43 mg/l (median 5.5 mg/l). The Spearman’s rank correlation coefficients between the CRP level and WBC and blast cell counts were 0.664 (p = 0.006) and 0.473 (p = 0.062), respectively. The obtained data confirm activation of CRP synthesis in case of leukemia. In patients with an infection and/or fever (n = 23), CRP levels were significantly higher than those in patients without an infection: 8–383 mg/l (median 81 mg/l). No correlation between the CRP level and WBC and blast cell counts was found. Therefore, the CRP synthesis during the onset of AML is significantly increased as a response to the infection. In groups of patients with and without infections, 95% CI were equal to 0–40 mg/l and 12–315 mg/l, respectively. Since they overlap within the range from 12 to 40 mg/l, they may be considered a «grey zone». The CRP concentrations within this range suggest infection. CRP levels lower than 12 mg/l or higher than 40 mg/l with a high degree of probability confirm either absence or presence of infectious complications, respectively.

Conclusion. Therefore, CRP is an accessible and informative marker of infection in patients with AML during the onset of the disease. Monitoring of its levels permits to start a timely antimicrobial therapy; at that, the efficacy of the therapy can be assessed based on the dynamics of this parameter.

Keywords: acute myeloid leukemias, infectious complications, acute-phase proteins, C-reactive protein, blast cells, white blood cells.

Received: April 20, 2015

Accepted: October 22, 2015

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Local Immunity in Hematological Patients with Oropharyngeal Candidiasis

INFECTIONS IN ONCOHEMATOLOGY , , ,

E.Yu. Danilovа, N.V. Shabashova, E.V. Frolova, A.E. Uchevatkina, L.V. Filippova

I.I. Mechnikov North-West State Medical University under the Ministry of Health of Russia, 41 Kirochnaya str., Saint Petersburg, Russian Federation, 191015

For correspondence: Evgeniya Yur’evna Danilova, graduate student in the Department of Clinical Mycology, 41 Kirochnaya str., Saint Petersburg, Russian Federation, 191015; Tel.: +7(812)303-51-41; e-mail: danilovaimmuno@yandex.ru

For citation: Danilova EYu, Shabashova NV, Frolova EV, et al. Local Immunity in Hematological Patients with Oropharyngeal Candidiasis. Clinical oncohematology. 2015;8(4):436–441 (In Russ).

DOI: 10.21320/2500-2139-2015-8-4-436-441

ABSTRACT

Aim. To evaluate the incidence of oropharyngeal candidiasis (OFC) among oncohematological patients depending on the type of the malignancy and anti-tumor treatment, as well as to assess key cytokine levels in saliva samples.

Methods. 430 patients were enrolled in the study, and 85 samples of saliva were collected from patients with OFC (n = 38) and without it. The control group consisted of 19 healthy volunteers.

Results. The OFC incidence was 9 % and it did not depend on the immunomorphological type of the malignancy and the type of chemotherapy. Before the anti-tumor treatment, TNF-a, IL-17 and G-CSF levels in saliva samples were elevated in all patients. The TNF-a (p < 0.05) synthesis was decreased after the anti-tumor treatment. Besides, a tendency to reduced G-CSF and IL-17 production was found. In patients with OFC, MCP-1, IL-17, IFN-g levels were decreased.

Conclusion. In OFC patients with hematopoietic and lymphoid tissue malignancies, impairment of basic types of local antifungal protection was found.

Keywords: oropharyngeal candidiasis, hematopoietic and lymphoid tissue malignancies, local immunity, Candida spp.

Received: July 1, 2015

Accepted: November 9, 2015

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  16. Edgerton ML, Koshlukova SE, Araujo MW. Salivary histatin 5 and human neutrophil defensin 1 kill Candida albicans via shared pathways. Antimicrob Agents Chemother. 2000;44(12):3310–6. doi: 10.1128/aac.44.12.3310-3316.2000.

Taxonomic Structure and Antibiotic Resistance of Bloodstream Infection Pathogens in Oncohematological Patients

INFECTIONS IN ONCOHEMATOLOGY , , , , , ,

NS Bagirova

N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

For correspondence: Natal’ya Sergeevna Bagirova, DSci, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-18-60; e-mail: nbagirova@mail.ru

For citation: Bagirova NS. Taxonomic Structure and Antibiotic Resistance of Bloodstream Infection Pathogens in Oncohematological Patients. Clinical oncohematology. 2015;8(2):191–200 (In Russ).

ABSTRACT

Background & Aims. In oncohematology, infections are one of main causes of morbidity and mortality in patients with hematological malignancies. Changing epidemiological patterns of infections in patients with hematological malignancies are characterized not only by the appearance of new pathogens of bloodstream infections, but also by the growth of pathogens resistant to antimicrobial drugs. It is important to conduct constant monitoring of taxonomic structure of bloodstream infections pathogens and their antimicrobial resistance in order to ensure adequate and timely treatment of severe infections. The aim of the study is the following: analysis of the taxonomic structure of pathogens isolated while diagnosing bacteremia in adult cancer patients using modern devices taking into account efficacy of the therapy of severe infections.

Methods. A microbiological study of blood samples of adult patients with hematological malignancies was carried out over the period from 2005 till 2013, if sepsis and other severe infections were suspected. Bacteremia was diagnosed using hematological analyzer/incubator Bactec FX400 (Becton Dickinson, USA) and Bact/Alert (BioMerieux, France), identification of strains was done using mass-spectrometer MALDI-TOF Microflex LT (Biotyper, Bruker Daltonics, Germany). Antimicrobial susceptibility was determined using automatic analyzers Microscan Walk Away 40/96+ (Siemens, Germany) and Vitek 2 (BioMerieux, France). Comparative data of foreign researchers are presented.

Results. 3794 blood cultures were obtained, 600 of which (15.8 %) demonstrated growth. Of 392 strains, only 210 (53.6 %) strains were considered true causative agents of bacteremia. No statistically significant differences in the frequency of isolation of Gram-positive cocci (47.6 %) and Gram-negative rods (39.5 %) were found. Fungi were significantly less common than Gram-positive cocci and Gram-negative rods (9 %; p < 0.0001). Other microorganisms constituted 3.8 %.

Conclusion. Therapy and prevention of infectious complications in adult patients with hematological malignancies are accompanied by development of growing antibiotic resistance of pathogens. Changes in taxonomic structure of pathogens of bloodstream infections should be taken into account when prescribing the empirical and etiotropic treatment.

Keywords: infections, cancer, bloodstream infections, bacteriemia, antimicrobial resistance, oncohematological disorders, antimicrobial therapy.

Received: January 12, 2015

Accepted: January 30, 2015

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Case of Pneumocystis Pneumonia after High-Dose Chemotherapy with Autologous Hematopoietic Transplantation

INFECTIONS IN ONCOHEMATOLOGY , ,

V.O. Sarzhevskii1, V.Ya. Mel’nichenk1, D.S. Kolesnikova1, O.Yu. Bronov1, V.M. Sotnikov2, N.N. Smol’tsova2

1 N.I. Pirogov National Medical and Surgical Centre under the Ministry of Health of the Russian Federation, 70 Nizhnyaya Pervomaiskaya str., Moscow, Russian Federation, 105203

2 Russian Scientific Center of Roentgenoradiology under the Ministry of Health of the Russian Federation, 86 Profsoyuznaya str., Moscow, Russian Federation, 117997

For correspondence: V.O. Sarzhevskii, PhD, Associate Professor, 70 Nizhnyaya Pervomaiskaya str., Moscow, Russian Federation, 105203; Tel: +7(495)603-72-18; e-mail: vladsar@pochta.ru

For citation: Sarzhevskii V.O., Mel’nichenko V.Ya., Kolesnikova D.S., Bronov O.Yu., Sotnikov V.M., Smol’tsova N.N. Case of Pneumocystis Pneumonia after High-Dose Chemotherapy with Autologous Hematopoietic Stem Cell Transplantation. Klin. Onkogematol. 2014; 7(4): 583–586 (In Russ.).

ABSTRACT

Pneumocystis pneumonia is a rare complication of a high-dose chemotherapy and autologous bone marrow/peripheral hematopoietic stem cells transplantation in patients with hematological malignances. The absence of typical clinical symptoms and the probability of a lethal outcome require a special approach to this problem. A brief review of literature and presented clinical case give an idea of clinical manifestations, course, diagnostic approaches, prevention, and treatment of pneumocystis pneumonia in this category of patients.

Keywords: autologous bone marrow transplantation, high-dose chemotherapy, pneumocystis pneumonia

Accepted: September 19, 2014

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REFERENCES

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Clinico-immunological features of invasive aspergillosis in patients with Hodgkin’s disease

INFECTIONS IN ONCOHEMATOLOGY , ,

O.V. Shadrivova1, Ye.V. Frolova1, L.V. Filippova1, A.Ye. Uchevatkina1, S.N. Khostelidi1, R.M. Chernopyatova1, Ye.A. Desyatik1, A.G. Volkova2, Ye.V. Shagdileyeva1, L.S. Zubarovskaya2, A.V.Rysev1, S.M. Ignatyeva1, T.S. Bogomolova1, Yu.N. Vinogradova3, N.V. Vasilyeva1, and N.N. Klimko1

1 I.I. Metchnikov Northwest State Medical University, Saint Petersburg, Russian Federation

2 R.M. Gorbacheva Institute of Pediatric Oncology, Hematology and Transplantology, I.P. Pavlov Saint Petersburg State Medical University, Saint Petersburg, Russian Federation

3 Russian Research Centre for Radiology and Surgical Technologies, RF Ministry of Health, Saint Petersburg, Russian Federation

ABSTRACT

Invasive aspergillosis is a serious mycotic infection with high mortality that mostly occurs in patients with hematological malignancies and severe immunodeficiency. Immunological defects in the various groups of hematological patients with invasive aspergillosis are not well understood. We are the first to present the results of studying clinico-immunological features of invasive aspergillosis in the patients with Hodgkin’s lymphoma.

Keywords: invasive aspergillosis, Hodgkin’s lymphoma, immune response.

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Unknown bacteria in oral flora of children with hematological malignancies

INFECTIONS IN ONCOHEMATOLOGY , , ,

M.F. Vecherkovskaya, G.V. Tetz, and V.V. Tetz

I.P. Pavlov Saint Petersburg State Medical University, Saint Petersburg, Russian Federation

ABSTRACT

The objective of this study was to investigate the oral flora of children with hematological malignancies. The variance in the oral microflora of healthy children and children with hematological malignancies are shown. An unknown bacterium was isolated from the mixed biofilms obtained from the saliva of children with hematological malignancies that was absent in the saliva of healthy children of the same age. The microbiological data combined with the proteome assessment and genome sequence analysis indicate that the isolated microorganism belongs to the previously undescribed Streptococcus species.

Keywords: uncultured bacteria, biofilms, microbiota, children

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