Medical mycology journal最新文献

{"title":"P151 Molecular epidemiology of environmental strains of Cryptococcus isolated from Varanasi, Uttar Pradesh, India","authors":"Neha Nidhi Tirkey, Karuna Singh","doi":"10.1093/mmy/myac072.P151","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P151","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Cryptococcosis affects more than one million people per year worldwide. Despite the worldwide emergence of this ubiquitous infection, little is known about the global molecular epidemiology of this fungal pathogen. The ecological niche of the etiological agents of C. neoformans and C. gattii are not well established yet in various parts of India. Methodology The present study was performed on the C. neoformans isolated from the Eucalyptus terreticornis at Varanasi, India. A total of 265 samples including flowers, leaves, bark, and nearby soil of E. terreticornis. The fungal pathogens were identified by both the conventional and molecular methods. The isolates were also grown in Staib's and tobacco agar medium. In addition, all isolates were identified on the basis of different biochemical tests such as urease test and canavanine-glycine-bromothymol blue (CGB). Further, molecular characterization was carried out by using PCR and DNA sequence analyses. Results Of all the 265 samples, 11 were positive for C. neoformans. 8% (4/50) for E. tereticornis bark, 5% (3/60) for nearby soil, 6.66% (2/30) for debris, and 3.07% (2/65) for decayed wood from tree hollows. C. neoformans was not recovered from the leaves and flowers of E. tereticornis. The presence of brown colonies on Staib's and tobacco agar media confirmed that the isolated pathogen is Cryptococcus. Further the isolates of Cryptococcus were tested for urease production using Christensen urea citrate agar medium in which all isolates were found to hydrolyze urea rapidly and reddish pink color was obtained confirming it to be C. neoformans. All isolated yeast were negative for Canavanine glycinebromothymol blue (CGB) as they fail to produce a color change in the medium. Five strains were identified as C. neoformans var. grubii and one of the isolates was identified as C. neoformans var. neoformans. Molecular typing grouped the isolates into two major genotypes. Five were molecular type VNI (serotype A, var. grubii), one of the isolates was molecular type VNIV (serotype D, var. neoformans). Figure 3 shows the Gel electrophoresis image of ITS1- ITS4 amplicons. The nucleotide sequences were submitted in NCBI GenBank with accession numbers MZ824412, MZ848145, MZ823611, MZ882370, MZ882372, and MZ817986. Conclusion In spite of a major Eucalyptus growing region of India, there is no report of C. neoformans/C. gattii-Eucalyptus association from Eastern Uttar Pradesh. Therefore, the current study would certainly be helpful in the establishment of molecular epidemiology of Cryptococcus in this area.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"8 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87433103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P303 An unusual case of isolated gluteal abscess","authors":"Viplov Vaidya, V. Wagh, S. Sinha, Santosh R Konde, Sohini Arora","doi":"10.1093/mmy/myac072.P303","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P303","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Background Mucormycosis is an invasive infection caused by fungi belonging to the order Mucorales. The angioinvasive disease caused by these fungi can prove to be fatal despite appropriate treatment. We report an unusual case of a gluteal abscess caused by a probable mucormycosis in an apparently immunocompetent individual. Case Description A 68-year-old gentleman hailing from a rural area of Bihar, India presented with a painful swelling over the left buttock region for 4 weeks. He was a known hypertensive and had ischemic heart disease. He denied any history of fever. The lump had gradually increased in size. He was a retired school teacher with a farmland and reared livestock at home. He was a non-vegetarian and denied any addictions. He had a history of intermittent lower backache for which he used to take occasional intramuscular analgesic injections over his buttocks from a local medical practitioner. On examination, the swelling was about 4 cm X 4 cm in size, fluctuant, with ill-defined margins over the lateral region of the left buttock. The swelling was tender, warm, and not fixed to underlying structures. Systemic examination was unremarkable. Ultrasound examination revealed an ∼7.2 × 4.2 × 7.8 cm cystic lesion with a volume of 126cC. It was located predominantly in subcutaneous fat extending into muscular plane with septa and solid components in the left gluteal region (Fig. 1). It had thick walls and fine internal echoes within. Other investigations were unremarkable except for glycosylated Hb, which was 6.2%. Incision and drainage were done. During the procedure, it was seen as a cyst with a thick wall that was removed in toto. The contents were explored after removal and were found to be yellowish black with mucoid consistency. Histopathological examination revealed numerous broad, ribbon-like, aseptate fungal hyphae with right-angled branching infiltrating the inflamed tissue (Fig.2). There were numerous epithelioid granulomas surrounding the fungal elements in the soft tissue of the wall. The findings were consistent with a fungal abscess caused by mucormycosis. Culture of the fluid/pus was negative. Thus, a diagnosis of mucormycotic gluteal abscess was made and patient was commenced on 50 mg of amphotericin B deoxycholate in view of financial restraints. High resolution computed tomography of chest was done which was unremarkable. He developed an acute kidney injury after 2 doses of amphotericin B deoxycholate which was then stopped. Oral posaconazole was started. He has developed bilateral leg swelling post-oral posaconazole and is commenced on oral spironolactone for the same. The postoperative wound has healed well and there is no new swelling or tenderness over the area. He is planned for further follow-up. Conclusions Isolated gluteal abscess caused by mucormycosis is rare in an apparently immunocompetent host. We assume that repeated intramuscular injections ","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"22 2","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72471675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P176 Basidiobolus meristosporus — anew species on the block!","authors":"Ruchita Chabra, S. Raju, P. Padaki, A. Shubha, J. Crasta, C. Indumathi, J. Savio","doi":"10.1093/mmy/myac072.P176","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P176","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Entomophthorales, including genus Basidiobolus, and Conidiobolus are a well-recognized cause of subcutaneous infections in immunocompetent hosts. Genus Basidiobolus is ubiquitous. All human infections except one reported so far have been due to B.ranarum. Here we present a case of an immunocompetent 5-year-old girl with a soft tissue swelling on the right upper buttock caused by B. meristosporus. Methods Tissue biopsy samples from swelling over right buttock were sent for microbiological and histopathological examination. In microbiology, the samples were subjected to microscopy with Gram stain and KOH-calcofluor, aerobic, anaerobic, and fungal culture. Additionally, CBNAAT was done to rule out Mycobacterium tuberculosis. Growth on fungal culture was identified by slide culture and microscopy. The isolate was sent to PGIMER, Chandigarh for characterization using whole genome sequencing. Environmental surveillance included surveillance of soil samples from in and around the patient's house was attempted to identify the source of infection. Results On physical examination, an indurated mass was noted on the right lower back with a scar of a previously attempted drainage. The surface over the lesion was erythematous, the skin was scaly with no discharging sinuses. Gram stain of the biopsy sample revealed few polymorphonuclear leukocytes and no microorganisms. KOH-calcofluor revealed broad, partially septate, hyaline fungal hyphae. Aerobic and anaerobic cultures did not yield any pathogen. CBNAAT was negative for Mycobacterium tuberculosis. Fungal culture on SDA yielded growth of waxy, expanding colonies with cerebriform center, without aerial mycelium after 72 h of incubation, at both 25°C and 37°C. LPCB mount was prepared from the primary tubes and slide culture was performed. Preliminary identification was established as B. ranarum. VITEK MS (MALDI-TOF) did not identify the isolate as this is not available in the database. Molecular characterization and phylogenetic analysis were done and the isolate was identified as B. meristosporus. Soil samples from in and around the house did not yield fungal growth morphologically resembling Basidiobolus species. Histopathological examination of the sample revealed Splendore Hoeppli phenomenon with occasional broad, aseptate hyphae. The child was initially treated with oral potassium iodide and later initiated on oral nitroimidazole. The response was dramatic with 70% resolution of the lesion within 3 weeks of therapy and almost complete resolution after 6 weeks. The child is on regular follow-up since then and is doing well. Conclusion Subcutaneous entomophthoramycosis in children are rare tropical infections that can mimic malignancy and hence are often misdiagnosed resulting in unnecessary pharmacotherapy or mutilating surgery. Diagnosis is established by isolation and correct identification of fungal species. To the best of our ","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"158 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76813738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P282 Bacterial co-infections in Mucormycosis infected COVID-19 patients: experience from a tertiary care center in India","authors":"Neha Sharad, Smriti Srivastava, Aparna Ningombam, V. Kiro, Sharin Varma, Sharad Srivastav, R. Malhotra, P. Mathur","doi":"10.1093/mmy/myac072.P282","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P282","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM During the second wave of COVID-19 in India, there was a deluge in Mucormycosis cases; which posed a serious threat as both conditions require extended hospital stay thus serving as an ideal setting for secondary infections. Objectives 1. To ascertain the prevalence and anti-microbial profile of hospital-acquired secondary infections in COVID- 19 patients with Mucormycosis. 2. To evaluate the outcome in these patients and compare it with the outcome of COVID-19 patients with Mucormycosis but without any other secondary infection. Methods A 2-month retrospective observational study was conducted, where we compared outcomes in two groups of COVID-19 patients with Mucormycosis, one group being patients with secondary infections and the other group including patients without secondary infections. A total of 180 samples from suspected cases of Mucormycosis, that underwent evaluation by conventional methods, KOH mount and cultures on SDA, were included. Fungal pathogens were identified from the positive cultures, based on macroscopic and microscopic features, as per standard Mycological methods. Secondary infections inpatients were studied based on conventional bacteriological culture, microbiological profile, along-with identification and antibiotic susceptibility by VITEK 2. PCT and CRP values were also compared. The outcome was then evaluated. Data analysis was done using SPSS V-20. Results A total of 55 patients out of 140 patients, tested positive for Mucormycosis, either by KOH, culture or both. Rhizopus arrhizus was the most common isolate identified. A total of 12/55 (21.8%) people with Mucormycosis developed secondary infections during their stay in the hospital, bloodstream infection being the most common (7/15; 46.67%). Overall, gram-negative (GN) organisms were more common (11/16; 68.75%), in comparison to Gram Positives (GP) (5/16; 31.25%), but the most common organism isolated was Enterococcus faecium (5/16; 31.25%), followed by Klebsiella pneumoniae (4/16) and E. coli (4/16). A total of 4/5 isolates (80%) of Enterococcus faecium were multi-drug resistant (MDR) and two of them were vancomycin-resistant. In all, 10/11 GN isolates (90.9%) were MDR, high resistance to carbapenems was observed, nine out of 11(81.81%) isolates were resistant to imipenem and eight (72.72%) were resistant to meropenem. A total of 3/12 (25%) patients succumbed to their infection in the group with secondary infections, after an average length of stay of 23.33 days. The most common cause of death in these patients was septic shock. A total of 8/43 (18.6%) succumbed to their infection in the group without any secondary infection at an average stay of 9.12 days in the hospital. CRP was found to be consistently elevated, this biomarker might not have a predictive value for bacterial infections in COVID-19 but PCT had a positive predictive value for the secondary bacterial infections overall (P-value <.0","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"200 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76971554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P010 Evaluation of antifungal efficacy of two novel cyclic lipopeptides of the class Bacillomycin from Bacillus subtilis RLID 12.1 in a murine model of invasive candidiasis","authors":"N. Kashyap, R. Paul, S. Rudramurthy, U. Roy, H. Kaur, Anup K. Ghosh, A. Chakrabarti","doi":"10.1093/mmy/myac072.P010","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P010","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objective To evaluate the in vivo efficacy of HPLC–purified antifungal lipopeptides (AF4 and AF5) in a murine model of disseminated candidiasis. Methods C. albicans AMR16294 isolate was used for all the in vivo experiments. A total of 6-week-old pathogen-free, female BALB/c mice, weighing 20-25 g were used for all animal experiments. For Kaplan-Mier analysis, mice were rendered neutropenic by a loading dose of 200 mg/kg cyclophosphamide three days prior (D-3) to infection and 150 mg/kg (D + 1) maintenance dose on day 1 post-infection (D + 1). A total of 60 mice were randomized into 8 different groups with 5 or 6 animals in each group. Animals were infected with 100μL of ∼ 1 × 10⁵ blastospores (corresponding to LD90) via the lateral tail vein. AF4 and AF5 were formulated in sterile PBS and administered intraperitoneally at doses of 5 mg/kg and 10 mg/kg body weight and compared with a clinically-relevant human equivalent dose of caspofungin. AF4, AF5, caspofungin, or vehicle were administered at 1 h and 24 h post-infection. The survival of the mice was monitored for 14 days post-infection. For organ fungal-burden assessment, mice from each group were euthanized by CO2 inhalation, and the organs were aseptically removed, homogenized, and cultured on SDA. Results Both the doses of AF4 significantly reduced the mortality of mice compared to vehicle-treated mice. The survival over 2 weeks in 5 mg/kg, 10 mg/kg, and caspofungin arms were similar and no death was reported in the three groups (P <.01). In contrast, the mortality in-vehicle- administered group was 80% with a median survival of 8 days. A similar survival benefit was observed in AF5-treated mice. While the median survival in the vehicle-treated arm was 5 days, the 2-week survival in 5 mg/kg and 10 mg/kg arms was 80%-100%, comparable to that in the caspofungin arm (P <.01) (Fig. 1). The median CFU/g kidney tissue in 5 mg/kg arm of AF4 was 1.3 × 10⁴ equivalent to a 4-log reduction compared to the vehicle arm (3.8 × 10⁸ CFU/g kidney, P <.0001). The in vivo efficacy was higher at a higher dose with the kidney homogenates of 10 mg/kg arm yielding sterile cultures comparable to that of CAS arm (Fig. 2). Similar organ fungal-burden reduction was noted in heart and splenic tissues with a median cfu/g tissue of 1.3 × 10⁴ in 10 mg/kg, while CAS arms yielded sterile cultures. In AF5 treated groups, the median cfu/g kidney tissue in 5 mg/kg arm was 1.3 × 10⁴, however, the heart and splenic tissue homogenates yielded less fungal burden with median (q2) cfu/g as 0, while q3 of 6.7 × 10³and 1.3 × 10⁴, respectively (Fig. 2). Conclusion Both the antifungal compounds demonstrated a remarkable in vivo efficacy against C. albicans with a significant improvement in survival and a reduction in the organ-fungal burden.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"66 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72535708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P051 A case of recalcitrant sporotrichosis by infection of Sporothrix globosa","authors":"Eun-seon jeong, J. Yim, H. Kwon, J. Choi, Dong-Yeon Shin, Jayoung Kim","doi":"10.1093/mmy/myac072.P051","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P051","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives Sporotrichosis is the leading subcutaneous mycosis caused by the Sporothrix (S.) schenckii complex. S. globosa is the causative organism of fixed sporotrichosis in Korea. The preferred regimen of cutaneous sporotrichosis is itraconazole for 3-6 months, however, there were few studies for recalcitrant sporotrichosis. Methods In 2018, we performed a histological examination of a patient who suffered sporotrichosis for 3 years and cultured part of the specimen. Despite various regimens for years, improvement and exacerbation were repeated, so we took another skin biopsy and cultured it in 2021. Isolates from the 2018 and 2021 lesions were identified as S. globosa by ribosomal DNA ITS sequencing (GenBank accession number: MH499862 and MH499863). The in vitro antifungal sensitivity tests were performed by broth microdilution method according to CLSI M38-A2 guidelines or Sensititre YeastOne® manufacturer's instructions. They were incubated at 30°C in a non-CO2 incubator for 7 days. Results In 2018, histologically, we observed chronic inflammatory granuloma comprising lymphocytes, histiocytes, and giant cells, and several spores with periodic acid-Schiff (PAS) staining. Microscopic findings and ITS sequences of rRNA gene were identical with S. globosa. The antifungal susceptibility profile in 2018 revealed sensitive to terbinafine (0.125 μg/ml), and moderate to high MIC values for amphotericin B (2 μg/ml), itraconazole (>16 μg/ml), voriconazole (>16 μg/ml), and echinocandins (>16 μg/ml). Treatment with terbinafine, itraconazole, or amphotericin B, the skin lesions were partially improved, but were not cured. In 2021, we took another skin biopsy and culture specimen. Histopathological and mycological examination results were the same as before. The antifungal susceptibility profile revealed sensitive to itraconazole (0.5/ml), and high MIC for others. Clinically, skin lesions were not improved with the use of itraconazole 200 mg/d. Itraconazole 400 mg/d with local heating induced moderate improvement. There was no evidence of immune deficiency. Conclusion We experienced recalcitrant sporotrichosis that did not respond to itraconazole and terbinafine, and the sensitivity of antifungal was changed. In this case, the combination treatment including local heating, saturated KI may be considered, and frequent antifungal susceptibility tests are needed.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"6 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72641838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P365 Upsurge of Mucormycosis in COVID-19—a retrospective study in a tertiary care hospital in Punjab","authors":"S. Mohan","doi":"10.1093/mmy/myac072.P365","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P365","url":null,"abstract":"Abstract Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been linked to a variety of opportunistic bacterial and fungal infections. Mucorales have been reported as the main fungal pathogens to exist as co-infection with COVID-19. Factors that contribute to a higher incidence of Mucormycosis or Mucorales to germinate in COVID-19 patients are high glucose levels in their blood (diabetes, steroid-induced hyperglycemia), low oxygen content (hypoxia), high iron levels, and decreased phagocytic activity of neutrophils due to immunosuppression because of cytokine storm in SARS-CoV-2 infection. Mucormycosis is an angioinvasive disease caused by order Mucorales and genus Rhizopus, Mucor, Rhizomucor, Cunnighamella, and Lichthemia. The most common species amongst all is Rhizopus arrhizus which is responsible for 90% cases of Rhino-Orbital Cerebral form and accounts for 60% cases of mucormycosis cases in India. Methods A retrospective study was conducted at Christian Medical College and Hospital, Ludhiana from May 1, 2021 to February 28, 2022 for a duration of 10 months. Most of the samples obtained were necrotic bone/tissue or mucosa from the rhino-cerebral part. The obtained sample was inoculated on Sabouraud's Dextrose Agar (SDA) at 22°C as well as 37°C followed by 40% KOH examination. The tubes were routinely checked once in a week and Lactophenol Cotton Blue (LPCB) preparation was made from teasing the isolate once it becomes culture positive. Results Total 29 samples were smear-positive for broad, sparsely septate hyphae in KOH examination under the microscope. Out of those 29 cases, 18 (62.06%) patients were COVID-19 positive (either RTPCR positive, TrueNat PCR positive, or Rapid Antigen positive), 5 patients were COVID-19 negative and COVID-19 testing was not done in 6 patients. Out of 29 smear-positive cases, 17 (58.62%) were culture positive for Mucorales, 7 (24.13%) grew contaminants namely Aspergillus species (mainly Aspergillus flavus), Penicillium species, bacterial contamination, and 5 (17.24%) were culture negative. Amongst 17 cases of Mucorales, 9 (52.94%) were Rhizopus species, 6 (35.29%) were Mucor species and 2 (11.76%) were Rhizomucor species. Amongst the culture-positive cases for Mucorales, 13 (72.22%) cases were COVID-19 positive. Conclusion COVID-19 has thrown the entire globe into chaos, and there is still no specific cure for this viral illness. Patients are susceptible to secondary fungal infections such as Mucormycosis as a result of the infection, immunosuppression, previous comorbidities, and medicines. Mucormycosis infection is severe because of its rapid disease progression and angioinvasive nature. As a result, researchers and healthcare practitioners should take immediate steps to control this mucormycosis infection by understanding its impact and severity, particularly in COVID-19 patient","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"18 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79859547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P118 Pentraxin-3 interacts with Aspergillus fumigatus conidia to regulate pro-inflammatory cytokine production","authors":"S. Dellière, S. Wong, C. Chauvin, J. Bayry, A. Carvalho, A. Inforzato, V. Aimanianda","doi":"10.1093/mmy/myac072.P118","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P118","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives Long pentraxin-3 (PTX3) is a soluble pattern-recognition receptor secreted by phagocytes and non-immune cells at sites of inflammation. It has been reported to have a nonredundant role in the immune response against Aspergillus fumigatus. Indeed, PTX3 knock-out mice show an increased susceptibility to invasive pulmonary aspergillosis (IPA) with a higher mortality rate. In humans, PTX3 genetic deficiency or single nucleotide polymorphism has also been associated with an increased risk of IPA. However, the way in which PTX3 interacts with A. fumigatus and its mechanism of action has yet to be elucidated. The aim of the study was to investigate potential A. fumigatus ligands for PTX3 and the impact of A. fumigatus opsonization by PTX3 on modulating the immune response. Methods Aspergillus fumigatus conidia, the infective morphotype, were incubated with PTX3 with or without human serum, stained with anti-PTX3 antibody, and studied by immunofluorescence. Identification of potential fungal ligands for PTX3 was performed by ELISA. Fixed conidia and germinated conidia were opsonized with different serum factors and co-incubated with human monocyte-derived macrophages (hMDM) for 24 h at 37°C. Culture supernatants were collected, and pro-/anti-inflammatory cytokines were measured by sandwich ELISA. Results PTX3 did not bind A. fumigatus conidia directly but in the presence of human serum, purified collectins [surfactant protein D (SP-D) or C1q], and complement products (C3b). Pre-opsonization of conidia with these complement proteins or SP-D stimulated proinflammatory cytokine secretion by hMDM upon interaction (Fig. 1a). In contrast, secondary opsonization of complement proteins or SP-D opsonized conidia with PTX3 significantly reduced pro-inflammatory cytokines and increased anti-inflammatory cytokine secretion from hMDM. PTX3 opsonized PFA-fixed germinating conidia significantly reduced pro-inflammatory cytokine and increased anti-inflammatory cytokines secretion from hMDM (Fig. 1b). Conclusion PTX3 is an acute phase protein expressed in response to pro-inflammatory stimuli during infection and that is increased in bronchoalveolar lavage of patients with aspergillosis. Our recent data with A. fumigatus suggest that PTX3 is an immunoregulatory protein that reduces pro-inflammatory response. Although an inflammatory response is necessary to fight against fungal pathogens, the tissue damage associated with enhanced inflammation can be deleterious and facilitate A. fumigatus infection.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"141 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80564472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P133 Post-COVID-19 recurrent fungal urinary tract infections: A case series","authors":"Siddhant Shetty, U. Agrawal, M. Kruthi, Amar Kardale, Camilla Rodrigues, V. Joshi, A. Hegde, A. Sunavala","doi":"10.1093/mmy/myac072.P133","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P133","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Background COVID-19 has opened a pandora's box of opportunistic infections and immune alteration. We hereby present a series of patients with recurrent fungal urinary tract infections triggered by an episode of COVID-19. Description Case 1: A 66-year-old male, diabetic, known chronic kidney disease, had moderate COVID-19 in September 2020 needing remdesivir and steroids; 2 months later, he was treated for a fungal UTI elsewhere. In May 2021, he presented with right-sided pyelonephritis, hydroureter, and pyonephrosis. DJ stenting was done and cultures grew C. tropicalis. Record of anti-fungal susceptibility from the fluconazole resistance and was hence treated with 21 days of micafungin with significant improvement. Despite 3 weeks of directed anti-fungal treatment, he had recurrent episodes of candiduria with azotemia. Cystoscopy and selective sampling yielded C. tropicalis from the right pelvi-calyceal system, but as he was unwilling for nephrostomy and local antibiotic instillation he was started on anidulafungin and long-term 5-flucytosine suppression. Case 2: A 61-year-old male, diabetic, with uncontrolled sugars, had severe COVID-19 in September 2020 needing oxygen, remdesivir, and steroids; 1 month later, presented with right-sided flank pain and four episodes of painless passage of fleshy tissue per urethra in the last 1 year (Fig. 2). He had multiple episodes of bacterial UTIs which were treated, with complete resolution. The fleshy mass showed septate fungal elements and culture grew Aspergillus flavus sensitive to voriconazole, itraconazole, and posaconazole. He received multiple prolonged courses of voriconazole and caspofungin prior to presenting to us. CT revealed right-sided pyelonephritis with dilated pelvi-calyceal system. The patient was started on 2 weeks of micafungin followed by a prolonged course of voriconazole and 5-flucytosine with close clinical and therapeutic drug monitoring. Case 3: A 68-year-old female, diabetic, had moderate COVID-19 in April 2021, and was given remdesivir and steroids. She was admitted 1 month later with UTI (Pyelonephritis with early forming renal abscess) with urine culture growing CR Klebsiella p. (OXA-48) and C. glabrata for which she was given ceftazidime-A, vibactam, and voriconazole and underwent bilateral DJ stenting followed by stent removal after 1 month along with switching to micafungin in view of repeated candiduria on treatment. She has developed multiple UTIs in the subsequent months with C. auris being isolated twice and bacterial UTIs, treated with antibiotics and micafungin. Subsequent CT revealed retroperitoneal fibrosis encasing the ureters causing obstruction, a biopsy was inconclusive but was empirically started on methotrexate for IgG4 disease. Discussion The proposed immune alteration mechanism of COVID-19 of decreased phagocytic function, uncontrolled sugars, and steroid-related neutrophil dysfunction predispo","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"60 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80578013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P440 General protocol applied to the identification and production of new biomarkers with potential use for the diagnosis of histoplasmosis","authors":"Juan David Puerta Arias, J. P. Isaza, E. Moreno, I. Berrio, Luz Elena Cano Restrepo, Tonny W. Naranjo","doi":"10.1093/mmy/myac072.P440","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P440","url":null,"abstract":"Abstract Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objective To identify and produce novel biomarkers with potential use for the specific diagnosis of H. capsulatum infection. Methods Here, we design a novel strategy to search and select new Candidate genes for biomarkers that integrates the use of a computational analysis model that includes the application of bioinformatic tools such as OrthoMCL, BLASTp, TargetP, and SignalP, applied on a local collection of proteome database obtained manually from GenBank-NCBI, and the analysis of previously published biological and experimental data sets, including a secreted proteome database obtained from pathogenic yeast-phase H. capsulatum culture filtrates, a Histoplasma yeast and mycelial transcriptomes database, and a urine-peptides database from Histoplasma-immunoassay-positive patients. For the synthesis of the Candidates, an internal protocol for the production of recombinant proteins in prokaryotic and eukaryotic systems was applied. Obtaining polyclonal antibodies (PAb) specific for each biomarker was carried out by adapting a rapid immunization protocol for BALB/c mice. Finally, the computational model was experimentally validated, evaluating the reactivity and specificity of PAb anti-Histoplasma with fungus culture extracts and samples from patients with histoplasmosis. Results Using the computational analysis model, 2 Candidate genes for diagnostic biomarkers were identified. Subsequently, the construction of expression vector for each Candidate and the production of these genes were achieved using a standardized protocol for the production of recombinant proteins. Polyclonal antibodies (PAb) anti-histoplasma were obtained and shown to be reactive against purified H. capsulatum-antigens. Finally, we confirmed the presence of these antigens in yeast culture extracts of H. capsulatum and demonstrated the immunoreactivity of anti-Histoplasma PAb with urine samples from patients previously diagnosed with histoplasmosis. Conclusion The generation of novel strategies that combine data analysis, computational tools, and transcriptomic and proteomic techniques could be very useful for the identification of new biomarker genes and the development of microbiological diagnostic tests for important pathogens.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"50 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83546983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}