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SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report—Focus on Fungal Susceptibility and Potential Virulence Attributes

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been responsible for approximately 6.8 million deaths worldwide, threatening more than 753 million individuals. People with severe coronavirus disease-2019 (COVID-19) infection often exhibit an immunosuppress...

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Autores principales: Ramos, Lívia S., Mokus, Luca, Frota, Heloisa F., Santos, Marcos V., Oliveira, Simone S. C., Oliveira, Manoel M. E., Costa, Gisela L., Alves, Ana Luísa, Bernardes-Engemann, Andréa R., Orofino-Costa, Rosane, Aor, Ana Carolina, Branquinha, Marta H., Santos, André L. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963862/
https://www.ncbi.nlm.nih.gov/pubmed/36828515
http://dx.doi.org/10.3390/tropicalmed8020099
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author Ramos, Lívia S.
Mokus, Luca
Frota, Heloisa F.
Santos, Marcos V.
Oliveira, Simone S. C.
Oliveira, Manoel M. E.
Costa, Gisela L.
Alves, Ana Luísa
Bernardes-Engemann, Andréa R.
Orofino-Costa, Rosane
Aor, Ana Carolina
Branquinha, Marta H.
Santos, André L. S.
author_facet Ramos, Lívia S.
Mokus, Luca
Frota, Heloisa F.
Santos, Marcos V.
Oliveira, Simone S. C.
Oliveira, Manoel M. E.
Costa, Gisela L.
Alves, Ana Luísa
Bernardes-Engemann, Andréa R.
Orofino-Costa, Rosane
Aor, Ana Carolina
Branquinha, Marta H.
Santos, André L. S.
author_sort Ramos, Lívia S.
collection PubMed
description The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been responsible for approximately 6.8 million deaths worldwide, threatening more than 753 million individuals. People with severe coronavirus disease-2019 (COVID-19) infection often exhibit an immunosuppression condition, resulting in greater chances of developing co-infections with bacteria and fungi, including opportunistic yeasts belonging to the Saccharomyces and Candida genera. In the present work, we have reported the case of a 75-year-old woman admitted at a Brazilian university hospital with an arterial ulcer in the left foot, which was being prepared for surgical amputation. The patient presented other underlying diseases and presented positive tests for COVID-19 prior to hospitalization. She received antimicrobial treatment, but her general condition worsened quickly, leading to death by septic shock after 4 days of hospitalization. Blood samples collected on the day she died were positive for yeast-like organisms, which were later identified as Saccharomyces cerevisiae by both biochemical and molecular methods. The fungal strain exhibited low minimal inhibitory concentration values for the antifungal agents tested (amphotericin B, 5-flucytosine, caspofungin, fluconazole and voriconazole), and it was able to produce important virulence factors, such as extracellular bioactive molecules (e.g., aspartic peptidase, phospholipase, esterase, phytase, catalase, hemolysin and siderophore) and biofilm. Despite the activity against planktonic cells, the antifungals were not able to impact the mature biofilm parameters (biomass and viability). Additionally, the S. cerevisiae strain caused the death of Tenebrio molitor larvae, depending on the fungal inoculum, and larvae immunosuppression with corticosteroids increased the larvae mortality rate. In conclusion, the present study highlighted the emergence of S. cerevisiae as an opportunistic fungal pathogen in immunosuppressed patients presenting several severe comorbidities, including COVID-19 infection.
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spelling pubmed-99638622023-02-26 SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report—Focus on Fungal Susceptibility and Potential Virulence Attributes Ramos, Lívia S. Mokus, Luca Frota, Heloisa F. Santos, Marcos V. Oliveira, Simone S. C. Oliveira, Manoel M. E. Costa, Gisela L. Alves, Ana Luísa Bernardes-Engemann, Andréa R. Orofino-Costa, Rosane Aor, Ana Carolina Branquinha, Marta H. Santos, André L. S. Trop Med Infect Dis Article The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been responsible for approximately 6.8 million deaths worldwide, threatening more than 753 million individuals. People with severe coronavirus disease-2019 (COVID-19) infection often exhibit an immunosuppression condition, resulting in greater chances of developing co-infections with bacteria and fungi, including opportunistic yeasts belonging to the Saccharomyces and Candida genera. In the present work, we have reported the case of a 75-year-old woman admitted at a Brazilian university hospital with an arterial ulcer in the left foot, which was being prepared for surgical amputation. The patient presented other underlying diseases and presented positive tests for COVID-19 prior to hospitalization. She received antimicrobial treatment, but her general condition worsened quickly, leading to death by septic shock after 4 days of hospitalization. Blood samples collected on the day she died were positive for yeast-like organisms, which were later identified as Saccharomyces cerevisiae by both biochemical and molecular methods. The fungal strain exhibited low minimal inhibitory concentration values for the antifungal agents tested (amphotericin B, 5-flucytosine, caspofungin, fluconazole and voriconazole), and it was able to produce important virulence factors, such as extracellular bioactive molecules (e.g., aspartic peptidase, phospholipase, esterase, phytase, catalase, hemolysin and siderophore) and biofilm. Despite the activity against planktonic cells, the antifungals were not able to impact the mature biofilm parameters (biomass and viability). Additionally, the S. cerevisiae strain caused the death of Tenebrio molitor larvae, depending on the fungal inoculum, and larvae immunosuppression with corticosteroids increased the larvae mortality rate. In conclusion, the present study highlighted the emergence of S. cerevisiae as an opportunistic fungal pathogen in immunosuppressed patients presenting several severe comorbidities, including COVID-19 infection. MDPI 2023-02-02 /pmc/articles/PMC9963862/ /pubmed/36828515 http://dx.doi.org/10.3390/tropicalmed8020099 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ramos, Lívia S.
Mokus, Luca
Frota, Heloisa F.
Santos, Marcos V.
Oliveira, Simone S. C.
Oliveira, Manoel M. E.
Costa, Gisela L.
Alves, Ana Luísa
Bernardes-Engemann, Andréa R.
Orofino-Costa, Rosane
Aor, Ana Carolina
Branquinha, Marta H.
Santos, André L. S.
SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report—Focus on Fungal Susceptibility and Potential Virulence Attributes
title SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report—Focus on Fungal Susceptibility and Potential Virulence Attributes
title_full SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report—Focus on Fungal Susceptibility and Potential Virulence Attributes
title_fullStr SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report—Focus on Fungal Susceptibility and Potential Virulence Attributes
title_full_unstemmed SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report—Focus on Fungal Susceptibility and Potential Virulence Attributes
title_short SARS-CoV-2 Post-Infection and Sepsis by Saccharomyces cerevisiae: A Fatal Case Report—Focus on Fungal Susceptibility and Potential Virulence Attributes
title_sort sars-cov-2 post-infection and sepsis by saccharomyces cerevisiae: a fatal case report—focus on fungal susceptibility and potential virulence attributes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963862/
https://www.ncbi.nlm.nih.gov/pubmed/36828515
http://dx.doi.org/10.3390/tropicalmed8020099
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