Co-Occurrence of Gram-Negative Rods in Patients with Hematologic Malignancy and Sinopulmonary Mucormycosis
Both Mucorales and Gram-negative rods (GNRs) commonly infect patients with hematological malignancies (HM); however, their co-occurrence is understudied. Therefore, we retrospectively reviewed the records of 63 patients with HM and proven or probable sinopulmonary mucormycosis at MD Anderson Cancer...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-01-01
|
| Series: | Journal of Fungi |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2309-608X/10/1/41 |
| _version_ | 1797343251024314368 |
|---|---|
| author | Stephanie L. Egge Sebastian Wurster Sung-Yeon Cho Ying Jiang Dierdre B. Axell-House William R. Miller Dimitrios P. Kontoyiannis |
| author_facet | Stephanie L. Egge Sebastian Wurster Sung-Yeon Cho Ying Jiang Dierdre B. Axell-House William R. Miller Dimitrios P. Kontoyiannis |
| author_sort | Stephanie L. Egge |
| collection | DOAJ |
| description | Both Mucorales and Gram-negative rods (GNRs) commonly infect patients with hematological malignancies (HM); however, their co-occurrence is understudied. Therefore, we retrospectively reviewed the records of 63 patients with HM and proven or probable sinopulmonary mucormycosis at MD Anderson Cancer Center (Houston, Texas) from 2000–2020. Seventeen out of sixty-three reviewed patients (27.0%) had sinopulmonary co-occurrence of GNRs (most commonly <i>Pseudomonas aeruginosa</i> and <i>Stenotrophomonas maltophilia</i>) within 30 days of a positive Mucorales culture or histology demonstrating Mucorales species. Eight of seventeen co-isolations of Mucorales and GNRs were found in same-day samples. All 15 patients with GNR co-occurrence and reported antimicrobial data had received anti-Pseudomonal agents within 14 days prior to diagnosis of mucormycosis and 5/15 (33.3%) had received anti-Stenotrophomonal agents. Demographic and clinical characteristics of patients with and without GNR co-occurrence were comparable. Forty-two-day all-cause mortality was high (34.9%) and comparable in patients with (41.2%) and without (32.6%) GNR detection (<i>p</i> = 0.53). In summary, over a quarter of heavily immunosuppressed patients with sinopulmonary mucormycosis harbored GNRs in their respiratory tract. Although no impact on survival outcomes was seen in a background of high mortality in our relatively underpowered study, pathogenesis studies are needed to understand the mutualistic interplay of GNR and Mucorales and their influence on host responses. |
| first_indexed | 2024-03-08T10:45:04Z |
| format | Article |
| id | doaj.art-25a1771e23794d5e95f07b10d282e311 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-08T10:45:04Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-25a1771e23794d5e95f07b10d282e3112024-01-26T17:19:03ZengMDPI AGJournal of Fungi2309-608X2024-01-011014110.3390/jof10010041Co-Occurrence of Gram-Negative Rods in Patients with Hematologic Malignancy and Sinopulmonary MucormycosisStephanie L. Egge0Sebastian Wurster1Sung-Yeon Cho2Ying Jiang3Dierdre B. Axell-House4William R. Miller5Dimitrios P. Kontoyiannis6Center for Infectious Diseases, Houston Methodist Research Institute, Houston, TX 77030, USADepartment of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USADepartment of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USADepartment of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USACenter for Infectious Diseases, Houston Methodist Research Institute, Houston, TX 77030, USACenter for Infectious Diseases, Houston Methodist Research Institute, Houston, TX 77030, USADepartment of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USABoth Mucorales and Gram-negative rods (GNRs) commonly infect patients with hematological malignancies (HM); however, their co-occurrence is understudied. Therefore, we retrospectively reviewed the records of 63 patients with HM and proven or probable sinopulmonary mucormycosis at MD Anderson Cancer Center (Houston, Texas) from 2000–2020. Seventeen out of sixty-three reviewed patients (27.0%) had sinopulmonary co-occurrence of GNRs (most commonly <i>Pseudomonas aeruginosa</i> and <i>Stenotrophomonas maltophilia</i>) within 30 days of a positive Mucorales culture or histology demonstrating Mucorales species. Eight of seventeen co-isolations of Mucorales and GNRs were found in same-day samples. All 15 patients with GNR co-occurrence and reported antimicrobial data had received anti-Pseudomonal agents within 14 days prior to diagnosis of mucormycosis and 5/15 (33.3%) had received anti-Stenotrophomonal agents. Demographic and clinical characteristics of patients with and without GNR co-occurrence were comparable. Forty-two-day all-cause mortality was high (34.9%) and comparable in patients with (41.2%) and without (32.6%) GNR detection (<i>p</i> = 0.53). In summary, over a quarter of heavily immunosuppressed patients with sinopulmonary mucormycosis harbored GNRs in their respiratory tract. Although no impact on survival outcomes was seen in a background of high mortality in our relatively underpowered study, pathogenesis studies are needed to understand the mutualistic interplay of GNR and Mucorales and their influence on host responses.https://www.mdpi.com/2309-608X/10/1/41mucormycosispulmonary infectionbacterial pneumoniaGram-negative rodsco-infection<i>Pseudomonas aeruginosa</i> |
| spellingShingle | Stephanie L. Egge Sebastian Wurster Sung-Yeon Cho Ying Jiang Dierdre B. Axell-House William R. Miller Dimitrios P. Kontoyiannis Co-Occurrence of Gram-Negative Rods in Patients with Hematologic Malignancy and Sinopulmonary Mucormycosis Journal of Fungi mucormycosis pulmonary infection bacterial pneumonia Gram-negative rods co-infection <i>Pseudomonas aeruginosa</i> |
| title | Co-Occurrence of Gram-Negative Rods in Patients with Hematologic Malignancy and Sinopulmonary Mucormycosis |
| title_full | Co-Occurrence of Gram-Negative Rods in Patients with Hematologic Malignancy and Sinopulmonary Mucormycosis |
| title_fullStr | Co-Occurrence of Gram-Negative Rods in Patients with Hematologic Malignancy and Sinopulmonary Mucormycosis |
| title_full_unstemmed | Co-Occurrence of Gram-Negative Rods in Patients with Hematologic Malignancy and Sinopulmonary Mucormycosis |
| title_short | Co-Occurrence of Gram-Negative Rods in Patients with Hematologic Malignancy and Sinopulmonary Mucormycosis |
| title_sort | co occurrence of gram negative rods in patients with hematologic malignancy and sinopulmonary mucormycosis |
| topic | mucormycosis pulmonary infection bacterial pneumonia Gram-negative rods co-infection <i>Pseudomonas aeruginosa</i> |
| url | https://www.mdpi.com/2309-608X/10/1/41 |
| work_keys_str_mv | AT stephanielegge cooccurrenceofgramnegativerodsinpatientswithhematologicmalignancyandsinopulmonarymucormycosis AT sebastianwurster cooccurrenceofgramnegativerodsinpatientswithhematologicmalignancyandsinopulmonarymucormycosis AT sungyeoncho cooccurrenceofgramnegativerodsinpatientswithhematologicmalignancyandsinopulmonarymucormycosis AT yingjiang cooccurrenceofgramnegativerodsinpatientswithhematologicmalignancyandsinopulmonarymucormycosis AT dierdrebaxellhouse cooccurrenceofgramnegativerodsinpatientswithhematologicmalignancyandsinopulmonarymucormycosis AT williamrmiller cooccurrenceofgramnegativerodsinpatientswithhematologicmalignancyandsinopulmonarymucormycosis AT dimitriospkontoyiannis cooccurrenceofgramnegativerodsinpatientswithhematologicmalignancyandsinopulmonarymucormycosis |