Pub Date : 2024-04-01Epub Date: 2024-12-05DOI: 10.1016/j.riam.2024.07.001
Gabriela López Daneri , Natali Niebles , Agustina Bustos , Pablo Martin Bravo , Edith Susana Paterno , Fernando Picco , Alejandra Margari , María Teresa Mujica
Background
Scedosporium species are considered emerging pathogens causing illness in immunocompetent and immunocompromised hosts.
Case report
A case of non-invasive pulmonary (fungal ball) infection by Scedosporium apiospermum complex in a 49-year-old female with bronchiectasis and cavities secondary to tuberculosis is described. The patient had a history of three years of cough and hemoptysis. A computed tomography scan of the thorax revealed the presence of a cavity in the lower lobe of the right lung, associated with bronchiectasis. A combination of surgical debridement and antifungal therapy (voriconazole) was the treatment of choice. Pulmonary resection (right lower lobectomy) was performed, and samples were sent for microbiological culture and histopathological examination; by means of the latter technique, hyphae were shown. The identification of Scedosporium angustum, a phylogenetic species of the S. apiospermum complex, was obtained by amplifying and sequencing the β-tubulin locus. Voriconazole therapy was started at a loading dose of 800 mg/12 h for the first 24 h, followed by 200 mg/12 h for 6 months. The patient responded favorably to the treatment and remained asymptomatic.
Conclusions
This case emphasizes the importance of considering Scedosporium species in the differential diagnosis of fungal balls by Aspergillus.
{"title":"Fungal ball due to a species of the Scedosporium apiospermum complex in a post-tuberculosis patient","authors":"Gabriela López Daneri , Natali Niebles , Agustina Bustos , Pablo Martin Bravo , Edith Susana Paterno , Fernando Picco , Alejandra Margari , María Teresa Mujica","doi":"10.1016/j.riam.2024.07.001","DOIUrl":"10.1016/j.riam.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><div><em>Scedosporium</em> species are considered emerging pathogens causing illness in immunocompetent and immunocompromised hosts.</div></div><div><h3>Case report</h3><div>A case of non-invasive pulmonary (fungal ball) infection by <em>Scedosporium apiospermum</em> complex in a 49-year-old female with bronchiectasis and cavities secondary to tuberculosis is described. The patient had a history of three years of cough and hemoptysis. A computed tomography scan of the thorax revealed the presence of a cavity in the lower lobe of the right lung, associated with bronchiectasis. A combination of surgical debridement and antifungal therapy (voriconazole) was the treatment of choice. Pulmonary resection (right lower lobectomy) was performed, and samples were sent for microbiological culture and histopathological examination; by means of the latter technique, hyphae were shown. The identification of <em>Scedosporium angustum</em>, a phylogenetic species of the <em>S. apiospermum</em> complex, was obtained by amplifying and sequencing the β-tubulin locus. Voriconazole therapy was started at a loading dose of 800<!--> <!-->mg/12<!--> <!-->h for the first 24<!--> <!-->h, followed by 200<!--> <!-->mg/12<!--> <!-->h for 6 months. The patient responded favorably to the treatment and remained asymptomatic.</div></div><div><h3>Conclusions</h3><div>This case emphasizes the importance of considering <em>Scedosporium</em> species in the differential diagnosis of fungal balls by <em>Aspergillus</em>.</div><div>.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 2","pages":"Pages 43-47"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-12-09DOI: 10.1016/j.riam.2021.07.003
Yahui Feng , Zhiya Yang , Dengli Li , Juanjuan Li , Dongmei Li , Sybren de Hoog , Dongmei Shi
Background
Post-traumatic Fusarium infection is rare. Arterial occlusive disease, a common vascular disorder in the elderly, often leads to ischemic necrosis of the lower extremities, which in turn increases the likelihood of secondary infections. Those secondary infections can be caused by bacteria, virus, or fungi.
Case report
We present the case of a 64-year-old male patient with a co-infection by Fusarium verticillioides and Proteus vulgaris on nails and foot skin, secondary to senile arterial occlusion on the lower extremities. The skin and nails recovered well after following stent implantation and a combination treatment of itraconazole and a macrolide antibiotic. A retrospective analysis of the literature identified 17 patients with Fusarium infection, all of whom were immunocompetent.
Conclusions
Trauma may be a predisposing cause of Fusarium infection. Combination of oral itraconazole and terbinafine, or amphotericin B and surgical means, are all effective treatments.
{"title":"Nails and skin co-infection by Fusarium verticillioides and Proteus vulgaris secondary to arterial occlusion of lower extremity","authors":"Yahui Feng , Zhiya Yang , Dengli Li , Juanjuan Li , Dongmei Li , Sybren de Hoog , Dongmei Shi","doi":"10.1016/j.riam.2021.07.003","DOIUrl":"10.1016/j.riam.2021.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic <em>Fusarium</em> infection is rare. Arterial occlusive disease, a common vascular disorder in the elderly, often leads to ischemic necrosis of the lower extremities, which in turn increases the likelihood of secondary infections. Those secondary infections can be caused by bacteria, virus, or fungi.</div></div><div><h3>Case report</h3><div>We present the case of a 64-year-old male patient with a co-infection by <em>Fusarium verticillioides</em> and <em>Proteus vulgaris</em> on nails and foot skin, secondary to senile arterial occlusion on the lower extremities. The skin and nails recovered well after following stent implantation and a combination treatment of itraconazole and a macrolide antibiotic. A retrospective analysis of the literature identified 17 patients with <em>Fusarium</em> infection, all of whom were immunocompetent.</div></div><div><h3>Conclusions</h3><div>Trauma may be a predisposing cause of <em>Fusarium</em> infection. Combination of oral itraconazole and terbinafine, or amphotericin B and surgical means, are all effective treatments.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 2","pages":"Pages 37-42"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-12-11DOI: 10.1016/j.riam.2024.10.001
Cristian Mateo León , Ángeles Sampere Martínez , Isabel Fabelo Hidalgo , Diego García Martínez de Artola
Background
Aspergillus flavus and Aspergillus fumigatus are commonly involved in fungal endophthalmitis. However, other less pathogenic species of the genus are also causal agents of opportunistic infections. Aspergillus hiratsukae, a species within Aspergillus section Fumigati, is an uncommon fungus responsible for a few infectious cases worldwide.
Case report
We present a case of post-surgical endophthalmitis in a man caused by A. hiratsukae after phacoemulsification surgery and intraocular lens implantation. The patient underwent an urgent vitrectomy in which infectious foci were observed. Due to adverse clinical evolution, evisceration was performed five days after admission. In the study of the intraoperative samples fungal growth was observed. Microscopic analysis showed conidial heads resembling Aspergillus species. The final identification of A. hiratsukae was achieved by amplifying and sequencing the ITS1-5.8S-ITS2 spacer region. Antifungal susceptibility testing was performed using the method described by EUCAST. The isolate exhibited sensitivity to azoles and polyenes.
Conclusions
Due to the morphological similarity of the Aspergillus species, molecular techniques are essential for discriminating among them, as there are different antifungal susceptibility profiles within the same complex. Further studies to improve clinical surveillance, make an early diagnosis and start a targeted therapy are necessary.
{"title":"Aspergillus hiratsukae as a causative agent of endophthalmitis: A case report","authors":"Cristian Mateo León , Ángeles Sampere Martínez , Isabel Fabelo Hidalgo , Diego García Martínez de Artola","doi":"10.1016/j.riam.2024.10.001","DOIUrl":"10.1016/j.riam.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div><em>Aspergillus flavus</em> and <em>Aspergillus fumigatus</em> are commonly involved in fungal endophthalmitis. However, other less pathogenic species of the genus are also causal agents of opportunistic infections. <em>Aspergillus hiratsukae</em>, a species within <em>Aspergillus</em> section <em>Fumigati</em>, is an uncommon fungus responsible for a few infectious cases worldwide.</div></div><div><h3>Case report</h3><div>We present a case of post-surgical endophthalmitis in a man caused by <em>A. hiratsukae</em> after phacoemulsification surgery and intraocular lens implantation. The patient underwent an urgent vitrectomy in which infectious foci were observed. Due to adverse clinical evolution, evisceration was performed five days after admission. In the study of the intraoperative samples fungal growth was observed. Microscopic analysis showed conidial heads resembling <em>Aspergillus</em> species. The final identification of <em>A. hiratsukae</em> was achieved by amplifying and sequencing the ITS1-5.8S-ITS2 spacer region. Antifungal susceptibility testing was performed using the method described by EUCAST. The isolate exhibited sensitivity to azoles and polyenes.</div></div><div><h3>Conclusions</h3><div>Due to the morphological similarity of the <em>Aspergillus</em> species, molecular techniques are essential for discriminating among them, as there are different antifungal susceptibility profiles within the same complex. Further studies to improve clinical surveillance, make an early diagnosis and start a targeted therapy are necessary.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 2","pages":"Pages 48-50"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-12-06DOI: 10.1016/j.riam.2024.09.001
Ana L. Ríos-López, María Fernanda Garza-Velásquez, Gloria M. González, Miguel A. Becerril-García, Orlando Flores-Maldonado
Background
Candida species are frequently isolated from the oral cavity of patients with cystic fibrosis. However, the information on the role of Candida in cystic fibrosis is scarce.
Aims
This study aimed to evaluate the prevalence, virulence profile and antifungal susceptibility of oral isolates of Candida albicans recovered from patients with cystic fibrosis.
Methods
Oropharyngeal swab samples were collected from sixty-five cystic fibrosis patients and sixty-five healthy individuals. Candida isolates were identified by MALDI-TOF VITEK-MS. Proteinase, phospholipase and esterase activity, biofilm production and level expression of ALS, SAP and PLB genes in C. albicans were evaluated. Minimal inhibitory concentration values were determined by means of an antifungal susceptibility test.
Results
Oral Candida colonization in cystic fibrosis patients was 66.15%, while in healthy individuals was 36.92%. C. albicans was the most frequently isolated species. C. albicans strains from cystic fibrosis patients were high producers of protease and biofilm, and had higher expression levels of adhesin and protease-associated genes in comparison with healthy subjects. Among the C. albicans strains isolated from cystic fibrosis patients, 18.91% were resistant to itraconazole, while 16.21% exhibited resistance to ketoconazole and fluconazole, and only one strain was resistant to voriconazole.
Conclusions
This work represents a surveillance study on virulence patterns and antifungal susceptibility of Candida from the oropharyngeal tract in cystic fibrosis.
{"title":"Prevalence, virulence factors and antifungal susceptibility of oral isolates of Candida albicans from patients with cystic fibrosis in Mexico","authors":"Ana L. Ríos-López, María Fernanda Garza-Velásquez, Gloria M. González, Miguel A. Becerril-García, Orlando Flores-Maldonado","doi":"10.1016/j.riam.2024.09.001","DOIUrl":"10.1016/j.riam.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida</em> species are frequently isolated from the oral cavity of patients with cystic fibrosis. However, the information on the role of <em>Candida</em> in cystic fibrosis is scarce.</div></div><div><h3>Aims</h3><div>This study aimed to evaluate the prevalence, virulence profile and antifungal susceptibility of oral isolates of <em>Candida albicans</em> recovered from patients with cystic fibrosis.</div></div><div><h3>Methods</h3><div>Oropharyngeal swab samples were collected from sixty-five cystic fibrosis patients and sixty-five healthy individuals. <em>Candida</em> isolates were identified by MALDI-TOF VITEK-MS. Proteinase, phospholipase and esterase activity, biofilm production and level expression of <em>ALS</em>, <em>SAP</em> and <em>PLB</em> genes in <em>C. albicans</em> were evaluated. Minimal inhibitory concentration values were determined by means of an antifungal susceptibility test.</div></div><div><h3>Results</h3><div>Oral <em>Candida</em> colonization in cystic fibrosis patients was 66.15%, while in healthy individuals was 36.92%. <em>C. albicans</em> was the most frequently isolated species. <em>C. albicans</em> strains from cystic fibrosis patients were high producers of protease and biofilm, and had higher expression levels of adhesin and protease-associated genes in comparison with healthy subjects. Among the <em>C. albicans</em> strains isolated from cystic fibrosis patients, 18.91% were resistant to itraconazole, while 16.21% exhibited resistance to ketoconazole and fluconazole, and only one strain was resistant to voriconazole.</div></div><div><h3>Conclusions</h3><div>This work represents a surveillance study on virulence patterns and antifungal susceptibility of <em>Candida</em> from the oropharyngeal tract in cystic fibrosis.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 2","pages":"Pages 31-36"},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-06-18DOI: 10.1016/j.riam.2024.04.001
Background
Paracoccidioidomycosis is a neglected tropical disease caused by fungi of the genus Paracoccidioides. A wide range of symptoms is related to the disease; however, lungs and skin are the sites predominantly affected. The disease is mostly seen in people living in rural areas in Latin America.
Case report
We present a pediatric case of severe disseminated paracoccidioidomycosis that slowly responded to the antifungal treatment. Within three months, symptoms evolved into hepatosplenomegaly, necrotic cervical and abdominal lymph nodes, and splenic abscess. Clinical response to amphotericin B deoxycholate and itraconazole was slow, resulting in pleural and peritoneal cavity effusions, heart failure and shock. Amphotericin B deoxycholate was replaced by the liposomal formulation, with no response. Subsequently, prednisone was added to the treatment, which led to improvement in the clinical response. Serological Paracoccidioides antibody titers were atypical, with very low titers in the critical phase and significant increase during the convalescence phase. The infection was finally cleared up with amphotericin B deoxycholate, liposomal amphotericin B and the use of corticosteroids. Paracoccidioidomycosis serology was non-reactive two years post-discharge.
Conclusions
Due to the intense inflammatory response triggered by Paracoccidioides cells, giving low-dose prednisone for a short period of time modulated the inflammatory response and supported antifungal treatment.
背景：副球孢子菌病是由副球孢子菌属真菌引起的一种被忽视的热带疾病。该病的症状多种多样，但主要受累部位是肺部和皮肤。这种疾病主要发生在拉丁美洲的农村地区：我们报告了一例严重的播散性副球孢子菌病儿科病例，患者对抗真菌治疗反应缓慢。三个月内，症状演变为肝脾肿大、颈部和腹部淋巴结坏死以及脾脓肿。脱氧胆酸两性霉素 B 和伊曲康唑的临床反应缓慢，导致胸腔和腹腔积液、心力衰竭和休克。脱氧胆酸两性霉素 B 被脂质体制剂取代，但无反应。随后，在治疗中加入了泼尼松，临床反应有所改善。血清学中的副球孢子菌抗体滴度不典型，在临界期滴度很低，而在恢复期滴度显著升高。通过使用脱氧胆酸两性霉素 B、两性霉素 B 脂质体和皮质类固醇，感染最终被清除。出院后两年，副球孢子菌病血清学检查未见反应：结论：由于副球孢子菌细胞引发了强烈的炎症反应，短期使用小剂量泼尼松可调节炎症反应，支持抗真菌治疗。
{"title":"Clinical response to prednisone in a severe case of infant-juvenile paracoccidioidomycosis","authors":"","doi":"10.1016/j.riam.2024.04.001","DOIUrl":"10.1016/j.riam.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Paracoccidioidomycosis is a neglected tropical disease caused by fungi of the genus <em>Paracoccidioides</em>. A wide range of symptoms is related to the disease; however, lungs and skin are the sites predominantly affected. The disease is mostly seen in people living in rural areas in Latin America.</div></div><div><h3>Case report</h3><div>We present a pediatric case of severe disseminated paracoccidioidomycosis that slowly responded to the antifungal treatment. Within three months, symptoms evolved into hepatosplenomegaly, necrotic cervical and abdominal lymph nodes, and splenic abscess. Clinical response to amphotericin B deoxycholate and itraconazole was slow, resulting in pleural and peritoneal cavity effusions, heart failure and shock. Amphotericin B deoxycholate was replaced by the liposomal formulation, with no response. Subsequently, prednisone was added to the treatment, which led to improvement in the clinical response. Serological <em>Paracoccidioides</em> antibody titers were atypical, with very low titers in the critical phase and significant increase during the convalescence phase. The infection was finally cleared up with amphotericin B deoxycholate, liposomal amphotericin B and the use of corticosteroids. Paracoccidioidomycosis serology was non-reactive two years post-discharge.</div></div><div><h3>Conclusions</h3><div>Due to the intense inflammatory response triggered by <em>Paracoccidioides</em> cells, giving low-dose prednisone for a short period of time modulated the inflammatory response and supported antifungal treatment.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 1","pages":"Pages 27-30"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-09-26DOI: 10.1016/j.riam.2024.04.002
Wenwen Yu , Hua Ye , Yunlei Li , Xiaoqiong Bao, Yangyang Ni, Xiangxiang Chen, Yangjie Sun, Ali Chen, Weilong Zhou, Jifa Li
Background
Pneumocystis carinii is an opportunistic fungal pathogen that may cause pneumonia and lead to pulmonary fibrosis.
Aims
This study attempted to investigate the role of P. carinii infection-related genes in regulating lung fibrosis in mice.
Methods
A screening of P. carinii infection-related differential mRNAs was performed using the GEO database, followed by protein–protein interaction (PPI) network construction using the STRING website in order to obtain P. carinii infection-related key genes. The development of a mouse model with gene aberrant expression was achieved by utilizing mice carrying the Cre-LoxP recombinase system. Dexamethasone was employed to induce tracheal infection in order to develop a model of pulmonary fibrosis, and the magnitude of lung injury was assessed by performing hematoxylin–eosin (H&E) staining and Masson staining. Lung coefficient and hydroxyproline level were assessed on sections of lung tissue as well. Finally, the magnitude of lung fibrosis and inflammation in mice was determined based on immunofluorescence and on the expression of genes associated with lung fibrosis and inflammation.
Results
Fn1 was found by PPI with the highest connectivity in the PPI network associated with immunity and inflammation. Besides, Fn1 was significantly highly expressed in P. carinii-infected mice samples. The P carinii pneumonia (PCP)+Fn1fl/fl group had significantly higher lung coefficients, hydroxyproline levels and TNF-α, IL-6, IL-1β, IL-8 and NLRP3 expression levels, and significantly lower IL-10 expression levels. The results found in PCP+SPC-Cre:Fn1fl/fl group were the opposite. The results of the pulmonary fibrosis level study showed that the PCP+Fn1fl/fl group had the most intense H&E and Masson staining, and significantly higher expression levels of Col1A2, Col3A1 and α-SMA, which were lower in the PCP+SPC-Cre:Fn1fl/fl group.
Conclusions
P. carinii infection may promote the upregulation of Fn1, which causes pulmonary fibrosis with an inflammatory response.
{"title":"Pneumocystis carinii infection drives upregulation of Fn1 expression that causes pulmonary fibrosis with an inflammatory response","authors":"Wenwen Yu , Hua Ye , Yunlei Li , Xiaoqiong Bao, Yangyang Ni, Xiangxiang Chen, Yangjie Sun, Ali Chen, Weilong Zhou, Jifa Li","doi":"10.1016/j.riam.2024.04.002","DOIUrl":"10.1016/j.riam.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><div><em>Pneumocystis carinii</em> is an opportunistic fungal pathogen that may cause pneumonia and lead to pulmonary fibrosis.</div></div><div><h3>Aims</h3><div>This study attempted to investigate the role of <em>P. carinii</em> infection-related genes in regulating lung fibrosis in mice.</div></div><div><h3>Methods</h3><div>A screening of <em>P. carinii</em> infection-related differential mRNAs was performed using the GEO database, followed by protein–protein interaction (PPI) network construction using the STRING website in order to obtain <em>P. carinii</em> infection-related key genes. The development of a mouse model with gene aberrant expression was achieved by utilizing mice carrying the Cre-LoxP recombinase system. Dexamethasone was employed to induce tracheal infection in order to develop a model of pulmonary fibrosis, and the magnitude of lung injury was assessed by performing hematoxylin–eosin (H&E) staining and Masson staining. Lung coefficient and hydroxyproline level were assessed on sections of lung tissue as well. Finally, the magnitude of lung fibrosis and inflammation in mice was determined based on immunofluorescence and on the expression of genes associated with lung fibrosis and inflammation.</div></div><div><h3>Results</h3><div>Fn1 was found by PPI with the highest connectivity in the PPI network associated with immunity and inflammation. Besides, Fn1 was significantly highly expressed in <em>P. carinii</em>-infected mice samples. The <em>P carinii</em> pneumonia (PCP)+Fn1<sup>fl/fl</sup> group had significantly higher lung coefficients, hydroxyproline levels and TNF-α, IL-6, IL-1β, IL-8 and NLRP3 expression levels, and significantly lower IL-10 expression levels. The results found in PCP+SPC-Cre:Fn1<sup>fl/fl</sup> group were the opposite. The results of the pulmonary fibrosis level study showed that the PCP+Fn1<sup>fl/fl</sup> group had the most intense H&E and Masson staining, and significantly higher expression levels of Col1A2, Col3A1 and α-SMA, which were lower in the PCP+SPC-Cre:Fn1<sup>fl/fl</sup> group.</div></div><div><h3>Conclusions</h3><div><em>P. carinii</em> infection may promote the upregulation of Fn1, which causes pulmonary fibrosis with an inflammatory response.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 1","pages":"Pages 17-26"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-07-02DOI: 10.1016/j.riam.2024.01.001
Background
Fungemia due to uncommon fungi and secondary to multiple risk factors has become an emergent health problem, particularly in oncology patients.
Aims
This study shows the following data collected during an 11-year period in a tertiary care oncologic center from patients with fungemia: demographic data, clinical characteristics, and outcome.
Methods
A retrospective study was performed at Instituto Nacional de Cancerología, a 135-bed referral cancer center in Mexico City, from July 2012 to June 2023. All episodes of non-Candida fungemia were included.
Results
Sixteen cases with uncommon fungemia were found in the database, representing 0.3% from all the blood cultures positive during the study period, and 8.5% from all the fungi isolated. The most common pathogens identified in our series were Histoplasma capsulatum, Acremonium spp., Trichosporon asahii, and Saccharomyces cerevisiae. Eight patients had hematologic malignancies, and five had severe neutropenia. In eight cases fungemia was considered catheter-related, in four cases was classified as primary, and in the last four it was diagnosed as disseminated fungal diseases. Mortality at 30 days was 43.8%.
Conclusions
The improved diagnostic tools have led to a better diagnosis of uncommon fungal infections. More aggressive therapeutic approaches, particularly in patients with malignancies, would increase survival rates in these potentially fatal diseases.
背景：由不常见真菌引起并继发于多种风险因素的真菌血症已成为一个紧迫的健康问题，尤其是在肿瘤患者中。目的：本研究显示了在一家三级肿瘤中心的11年间收集的真菌血症患者的以下数据：人口统计学数据、临床特征和结果：2012年7月至2023年6月，在墨西哥城一家拥有135张床位的癌症转诊中心--国立癌症研究所（Instituto Nacional de Cancerología）进行了一项回顾性研究。研究纳入了所有非念珠菌性真菌病病例：结果：数据库中发现了16例非典型真菌血症病例，占研究期间所有血液培养阳性病例的0.3%，占所有真菌分离病例的8.5%。在我们的系列研究中，最常见的病原体是荚膜组织胞浆菌（Histoplasma capsulatum）、Acremonium spp.、旭三孢子菌（Trichosporon asahii）和酿酒酵母菌（Saccharomyces cerevisiae）。八名患者患有血液系统恶性肿瘤，五名患者患有严重的中性粒细胞减少症。8例真菌血症被认为与导管有关，4例被归类为原发性，最后4例被诊断为播散性真菌病。30天后的死亡率为43.8%：结论：诊断工具的改进提高了对不常见真菌感染的诊断率。更积极的治疗方法，尤其是针对恶性肿瘤患者的治疗方法，将提高这些潜在致命疾病的存活率。
{"title":"Fungemia due to opportunistic fungi in patients with cancer","authors":"","doi":"10.1016/j.riam.2024.01.001","DOIUrl":"10.1016/j.riam.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Fungemia due to uncommon fungi and secondary to multiple risk factors has become an emergent health problem, particularly in oncology patients.</div></div><div><h3>Aims</h3><div>This study shows the following data collected during an 11-year period in a tertiary care oncologic center from patients with fungemia: demographic data, clinical characteristics, and outcome.</div></div><div><h3>Methods</h3><div>A retrospective study was performed at Instituto Nacional de Cancerología, a 135-bed referral cancer center in Mexico City, from July 2012 to June 2023. All episodes of non-<em>Candida</em> fungemia were included.</div></div><div><h3>Results</h3><div>Sixteen cases with uncommon fungemia were found in the database, representing 0.3% from all the blood cultures positive during the study period, and 8.5% from all the fungi isolated. The most common pathogens identified in our series were <span><span>Histoplasma capsulatum</span></span>, <span><span>Acremonium</span></span> spp., <span><span>Trichosporon asahii</span></span>, and <span><span>Saccharomyces cerevisiae</span></span><span>. Eight patients had hematologic malignancies, and five had severe neutropenia. In eight cases fungemia was considered catheter-related, in four cases was classified as primary, and in the last four it was diagnosed as disseminated fungal diseases. Mortality at 30 days was 43.8%.</span></div></div><div><h3>Conclusions</h3><div>The improved diagnostic tools have led to a better diagnosis of uncommon fungal infections. More aggressive therapeutic approaches, particularly in patients with malignancies, would increase survival rates in these potentially fatal diseases.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 1","pages":"Pages 1-6"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-09-19DOI: 10.1016/j.riam.2024.04.003
Eduardo Álvarez Duarte , Nicolás Cepeda , Jean Miranda
Background
Aspergillus fumigatus is a ubiquitous opportunistic pathogen. This fungus can acquire resistance to azole antifungals due to different mutations in the cyp51A gene. Azole resistance has been observed in several continents and appears to be a globally distributed phenomenon. Specific mutations in cyp51A that lead to azole resistance, such as the TR34/L98H modification, have been reported.
Aims
To evaluate the azole resistance in clinically isolated A. fumigatus strains.
Methods
As a result of our passive surveillance strategy, a total of 23 A. fumigatus isolates from clinical origins were identified through a phylogenetic analysis using the ITS region and β-tubulin gene fragments, and typed with the CSP microsatellite. Azole susceptibility profiles were performed by disk diffusion and microdilution broth methodologies according to CLSI guidelines.
Results
Here we describe, for the first time, the detection of azole-resistant A. fumigatus isolates from clinical origins in Chile with mutations in the cyp51A gene. In addition to the TR34/L98H mutation, one isolate exhibited an F46Y/M172V/E427K-type mutation. Furthermore, microsatellite typing based on cell surface protein (CSP) was performed, showing the t02 (TR34/L98H), t15 (F46Y/M172V/E427K) and t01 (susceptible clinical isolates) genotypes.
Conclusions
Our study demonstrates the presence of mutations related to azole resistance in A. fumigatus strains isolated from clinical samples in Chile. In order to obtain information that may help to tackle the spread of antifungal resistance among A. fumigatus populations, and to ensure the efficacy of future treatments against aspergillosis, a further research is necessary.
{"title":"Azole resistance in a clinical isolate of Aspergillus fumigatus from Chile","authors":"Eduardo Álvarez Duarte , Nicolás Cepeda , Jean Miranda","doi":"10.1016/j.riam.2024.04.003","DOIUrl":"10.1016/j.riam.2024.04.003","url":null,"abstract":"<div><h3>Background</h3><div><em>Aspergillus fumigatus</em> is a ubiquitous opportunistic pathogen. This fungus can acquire resistance to azole antifungals due to different mutations in the cyp51A gene. Azole resistance has been observed in several continents and appears to be a globally distributed phenomenon. Specific mutations in cyp51A that lead to azole resistance, such as the TR34/L98H modification, have been reported.</div></div><div><h3>Aims</h3><div>To evaluate the azole resistance in clinically isolated <em>A. fumigatus</em> strains.</div></div><div><h3>Methods</h3><div>As a result of our passive surveillance strategy, a total of 23 <em>A. fumigatus</em> isolates from clinical origins were identified through a phylogenetic analysis using the ITS region and β-tubulin gene fragments, and typed with the CSP microsatellite. Azole susceptibility profiles were performed by disk diffusion and microdilution broth methodologies according to CLSI guidelines.</div></div><div><h3>Results</h3><div>Here we describe, for the first time, the detection of azole-resistant <em>A. fumigatus</em> isolates from clinical origins in Chile with mutations in the cyp51A gene. In addition to the TR34/L98H mutation, one isolate exhibited an F46Y/M172V/E427K-type mutation. Furthermore, microsatellite typing based on cell surface protein (CSP) was performed, showing the t02 (TR34/L98H), t15 (F46Y/M172V/E427K) and t01 (susceptible clinical isolates) genotypes.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates the presence of mutations related to azole resistance in <em>A. fumigatus</em> strains isolated from clinical samples in Chile. In order to obtain information that may help to tackle the spread of antifungal resistance among <em>A. fumigatus</em> populations, and to ensure the efficacy of future treatments against aspergillosis, a further research is necessary.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 1","pages":"Pages 7-12"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Early diagnosis of candidemia is critical for the correct management and treatment of patients.
Aims
To test the efficacy of different blood culture bottles in the growth of Candida strains.
Methods
We compared the performance of BD BACTEC™ Plus Aerobic/F (Aero) culture bottles with the specific BD BACTEC™ Mycosis IC/F Lytic (Myco) culture bottles using the BD BACTEC™ FX 40 automated blood culture system to determine the mean time-to-detection (TTD) in Candida species. One isolate each of six Candida species was inoculated into blood culture bottles (final concentration, 1–5 CFU ml−1) and incubated at 37 °C until automated growth detection.
Results
Candida albicans and Nakaseomyces glabratus (Candida glabrata) were detected earlier in the specific culture bottle, whereas Candida tropicalis was detected earlier in the nonspecific bottle; Candida parapsilosis, Pichia kudriavzevii (Candida krusei), and Meyerozyma guilliermondii (Candida guilliermondii) presented similar TTD in both bottles.
Conclusions
Our study suggests the suitability of using both bottles in clinical laboratories for a faster diagnosis and prompt starting of any treatment.
{"title":"Experimental study of specific and nonspecific blood culture bottles for the diagnosis of candidemia","authors":"Leandre Carmem Wilot , Vanice Rodrigues Poester , Cecília Bittencourt Severo , Karine Ortiz Sanchotene , Bruna Muradás Esperon , Mariana Rodrigues Trápaga , David A. Stevens , Melissa Orzechowski Xavier","doi":"10.1016/j.riam.2024.06.001","DOIUrl":"10.1016/j.riam.2024.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Early diagnosis of candidemia is critical for the correct management and treatment of patients.</div></div><div><h3>Aims</h3><div>To test the efficacy of different blood culture bottles in the growth of <em>Candida</em> strains.</div></div><div><h3>Methods</h3><div>We compared the performance of BD BACTEC™ Plus Aerobic/F (Aero) culture bottles with the specific BD BACTEC™ Mycosis IC/F Lytic (Myco) culture bottles using the BD BACTEC™ FX 40 automated blood culture system to determine the mean time-to-detection (TTD) in <em>Candida</em> species. One isolate each of six <em>Candida</em> species was inoculated into blood culture bottles (final concentration, 1–5<!--> <!-->CFU<!--> <!-->ml<sup>−1</sup>) and incubated at 37<!--> <!-->°C until automated growth detection.</div></div><div><h3>Results</h3><div><em>Candida albicans</em> and <em>Nakaseomyces glabratus</em> (<em>Candida glabrata</em>) were detected earlier in the specific culture bottle, whereas <em>Candida tropicalis</em> was detected earlier in the nonspecific bottle; <em>Candida parapsilosis</em>, <em>Pichia kudriavzevii</em> (<em>Candida krusei</em>), and <em>Meyerozyma guilliermondii</em> (<em>Candida guilliermondii</em>) presented similar TTD in both bottles.</div></div><div><h3>Conclusions</h3><div>Our study suggests the suitability of using both bottles in clinical laboratories for a faster diagnosis and prompt starting of any treatment.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"41 1","pages":"Pages 13-16"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01Epub Date: 2024-02-07DOI: 10.1016/j.riam.2023.10.001
Silvana Ramadán , Hernán Dalmaso , Alicia Luque , Maximiliano Sortino , María Luján Cuestas , Katherine Hermida Alava , Diego Bertola , Lucía Bulacio
Background
Scedosporiasis is an emerging mycosis that has gained importance in recent years due to its worldwide prevalence. It is caused by species of the Scedosporium apiospermum complex. These species can cause opportunistic infections in immunocompromised patients and, occasionally, in immunocompetent patients as well. The high intrinsic antifungal resistance make these infections difficult to manage.
Aims
The objective of this study was to interpret the mycological findings in a transplant patient, together with the images obtained in the radiological studies, in order to provide an early and effective antifungal therapy.
Methods
The mycological analysis of samples taken from a heart transplant patient with radiological images suggesting a fungal infection was performed. Computed tomography scan of the head and thorax showed space-occupying lesions in both the frontal lobe and cerebellum, and multiple pulmonary nodules. The nodules were punctured and the samples obtained were analyzed according to the procedures for mycological analysis. The identity of the isolates was confirmed by nucleotide sequencing. Eventually, the antifungal susceptibility was studied.
Results
The fungal isolates obtained, whose identity was confirmed by sequencing, belonged to the species Scedosporium boydii. Injured tissues were surgically removed and a treatment with amphotericin B and voriconazole-minimum inhibitory concentration (MIC) 0.5 μg/mL and ≥0.5 μg/mL respectively – was administered.
Conclusions
Although the patient died due to complications of a Klebsiella pneumoniae sepsis refractory to treatment, the progression of the fungal disease, although slow, was favourable in the early phases of the treatment due to a correct diagnosis and the antifungal susceptibility test carried out. Clinical cases of this nature highlight the need to increase the epidemiological study of these microorganisms, as well as the proper treatment of the diseases caused, in order to achieve early diagnoses that reduce the morbidity and mortality of patients.
背景：头孢子虫病是一种新出现的真菌病，近年来由于在全球范围内的流行而变得越来越重要。它是由Scedosporium apiospermum复合菌种引起的。这些孢子菌可导致免疫力低下的患者发生机会性感染，偶尔也会导致免疫力正常的患者发生机会性感染。本研究的目的是结合放射学研究获得的图像，对一名移植患者的真菌学检查结果进行解读，以便及早提供有效的抗真菌治疗：方法：对一名心脏移植患者的样本进行了真菌学分析，其放射学图像显示存在真菌感染。头部和胸部的计算机断层扫描显示，额叶和小脑均有占位性病变，肺部有多个结节。对结节进行了穿刺，并按照真菌学分析程序对获得的样本进行了分析。通过核苷酸测序确认了分离物的身份。最后，对抗真菌药敏性进行了研究：结果：通过测序确认的真菌分离物属于Scedosporium boydii。手术切除了受伤组织，并使用两性霉素 B 和伏立康唑（最低抑菌浓度（MIC）分别为 0.5μg/mL 和≥0.5μg/mL）进行治疗：结论：虽然患者因难治性肺炎克雷伯菌败血症并发症而死亡，但由于诊断正确和进行了抗真菌药敏试验，真菌病的进展虽然缓慢，但在治疗的早期阶段是有利的。这种性质的临床病例突出表明，有必要加强对这些微生物的流行病学研究，并对引起的疾病进行适当治疗，以便实现早期诊断，降低患者的发病率和死亡率。
{"title":"Scedosporium boydii finding in an immunocompromised patient and review of the literature","authors":"Silvana Ramadán , Hernán Dalmaso , Alicia Luque , Maximiliano Sortino , María Luján Cuestas , Katherine Hermida Alava , Diego Bertola , Lucía Bulacio","doi":"10.1016/j.riam.2023.10.001","DOIUrl":"10.1016/j.riam.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Scedosporiasis is an emerging mycosis that has gained importance in recent years due to its worldwide prevalence. It is caused by species of the <span><span>Scedosporium apiospermum</span></span> complex. These species can cause opportunistic infections in immunocompromised patients and, occasionally, in immunocompetent patients as well. The high intrinsic antifungal resistance make these infections difficult to manage.</div></div><div><h3>Aims</h3><div>The objective of this study was to interpret the mycological findings in a transplant patient, together with the images obtained in the radiological studies, in order to provide an early and effective antifungal therapy.</div></div><div><h3>Methods</h3><div>The mycological analysis of samples taken from a heart transplant patient with radiological images suggesting a fungal infection was performed. Computed tomography scan of the head and thorax showed space-occupying lesions in both the frontal lobe and cerebellum, and multiple pulmonary nodules. The nodules were punctured and the samples obtained were analyzed according to the procedures for mycological analysis. The identity of the isolates was confirmed by nucleotide sequencing. Eventually, the antifungal susceptibility was studied.</div></div><div><h3>Results</h3><div>The fungal isolates obtained, whose identity was confirmed by sequencing, belonged to the species <span><span>Scedosporium boydii</span></span>. Injured tissues were surgically removed and a treatment with amphotericin B and voriconazole-minimum inhibitory concentration (MIC) 0.5<!--> <!-->μg/mL and ≥0.5<!--> <!-->μg/mL respectively – was administered.</div></div><div><h3>Conclusions</h3><div>Although the patient died due to complications of a <span><span>Klebsiella pneumoniae</span></span><span> sepsis refractory to treatment, the progression of the fungal disease, although slow, was favourable in the early phases of the treatment due to a correct diagnosis and the antifungal susceptibility test carried out. Clinical cases of this nature highlight the need to increase the epidemiological study of these microorganisms, as well as the proper treatment of the diseases caused, in order to achieve early diagnoses that reduce the morbidity and mortality of patients.</span></div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"40 4","pages":"Pages 39-44"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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