Trichosporon beigelii, an emerging pathogen resistant to amphotericin B. |
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Authors: | T J Walsh G P Melcher M G Rinaldi J Lecciones D A McGough P Kelly J Lee D Callender M Rubin P A Pizzo |
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Affiliation: | Infectious Diseases Section, National Cancer Institute, Bethesda, Maryland 20892. |
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Abstract: | Trichosporon beigelii caused fatal disseminated infections that were resistant to amphotericin B in two granulocytopenic patients. In vitro susceptibility studies demonstrated that both index strains of T. beigelii were inhibited but not killed by amphotericin B at achievable concentrations in serum. The minimum lethal concentration for both isolates was greater than or equal to 18 micrograms/ml. Five of seven other isolates were found to have a similar pattern of amphotericin B resistance. The fact that the minimum lethal concentration of T. beigelii was many times greater than its MIC was consistent with a resistance pattern of tolerance. We concluded that T. beigelii may be resistant in vitro to amphotericin B and that this in vitro resistance was correlated with refractory, disseminated trichosporonosis in granulocytopenic patients. T. beigelii should be included in the expanding list of amphotericin B-resistant fungi. |
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