Mycopathologia最新文献

We describe a novel Malassezia species named Malassezia polysorbatinonusus, isolated from a Japanese patient with seborrheic dermatitis. The internal transcribed spacer (ITS) region of the isolate (LSEM 4845^T) were only 94.7% identical to those of M. yamatoensis. A phylogenetic analysis of D1/D2 domain of 26S rDNA and β-TUB-encoding gene sequences also revealed that the novel isolate was distinct from the cluster formed by other Malassezia species. Notably, morphological characteristics and molecular analysis indicated that the novel species is most closely related to M. yamatoensis isolated from a Japanese patient with seborrheic dermatitis, although the two species exhibit different physiological characteristics. In contrast to M. yamatoensis, the novel isolate does not metabolize Tweens and can grow at 40 °C. These characteristics have historically distinguished animal Malassezia isolates from those isolated from humans. Therefore, we conclude the novel isolate constitutes a new species, which we designate M. polysorbatinonusus.

Epidemiological studies combining taxonomic and clinical data have been limited globally, particularly Guiyang, the most under-developed economic provincial capital city in southwestern China. A retrospective analysis was performed of dermatophyte epidemiology involving all culture-positive cases received between May 2017 and May 2023 at the Affiliated Hospital of Guizhou Medical University. Phylogenetic analysis was conducted on 391 dermatophyte isolates collected from patients using the rDNA internal transcribed spacer sequences. Clinical relevance information was analyzed statistically using T-test, one-way ANOVA, Kruskal-Wallis H test, and Chi-square test. Eight species were recognized, and their identity was confirmed on the basis of phylogenetics. Trichophyton rubrum (n = 308, 78.77%) ranked first, followed by T. mentagrophytes (n = 39, 9.97%) and Microsporum canis (n = 32, 8.18%). Tinea unguium (48.56%) was the most common type of dermatophytosis in this study, rates of detection being impacted by the host population's attention for dermatophyte infections. The hypothesized patterns of evolution in the M. canis series, T. mentagrophytes series and T. rubrum series, i.e. from zoophilic to a preponderantly anthropophilic nature, was reflected in clinical parameters such as host age, occupational background, infection pattern, degree of skin involvement and site preference. To the best of our knowledge, we provide the first detailed analysis of epidemiological characteristics and pathogenic patterns of dermatophytosis in Guiyang.

Trichophyton indotineae, first identified in India, has increasingly been reported in Asia, the Middle East, Europe, and recently in the USA. The global spread of terbinafine-resistant T. indotineae underscores the urgency of the issue. With its ability for human-to-human transmission, it can be considered anthropophilic. However, its highly virulent nature suggests a possible link to zoophilic species, raising the potential for disease transmission from animals. In this study, we have performed whole genome sequencing (WGS) of terbinafine susceptible and resistant Trichophyton species from animal and human origin to understand transmission dynamics of this species. Thirteen isolates of Trichophyton spp. from human (n = 9) and canine (n = 4) origin, respectively from Chandigarh and Bareilly, India, were included in this study. Isolate identification based on ITS extracted from WGS data identified six T. indotineae (ITS genotype VIII) and seven T. interdigitale (ITS genotype II) isolates. WGS single nucleotide polymorhpism (SNP) analysis separated the isolates into two distinct groups, T. indotineae and T. interdigitale and showed the clonal nature of both species. For both species, low SNP differences between isolates from humans and dogs were observed as well as low differences between isolates from Chandigarh and Bareilly, cities >350 km apart from each other. These findings suggest zoonotic transmission, next to fast spread across large distances. The T. indotineae terbinafine-resistant strains exhibited the SQLE^F397L substitution while susceptible strains had the SQLE^S395P substitution or demonstrated a wild-type (WT) SQLE sequence. However, all T. interdigitale strains displayed a WT SQLE sequence despite terbinafine minimum inhibitory concentrations (MICs) ranging between 0.031 to 64 µg/mL.

We present Enterocytozoon bieneusi infection in four patients with autoimmune diseases undergoing prolonged monoclonal antibody therapies. Two patients suffered from inflammatory bowel disease and received anti-TNF therapies, whereas two other patients suffered from systemic lupus erythematosus with renal involvement and received anti-CD20 or anti-BLyS protein therapies. Three out of four patients consulted for diarrhea with abdominal pain without intestinal inflammation or bleeding at the time of sampling. The fourth patient did not declare intestinal troubles. Microsporidia genotype detected in this study were S9, C, Wildboard3 with one patient harboring 2 genotypes S6 and EBCMAP-038. Management of microsporidia infection included albendazole and reduction of immunosuppression treatment, but no specific treatment was implemented in two other patients. In conclusion, microsporidia infection occurs in patients with autoimmune diseases undergoing prolonged monoclonal antibody therapies. Diagnosis should be carefully assessed in this population and a thorough benefit-risk analysis is essential prior to initiating therapeutic interventions.

In the healthcare landscape, diseases such as cancer and HIV/AIDS have benefited from the patient's perspective. For fungal diseases, the patient voice remains absent in critical areas such as policy formulation, funding decisions, and research priorities. Patients affected by fungal disease, along with their caregivers and advocacy groups, possess invaluable insights into the challenges and unmet needs they face. By elevating their voices and experiences, policymakers, funding agencies, and researchers can gain a more comprehensive understanding of the multifaceted nature of fungal disease and the urgency of addressing them. This paper addresses the pressing need for a coordinated effort to elevate the patient voice in advocating for improved policies, increased funding, and enhanced research initiatives regarding fungal disease.

Background: LDBio immunochromatographic lateral flow assay, a point-of care test, detects IgM/IgG antibodies against Aspergillus fumigatus (LDBio-ALFA). LDBio-ALFA has been evaluated for diagnosing chronic pulmonary aspergillosis (CPA) in hospital patients, though its efficacy in field settings remains unexamined.

Objective: Our primary objective was to assess the diagnostic accuracy of LDBio-ALFA in diagnosing CPA in a field and a hospital cohort. The secondary objective was to compare the diagnostic performance of LDBio-ALFA and A. fumigatus-IgG measured by a commercial automated fluorescent enzyme immunoassay (FEIA) using latent class analysis (LCA).

Methods: We prospectively enrolled adult subjects with post-tuberculosis lung abnormality (PTLA) from a tertiary care hospital (hospital cohort), and designated microscopy centers and a community health center (field cohort). We measured A. fumigatus-IgG using LDBio-ALFA and FEIA in the same serum sample.

Results: We enrolled 508 subjects, of which 122 and 386 constituted field and hospital cohorts. CPA was diagnosed in 325/508 (64%) subjects. The CPA prevalence was higher in the hospital (78% [301/386]) than in the field cohort (19.7% [24/122]). The sensitivity and specificity of LDBio-ALFA in the entire cohort in diagnosing CPA was 81.2% and 85.3%. The sensitivity of LDBio-ALFA in the field cohort was 83.3% and 81.1% in the hospital population. On LCA, the sensitivity and specificity of the FEIA method (A. fumigatus-IgG ≥ 27 mgA/L) was 100% and 86.7%, while for LDBio-ALFA it was for 84.5% and 81.3% for diagnosing CPA.

Conclusion: LDBio-ALFA is a valuable test for diagnosing CPA in the field and in hospital patients. However, a negative test should be confirmed using an automated immunoassay.

The clinical diagnosis of dermatophytosis and identification of dermatophytes face challenges due to reliance on culture-based methods. Rapid, cost-effective detection techniques for volatile organic compounds (VOCs) have been developed for other microorganisms, but their application to dermatophytes is limited. This study explores using VOCs as diagnostic markers for dermatophytes. We compared VOC profiles across different dermatophyte taxa using solid-phase microextraction (SPME) and advanced analytical methods: gas chromatography-mass spectrometry (GC-MS) and comprehensive two-dimensional gas chromatography with time-of-flight mass spectrometry (GC×GC-TOFMS). We analyzed 47 dermatophyte strains from 15 taxa grown on sheep wool, including clinically significant species. Additionally, we examined phylogenetic relationships among the strains to correlate genetic relatedness with metabolite production. Our results showed that GC×GC-TOFMS offered superior resolution but similar differentiation of VOC profiles compared to GC-MS. VOC spectra allowed reliable distinction of taxonomic units at the species level and below, however, these distinctions showed only a slight correlation with phylogenetic data. We identified pan-dermatophyte and species- or strain-specific VOC profiles, indicating their potential for rapid, non-invasive detection of dermatophyte infections, including epidemic strains. These patterns could enable future taxa-specific identification. Our study highlights the potential of VOCs as tools for dermatophyte taxonomy and diagnosis.

Magnusiomyces capitatus is an environmental fungus found in soil, water, air, plants, and dairy products which may cause opportunistic infections in patients with haematological disorders resulting in high mortality rates. This series of the first reported cases in Ireland discusses investigation of two patients with underlying haematological disorders, hospitalised in the Irish National Adult Stem Cell Transplant Unit (NASCTU), who developed line-related fungaemias with M. capitatus within a three-month period. Patient A was a 49-year-old gentleman with a background of myelodysplastic syndrome with a large paroxysmal nocturnal haemoglobinuria clone who underwent an allogeneic stem cell transplant (ASCT). He developed a prolonged bloodstream infection with M. capitatus and was treated with antifungals but unfortunately passed away 30 days following first detection of M. capitatus from blood. Patient B is a 35-year-old lady with a background of aplastic anaemia who received an ASCT with blood cultures later growing M. capitatus. She developed a disseminated infection with skin involvement and brain lesions. She remains on long-term suppressive antifungals post discharge. Outbreaks of disseminated M. capitatus infection have been reported in several haematology units, related to contaminated medical devices and dairy products. In this situation, environmental and food sampling did not provide any evidence of M. capitatus, and whole genome sequencing proved that the isolates were unrelated. indicating no link between the two cases within a short period in the NASCTU. Increasing rates of rare invasive yeasts means that consideration should be given to management in vulnerable populations such as haematology patients post ASCT.

Background: Traditional methods for diagnosing onychomycosis are characterized by limited sensitivity and prolonged processing times, and heavily rely on the skill level of laboratory personnel.

Objectives: To develop a fast, simple, user-friendly, and reliable molecular assay that offers high sensitivity and specificity for the detection of common dermatophytes in nail specimens.

Methods: We developed a technique that integrates recombinase polymerase isothermal amplification with lateral flow dipstick (RPA-LFD) for the detection of pan-dermatophytes and Trichophyton rubrum, and evaluated its analytical sensitivity and specificity. This method was applied to analyze 190 nail specimens, with the results compared with traditional microscopy and fungal culture.

Results: The RPA-LFD assay demonstrated an analytical sensitivity of 10 pg/reaction for pan-dermatophytes and 1 pg/reaction for T. rubrum. In clinical evaluations for tinea unguium, the sensitivity of the RPA-LFD, fungal culture, and microscopy methods, as determined through latent class analysis, was estimated to be 91.0%, 70.8%, and 93.9%, respectively. Correspondingly, the specificity of these methods-RPA-LFD, fungal culture, and microscopy-was assessed at approximately 95.7%, 98.0%, and 94.3%.

Conclusions: Our RPA-LFD assay exhibited high sensitivity and specificity in the detection of dermatophytes. Due to its technical simplicity, enhanced sensitivity, and reduced processing times, it represents a promising alternative to conventional fungal culture methods for the mycological detection and identification of dermatophytes.