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Amphotericin-B/fluconazole Development of resistance in fungal infections: 3 case reports

In a retrospective study of 19 patients conducted between 01 January 2001 and 31 December 2018, three patients [ages and sexes not stated] were described, who acquired resistance to amphotericin-B or fluconazole, during treatment of Rhodotorula mucilaginosa or Trichosporon asahii fungal infections [dosages and routes not stated]. The patients, who had haematological malignancies, presented with unspecified fungal infection and started receiving treatment with amphotericin-B (2 patients) or fluconazole (1 patient). However, during treatment, the patients showed breakthrough fungaemia, suggestive of acquired resistance to the antifungal drugs. Subsequent blood culture reports revealed Trichosporon asahii infection in the two patients receiving amphotericin-B and Rhodotorula mucilaginosa infection in the patient receiving fluconazole. The patient who was receiving fluconazole died before the yeast-positive blood culture report [immediate cause of death not stated]. Based on the results of antimicrobial susceptibility test, the two patients with Trichosporon asahii infection were successfully treated with fluconazole (1 patient) and voriconazole (1 patient). Alp S, et al. Fungaemia due to rare yeasts in a tertiary care university centre within 18 years. Mycoses 63: 488-493, No. 5, May 2020. Available from: URL: http:// doi.org/10.1111/myc.13072

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Reactions 5 Dec 2020 No. 1833