Know your enemy: fungal pathogens

This website is developed and fully funded by Gilead Sciences Europe Limited

Photo of lady wearing green jumper

KNOW YOUR ENEMY

Invasive fungal infections (IFIs) are a leading cause of mortality in intensive care units (ICU),1 and in haematology2,3 and HIV settings.4-6 With resistance to antifungal treatment on the rise,7,8 fight back against the threat by understanding the different fungal pathogens – where they are found, what makes them thrive, and how AmBisome® can help.

AmBisome® has a broad spectrum of activity against the majority of fungal pathogens

When the fungal pathogen is unknown, consider AmBisome® as an option when treating the next IFI – in vitro data demonstrates that AmBisome® is effective against rare and difficult-to-treat infections, including azole-resistant strains.9-12

Micrsocopic image of fungal pathogen in a Petri dish

Aspergillus

  • Aspergillus is a type of mould that can cause invasive infection (aspergillosis) in those who are immunocompromised or have respiratory disease13
  • The microscopic spores present in Aspergillus species are found in soil, dust, decaying vegetation and many other settings, and are inhaled by most people every day14
  • There are over 300,000 cases of aspergillosis every year and mortality rates can be as high as 70%15,16
  • The most common species of Aspergillus include A. fumigatus and A. flavus17
  • Common symptoms include fever, chest pain, coughing and shortness of breath18

AmBisome® demonstrates in vitro fungicidal activity against major Aspergillus species, including A. fumigatus and A. flavus.19

Micrsocopic image of fungal pathogen in a Petri dish

Candida

  • Candida is a type of yeast that can enter the bloodstream or internal organs and cause infection (candidaemia) in patients at risk, such as those in ICUs or those with a weakened immune system20
  • A common route of infection is through intravenous catheters or cannulas that are needed by patients in the ICU for extended periods of time20
  • There are an estimated 700,000 global cases of invasive candidiasis each year15
  • With candidaemia, mortality rates are between 30-60%21
  • One of the most common IFIs in immunocompromised ICU patients is candidaemia;22 however, there is an increasing variety of rare, resistant, and post-viral life-threatening fungal infections18,23,24
  • The most common species that cause infections are C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei 20
  • Common symptoms include fever or chills that do not improve after antibiotic treatment20

AmBisome® demonstrates in vitro fungicidal activity against a multitude of Candida species, including C. albicans, C. glabrata, C. krusei, C. parapsilosis, C. tropicalis and C. lusitaniae.10

Micrsocopic image of fungal pathogen in a Petri dish

Mucorales

  • Mucorales are an order of mould fungi that can cause a serious but rare fungal infection (mucormycosis) in at-risk patients20
  • These environmental fungi live in soil and decaying organic matter, and can infect via inhalation of the spores or contact with the skin25
  • The estimated prevalence of mucormycosis is 910,000 cases globally, with around 900,000 of these cases localised to India,15,26 and mortality rates are between 46-96%26-28
  • The most common species are  Rhizopus species and Mucor species28
  • Symptoms depend on the location of the infection (sinus and brain, lungs, skin, gastrointestinal, or disseminated)29-31 but can include swelling, fever, black lesions, blisters or ulcers, coughing, abdominal pain, nausea, and bleeding20

In the fight against mucormycosis, AmBisome® demonstrates in vitro fungicidal activity against Mucorales.10

Micrsocopic image of fungal pathogen in a Petri dish

Cryptococcus

  • Cryptococcus is an invasive yeast fungus that can cause serious infection (cryptococcosis), commonly associated with immunosuppressed individuals32
  • The two types of species most associated with cryptococcosis are Cryptococcus neoformans and Cryptococcus gattii 32
  • They are commonly found in soil, decaying wood, tree hollows and bird droppings and can cause infection through inhalation20
  • Cryptococcal meningitis is a major cause of illness in patients with HIV/AIDS, with an estimated 220,000 cases globally each year33
  • Mortality rates for patients with Cryptococcus gatti are between 12-33%34,35
  • Symptoms of cryptococcosis depend on the location of the infection (lungs, brain, skin or other organs), but can include coughing, breathlessness, fever, nausea and vomiting34-40

AmBisome® demonstrates efficacy in HIV/AIDS patients with acute cryptococcal meningitis and in vitro fungicidal activity against cryptococcus neoformans*10,41

Man wearing red shirt looking pensive

With the threat to your at-risk patients increasing,18,23,27,42-44 learn how to suspect IFIs early so you can initiate prompt treatment with AmBisome®

Discover more

HOW CAN YOU STAY ONE STEP AHEAD OF IFIs? HEAR WHAT THE EXPERTS HAVE TO SAY

Professor Arnaldo Lopes Colombo

Managing cryptococcosis and histoplasmosis with AmBisome®

Prof. AL Colombo - Professor of Medicine, Federal University of São Paulo
Watch now
Professor Souha Kanj

Challenges of aspergillosis in the ICU

Prof. S Kanj - Professor of Medicine, AUBMC, Lebanon & Consulting Professor, Duke University Medical Center, USA
Watch now

Footnotes

*Prospective, randomised, multicentre, double-blind study in 267 patients with confirmed HIV infection and cryptococcal meningitis. Patients were randomised (ratio, 1:1:1) from multiple sites in the United States and Canada to receive either amphotericin B at 0.7 mg/kg/day (n=87), AmBisome® at 3 mg/kg/day (n=86), or AmBisome® at 6 mg/kg/day (n=94). The overall incidence of infusion-related reactions was significantly lower for both the 3 mg/kg/day and 6 mg/kg/day dosages of AmBisome® compared with conventional amphotericin B (P<0.001).41

Abbreviations

AUBMC: American University of Beirut Medical Center.

References

  • Shen H et al. J Emerg Crit Care Med. 2019;3:54.
  • Valentine J et al. BMC Infectious Diseases. 2019;19(1):274.
  • Rayens E et al. Clin Microbiol Infect. 2021;74(2):309-318.
  • World Health Organization. Guidelines for diagnosing and managing disseminated histoplasmosis in people living with HIV. Available at: https://iris.paho.org/handle/10665.2/52304 [Last accessed: June 2022].
  • Srichatrapimuk S and Sungkanuparph S. AIDS Res Ther. 2016;13(1):42.
  • Okurut S et al. Mycoses. 2020;63:840-853.
  • Arendup MC. Clin Microbiol Infect. 2014;20(suppl. 6):42-44.
  • Nett JE and Andres DR. Infect Dis Clin North Am. 2016;30(1):51-83.
  • Chandrasekar P. J Antimicrob Chemother. 2011;66(3):457-465.
  • Lass-Flörl et al. Antimicrob Agents Chemother. 2008;52(10):3637-3641.
  • Almyroudis NG et al. Antimicrob Agents Chemother. 2007;51(7):2587-2590.
  • Manavathu M et al. J Antimicrob Chemother. 2000;46:229-234.
  • Barnes PD and Marr KA. Inf Dis Clin North Am. 2006;20(3):545-61.
  • Warris A and Verweij PE. Med Mycol Suppl. 2005;43:S59-S65.
  • Bongomin F et al. J Fungi (Basel). 2017;3(4):57.
  • Sun KS et al. PLoS One. 2017;12(10):e0186422.
  • Lass-Flörl C. Mycoses. 2009;52(3):197-205.
  • Taccone FS et al. Critical Care. 2015;9:7.
  • Meletiadis J et al. Antimicrob Agents Chemother. 2007;51(9):3329-3337.
  • CDC: Fungal Diseases. Available at: https://www.cdc.gov/fungal/diseases/[Last accessed: June 2022].
  • Hirano R et al. Infect Drug Resist. 2015;8:199-205.
  • Ostrosky-Zeichner L and Al-Obaidi M. Infect Dis Clin North Am. 2017;31(3)475-487.
  • Peman J et al. Rev Iberoam Micol. 2020;37(2):41-46.
  • Bassetti M et al. Intensive Care Med. 2014;40:839-845.
  • Richardson M. Clin Microbiol Infect. 2009;15(5):2-9.
  • Prakash H et al. Med Mycol. 2019;57(4):395-402.
  • Jeong W et al. Clin Microbiol Infect. 2015;25(1):26-34.
  • Roden MM et al. Clin Infect Dis. 2005;41(5):634-53.
  • Petrikkos G et al. Clin Infect Dis. 2012;54(1):S23-34.
  • Ribes JA et al. Clin Microbiol Rev. 2000;13(2):236-301.
  • Spellberg B et al. Clin Microbiol Rev. 2005;18(3):556-569.
  • Mada PK et al. StatPearls. 2022. Available from:https://www.ncbi.nlm.nih.gov/books/NBK431060/ [Last accessed: June 2022].
  • Rajasingham R et al. Lancet Infect Dis. 2017;17(8):873-881.
  • Galanis E et al. Emerg Infect Dis. 2010;16(2):251-257.
  • Harris JR et al. Clin Infect Dis. 2011;53(12):1188-95.
  • Chang WC et al. Chest. 2006;129(2):333-340.
  • Sabiiti A and May RC. Future Microbiol. 2012;7(11):1297-313.
  • Clark RA et al. Rev Infect Dis. 1990;12(5):768-77.
  • Bratton EW et al. PLoS One. 2012;7(8):e43582.
  • Chen S et al. Clin Infect Dis. 2000;31(2):499-508.
  • Hamill RJ et al. Clin Infect Dis. 2010;51(2):225-32.
  • Wiederhold NP. Infect Drug Resist. 2017;29;10:249-259.
  • Hoenigl M et al. (2021). The emergence of COVID-19 associated mucormycosis: analysis of cases from 18 countries. Available at: https://www.researchgate.net/publiction/351558444 [Last accessed: June 2022].
  • Moorthy A et al. J Maxillofoc Oral Surg. 2021;1-8.

Date of preparation: June 2022. Job code: IHQ-AMB-0708.