Medical mycology journal最新文献

{"title":"P189 The effect of COVID-19 and immunosuppressive drugs and diabetes on the spread of mucomycosis","authors":"Maryam Esfidani","doi":"10.1093/mmy/myac072.P189","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P189","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Mucormycosis is a serious but rare opportunistic fungal infection that spreads rapidly, so prompt diagnosis and treatment are essential to prevent high mortality rates and complications. Mucormycosis is caused by the inhalation of filamentous fungi, especially in patients with suppressed immune systems. Mucormycosis affected human populations after COVID-19. According to searches, invasive mucormycosis to COVID-19 has been widely reported from survivors, mild to severe. Of course, it seems that the underlying diseases and most importantly uncontrolled diabetes or immunosuppressive diseases have provided the conditions for the development of black fungus. In addition, over-the-counter administration of steroid drugs to control inflammation of the cornea seems to be another cause of the spread of the disease. Groups of patients were analyzed for the link between the COVID-19 epidemic and the nightmare of mucormycosis. Black fungus usually causes necrosis of the head and neck, including the nose, paranasal sinuses, and facial bones, which can sometimes cause complications. Therefore, the present study emphasizes mucormycosis and its associated conditions, its mechanism in normal individuals with COVID-19, the effective factors and challenges to overcome this black mold infection.","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":"89903255","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":"P474 The value of PCR-based azole resistance detection in invasive aspergillosis: A prospective multicenter study","authors":"S. Huygens, A. Dunbar, Jochem Buijl, J. Maertens, P. Verweij, C. Klaassen, K. Lagrou, K. van Dijk, T. Mercier, A. Schauwvlieghe, B. Rijnders","doi":"10.1093/mmy/myac072.P474","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P474","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives Prompt detection of azole-resistant Aspergillus fumigatus will result in the timely start of active treatment and may improve the survival of invasive aspergillosis (IA). The use of a multiplex polymerase chain reaction (PCR) targeting Aspergillus species and fumigatus DNA as well as the two most prevalent azole resistance- associated mutations (RAMs) in the cyp51A gen (TR34/L98H and TR46/Y121F/T289A) could shorten the time to detect azole-resistant IA. Methods In a prospective study in 12 Dutch and Belgian centers, we evaluated the clinical value of the multiplex AsperGenius®PCR in hematology patients with a pulmonary infiltrate undergoing bronchoalveolar lavage (BALf) sampling. The primary endpoint was antifungal treatment failure in the 6 weeks after antifungal treatment initiation in the patients in which azole-resistant IA was detected. Treatment failure was defined as death or a switch to an antifungal agent from another class after at least 5 days of first-line therapy. Patients with a mixed azole-susceptible/resistant infection were excluded from this analysis to ascertain that the infection was indeed caused by the resistant strain. Results Of 323 patients enrolled, sufficient BALf for PCR testing remained in 299. Probable fungal disease was diagnosed in 95 (34%), Aspergillus cultured in 24 (8%), Aspergillus DNA detected in 118 (39%), and A. fumigatus DNA in 88 (29%) patients. The resistance PCR was conclusive in 54/88 (61%) and RAMs were detected in 8 (15%), Table 1. All 8 had probable IA but 2 had a mixed infection and were excluded. In the 6 remaining patients, treatment failure was observed in one. Compared with the GM negative patients and despite antifungal therapy, a positive GM test was associated with a 13% higher 6-week overall mortality (P = .01), Table 2. Surprisingly, the 6-week mortality in the 65 patients who had a positive Aspergillus PCR but a negative GM and culture was not increased compared to those with a negative PCR (PCR + 14% vs. PCR- 16% mortality, P = .68). Conclusions In patients with an underlying hematological disease and a pulmonary infiltrate, the detection of Aspergillus DNA by PCR on BALf was not associated with increased mortality. The exact place of the Aspergillus PCR in the EORTC-MSGERC invasive fungal infection criteria is therefore uncertain. In 15% of the patients in whom A. fumigatus DNA was present, azole RAMs were detected by PCR. In only 1/6 probable cases of IA with RAMs detected, antifungal treatment failure was observed. Basing the choice of antifungal therapy on the result of a cyp51a resistance PCR may help to reduce the impact of azole resistance on mortality.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"256 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86714942","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":"P165 Mycological profile of keratitis from tertiary care center in the state of Chattisgarh, India","authors":"Archana Y. Keche, Sibani Behera, R. Tigga, Vijaya Sahu, N. Mishra","doi":"10.1093/mmy/myac072.P165","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P165","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objective To assess the burden of fungal etiology of clinically suspected mycotic keratitis amongst the patient presented to the Ophthalmology department in a tertiary care hospital in Chhattisgarh. Methods This is a laboratory-based retrospective study of the corneal scrapings received for mycological processing between January 2020-December 2021. Demographic data were collected from patients and from their medical records. Corneal scrapings were aseptically collected from the margins of the ulcer using a sterile Kimura blade in the Ophthalmology department and the samples were processed by following the standard microbiology protocol. A wet mount examination with 10% KOH was done. Samples were also smeared onto a sterile slide for Gram stain. Samples were inoculated in a C-shaped manner on media on blood agar, chocolate agar, and Sabouraud's dextrose agar supplemented with chloramphenicol. Media were incubated in a 25°C aerobic incubator and observed for growth daily for a week and thereafter on alternate days. Blood agar was incubated at 37°C. Fungi were identified by the conventional method by Lactophenol cotton blue microscopy (LPCB) and slide culture. Antifungal susceptibility testing for Voriconazole with E-test was performed for Aspergillus and Fusarium species. Results A total of 37 patients with suspected mycotic keratitis were included in the duration of the study period. The demographic details hinted more predisposition of keratitis in females than in males; with a mean age of 49 ± 2 years and a range from 21 to 80 years. The predominant predisposing factor was trauma with organic matter in agricultural background. Amongst the total 37.8% (14/37) were positive for both KOH and culture, while 5.4% (2/37) were KOH negative but culture positive. There were 5 isolates that could hint toward low sample load or certain technical logistic issues could not be culture. Amongst culture-positive isolates, Fusarium species (37.5%) was the most common isolate showing predominance of Fusarium oxysporum, followed by Acremonium species and Aspergillus species 19%, with rare isolation of Colletotrichum dematium and Scedosporium species. Conclusion Culture remained the gold standard for the detection of fungal agents which will help to know the epidemiology of the local areas and guide the clinicians to prevent and treat the affected patients effectively. The tropical environment and agricultural occupation in Chhattisgarh present variability in the etiology of mycotic keratitis. With the predominance of Fusarium species, unusual fungal isolates of C. dematium and Scedosporium species from corneal ulcers were observed. Early detection is essential to initiate appropriate antifungal therapy and to minimize preventable ocular complications like blindness.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"179 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74951337","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":"P045 The association of performance of air pollutants on Candida drug resistance","authors":"Sahar Ghazanfari, Shahla Roudbar mohammadi, Sasan Rezaei","doi":"10.1093/mmy/myac072.P045","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P045","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objective Therapeutic methods are very important in the prevalence of opportunistic fungal infections, which are among the main causes of human diseases. In this study, air pollution agents that are in direct contact with microorganisms and as a carbon source using CO2 and MTBE and their effects on aspects such as growth and particularly the evaluation of changes in the expression of interfering genes in susceptibility and drug resistance in these fungi were investigated. Materials and Methods Collecting samples and isolating Candida glabrata (C. glabrata) and Candida albicans (C. albicans) with phenotypic methods were accomplished. In this way, evaluating the minimum inhibitory concentration (MIC) with M27A4 protocol of CLSI was done. Adjusting to sensitive strains from the MIC test, which included 20 C. albicans and 10 C. glabrata which were sensitive to fluconazole and itraconazole drugs with 5% CO2 and 5 mg/ml MTBE interfering agents that are considered as air pollutants and also re-evaluating MIC testing to separate strains resistant to azole drug were accomplished. Results Up-regulation of some genes on two mentioned yeast had led to drug resistance in them, which were previously sensitive to both drugs. Correspondingly, 41% of C. glabrata samples in sputum showed sensitivity to these drugs. Up-regulation of ERG11(71%) and EPA1 (90%) were observed in resistant strains. Up regulation of genes associated with aspartate proteins and down regulation of SAP3 genes were recognized in C. glabrata in sputum and a 15% down-regulation of BAL isolate and 50% up-regulation of SAP1 gene in C. albicans sensitive samples were observed and compared with fluconazole and itraconazole with oral and joint source. Remarkably, decreased SAP2 expression in oral sources and 60% increase in resistant strains in C. albicans was observed. The down-regulation of SAP3 expression showed in the joint samples. An increase in HWP1expression (30%) was noted in isolated and drug-sensitive samples at the sputum and BAL source. CDR1 expression was increased in MTBE-affected species however, it decreased in the vicinity of CT. Conclusion Air pollutants such as CO2 and MTBE eventually caused drug resistance in Candida, which can be one of the causes of drug resistance in candidiasis infections.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"133 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73366883","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":"P334 Fungal infections in patients with COVID-19 in 1-year pandemic 2020-2021 from Cote d'Ivoire","authors":"D. Koffi, A. Touré, Valerie Ira, M. F. Kouadjo, Reine M'boh, K. Sylla, M. Dosso","doi":"10.1093/mmy/myac072.P334","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P334","url":null,"abstract":"Abstract Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Background and Objectives The COVID-19 pandemic has caused significant public health problems both in Côte d'Ivoire and around the world. Among the different causes of morbidity and mortality in COVID-19 patients, the frequency and impact of co-infections are still little studied, especially in patients with acute respiratory distress syndrome (ARDS). However, people with severe COVID-19 infection are particularly vulnerable to bacterial and fungal infections. This study aims to determine the frequency and susceptibility profile of isolated fungi in severe COVID-19 patients living in west Africa. Methodology We conducted a retrospective observational study of COVID-19 patients who were tested for invasive fungal infections (IFI) between 2020 and 2021 in the laboratory of mycology at Pasteur Institute of Cote d'Ivoire. Results We received a total of 77 samples (from superficial specimens, deep sites, urine) collected from 35 patients admitted for severe COVID-19. The patients were predominantly female (n = 21, 60%) and had a median age of 54,5 years (range16-79 years). The mycological analysis for IFI diagnosis showed 20% of samples positive only for yeasts, 66.7% of which were Candida albicans and responsible for 90% of invasive infections in COVID-19 patients. No difference in fungal species was found regarding of the sex, age of the patients, and waves of the pandemic. Antifungal susceptibility testing revealed no resistance to antifungals (fluconazole, voriconazole, itraconazole, amphotericin B, and flucytosine) among Candida isolates. Conclusion These data show significant Candidiasis infection associated with the severe form of COVID-19. Given this prevalence of 20%, it is important for clinicians to remain vigilant and take proactive measures to prevent candidemia in patients with COVID-19. The widespread surveillance for fungal co-infections is still essential to reduce mortality associated with COVID-19.","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":"72800066","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":"S5.3d How mitochondrial complex I proteins in Candida albicans moderate phagocytosis and the production of pro-inflammatory cytokines in murine macrophages and dendritic cells","authors":"Xiaodong She, Pengyi Zhang, R. Calderone, Weida Liu, Dongmei Li","doi":"10.1093/mmy/myac072.S5.3d","DOIUrl":"https://doi.org/10.1093/mmy/myac072.S5.3d","url":null,"abstract":"Abstract S5.3 Cellular pleomorphism and fungal virulence, September 22, 2022, 3:00 PM - 4:30 PM Objectives Inhibition of respiration in Candida albicans impairs its colonization in the host tissues and causes avirulence in a murine vascular candidiasis model. Accordingly, blockage of the mitochondrial electron transport chain (ETC) of C. albicans by respiratory inhibitors promotes phagocytosis by increasing exposure of glucan which could be due to the mannan reduction. In our model, we have reported that 85% mannan reduction in goa1Δ, a deletion mutant of an ETC Complex I (CI) regulator, oppositely decreased phagocytosis. To understand such a difference, we broaden our investigation with three CI respiratory subunit mutants, which are either fungal-specific (nuo1Δ and nuo2Δ) or broadly conserved subunits (ndh51Δ) for cell wall analysis and innate immune responses. Methods We characterized mutant cell wall defects in these mutants, then analyzed their respective survival in macrophages. Fungal internalization into macrophages was visualized under fluorescent microscopy and live-cell imaging and analyzed through flow cytometry analysis. Cytokine production in dendritic cells (DCs) infected by fungal cells was measured by xMAP technology and the transcriptional profiles of murine macrophages-infected by different mutants were compared. Results We find that phosphopeptidomannan (PPM) reduction in goa1Δ and nuo1Δ and phospholipomannan (PLM) reduction in nuo2Δ correlate with massive inhibition of cytokine. PPM loss in nuo1Δ or goa1Δ fails to promote phagocytosis but promotes opsonized neutrophil killing. The cause of PPM insufficiency results from reduced phosphorylation of the Cek1 MAPK in goa1Δ and nuo1Δ. In contrast other three mutants, phagocytosis and cytokine production of ndh51Δ more resemble WT cells, which have shown an ∼ 30% glucan reduction due to a defective Mek1 MAPK response. The divergent immune responses to these CI mutants are shown at the transcriptional level in infected macrophages. We noted that those well-characterized host receptors such as dectins and TLR2/4 for PPM, PLM, and glucan ligands are not significantly affected at 1 h post-infection. However, the scavenger receptor CD36, integrin ICAM, and growth factor receptors are downregulated along with a generally downregulated endocytosis and antigen processing/presentation. In addition, the host metabolic processes, oxidative stress-induced senescence, apoptosis, and signaling pathways such as Ras1/Erk5, the cAMP/CREB, and TLR9 pathway, are each individually affected in the host cells. Conclusion We speculate that mitochondrial signals of fungal origin may also be sensed by the host immune cells to coordinate the immune responses together with cell replication and metabolism during the early stage of infection.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"25 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72811255","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":"P256 A rare case of co-infection with Nigrospora oryzae with mucormycosis in an immunocompromised post-COVID patient","authors":"Ankita Patel, Alisha Sharma, P. Mahajan, A. Bahal, S. Ninawe, P. Bhatt, N. Grover","doi":"10.1093/mmy/myac072.P256","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P256","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objective A rare case of co-infection of Nigrospora oryzae with mucormycosis in an immunocompromised post-COVID patient. Methods A 41-year-old male diabetic patient, with sub-optimal glycemic control, contracted COVID-19 infection and was managed with high-dose steroids. A month after recovery from COVID-19 infection, he developed severe headache with sudden onset right-sided facial swelling. A contrast-enhanced magnetic resonance imaging was done which was suggestive of infective/inflammatory rhinosinusitis with intracranial extension with a possibility of fungal etiology. Functional endoscopic sinus surgery was performed and tissue was sent for microbiological processing. On KOH mount, broad pauciseptate fungal hyphae were seen. Fungal growth was obtained on SDA at 25°C and 37°C within 4 days of inoculation. It was confirmed as Rhizopus arrhizus both phenotypically as well as by MALDI-TOF. Patient was put on antifungal therapy in form of Inj liposomal Amphotericin B 500 mg/d. However, patient had persistent headache, vomiting, and low-grade fever post-procedure. A repeat CE-MRI was performed which was suggestive of necrotic brain tumor/abscess and was planned for frontal lobe abscess drainage. Pus was inoculated on routine mycological media. On KOH mount, broad pauciseptate hyphae along with narrow septate hyphae were seen. Fungal growth was obtained on SDA at 25°C within 5 days of inoculation, which on LPCB were identified as Nigrospora spp. The identity of the isolate was confirmed by Next generation sequencing as Nigrospora oryzae. Post-2 weeks of treatment and strict glycemic control, patient started improving. The headache and swelling subsided. He was further started on oral hypoglycemic agents and discharged and was asked to follow up after a month. Results COVID-19 epidemic that emerged by the end of 2019 has been associated with a huge number of deaths globally. Acute invasive fungal rhino-sinusitis is a potentially fatal infection in immune-compromised patients post COVID-19. Various studies reveal that invasive fungal infections have been the leading cause of death in 25%-73.7% of patients. Among these invasive fungal infections, Mucor spp. were detected in 77.8% patient, Aspergillus fumigatus in 30.6% while 8.3% showed mixed infection with both the fungi. Along with the established pathogenicity of Mucorales in causing invasive fungal infection, other fungal co-infections are also being observed. These invasive fungal infections in an immune-compromised host carry a high mortality and morbidity rate (18%-80%). Therefore, early diagnosis, followed by aggressive medical care, surgical debridement, and control of underlying diseases is of utmost importance. Conclusion Acute invasive fungal rhinosinusitis saw a spurt in incidence during the widespread COVID-19 pandemic. Diagnosis of invasive fungal infection is based on the clinical setting and characteristic presentation","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"78 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77475889","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":"P307 Clinical profile of fusarium infections: case series from a tertiary care hospital","authors":"V. Vineeth, N. Sethuraman, R. Gopalakrishnan","doi":"10.1093/mmy/myac072.P307","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P307","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objective To study the clinical profile of patients with Fusarium infections diagnosed at our tertiary care center during the study period from February 2017 to March 2022. Methods We conducted a retrospective case study wherein all consecutive patients with Fusarium infections between February 2017 to March 2022 were accessed. The diagnosis was categorized based on either fungal culture alone or fungal culture with histopathology findings. Results A total of 12 patients with Fusarium infections were encountered during this period. The mean age was 49. In all, 5 were females and 7 were males, and 5 patients had diabetes as a risk factor. Other risk factors included were chemotherapy for multiple myeloma (1) and lymphoma (1), polytrauma (1), and surgery after pituitary macroadenoma. A total of 8 (66.7%) patients were on antifungal prophylaxis at the time of diagnosis. A total of 6 (50%) had localized infections whereas, remainder 6 (50%) had disseminated infection, and 25% presented with onychomycosis. Seven patients were diagnosed based on fungal culture and five were diagnosed based on histopathology findings collaborated with a fungal culture. There was one patient with Fusarium blood stream infection, who expired within 2 weeks of hospitalization. A total of 10 patients had F. solani whereas, 2 had F. oxysporum isolated in fungal cultures. In all, 42% of patients in the study had high Beta- D-Glucan (BDG) and 67% of the patients underwent source control of the involved region. A total of 9 patients (75%) received voriconazole as antifungal treatment and 3 patients received Amphotericin B. Four patients expired, three were lost to follow up and five did not develop relapse on follow-up. Conclusion Fusarium is an opportunistic human pathogen severely affecting immunocompromised patients, especially patients with hematological malignancies, prolonged neutropenia, and post-hematopoietic stem cell transplantation. Our study records a notable number of Fusarium infections among diabetics and onychomycosis was a common presentation. A high index of suspicion is of utmost importance in patients with risk factors and serum BDG may help in suspicion of invasive Fusarium infections. The 33% mortality in our study stresses the need for early diagnosis and treatment.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"355 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77504496","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":"P273 Diagnostic dilemmas in Pneumocystis pneumonia in case of long COVID -19","authors":"Arpit Shah","doi":"10.1093/mmy/myac072.P273","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P273","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Background To diagnose Pneumocystis pneumonia in an underlying COVID-19 infection is difficult because of the clinical and radiological indistinguishableness of the presentation. Case Presentation We report the case of a 67-year-old male background of type 2 diabetes mellitus (DM) and hypertension (HTN), who presented to the emergency department for severe dyspnea for 6 days. He is treated with corticosteroid and other supportive therapy. Initially, the patient responded with that treatment but suddenly his hypoxia is increasing and getting intubated. All possible causes of deterioration hypoxia were evaluated and came negative. Later stage, BAL was done and immunofluorescence test for PCP came positive. Systemic, cotrimoxazole started and gradually hypoxia improved and extubated. Conclusion Pneumocystis and COVID-19 co-infection needs serious consideration, particularly for patients with long-term COVID-19, even if patients do not have conventional risk factors for Pneumocystis pneumonia.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"64 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77939182","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":"P309 Clonal outbreak of Trichophyton tonsurans causing tinea capitis among wrestlers in Beijing, China","authors":"Qiqi Wang, Ruoyu Li, Wei Chen, Z. Wan, Wei Liu","doi":"10.1093/mmy/myac072.P309","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P309","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Trichophyton tonsurans, an anthropophilic dermatophyte, mostly causes tinea capitis and tinea corporis and is often associated with outbreaks among athletes involved in combat sports, such as wrestlers and judo athletes. Here, we report an outbreak of tinea capitis caused by Trichophyton tonsurans among five juvenile athletes aged ten to fourteen in a wrestling team in Beijing, China. Methods A total of 5 wrestlers aged 10-14 years presented with alopecia, erythema, scales, and pustule on the scalp (Fig. 1a). Scrapings from the lesions were performed by direct microscopic examination using 10% potassium hydroxide (KOH) with calcofluor white and fungal culture. The fungal pathogens were identified by morphology and sequencing of the internal transcribed spacer (ITS) regions. Multilocus genotyping analysis was performed by sequencing of the five gene loci including the ITS and non-transcribed spacer (NTS) of the ribosomal RNA (rRNA) locus, alkalineprotease-1 (ALP1), metalloprotease-5 (MEP5), carboxypeptidases Y (CarbY), which show intraspecies diversity and can be applied to epidemiological investigations and determining the route of infection transmission. Antifungal susceptibility of terbinafine (TBF), itraconazole (ITC), fluconazole (FLC), ketoconazole (KTC), and amphotericin B (AMB) against the causative fungal isolates was determined by broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) M38-A3 document. Results The five patients were diagnosed with tinea capitis because of the scalp lesions, spores, and hyphae observed by direct microscopic examination (Fig. 1b), and positive fungal culture. The causative isolates were all identified as T. tonsurans by macroscopic and microscopic characteristics (Fig. 2) and sequencing of ITS regions. The sequences of ITS, NTS, ALP1, MEP5, and CarbY were identical among the five isolates, revealing a single genotype. The abovementioned sequences have been deposited to Genbank. The minimum inhibitory concentrations (MICs) of TBF, ITC, FLC, KTC, and AMB against five T. tonsurans isolates were 0.015 μg/ml, 0.015 μg/ml, 8 μg/ml, 0.06 μg/ml, and 0.5 μg/ml, respectively. Conclusion We report an outbreak of tinea capitis caused by T. tonsurans among wrestlers in Beijing, China. Multilocus genotyping analysis revealed that all isolates consisted of a single genotype, suggesting the outbreak may be caused by a single strain of T. tonsurans. The isolates were all susceptible to the common antifungal drugs treating tinea capitis.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"45 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78953184","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}