Dolan Anne-Marie, Hoban Tamara, Brennan Grainne, Flanagan Peter R, O'Rourke Sadhbh, Teoh Tee Keat, Boyle Breida, Mellerick Lisa, Toolan Shane, Flynn Catherine, Wagener Johannes, O'Connell Brian
Department of Clinical Microbiology, St. James Hospital, Dublin, Ireland.
National Methicillin Resistance Staphylococcus Aureus Reference Laboratory, St James Hospital, Dublin, Ireland.
Mycopathologia. 2025 Jan 7;190(1):8. doi: 10.1007/s11046-024-00916-4.
Magnusiomyces capitatus is an environmental fungus found in soil, water, air, plants, and dairy products which may cause opportunistic infections in patients with haematological disorders resulting in high mortality rates. This series of the first reported cases in Ireland discusses investigation of two patients with underlying haematological disorders, hospitalised in the Irish National Adult Stem Cell Transplant Unit (NASCTU), who developed line-related fungaemias with M. capitatus within a three-month period. Patient A was a 49-year-old gentleman with a background of myelodysplastic syndrome with a large paroxysmal nocturnal haemoglobinuria clone who underwent an allogeneic stem cell transplant (ASCT). He developed a prolonged bloodstream infection with M. capitatus and was treated with antifungals but unfortunately passed away 30 days following first detection of M. capitatus from blood. Patient B is a 35-year-old lady with a background of aplastic anaemia who received an ASCT with blood cultures later growing M. capitatus. She developed a disseminated infection with skin involvement and brain lesions. She remains on long-term suppressive antifungals post discharge. Outbreaks of disseminated M. capitatus infection have been reported in several haematology units, related to contaminated medical devices and dairy products. In this situation, environmental and food sampling did not provide any evidence of M. capitatus, and whole genome sequencing proved that the isolates were unrelated. indicating no link between the two cases within a short period in the NASCTU. Increasing rates of rare invasive yeasts means that consideration should be given to management in vulnerable populations such as haematology patients post ASCT.
头状马格努斯酵母是一种存在于土壤、水、空气、植物和乳制品中的环境真菌，可能会导致血液系统疾病患者发生机会性感染，死亡率很高。本系列爱尔兰首例报告病例讨论了对两名患有潜在血液系统疾病的患者的调查，这两名患者在爱尔兰国家成人干细胞移植单位（NASCTU）住院，在三个月内发生了与头状马格努斯酵母相关的导管相关性真菌血症。患者A是一名49岁的男性，有骨髓增生异常综合征背景，伴有大型阵发性夜间血红蛋白尿克隆，接受了异基因干细胞移植（ASCT）。他发生了由头状马格努斯酵母引起的长时间血流感染，并接受了抗真菌治疗，但不幸的是，在首次从血液中检测到头状马格努斯酵母30天后去世。患者B是一名35岁的女性，有再生障碍性贫血背景，接受了ASCT，血培养后来生长出头状马格努斯酵母。她发生了播散性感染，累及皮肤和脑部病变。出院后她仍在接受长期抑制性抗真菌治疗。几个血液科单位报告了头状马格努斯酵母播散性感染的暴发，与受污染的医疗设备和乳制品有关。在这种情况下，环境和食品采样未提供任何头状马格努斯酵母的证据，全基因组测序证明分离株无关。表明在NASCTU短时间内这两例病例之间没有关联。罕见侵袭性酵母的发病率增加意味着应考虑对ASCT后的血液学患者等脆弱人群进行管理。
