Medical mycology journal最新文献

{"title":"P021 Comparative transcriptomic analysis of environmental Candida auris showing variable azole susceptibility","authors":"K. Jain, Raju Shivarathri, Ashutosh Singh, N. Chauhan, A. Chowdhary","doi":"10.1093/mmy/myac072.P021","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P021","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objective Candida auris is a multidrug-resistant pathogen that presents a serious global threat to human health. The U.S. Centers for Disease Control and Prevention has classified C. auris as an urgent threat to public health due to its clinical and economic impact and future projections of new infections over the next 10 years. Candida auris infections are difficult to treat since many isolates display high levels of resistance to fluconazole and exhibit variable resistance to amphotericin B and echinocandins. In this study, we performed comparative transcriptomics to understand the molecular mechanisms associated with azole-resistance in C. auris environmental isolates. Material and Methods Two sets of environmental isolates including azole-resistant (n = 2) and azole susceptible (n = 1) isolates were used for RNA-Seq analysis. Pair-wise comparisons in edgeR were used for comparing the number of differentially expressed genes (DEGs) between the azole susceptible and resistant isolates. GO term enrichment analysis was performed using the ‘enrichGO’ function from the cluster Profiler package. Only GO categories with a q-value <0.05 were considered significant. Results Our data show significant enrichment of ergosterol biosynthesis genes, drug transport, MAPK pathway as well as chromatin remodeling genes in azole-resistant strains compared to susceptible isolates. A total of 468 and 564 differentially expressed genes were identified in two azole-resistant isolates compared with the susceptible strain. A large number of multidrug transporter genes (CDR1, MDR1, HGT2, HGT7, HGT13, HGT17, and NGT1) were differentially expressed between the two sets of strains. Interestingly, the overexpression of ERG11 (azole target gene), and CDR1 (drug transporter) genes was observed in resistant isolates as compared with susceptible strain. Furthermore, resistant strain has two copies of ERG11 while susceptible isolate has single copy of ERG11. Notably, 8/21 genes involved in the ergosterol biosynthesis pathway were found to be induced in azole resistant isolates. These include HMG1, ERG1, ERG2, ERG3, ERG6, ERG10, ERG13, and ERG25. Furthermore, other multidrug transporters MDR1 and SNQ2 responsible for azole resistance in other Candida species like C. glabrata also showed significant expression changes between the two sets of isolates. Furthermore, HGT7 (glucose transporter) and NGT1, (N-acetyl glucosamine transporter) genes associated with azole and polyene resistance were found to be upregulated in the resistant isolate as compared with susceptible strain. Additionally, a Glycophosphatidylinositol (GPI)-anchored protein unique for C. auris, PGA7 was found to be overexpressed in resistant isolate. Importantly, we also identified several secreted aspartic proteases (SAP3, SAP5, SAP8, and SAP9) to be downregulated between the two sets. Conclusion The present study identifies several gene families that","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":"81913829","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":"S9.1d Chronic pulmonary aspergillosis in post-TB and retreatment TB patients in Lagos, Nigeria","authors":"Adeyinka A. Davies, Abiola O. Adekoya, R. Oladele","doi":"10.1093/mmy/myac072.S9.1d","DOIUrl":"https://doi.org/10.1093/mmy/myac072.S9.1d","url":null,"abstract":"Abstract S9.1 Chronic Pulmonary Aspergillosis - where do we stand?, September 23, 2022, 4:45 PM - 6:15 PM Objectives Chronic pulmonary aspergillosis (CPA) is a known complication of post-TB treatment. It is a progressive disease characterized by progressive cavitation, fibrosis, and pleural thickening among others. Globally, an estimated 3 million people are affected. This study determined the burden of CPA amongst the post-TB and retreatment TB patients in two facilities in Lagos, Nigeria. Methods This was a prospective longitudinal study that was carried out at two TB clinics (LUTH and NIMR) in Lagos, Nigeria between February 2021 and March 2022. The study cohorts were patients that had been previously managed (2-4 years earlier) for TB, they were clinically classified as retreatment TB and post-TB patients. Patients were seen in clinics every 3 months and the following data were collected: Quality of life (WHO and SGRO questionnaires used), 5 mls of blood for Aspergillus IgG level (using Bordier; cut-off of 0.8 AU/ML), sputum for culture (those with productive cough), and chest X-ray. Infectious disease society of America (IDSA) case definition was used to determine cases of CPA. Results A total of 112 post-TB treatment patients were recruited, 60 (53.1%) were retreatment TB and 52 (46.0%) post-TB patients. The mean age was 41.14 years; with the majority between the ages of 21-30 years. The male/female ratio was 0.9/1. 98 (87.5%) were HIV negative, and only 40 patients had GeneXpert testing done. In all 32/40 were GeneXpert negative; of which 24/32 and 8/32 belonged to the retreatment, and post-TB groups respectively. Cough was the predominant symptom with 39 (34.8%) having productive cough. Hemoptysis occurred in 11 (9.8%), 10 in the retreatment group with 2 having frank hemoptysis. Chest imaging revealed that 27/112 of the studied cohort presented with multiple cavities, 4/112 had single cavities, 26/112 had cavities with surrounding opacities and 23/112 had upper lobe consolidation. A total of 17/112 of them had bilateral lung infiltrates and 13/112 had pleural thickening. Sputum culture yielded growth of Aspergillus spp, with A. flavus (n-11; 36.7%) being the predominant species followed by A. fumigatus (n-10; 33.3%), and A. niger (n-9; 30%). In all 38/112 (33.93%) patients had Aspergillus IgG titer above the cut-off level, while 6 symptomatic patients had borderline Aspergillus IgG levels. A total of 11/112 (9.82%) of the study cohorts with positive Aspergillus IgG levels were also culture positive; 8/68 of the Aspergillus IgG negative patients were culture positive and had abnormal chest imaging reported. A total of 38 (33.93%) were confirmed cases of CPA using IDSA criteria. Of the GeneXpert positive; 7/40 were retreatment TB; 16/32 of GeneXpert negative and 8/40 of GeneXpert positive met the criteria for CPA. Conclusion Our findings demonstrate that CPA is easily misdiagnosed as treatment failure TB or TB relapse. There is a need for f","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"57 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82051108","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":"P242 Autochthonous cases of Madura foot from Jodhpur, Western Rajasthan, India","authors":"Venkat Goutham Nag, Zeeshan Noore Azim, Nithya S. Roy, Kirti Vishwakarma, Kirthika Sharma, Abhishek Bhardwaj, Vidhi Jain","doi":"10.1093/mmy/myac072.P242","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P242","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Mycetoma has been classified as a neglected tropical disease by the WHO. ‘Madura foot’ is a prominent presentation of phaeoid fungi Madurella complex in India. Maduromycotic mycetoma is frequently encountered in Western Rajasthan, where it is endemic. A high prevalence in this area is due to the desert climate of prolonged hot sunshine and scanty annual rainfall. The classic clinical ‘triad of Mycetoma’ involves a painless hard swelling, multiple fistulas, and discharge of grains. We report two cases of eumycetoma from Western Rajasthan: Case Report 1: A 41-year-old male, farmer presented a history of progressive swelling of the left foot in the last 4 years following trauma to the left sole 5 years ago. Patient took multiple treatments with no improvement. General examination showed a pallor and inguinal lymphadenopathy. Local examination revealed tumefaction with multiple sinuses discharging serosanguinous fluid with occasional black granules. Laboratory tests revealed hemoglobin of 6.2 g/dL. Serology was positive for Hepatitis B virus. Direct 40% KOH microscopy of the crushed grains shows septate branching phaeoid hyphae. Whitish brown dry colonies with diffusible brown pigment were seen on Sabouraud Dextrose Agar at 25°C. Lactophenol Cotton Blue Stain showed dark septate hyphae with chlamydoconidia. Histopathological studies confirmed Eumycetoma. X-rays of his foot showed large destructive bony lesions. Initial therapy given to patient was to correct anemia followed by specific antifungal treatment. A below knee amputation of left leg was performed once the anemia was corrected. Case Report 2: A 55-year-old borderline diabetic male daily-wage worker presented with multiple nodular discharging lesions over the anterior shin of the right leg for past 7 years. The lesion started in leg as a small nodule that ruptured discharging black grains intermittently. He could not recall any significant trauma to his foot. Patient took multiple treatments with temporary relief but the disease recurred. Direct microscopy of 40% potassium hydroxide mount of the crushed grains showing thin septate branching phaeoid hyphae and on Sabourad Dextrose Agar at 25°C. White to brown color colony growth with diffusible brown pigment was seen after 2 weeks of incubation. X-rays indicated no bony involvement. Ultrasonographic study of lesions was suggestive of mycetoma. Patient was treated with itraconazole 400 mg/day for 4 days in the hospital and discharged subsequently. Discussion The foot is commonly involved in those with outdoor occupations. The combination of the clinical specific lesions, typical grains, microscopy, and histopathological studies are characteristic of the diagnosis. Radiodiagnosis is useful to determine the extension of the lesions in bone and other tissues. Combined medical and surgical treatment is recommended. Amputation is indicated in advanced mycetoma not responding to medica","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"62 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83934497","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":"P411 Genus specific real-time PCR-a promising technique for rapid diagnosis of fungal keratitis","authors":"Yamini Tawde, Sourav Das, Shreya Singh, Savitri Sharma, Amit Gupta, S. Basak, T. Shrimali, S. Rudramurthy, H. Kaur, A. Chakrabarti, Anup K. Ghosh","doi":"10.1093/mmy/myac072.P411","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P411","url":null,"abstract":"Abstract Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objective Comparison of different existing molecular methods for diagnosis of fungal keratitis (FK) and to develop and validate genus-specific PCR for identification of most predominant FK causative agents. Method A prospective multicentric study was performed between November 2019 to August 2021 from four centers across India. Corneal tissue/scraping samples were collected from patients with suspected keratitis for preliminary microbiological workup at respective centers and molecular diagnosis at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. A total of 87 corneal button samples were used for standardization. All samples were subjected to DNA extraction followed by molecular diagnosis using pan-fungal primers by conventional PCR, semi-nested PCR, and real-time PCR targeting the internal transcribed spacer (ITS) region of rDNA. The genus-specific primers for the most common causative agents of FK (Aspergillus sp., Fusarium sp., Alternaria sp., and Curvularia sp.) were designed in ITS2 region and standardized for real-time PCR. The best performing protocol was validated in 145 corneal samples. Result A total of 68 patients out of 87 were diagnosed with FK of which 91.17% (n = 62/68) were microscopy positive and 82.3% (n = 56/68) were culture positive. Among the culture positive, the most common isolate was Aspergillus sp. (26, 46.42%) followed by Fusarium sp. (21, 37.5%) while the remaining samples grew dematiaceous fungi. Real-time PCR targeting ITS2 region proved to be most sensitive (52.94%) and specific (84.21%) compared with conventional PCR and semi-nested PCR. Genus-specific real-time PCR for Aspergillus sp. and Fusarium sp. showed improved sensitivity and specificity of 82.76%, 87.18%, and 90.91%, 93.48% respectively compared with all other diagnostic methods used in the study. The positive (PPV) and negative predictive value (NPV) for Aspergillus sp. specific PCR were 82.76% and 87.18% while Fusarium sp. specific PCR showed PPV of 86.96% and NPV of 95.56%. Genus-specific real-time PCRs did not show any amplification of 19 FK negative samples while faint amplification was observed in conventional PCR which on sequencing proved to be non-specific. No cross-reactivity was observed in clinical sample standardization. Due to the lack of Alternaria sp. and Curvularia sp. positive clinical samples, both PCRs were standardized using respective culture DNA which showed a positive result. Aspergillus sp. and Fusarium sp. genus-specific PCRs were further validated in 145 corneal samples, of which 91 were FK positive and showed similar results as that of standardization data. Genus-specific PCRs also reduced the turnaround time (˂24 h) by decreasing the need for the identification of causative agents. Conclusion Real-time PCR targeting ITS 2-region, particularly the genus-specific PCRs proved to be the most efficient for molecular diagnosis of FK. T","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"10 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74307192","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":"P089 Candidemia: prevalence, species characterization ,and the antibiotic susceptibility profile from a tertiary care hospital in north india","authors":"A. William, R. Kaur, D. Rawat, Pradeep Kumar","doi":"10.1093/mmy/myac072.P089","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P089","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives The aim of this study was to characterize the Candida spp. isolated from blood cultures and determine the antifungal susceptibility pattern of the Candida species prevalent in a tertiary care hospital in North India. Methods This retrospective study was conducted in Department of Microbiology of a tertiary care hospital in North India from April 2020 to March 2022. All blood cultures received in the department during this period were included in the study. Candida species isolated were identified and antifungal susceptibility testing was performed by VITEK as per standard protocol, The susceptibility pattern of 50 isolates was also performed by the broth microdilution method as per Clinical and Laboratory Standards Institute guidelines (CLSI) and the results were compared with VITEK results. Results Out of 21 804 blood cultures received during this period, 177 grew Candida species. Therefore, the overall prevalence of Candida species was 0.81% in our study. The incidence of bloodstream infection caused by non-albicans Candida species (80%) was higher than C. albicans (20%). Among NAC species, C. tropicalis (45%) was the most common, followed by C. pelliculosa (15%). Candidemia was predominantly observed in ICU patients. Resistance was seen in 14.1% isolates to voriconazole and fluconazole, 4.2% to flucytosine and 3.9% to caspofungin and amphotericin-B. No resistance was seen to micafungin. A total of 15% of the isolates were resistant to more than one drug. Conclusion There was a predominance of non-albicans Candida over C. albicans. Maximum resistance was seen to voriconazole followed by fluconazole. Continuous surveillance is necessary to follow trends and monitor changes in epidemiological and resistance patterns in different geographical regions, especially in critically ill patients.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"21 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73702333","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":"P125 Histoplasma capsulatum modulates the immune response exerted by mesenchymal stromal cells","authors":"Carolina Rodríguez-Echeverri, T. Tamayo, B. Gómez, Ángel González","doi":"10.1093/mmy/myac072.P125","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P125","url":null,"abstract":"Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Background Mesenchymal stromal cells (MSCs) have become a tool not only for tissue regeneration but also for the treatment of inflammatory diseases. Several studies have demonstrated the therapeutic potential of MSCs for the treatment of noninfectious inflammatory diseases; however, they appear to play a dual role in infectious diseases. Histoplasmosis is a systemic mycosis caused by Histoplasma spp., which occurs mainly in immunosuppressed individuals; this mycosis can present a severe clinical picture with dissemination to various organs and is associated with an exacerbated inflammatory response and with anemia and pancytopenia if bone marrow is affected. So far, the effect of a possible interaction of Histoplasma with stem cells present in the bone marrow is unknown. Objectives To examine, in vitro, the immunomodulatory effects of MSCs in response to H. capsulatum infection. Methods MSCs were obtained from bone marrow of C57BL/6 male mice; after isolation and purification, they were induced to mesodermal lineages and characterized by flow cytometry. Later, the basal expression of toll-like receptor (TLR)-2, TLR4, and Dectin-1 was determined using flow cytometry. MSCs were infected with H. capsulatum yeasts (isolate CIB 1980) in a multiplicity of infection (MOI) of 5 and incubated for 24 h. In addition, some of the co-cultures were previously treated with specific blocking antibodies for TLR2 and TLR4 or with a blocking peptide specific for Dectin-1 (CLEC7A). Furthermore, phagocytosis, microbicidal, and cell proliferation assays were done, and the expression of the genes encoding the cytokines IL-1β, IL-6, IL-10, IL-17, TNF-α, and TGF-β as well as of those for arginase-1 and iNOS were assessed. Results We observed that H. capsulatum has the capability to adhere and internalize within these MSCs; nonetheless, this process did not affect the survival of the fungus. The interaction of H. capsulatum with MSCs induced a slight but significantly increased expression of TLR2 but not TLR4 nor Dectin-1. In addition, this fungal interaction significantly induced an augmented expression of IL-6 and a decrease in the expression of IL-1β, IL-17, TNF-α, TGF-β, as well as the immune mediators Arg-1 and iNOS. Interestingly, blockade of these receptors did not affect phagocytosis, but increased IL-1β, IL-17, and TNF-α expression and reduced the expression of IL-6. Noteworthy, H. capsulatum induced apoptosis and inhibited the proliferation of these stem cells; furthermore, this fungus significantly reduced the expression of genes related to adipogenic differentiation and increased the expression of genes related to the osteogenic differentiation process. Conclusions The above results indicate that MSCs do not exert a notable antifungal effect against H. capsulatum; on the contrary, this fungal pathogen not only modulates the expression of inflammatory mediators in MSCs, by a mechanism dependent o","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"182 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74103680","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":"P162 Parinaud's Oculoglandular Syndrome as an atypical manifestation of sporotrichosis in Brazil","authors":"C. Coutinho, C. Batista, R. Batista, R. L. Neto, F. Batista","doi":"10.1093/mmy/myac072.P162","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P162","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Inform the general practitioner about the possibilities of atypical manifestations secondary to sporotrichosis, such as ocular manifestations, unrelated to the classic finding of contiguous lymphocutaneous ulcers. Methods This is a single-center, cross-sectional, retrospective study with patients evaluated and seen from June 2018 to April 2022 at the Mycology Outpatient Clinic of Hospital Universitário Oswaldo Cruz, University of Pernambuco. All patients were evaluated by the same infectious disease physician throughout the course, from diagnosis to outpatient discharge. Scrapings and cultures were collected by the institution's specialized Mycology team. Biopsies were sent to the University Pathology Service (CIAP). Results During the 4-year period, 231 patients started their treatment for sporotrichosis following clinical, laboratory, and histopathological criteria. Of these, 9 (3,8%) had Parinaud's Oculoglandular Syndrome, unilateral granulomatous conjunctivitis associated with ipsilateral preauricular or submandibular lymphadenitis (Fig. 1). Of the 9 reported cases, 8 presented manifestations only in the conjunctiva (88%), and 1 case also presented palpebral involvement (12%). Since most patients had a late diagnosis due to the difficulty in carrying out the specific investigation of the agent by a non-specialized team, the diagnosis by scraping and culture was compromised by early treatment with antifungals, especially itraconazole. It is becoming common in the Northeast of Brazil that the association of sick cats with typical manifestations of sporotrichosis is the main epidemiological factor since our case series for infections caused by soil manipulation is low. Therefore, 55% (5/9) had a clinical-epidemiological diagnosis of sporotrichosis, with an excellent clinical response to itraconazole 200 mg/day, as well as the 4 patients with diagnoses confirmed by culture (Fig. 2). The antifungal was taken after lunch since a fatty diet interferes with improved medication absorption. All patients were instructed not to use medications with known interactions, especially proton pump inhibitors and alcohol use. Conclusion Human sporotrichosis has become endemic in Latin America in the last two decades, bringing relevant morbidity to those infected. Zoonotic transmission by direct contact with infected sick cats has been gaining ground in Northeast Brazil, creating important epidemiology when typical sporotrichosis lesions appear following contact with these animals. Lymphocutaneous sporotrichosis is known to be the most common manifestation, but there is a need for care teams working in primary and secondary care to identify atypical manifestations and expand the investigation into the possibility of fungal infections. The epidemiology of the neighborhood associated with the presence and contact with sick cats with ulcerative lesions must be considered and taken into acco","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"35 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75251855","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":"S1.2c Diagnosis of fungal infections in animals: Combining the old and the new to maximize results","authors":"A. Peano","doi":"10.1093/mmy/myac072.S1.2c","DOIUrl":"https://doi.org/10.1093/mmy/myac072.S1.2c","url":null,"abstract":"Abstract S1.2 Emerging and Expanding Endemic Mycoses, September 21, 2022, 11:00 AM - 12:30 PM There is a broad spectrum of fungal infections involving companion, zootechnical and wild animals. Some fungi are distributed worldwide and act as opportunistic pathogens. Others, such as the dimorphic fungi Blastomyces dermatitidis and Sporothrix brasiliensis, are primary pathogens with a more defined geographical distribution. Dermatophytes cause less severe diseases limited to the skin. However, they are relevant since they are widely diffused. Moreover, some dermatophytes are transmitted from animals to humans; therefore, these infections represent a public health problem.   In recent years, opportunistic fungal infections (e.g., Aspergillosis, Candidiosis, Cryptococcosis) in human medicine have increased. The main reason is the rise of people with immunosuppression of various origins (AIDS, chemotherapy, immunosuppressive therapies in organ transplant) (Kozel and Wickes, 2014. Cold Spring Harb Perspect Med, 4: a019299). Moreover, the spectrum of fungi causing infections is expanding, which constitutes an identification challenge for even the most experienced mycologists. To achieve an even earlier and more precise diagnosis, new methods for the detection of fungal elements in tissue samples (e.g., PCR based techniques, serological tests) and fungal identification (e.g., matrix assisted laser desorption/ionisation time-of-flight analyzer technology) are now available in adjunction to traditional methods (microscopic examination of clinical samples, histopathology, and culture). Cases of opportunistic deep mycosis are more rarely reported in animals because the situations leading to immunosuppression in human patients are not mirrored in veterinary medicine. However, there is an increasing interest in these cases involving animals. Thus, new diagnostic procedures are being applied more and more to animal infections (Elad and Segal, 2018. Front Microbiol, 9:1303).   Direct microscopy retains its importance as a quick and inexpensive tool to ‘intercept’ a fungal infection. It also allows observing the cellular population involved in the immune response and finding other pathogens. It is helpful to interpret the results of more advanced tests (culture, PCR). The sensitivity of microscopic exams varies with the individual agent, source and quality of the specimen, and the skills and experience of the laboratorian. Diagnosis of invasive fungal infection by direct microscopy and histopathology may require the use of biopsies of deep tissues, which may pose a risk for the patient. Often it does not allow fungal identification.   Fungal culture can yield the specific etiological agent if positive, which allows antifungal susceptibility testing (AST). It may take many days to achieve a result. Identification of less common fungi requires a high level of expertise and equipment.   A widely employed identification method is PCR + sequencing of the ITS region (ot","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83005205","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":"P367 Candida sepsis in neonates a neglected pathogen: study from neonatal intensive care unit tertiary care hospital","authors":"K. Nirmal, Shukla Das, L. Jothisri, Charu Jain, Narender pal Singh","doi":"10.1093/mmy/myac072.P367","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P367","url":null,"abstract":"Abstract Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Introduction Significance of Candida species in neonatal intensive care units (NICU) is increasingly being recognized. It is the third most common cause of late-onset sepsis in NICU patients and accounts for 9 to 13% of bloodstream infections (BSI) in neonates. Although Candida albicans has historically been the most frequently isolated species, recently non-albicans Candida (NAC) have emerged as an important opportunistic pathogen, notably Candida tropicalis, C. parapsilosis, C. krusei, C. glabrata, and C auris. This changing trend and the increasing use of azoles agents is now a matter of concern due to the emerging resistance of the non-albicans species to azoles. Aim To evaluate the Candida sepsis in neonates from neonatal intensive care units from a tertiary care hospital. Material and Methods A cross-sectional study was conducted in the Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, East Delhi, India, during the period of July 2021 to December 2021. Overall, 30 suspected Candida sepsis patients from neonatal intensive care units were enrolled in the present study. The Candida spp. Isolated was identified as per standard mycological techniques. Preliminary identification was done by colony morphology on SDA, chromogenic media (Hichrome, Himedia Pvt. Ltd.), grown at 45°C, germ tube test, chlamydospore formation, and was confirmed by carbohydrate fermentation and assimilation tests. Antifungal susceptibility testing (AFST) was performed for Fluconazole (25 μg), and amphotericin B (AMB, 100 units) using the disc diffusion method on Muller-Hinton agar supplemented with 2% glucose and methylene blue (5 mg/ml). Zone diameters were interpreted as per the approved Clinical Laboratory Standards (CLSI-M44-A) guidelines. Quality control for AFST was performed using C. albicans-ATCC 90028 and C. parapsilosis-ATCC 22019. Statistical analysis The statistical analysis was done using Statistical Package for Social Sciences (SPSS) version. The P-value ˂0.05 were considered as statistically significant. Result Out of 30 Candida species from suspected septicemia neonates, non-albicans Candida (NAC) species accounted for (87%) compared to C. albicans (13.4%). Candida tropicalis was predominant at 9 (30%) followed by C. glabrata 8 (27%), C.parapsilosis 4 (13.3%), and C. krusei 3(10%), Pichia species (4.2%), and C.auris (3.4%). Antifungal sensitivity of the NAC isolates demonstrated >85% resistance to fluconazole amongst C. glabrata, C. parapsilosis, though amphotericin B had 100% sensitivity in all Candida species. The risk factor for candidemia as observed in our study were low birth weight 26(87%), use of broad-spectrum antibiotics 25 (83.4%), presence of an orogastric tube 18 (60%), and total parental nutrition 9 (30%) were significantly associated statistically (P <.05, paired t-test). The overall mortality amongst these neonates was 16.6%. Co","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"7 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88135588","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":"P265 Phaeohyphomycosis caused by Rhinocladiella similis mimicking Sporotrichosis","authors":"J. Taneja, R. Ranjan, Kuhu Chatterjee, V. Ramesh, B. Das","doi":"10.1093/mmy/myac072.P265","DOIUrl":"https://doi.org/10.1093/mmy/myac072.P265","url":null,"abstract":"Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objective A case of phaeophyphomycosis caused by Rhinocladiella similis with a clinical picture simulating sporotrichosis is described. Methods A 34-year-old male patient, employed in a textile factory presented with multiple subcutaneous nodules on the lateral aspect of the dorsum of the left hand and left forearm. There was a history of mechanical trauma 1 year back. On examination, three to four verrucous ulcerative nodules clustered on the dorsum of the left hand were observed. A preliminary diagnosis of sporotrichosis was made and a punch biopsy was performed from the lesion and subjected to KOH examination, fungal culture, and histopathological examination. ITS sequencing was done to confirm the identity of the isolate. Results The skin punch biopsy from the lesion on the dorsum of the hand showed marked hyperkeratosis, papillomatosis, parakeratosis, acanthosis, and irregular elongation of rete ridges. No fungal structures and neutrophils were seen. On examination with 40% Potassium hydroxide round yeast-like cells were seen. An initial diagnosis of sporotrichosis was established. After 5 days, white to grayish colonies with aerial hyphae were observed on Sabouraud's dextrose agar which eventually turned greenish black on further incubation. Lactophenol cotton blue (LPCB) mount of the slide culture showed thin, hyaline, septate hyphae with oval conidia arranged in a bottle brush pattern around erect conidiophores and also directly arising from the hyphae. The pathogen was confirmed by ITS sequencing as R. similis. Patient was started on itraconazole 200 mg twice daily for 12 weeks. The patient is on regular follow-up and has shown gradual regression of the lesions indicating response to therapy. Conclusion Rhinocladiella similis infections have been reported chiefly from Brazil causing chromoblastomycosis. There have been no reports of infections due to this pathogen from the Indian subcontinent. This report presents the first case of R. similis as an agent of phaeohyphomycosis and calls for the need of a thorough evaluation of these cases so as to manage cases appropriately. It also underlines the need to study and redefine the ecological niche of this pathogen as well as its clinical spectrum.","PeriodicalId":18325,"journal":{"name":"Medical mycology journal","volume":"57 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88285582","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}