Pathogenic fungi are a major threat to public health, and fungal infections are becoming increasingly common and treatment resistant. Chitin, a component of the fungal cell wall, modifies host immunity and contributes to antifungal resistance. Moreover, chitin content is regulated by chitin synthases and chitinases. However, the specific roles and mechanisms remain unclear. In this study, we developed a cytometric imaging assay to quantify chitin content and identify the distribution of chitin in the yeast cell wall.
Methods
The Candida albicans SC5314 and Nakaseomyces glabratus (ex. C. glabrata) ATCC2001 reference strains, as well as 106 clinical isolates, were used. Chitin content, distribution, and morphological parameters were analysed in 12 yeast species. Moreover, machine learning statistical software was used to evaluate the ability of the cytometric imaging assay to predict yeast species using the values obtained for these parameters.
Results
Our imaging-cytometry assay was repeatable, reproducible, and sensitive to variations in chitin content in C. albicans mutants or after antifungal stimulation. The evaluated parameters classified the yeast species into the correct clade with an accuracy of 85 %.
Conclusion
Our findings demonstrate that this easy-to-use assay is an effective tool for the exploration of chitin content in yeast species.
{"title":"Easy-to-use imaging-cytometry assay to analyze chitin patterns in yeasts","authors":"Delphine Aldebert , Bastien Suarez , François Bettega , Emilie Boucher , Cecile Garnaud , Muriel Cornet","doi":"10.1016/j.mycmed.2024.101493","DOIUrl":"10.1016/j.mycmed.2024.101493","url":null,"abstract":"<div><h3>Background & Aim</h3><p>Pathogenic fungi are a major threat to public health, and fungal infections are becoming increasingly common and treatment resistant. Chitin, a component of the fungal cell wall, modifies host immunity and contributes to antifungal resistance. Moreover, chitin content is regulated by chitin synthases and chitinases. However, the specific roles and mechanisms remain unclear. In this study, we developed a cytometric imaging assay to quantify chitin content and identify the distribution of chitin in the yeast cell wall.</p></div><div><h3>Methods</h3><p>The <em>Candida albicans</em> SC5314 and <em>Nakaseomyces glabratus (ex. C. glabrata)</em> ATCC2001 reference strains, as well as 106 clinical isolates, were used. Chitin content, distribution, and morphological parameters were analysed in 12 yeast species. Moreover, machine learning statistical software was used to evaluate the ability of the cytometric imaging assay to predict yeast species using the values obtained for these parameters.</p></div><div><h3>Results</h3><p>Our imaging-cytometry assay was repeatable, reproducible, and sensitive to variations in chitin content in <em>C. albicans</em> mutants or after antifungal stimulation. The evaluated parameters classified the yeast species into the correct clade with an accuracy of 85 %.</p></div><div><h3>Conclusion</h3><p>Our findings demonstrate that this easy-to-use assay is an effective tool for the exploration of chitin content in yeast species.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1156523324000349/pdfft?md5=4d8e2d51e08cad8a6ea5d5cce85d468f&pid=1-s2.0-S1156523324000349-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Terbinafine resistance has become epidemic as an emerging problem in treatment of dermatohpytosis. This could be attributed in part to a point mutation in the squalene epoxidase (SQLE) gene. In this study, point mutations in the SQLE gene were studied in T. rubrum and T. mentagrophytes/T. interdigitale species complex as two main causative agents of dermatophytosis. Antifungal susceptibility of clinical isolates of T. rubrum (n = 27) and T. mentagrophytes/T. interdigitale (n = 56) was assessed using the M38–3rd edition CLSI method. The SQLE gene and ITS region were sequenced for all the fungal strains, and the mutation sites and genotypes of the terbinafine-resistant strains were characterized. The results demonstrated that, in T. rubrum, the minimum inhibitory concentration of terbinafine (MIC50 and MIC90) was 0.03 μg/ml, and the geometric mean (G mean) concentration was 0.02. For the T. mentagrophytes complex, the MIC50 and MIC90 were 0.03 and 1.0 μg/ml, respectively, and the G mean concentration was 0.04 μg/ml. Four out of the five resistant strains were T. indotineae harboring the F397L and Q408L mutations, while the last one was T. mentagrophytes genotype VII, which harbors the F397L mutation. T. indotineae was the prominent causative agent of terbinafine resistance, with 80 % of the isolates, and T. mentagrophytes genotype VII was introduced as a new genotype in the terbinafine-resistant T. mentagrophytes complex. Our findings further substantiate the importance of antifungal susceptibility testing in selecting the choice of drug for effective treatment of dermatophytosis and highlight the importance of screening dermatophyte species for point mutations responsible for newly developed resistant strains to improve the current knowledge of overcoming infections caused by resistant species.
{"title":"Increased terbinafine resistance among clinical genotypes of Trichophyton mentagrophytes/T. interdigitale species complex harboring squalene epoxidase gene mutations","authors":"Leila Zahedi Mohammadi , Masoomeh Shams-Ghahfarokhi , Zahra Salehi , Mehdi Razzaghi-Abyaneh","doi":"10.1016/j.mycmed.2024.101495","DOIUrl":"10.1016/j.mycmed.2024.101495","url":null,"abstract":"<div><p>Terbinafine resistance has become epidemic as an emerging problem in treatment of dermatohpytosis. This could be attributed in part to a point mutation in the squalene epoxidase (<em>SQLE</em>) gene. In this study, point mutations in the <em>SQLE</em> gene were studied in <em>T. rubrum</em> and <em>T. mentagrophytes/T. interdigitale</em> species complex as two main causative agents of dermatophytosis. Antifungal susceptibility of clinical isolates of <em>T. rubrum</em> (<em>n</em> = 27) and <em>T. mentagrophytes/T. interdigitale</em> (<em>n</em> = 56) was assessed using the M38–3rd edition CLSI method. The <em>SQLE</em> gene and <em>ITS</em> region were sequenced for all the fungal strains, and the mutation sites and genotypes of the terbinafine-resistant strains were characterized. The results demonstrated that, in <em>T. rubrum</em>, the minimum inhibitory concentration of terbinafine (MIC<sub>50</sub> and MIC<sub>90</sub>) was 0.03 μg/ml, and the geometric mean (G mean) concentration was 0.02. For the <em>T. mentagrophytes</em> complex, the MIC<sub>50</sub> and MIC<sub>90</sub> were 0.03 and 1.0 μg/ml, respectively, and the G mean concentration was 0.04 μg/ml. Four out of the five resistant strains were <em>T. indotineae</em> harboring the F397L and Q408L mutations, while the last one was <em>T. mentagrophytes</em> genotype VII, which harbors the F397L mutation. <em>T. indotineae</em> was the prominent causative agent of terbinafine resistance, with 80 % of the isolates, and <em>T. mentagrophytes</em> genotype VII was introduced as a new genotype in the terbinafine-resistant <em>T. mentagrophytes</em> complex. Our findings further substantiate the importance of antifungal susceptibility testing in selecting the choice of drug for effective treatment of dermatophytosis and highlight the importance of screening dermatophyte species for point mutations responsible for newly developed resistant strains to improve the current knowledge of overcoming infections caused by resistant species.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12DOI: 10.1016/j.mycmed.2024.101494
Susana P. Mejía , Daniela López , Luz Elena Cano , Julián D. Muñoz , Jahir Orozco , Tonny W. Naranjo
Introduction
Histoplasma capsulatum is the etiological agent of histoplasmosis, the most common endemic pulmonary mycosis. Itraconazole (ITZ) is the choice for mild disease and a step-down therapy in severe and disseminated clinical presentations. Drug encapsulation into nanoparticles (NPs) is an alternative to improve drug solubility and bioavailability, reducing undesirable interactions and drug degradation and reaching the specific therapeutic target with lower doses.
Objective
evaluate the antifungal and immunomodulatory effect of ITZ encapsulated into poly(lactic-co-glycolic acid) (PLGA) NPs, administrated orally and intraperitoneally in an in vivo histoplasmosis model.
Results
After intranasal infection and treatment of animals with encapsulated ITZ by intraperitoneal and oral route, fungal burden control, biodistribution, immune response, and histopathology were evaluated. The results showed that the intraperitoneal administered and encapsulated ITZ has an effective antifungal effect, significantly reducing the Colony-Forming-Units (CFU) after the first doses and controlling the infection dissemination, with a higher concentration in the liver, spleen, and lung compared to the oral treatment. In addition, it produced a substantial immunomodulatory effect on pro- and anti-inflammatory cytokines and immune cell infiltrates confirmed by histopathology.
Conclusions
Overall, results suggest a synergistic effect of the encapsulated drug and the immunomodulatory effect contributing to infection control, preventing their dissemination.
{"title":"Antifungal efficacy and immunomodulatory effect of PLGA nanoparticle-encapsulated itraconazole in histoplasmosis in vivo model","authors":"Susana P. Mejía , Daniela López , Luz Elena Cano , Julián D. Muñoz , Jahir Orozco , Tonny W. Naranjo","doi":"10.1016/j.mycmed.2024.101494","DOIUrl":"10.1016/j.mycmed.2024.101494","url":null,"abstract":"<div><h3>Introduction</h3><p><em>Histoplasma capsulatum</em> is the etiological agent of histoplasmosis, the most common endemic pulmonary mycosis. Itraconazole (ITZ) is the choice for mild disease and a step-down therapy in severe and disseminated clinical presentations. Drug encapsulation into nanoparticles (NPs) is an alternative to improve drug solubility and bioavailability, reducing undesirable interactions and drug degradation and reaching the specific therapeutic target with lower doses.</p></div><div><h3>Objective</h3><p>evaluate the antifungal and immunomodulatory effect of ITZ encapsulated into poly(lactic-co-glycolic acid) (PLGA) NPs, administrated orally and intraperitoneally in an <em>in vivo</em> histoplasmosis model.</p></div><div><h3>Results</h3><p>After intranasal infection and treatment of animals with encapsulated ITZ by intraperitoneal and oral route, fungal burden control, biodistribution, immune response, and histopathology were evaluated. The results showed that the intraperitoneal administered and encapsulated ITZ has an effective antifungal effect, significantly reducing the Colony-Forming-Units (CFU) after the first doses and controlling the infection dissemination, with a higher concentration in the liver, spleen, and lung compared to the oral treatment. In addition, it produced a substantial immunomodulatory effect on pro- and anti-inflammatory cytokines and immune cell infiltrates confirmed by histopathology.</p></div><div><h3>Conclusions</h3><p>Overall, results suggest a synergistic effect of the encapsulated drug and the immunomodulatory effect contributing to infection control, preventing their dissemination.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1156523324000350/pdfft?md5=241e970230a8807799ba4dc0e3213e33&pid=1-s2.0-S1156523324000350-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.1016/j.mycmed.2024.101492
Marc Sautour , Adrien Guilloteau , Stéphane Valot , Louise Basmaciyan , Eloise Bailly , Nathalie Sixt , Jennifer Tetu , Ingrid Lafon , Denis Caillot , Frédéric Dalle
Background
Patients with hematological malignancies are at a high risk of developing invasive fungal infections (IFI) because they undergo several cycles of treatment leading to episodes of neutropenia. In addition, they alternate between hospital stays and periods spent at home. Thus, when an IFI is diagnosed during their hospital stays, it is highly challenging to identify the origin of the fungal contamination. The objective of this study was to analyze at home fungal exposure of 20 patients with leukemia by taking air and water samples in their living residence.
Methods
Air was sampled in 3 rooms of each home with a portable air system impactor. Tap water was collected at 3 water distribution points of each home. For positive samples, fungi were identified by mass spectrometry or on the basis of their morphological features.
Results
85 % of homes revealed the presence in air of Aspergillus spp. and those belonging to the section Fumigati presented the highest concentrations and the greatest frequency of isolation. Concerning mucorales, Rhizopus spp. and Mucor spp. were isolated in air of 20 % and 5 % of dwellings, respectively. In 4 homes, more than 70 % of the fungal species identified in air were potential opportunists; these were mainly Aspergillus spp. with concentrations greater than 20 cfu/m3. The water samples revealed the presence of Fusarium in 3 dwellings, with concentrations up to 80 cfu/L. Finally, for one patient, fungal species isolated during a period of hospitalization were phenotypically similar to those isolated in samples taken at home. For a second patient, a PCR Mucorale was positive on a sample of bronchoalveolar fluid while air samples taken at his home also revealed also the presence of mucorales.
Conclusion
The presence of opportunistic fungal species in the air of all the explored homes suggests the need for strengthened preventive measures in the home of immunocompromised patients. It would be interesting to compare the fungi isolated (from patients and from their environment) by genotyping studies aimed at specifying the correspondence existing between fungal species present in the patients’ homes and those responsible for IFI in the same patients.
{"title":"Risk of fungal exposure in the homes of patients with hematologic malignancies","authors":"Marc Sautour , Adrien Guilloteau , Stéphane Valot , Louise Basmaciyan , Eloise Bailly , Nathalie Sixt , Jennifer Tetu , Ingrid Lafon , Denis Caillot , Frédéric Dalle","doi":"10.1016/j.mycmed.2024.101492","DOIUrl":"https://doi.org/10.1016/j.mycmed.2024.101492","url":null,"abstract":"<div><h3>Background</h3><p>Patients with hematological malignancies are at a high risk of developing invasive fungal infections (IFI) because they undergo several cycles of treatment leading to episodes of neutropenia. In addition, they alternate between hospital stays and periods spent at home. Thus, when an IFI is diagnosed during their hospital stays, it is highly challenging to identify the origin of the fungal contamination. The objective of this study was to analyze at home fungal exposure of 20 patients with leukemia by taking air and water samples in their living residence.</p></div><div><h3>Methods</h3><p>Air was sampled in 3 rooms of each home with a portable air system impactor. Tap water was collected at 3 water distribution points of each home. For positive samples, fungi were identified by mass spectrometry or on the basis of their morphological features.</p></div><div><h3>Results</h3><p>85 % of homes revealed the presence in air of <em>Aspergillus</em> spp. and those belonging to the section <em>Fumigati</em> presented the highest concentrations and the greatest frequency of isolation. Concerning mucorales, <em>Rhizopus</em> spp. and <em>Mucor</em> spp. were isolated in air of 20 % and 5 % of dwellings, respectively. In 4 homes, more than 70 % of the fungal species identified in air were potential opportunists; these were mainly <em>Aspergillus</em> spp. with concentrations greater than 20 cfu/m<sup>3</sup>. The water samples revealed the presence of <em>Fusarium</em> in 3 dwellings, with concentrations up to 80 cfu/L. Finally, for one patient, fungal species isolated during a period of hospitalization were phenotypically similar to those isolated in samples taken at home. For a second patient, a PCR Mucorale was positive on a sample of bronchoalveolar fluid while air samples taken at his home also revealed also the presence of mucorales.</p></div><div><h3>Conclusion</h3><p>The presence of opportunistic fungal species in the air of all the explored homes suggests the need for strengthened preventive measures in the home of immunocompromised patients. It would be interesting to compare the fungi isolated (from patients and from their environment) by genotyping studies aimed at specifying the correspondence existing between fungal species present in the patients’ homes and those responsible for IFI in the same patients.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141303827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-04DOI: 10.1016/j.mycmed.2024.101489
Farag M. Mosallam , Eman A. Helmy , Hebatallah A. Nasser , Ahmed I. El-Batal
Dermatophytosis is a critical sort of skin infection caused by dermatophytes. The long-term treatment of such skin infections may be improved through the application of nanotechnology. This study aimed to prepare griseofulvin zinc Nanohybrid emulsion (GF-Zn–NHE) to improve griseofulvin activity against dermatophytes and some opportunistic pathogenic yeasts and bacteria. The GF-Zn-NHE is prepared by ultra-homogenization ultra-sonication strategies and validated by UV–visible spectroscopy analysis that confirms presences of griseofulvin and Zn-NPs peaks at 265 and 360 nm, respectively. The GF-Zn-NHE has mean distribution size 50 nm and zeta potential in the range from -40 to -36 mV with no significant changes in size distribution and particle size within 120 day ageing. Fourier transform infrared spectroscopy spectrum confirmed the presence of griseofulvin and Zn-NPs stretching vibration peaks. Gamma ray has a negative influence on GF-Zn-NE production and stability. GF-Zn-NHE drug release 95% up to 24 h and 98% up to 72 h of GF was observed and Zinc 90% up to 24 h and 95% up to 72 h, respectively. High antimicrobial activity was observed with GF-Zn–NHE against dermatophytic pathogens in compare with GF, GF-NE, zinc nitrate and ketoconazole with inhibition zone ranged from 14 to 36 mm. The results have shown that the MIC value for Cryptococcus neoformans, Prophyromonas gingivalis and Pseudomonas aeruginosa is 0.125 mg ml −1 and for Trichophyton rubrum, L. bulgaricus and Escherichia coli value is 0.25 mg ml −1 and for Candida albicans, Malassezia furfur and Enterococcus faecalis is 0.5 mg ml −1 and finally 1 mg ml −1 for Streptococcus mutans. TEM of treated Cryptococcus neoformans cells with GF-Zn-NHE displayed essentially modified morphology, degradation, damage of organelles, vacuoles and other structures.
{"title":"Novel griseofulvin zinc nanohybrid emulsion for intensifying the antimicrobial control of dermatophytes and some opportunistic pathogens","authors":"Farag M. Mosallam , Eman A. Helmy , Hebatallah A. Nasser , Ahmed I. El-Batal","doi":"10.1016/j.mycmed.2024.101489","DOIUrl":"10.1016/j.mycmed.2024.101489","url":null,"abstract":"<div><p>Dermatophytosis is a critical sort of skin infection caused by dermatophytes. The long-term treatment of such skin infections may be improved through the application of nanotechnology. This study aimed to prepare griseofulvin zinc Nanohybrid emulsion (GF-Zn–NHE) to improve griseofulvin activity against dermatophytes and some opportunistic pathogenic yeasts and bacteria. The GF-Zn-NHE is prepared by ultra-homogenization ultra-sonication strategies and validated by UV–visible spectroscopy analysis that confirms presences of griseofulvin and Zn-NPs peaks at 265 and 360 nm, respectively. The GF-Zn-NHE has mean distribution size 50 nm and zeta potential in the range from -40 to -36 mV with no significant changes in size distribution and particle size within 120 day ageing. Fourier transform infrared spectroscopy spectrum confirmed the presence of griseofulvin and Zn-NPs stretching vibration peaks. Gamma ray has a negative influence on GF-Zn-NE production and stability. GF-Zn-NHE drug release 95% up to 24 h and 98% up to 72 h of GF was observed and Zinc 90% up to 24 h and 95% up to 72 h, respectively. High antimicrobial activity was observed with GF-Zn–NHE against dermatophytic pathogens in compare with GF, GF-NE, zinc nitrate and ketoconazole with inhibition zone ranged from 14 to 36 mm. The results have shown that the MIC value for <em>Cryptococcus neoformans, Prophyromonas gingivalis</em> and <em>Pseudomonas aeruginosa</em> is 0.125 mg ml <sup>−1</sup> and for <em>Trichophyton rubrum, L. bulgaricus</em> and <em>Escherichia coli</em> value is 0.25 mg ml <sup>−1</sup> and for <em>Candida albicans, Malassezia furfur</em> and <em>Enterococcus faecalis</em> is 0.5 mg ml <sup>−1</sup> and finally 1 mg ml <sup>−1</sup> for <em>Streptococcus mutans</em>. TEM of treated <em>Cryptococcus neoformans</em> cells with GF-Zn-NHE displayed essentially modified morphology, degradation, damage of organelles, vacuoles and other structures.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-04DOI: 10.1016/j.mycmed.2024.101490
J. Guitard , A.P. Bellanger , J. Dorin , S. Cassaing , A. Capitaine , F. Gabriel , M. Nicolas , N. Coron , P. Penn , M. Moniot , D. Quinio , S. Ranque , M. Sasso , P. Lepape , E. Dannaoui , S. Brun , C. Lacroix , M. Cornu , A. Debourgogne , M.F. Durieux , C. Hennequin
Due to large outbreaks observed worldwide, Candida auris has emerged as a major threat to healthcare facilities. To prevent these phenomena, a systematic screening should be performed in patients transferred from regions where the pathogen is highly endemic. In this study, we recorded and analyzed French mycologists' current knowledge and practice regarding C. auris screening and diagnosis. Thirty-six centers answered an online questionnaire. Only 11 (30.6 %) participants were aware of any systematic screening for C. auris for patients admitted to their hospital. In the case of post-admission screening, axillae/groins (n = 21), nares (n = 7), rectum (n = 9), and mouth (n = 6) alone or various combinations were the body sites the most frequently sampled. Only six centers (8.3 %) reported using a commercially available plate allowing the differentiation of C. auris colonies from that of other Candida species, while five laboratories (13.8 %) had implemented a C. auris-specific qPCR. Considering the potential impact on infected patients and the risk of disorganization in the care of patients, it is crucial to remember to biologists and clinicians the utmost importance of systematic screening on admission.
{"title":"Current knowledge and practice of Candida auris screening in France: A nationwide survey from the French Society of Medical Mycology (SFMM)","authors":"J. Guitard , A.P. Bellanger , J. Dorin , S. Cassaing , A. Capitaine , F. Gabriel , M. Nicolas , N. Coron , P. Penn , M. Moniot , D. Quinio , S. Ranque , M. Sasso , P. Lepape , E. Dannaoui , S. Brun , C. Lacroix , M. Cornu , A. Debourgogne , M.F. Durieux , C. Hennequin","doi":"10.1016/j.mycmed.2024.101490","DOIUrl":"10.1016/j.mycmed.2024.101490","url":null,"abstract":"<div><p>Due to large outbreaks observed worldwide, <em>Candida auris</em> has emerged as a major threat to healthcare facilities. To prevent these phenomena, a systematic screening should be performed in patients transferred from regions where the pathogen is highly endemic. In this study, we recorded and analyzed French mycologists' current knowledge and practice regarding <em>C. auris</em> screening and diagnosis. Thirty-six centers answered an online questionnaire. Only 11 (30.6 %) participants were aware of any systematic screening for <em>C. auris</em> for patients admitted to their hospital. In the case of post-admission screening, axillae/groins (<em>n</em> = 21), nares (<em>n</em> = 7), rectum (<em>n</em> = 9), and mouth (<em>n</em> = 6) alone or various combinations were the body sites the most frequently sampled. Only six centers (8.3 %) reported using a commercially available plate allowing the differentiation of <em>C. auris</em> colonies from that of other <em>Candida</em> species, while five laboratories (13.8 %) had implemented a <em>C. auris</em>-specific qPCR. Considering the potential impact on infected patients and the risk of disorganization in the care of patients, it is crucial to remember to biologists and clinicians the utmost importance of systematic screening on admission.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1156523324000313/pdfft?md5=d88548f9fdef058f33432155b4636f75&pid=1-s2.0-S1156523324000313-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141277506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-04DOI: 10.1016/j.mycmed.2024.101491
Abin M Abraham , Mary John , Vikas Loomba , Navjot Singh , Lydia Solomon , Sunil Sam Varghese
Materials and methods
Patients diagnosed with COVID-19 associated mucormycosis were followed up for 6 months to study the clinical profile, readmissions, long-term treatment outcome and the mortality rate.
Results
Among 37 patients with COVID-19 associated mucormycosis, the mortality rate was 33.3 %, 42.9% and 100 % among patients with mild, moderate and severe COVID-19 infection. One month after discharge, among the 20 patients who survived, 10 (50 %) patients had worsening symptoms and required readmission. Nine patients required readmission for amphotericin and 1 patient was admitted for surgical intervention. On follow-up at 1 month, 30 % (6/20) patients became asymptomatic. However, at 3 months, 45 % (9/20) of the patients were asymptomatic. At 6 months of follow-up, 80 % (16/20) were asymptomatic. At 6 months, one each had residual abnormalities like visual loss in one eye, visual field deficit, change in voice and residual weakness of the limbs along with cranial nerve paresis.
Conclusion
The follow-up study revealed that a significant number of patients required readmission within the first month, but most of the patients became asymptomatic by 6 months. The readmission rate was higher in patients who received a shorter duration of amphotericin.
{"title":"Observational study on the clinical profile and treatment outcome on long-term follow-up of COVID-19 associated mucormycosis","authors":"Abin M Abraham , Mary John , Vikas Loomba , Navjot Singh , Lydia Solomon , Sunil Sam Varghese","doi":"10.1016/j.mycmed.2024.101491","DOIUrl":"10.1016/j.mycmed.2024.101491","url":null,"abstract":"<div><h3>Materials and methods</h3><p>Patients diagnosed with COVID-19 associated mucormycosis were followed up for 6 months to study the clinical profile, readmissions, long-term treatment outcome and the mortality rate.</p></div><div><h3>Results</h3><p>Among 37 patients with COVID-19 associated mucormycosis, the mortality rate was 33.3 %, 42.9% and 100 % among patients with mild, moderate and severe COVID-19 infection. One month after discharge, among the 20 patients who survived, 10 (50 %) patients had worsening symptoms and required readmission. Nine patients required readmission for amphotericin and 1 patient was admitted for surgical intervention. On follow-up at 1 month, 30 % (6/20) patients became asymptomatic. However, at 3 months, 45 % (9/20) of the patients were asymptomatic. At 6 months of follow-up, 80 % (16/20) were asymptomatic. At 6 months, one each had residual abnormalities like visual loss in one eye, visual field deficit, change in voice and residual weakness of the limbs along with cranial nerve paresis.</p></div><div><h3>Conclusion</h3><p>The follow-up study revealed that a significant number of patients required readmission within the first month, but most of the patients became asymptomatic by 6 months. The readmission rate was higher in patients who received a shorter duration of amphotericin.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141280990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.1016/j.mycmed.2024.101482
Priscila Guerino Vilela Alves , Ralciane de Paula Menezes , Nagela Bernadelli Sousa Silva , Gabriel de Oliveira Faria , Meliza Arantes de Souza Bessa , Lúcio Borges de Araújo , Paula Augusta Dias Fogaça Aguiar , Mário Paulo Amante Penatti , Reginaldo dos Santos Pedroso , Denise von Dolinger de Brito Röder
Fungal infections in neonatal intensive care units (NICU) are mainly related to Candida species, with high mortality rates. They are predominantly of endogenous origin, however, cross-infection transmitted by healthcare professionals' hands has occurred. The aim of this study was to identify Candida species isolated from the hands of healthcare professionals in a NICU before and after hygiene with 70% ethanol-based gel and evaluate virulence factors DNase, phospholipase, proteinase, hemolysin, biofilm biomass production, and metabolic activity. In vitro antifungal susceptibility testing and similarity by random amplified polymorphic DNA (RAPD) were also performed. C. parapsilosis complex was the most frequent species (57.1%); all isolates presented at least one virulence factor; three isolates (Candida parapsilosis complex) were resistant to amphotericin B, two (Candida famata [currently Debaryomyces hansenii] and Candida guilliermondii [currently Meyerozyma guilliermondii]) was resistant to micafungin, and six (Candida parapsilosis complex, Candida guilliermondii [=Meyerozyma guilliermondii], Candida viswanathi, Candida catenulata [currently Diutina catenulata] and Candida lusitaniae [currently Clavispora lusitaniae]) were resistant to fluconazole. Molecular analysis by RAPD revealed two clusters of identical strains that were in the hands of distinct professionals. Candida spp. were isolated even after hygiene with 70% ethanol-based gel, highlighting the importance of stricter basic measures for hospital infection control to prevent nosocomial transmission.
{"title":"Virulence factors, antifungal susceptibility and molecular profile in candida species isolated from the hands of health professionals before and after cleaning with 70% ethyl alcohol-based gel","authors":"Priscila Guerino Vilela Alves , Ralciane de Paula Menezes , Nagela Bernadelli Sousa Silva , Gabriel de Oliveira Faria , Meliza Arantes de Souza Bessa , Lúcio Borges de Araújo , Paula Augusta Dias Fogaça Aguiar , Mário Paulo Amante Penatti , Reginaldo dos Santos Pedroso , Denise von Dolinger de Brito Röder","doi":"10.1016/j.mycmed.2024.101482","DOIUrl":"10.1016/j.mycmed.2024.101482","url":null,"abstract":"<div><p>Fungal infections in neonatal intensive care units (NICU) are mainly related to <em>Candida</em> species, with high mortality rates. They are predominantly of endogenous origin, however, cross-infection transmitted by healthcare professionals' hands has occurred. The aim of this study was to identify <em>Candida</em> species isolated from the hands of healthcare professionals in a NICU before and after hygiene with 70% ethanol-based gel and evaluate virulence factors DNase, phospholipase, proteinase, hemolysin, biofilm biomass production, and metabolic activity. In vitro antifungal susceptibility testing and similarity by random amplified polymorphic DNA (RAPD) were also performed. <em>C. parapsilosis</em> complex was the most frequent species (57.1%); all isolates presented at least one virulence factor; three isolates (<em>Candida parapsilosis</em> complex) were resistant to amphotericin B, two (<em>Candida famata</em> [currently <em>Debaryomyces hansenii</em>] and <em>Candida guilliermondii</em> [currently <em>Meyerozyma guilliermondii</em>]) was resistant to micafungin, and six (<em>Candida parapsilosis</em> complex, <em>Candida guilliermondii</em> [=<em>Meyerozyma guilliermondii</em>], <em>Candida viswanathi, Candida catenulata</em> [currently <em>Diutina catenulata</em>] and <em>Candida lusitaniae</em> [currently <em>Clavispora lusitaniae</em>]) were resistant to fluconazole. Molecular analysis by RAPD revealed two clusters of identical strains that were in the hands of distinct professionals. <em>Candida</em> spp. were isolated even after hygiene with 70% ethanol-based gel, highlighting the importance of stricter basic measures for hospital infection control to prevent nosocomial transmission.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Several lateral flow assays (LFA) capable of detecting Aspergillus fumigatus in serum and broncho-alveolar lavage fluid (BALF) within the hour, thereby potentially accelerating the screening process, are now commercially available. We prospectively compared three LFA targeting A. fumigatus on BALF collected from non-surgical intensive care patients between June 2022 and February 2023. The three LFA tested were Sõna Aspergillus galactomannan LFA (Immy), Fungadia Aspergillus antigen (Gadia), and AspLFD (OLM Diagnostics). We compared the results of these LFA with those of the galactomannan (GM) Platelia
Aspergillus enzyme immunoassay (Bio-Rad), culture on Sabouraud medium and Aspergillus qPCR. We tested 97 BALF samples from 92 patients. In total 84 BALF samples tested negative with all three LFA, and four BALF samples tested positive with the AspLFD assay only (OLM). Only one BALF sample tested positive with the three LFA. In addition, three BALF samples tested positive only with the GM Platelia immunoassay. Four diagnosis of probable invasive aspergillosis were retained for the 92 patients tested. This prospective series included very few positive samples. From a practical point of view, the LFA from OLM presented the simplest protocol for use.
{"title":"Comparison of different lateral flow assays on bronchoalveolar lavage fluid for invasive aspergillosis screening in non-hematological patients","authors":"Eliane Devillers , Emeline Scherer , Jean-Chistophe Navellou , Frédéric Grenouillet , Laurence Millon , Anne-Pauline Bellanger","doi":"10.1016/j.mycmed.2024.101481","DOIUrl":"https://doi.org/10.1016/j.mycmed.2024.101481","url":null,"abstract":"<div><p>Several lateral flow assays (LFA) capable of detecting <em>Aspergillus fumigatus</em> in serum and broncho-alveolar lavage fluid (BALF) within the hour, thereby potentially accelerating the screening process, are now commercially available. We prospectively compared three LFA targeting <em>A. fumigatus</em> on BALF collected from non-surgical intensive care patients between June 2022 and February 2023. The three LFA tested were Sõna <em>Aspergillus</em> galactomannan LFA (Immy), Fungadia <em>Aspergillus</em> antigen (Gadia), and AspLFD (OLM Diagnostics). We compared the results of these LFA with those of the galactomannan (GM) Platelia</p><p><em>Aspergillus</em> enzyme immunoassay (Bio-Rad), culture on Sabouraud medium and <em>Aspergillus</em> qPCR. We tested 97 BALF samples from 92 patients. In total 84 BALF samples tested negative with all three LFA, and four BALF samples tested positive with the AspLFD assay only (OLM). Only one BALF sample tested positive with the three LFA. In addition, three BALF samples tested positive only with the GM Platelia immunoassay. Four diagnosis of probable invasive aspergillosis were retained for the 92 patients tested. This prospective series included very few positive samples. From a practical point of view, the LFA from OLM presented the simplest protocol for use.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140880087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present study aimed to assess the features, clinical characteristics, and species diversity among patients admitted to referral Hospitals for SARS-CoV-2 pneumonia and mucormycosis in Tehran, Iran, and the relationship between seasonal and species diversity was considered.
Methods
Confirmed COVID-19 patients with a positive reverse-transcriptase real-time (rRT-PCR) test for SARS-CoV2 were primarily included based on clinically suspected mucormycosis infection and confirmed by histopathology and mycology examination of biopsy specimens. The PCR technique was performed by the amplification of the high-affinity iron permease 1 (FTR1) gene for identification and discrimination between Rhizopus arrhizus and non- Rhizopus arrhizus isolates. In contrast, species identification of non-Rhizopus arrhizus was performed by sequencing of ITS rDNA region.
Results
Rhino-sino-orbital mucormycosis was identified in the majority of cases (n = 33), with 66 % and 34 % of the cases involving male and female patients, respectively. Rhizopus arrhizus was found to be the most prevalent (84.6 %), followed by Mucor circinelloides (7.6 %). Rhizopus arrhizus was the most prevalent species and present in all the seasons; however, Mucor circinelloides was only present in the autumn. The overall mortality of the total population was 24.6 % (16/ 65); the mortality rates occurring in patients diagnosed with rhino-sino-orbital infection and rhino-sinusal form were 21.4 % and 25 %, respectively.
Conclusion
CAM can be a serious complication of severe COVID-19, especially in patients with uncontrolled diabetes. It is important to monitor the epidemiology of mucormycosis to raise awareness of the disease and improve diagnosis, treatment and prognosis, particularly in the setting of pandemic.
{"title":"Features and evaluation of mucormycosis in COVID-19 patients from two referral hospitals in Iran","authors":"Hamed Fakhim , Shirin Irani , Zeynab Yassin , Hamid Badali , Elahe Nasri , Yasser Nasoori , Seyedhadi Samimiardestani , Saleh Mohebbi , Mojtaba Mohammadi Ardehali , Pegah Alizadeh Pahlavan , Mohammadreza Firouzifar , Ardavan Tajdini , Samira Ahadi , Afsane Vaezi","doi":"10.1016/j.mycmed.2024.101480","DOIUrl":"https://doi.org/10.1016/j.mycmed.2024.101480","url":null,"abstract":"<div><h3>Objectives</h3><p>The present study aimed to assess the features, clinical characteristics, and species diversity among patients admitted to referral Hospitals for SARS-CoV-2 pneumonia and mucormycosis in Tehran, Iran, and the relationship between seasonal and species diversity was considered.</p></div><div><h3>Methods</h3><p>Confirmed COVID-19 patients with a positive reverse-transcriptase real-time (rRT-PCR) test for SARS-CoV2 were primarily included based on clinically suspected mucormycosis infection and confirmed by histopathology and mycology examination of biopsy specimens. The PCR technique was performed by the amplification of the high-affinity iron permease 1 (FTR1) gene for identification and discrimination between <em>Rhizopus arrhizus</em> and non- <em>Rhizopus arrhizus</em> isolates<em>.</em> In contrast, species identification of non-<em>Rhizopus arrhizus</em> was performed by sequencing of ITS rDNA region.</p></div><div><h3>Results</h3><p>Rhino-sino-orbital mucormycosis was identified in the majority of cases (<em>n</em> = 33), with 66 % and 34 % of the cases involving male and female patients, respectively. <em>Rhizopus arrhizus</em> was found to be the most prevalent (84.6 %), followed by <em>Mucor circinelloides</em> (7.6 %). <em>Rhizopus arrhizus</em> was the most prevalent species and present in all the seasons; however, <em>Mucor circinelloides</em> was only present in the autumn. The overall mortality of the total population was 24.6 % (16/ 65); the mortality rates occurring in patients diagnosed with rhino-sino-orbital infection and rhino-sinusal form were 21.4 % and 25 %, respectively.</p></div><div><h3>Conclusion</h3><p>CAM can be a serious complication of severe COVID-19, especially in patients with uncontrolled diabetes. It is important to monitor the epidemiology of mucormycosis to raise awareness of the disease and improve diagnosis, treatment and prognosis, particularly in the setting of pandemic.</p></div>","PeriodicalId":14824,"journal":{"name":"Journal de mycologie medicale","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140918103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}