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1.
Mycoses ; 67(7): e13766, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39007526

RESUMO

BACKGROUND: The resistance of Aspergillus flavus to the azole antifungal drugs is an emerging problem. Mutations in the molecular targets of the azole antifungals - CYP 51 A, B and C - are possible mechanisms of resistance, but data to confirm this hypothesis are scarce. In addition, the behaviour of resistant strains in vitro and in vivo is not yet understood. OBJECTIVES: This study had 3 objectives. The first was to compare the sequences of CYP51 A, B and C in resistant and susceptible strains of A. flavus. The second was to look for the existence of a fitness cost associated with resistance. The third was to evaluate the activity of voriconazole and posaconazole on resistant strains in the Galleria mellonella model. METHODS: The CYP51 A, B and C sequences of seven resistant strains with those of four susceptible strains are compared. Fitness costs were assessed by growing the strains in RPMI medium and testing their virulence in G. mellonella larvae. In addition, G. mellonella larvae infected with strains of A. flavus were treated with voriconazole and posaconazole. RESULTS: In the CYP51A sequences, we found the A91T, C708T and A1296T nucleotide substitutions only in the resistant strains. The resistant strains showed a fitness cost with reduced in vitro growth and reduced virulence in G. mellonella. In vivo resistance to posaconazole is confirmed in a strain with the highest MIC for this antifungal agent. CONCLUSIONS: These results allow to conclude that some substitutions in CYP51 genes, in particular CYP51A, contribute to resistance to azole drugs in A. flavus. The study of the relationship between drug dosage and treatment duration with resistance and the reduction of fitness costs in resistant strains is a major perspective of this study. This work could help to establish recommendations for the treatment of infections with resistant strains of A. flavus.


Assuntos
Antifúngicos , Aspergillus flavus , Azóis , Sistema Enzimático do Citocromo P-450 , Farmacorresistência Fúngica , Larva , Testes de Sensibilidade Microbiana , Voriconazol , Aspergillus flavus/efeitos dos fármacos , Aspergillus flavus/genética , Antifúngicos/farmacologia , Farmacorresistência Fúngica/genética , Animais , Voriconazol/farmacologia , Azóis/farmacologia , Sistema Enzimático do Citocromo P-450/genética , Larva/microbiologia , Triazóis/farmacologia , Proteínas Fúngicas/genética , Mariposas/microbiologia , Aspergilose/microbiologia , Aspergilose/tratamento farmacológico , Virulência , Aptidão Genética , Modelos Animais de Doenças
2.
Crit Care ; 27(1): 470, 2023 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-38037130

RESUMO

BACKGROUND: Intra-abdominal candidiasis (IAC) is difficult to predict in critically ill patients with intra-abdominal infection, leading to the overuse of antifungal treatments. Serum and peritoneal 1.3-beta-D-glucan (sBDG and pBDG) have been proposed to confirm or invalidate the diagnosis of IAC, but clinical studies have reported inconsistent results, notably because of heterogeneous populations with a low IAC prevalence. This study aimed to identify a high-risk IAC population and evaluate pBDG and sBDG in diagnosing IAC. METHODS: This prospective multicenter noninterventional French study included consecutive critically ill patients undergoing abdominal surgery for abdominal sepsis. The primary objective was to establish the IAC prevalence. The secondary objective was to explore whether sBDG and pBDG could be used to diagnose IAC. Wako® beta-glucan test (WT, Fujifilm Wako Chemicals Europe, Neuss, Germany) was used for pBDG measurements. WT and Fungitell® beta-D-glucan assay (FA, Associate of Cape Cod, East Falmouth, USA) were used for sBDG measurements. RESULTS: Between 1 January 2020 and 31 December 2022, 199 patients were included. Patients were predominantly male (63%), with a median age of 66 [54-72] years. The IAC prevalence was 44% (87/199). The main IAC type was secondary peritonitis. Septic shock occurred in 63% of cases. After multivariate analysis, a nosocomial origin was associated with more IAC cases (P = 0.0399). The median pBDG level was significantly elevated in IAC (448 [107.5-1578.0] pg/ml) compared to non-IAC patients (133 [16.0-831.0] pg/ml), P = 0.0021. For a pBDG threshold of 45 pg/ml, the negative predictive value in assessing IAC was 82.3%. The median sBDG level with WT (n = 42) at day 1 was higher in IAC (5 [3.0-9.0] pg/ml) than in non-IAC patients (3 [3.0-3.0] pg/ml), P = 0.012. Similarly, median sBDG level with FA (n = 140) at day 1 was higher in IAC (104 [38.0-211.0] pg/ml) than in non-IAC patients (50 [23.0-141.0] pg/ml), P = 0.009. Combining a peritonitis score < 3, sBDG < 3.3 pg/ml (WT) and pBDG < 45 pg/ml (WT) yielded a negative predictive value of 100%. CONCLUSION: In critically ill patients with intra-abdominal infection requiring surgery, the IAC prevalence was 44%. Combining low sBDG and pBDG with a low peritonitis score effectively excluded IAC and could limit unnecessary antifungal agent exposure. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov (ID number 03997929, first registered on June 24, 2019).


Assuntos
Candidíase , Infecções Intra-Abdominais , Peritonite , beta-Glucanas , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Feminino , Estudos Prospectivos , Glucanos , Estado Terminal/terapia , Candidíase/tratamento farmacológico , Antifúngicos/uso terapêutico , Infecções Intra-Abdominais/diagnóstico , Peritonite/diagnóstico , beta-Glucanas/análise , Sensibilidade e Especificidade
3.
Eur J Clin Microbiol Infect Dis ; 40(6): 1191-1198, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33411170

RESUMO

In the non-AIDS group, several underlying conditions and immune defects could lead to different PCP presentations. This study compared PCP presentation and outcome according to the underlying disease. A secondary analysis of a previously published prospective observational study including 544 PCP patients was done. Only non-AIDS patients were included. Underlying disease was defined as chronic lymphocytic leukemia (CLL), organ transplantation, solid cancer, allogeneic hematopoietic stem cell transplant (AHSCT), other hematological diseases, and immunosuppressive treatment. Clinical characteristics and outcomes were compared between groups. Multiple correspondent analyses compared clinical characteristics at diagnosis. Day 30 mortality was analyzed. Three hundred and twenty-one patients were included in the study. The underlying diseases were hematological malignancy (n = 75), AHSCT (n = 14), CLL (n = 19), solid organ transplant (n = 94), solid tumor (n = 39), and immunosuppressive treatment (n = 57). Compared with other underlying diseases, PCP related to CLL was closer to PCP related to AIDS presentation (long duration of symptoms before diagnosis, high level of dyspnea, and low oxygen saturation at diagnosis). Day 30 mortality was associated with underlying disease, oxygen flow, and shock at ICU admission. PCP presentations may vary according to the underlying reason for immunosuppression. Response to treatment and adjuvant steroid therapy should be analyzed regarding this result.


Assuntos
Pneumonia por Pneumocystis/complicações , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/mortalidade , Doença Aguda , Idoso , Feminino , Doenças Hematológicas/complicações , Humanos , Leucemia Linfoide/complicações , Masculino , Pessoa de Meia-Idade , Pneumonia por Pneumocystis/diagnóstico , Estudos Prospectivos
4.
Molecules ; 24(20)2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31619024

RESUMO

The current rise in invasive fungal infections due to the increase in immunosuppressive therapies is a real concern. Moreover, the emergence of resistant strains induces therapeutic failures. In light of these issues, new classes of antifungals are anticipated. Therefore, the plant kingdom represents an immense potential of natural resources to exploit for these purposes. The aim of this review is to provide information about the antifungal effect of some important essential oils, and to describe the advances made in determining the mechanism of action more precisely. Finally, the issues of toxicity and resistance of fungi to essential oils will be discussed.


Assuntos
Antifúngicos/química , Antifúngicos/farmacologia , Produtos Biológicos/química , Produtos Biológicos/farmacologia , Óleos Voláteis/química , Óleos Voláteis/farmacologia , Resistência Microbiana a Medicamentos , Sinergismo Farmacológico , Fungos/efeitos dos fármacos , Testes de Sensibilidade Microbiana
5.
Med Mycol ; 56(5): 591-601, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29420818

RESUMO

Fusarium spp. are saprobic moulds that are responsible for severe opportunistic infections in humans and animals. However, we need epidemiological tools to reliably trace the circulation of such fungal strains within medical or veterinary facilities, to recognize environmental contaminations that might lead to infection and to improve our understanding of factors responsible for the onset of outbreaks. In this study, we used molecular genotyping to investigate clustered cases of Fusarium solani species complex (FSSC) infection that occurred in eight Sphyrnidae sharks under managed care at a public aquarium. Genetic relationships between fungal strains were determined by multi-locus sequence typing (MLST) analysis based on DNA sequencing at five loci, followed by comparison with sequences of 50 epidemiologically unrelated FSSC strains. Our genotyping approach revealed that F. keratoplasticum and F. solani haplotype 9x were most commonly isolated. In one case, the infection proved to be with another Hypocrealian rare opportunistic pathogen Metarhizium robertsii. Twice, sharks proved to be infected with FSSC strains with the same MLST sequence type, supporting the hypothesis the hypothesis that common environmental populations of fungi existed for these sharks and would suggest the longtime persistence of the two clonal strains within the environment, perhaps in holding pools and life support systems of the aquarium. This study highlights how molecular tools like MLST can be used to investigate outbreaks of microbiological disease. This work reinforces the need for regular controls of water quality to reduce microbiological contamination due to waterborne microorganisms.


Assuntos
Microbiologia Ambiental , Doenças dos Peixes/microbiologia , Fusariose/veterinária , Fusarium/classificação , Tipagem de Sequências Multilocus/veterinária , Filogenia , Tubarões/microbiologia , Animais , DNA Fúngico/genética , Doenças dos Peixes/patologia , Fusariose/microbiologia , Fusariose/patologia , Fusarium/genética , Fusarium/isolamento & purificação , Genes Fúngicos/genética , Técnicas de Tipagem Micológica/veterinária
6.
Mycoses ; 59(5): 304-11, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26806228

RESUMO

Onychomycosis is a common nail disorder mainly due to dermatophytes for which the conventional diagnosis requires direct microscopic observation and culture of a biological sample. Nevertheless, antifungal treatments are commonly prescribed without a mycological examination having been performed, partly because of the slow growth of dermatophytes. Therefore, molecular biology has been applied to this pathology, to support a quick and accurate distinction between onychomycosis and other nail damage. Commercial kits are now available from several companies for improving traditional microbiological diagnosis. In this paper, we present the first evaluation of the real-time PCR kit marketed by Bio Evolution for the diagnosis of dermatophytosis. Secondly, we compare the efficacy of the kit on optimal and non-optimal samples. This study was conducted on 180 nails samples, processed by conventional methods and retrospectively analysed using this kit. According to our results, this molecular kit has shown high specificity and sensitivity in detecting dermatophytes, regardless of sample quality. On the other hand, and as expected, optimal samples allowed the identification of a higher number of dermatophytes by conventional mycological diagnosis, compared to non-optimal samples. Finally, we have suggested several strategies for the practical use of such a kit in a medical laboratory for quick pathogen detection.


Assuntos
Fungos/isolamento & purificação , Onicomicose/diagnóstico , Kit de Reagentes para Diagnóstico/normas , Reação em Cadeia da Polimerase em Tempo Real/normas , Idoso , Arthrodermataceae/genética , Arthrodermataceae/crescimento & desenvolvimento , Arthrodermataceae/isolamento & purificação , DNA Fúngico/química , DNA Fúngico/isolamento & purificação , Feminino , Fungos/classificação , Fungos/genética , Fungos/crescimento & desenvolvimento , Humanos , Masculino , Onicomicose/microbiologia , Estudos Retrospectivos , Sensibilidade e Especificidade , Manejo de Espécimes/normas , Fatores de Tempo
7.
Int J Med Microbiol ; 305(3): 408-12, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25813244

RESUMO

Metarhizium anisopliae is a fungus utilized worldwide for insect-pest biocontrol. Few M. anisopliae infections have been reported previously. Here, M. anisopliae was isolated from a corneal ulcer in a healthy man. It is the first ocular case in France and Europe of this extremely rare fungus in humans.


Assuntos
Úlcera da Córnea/diagnóstico , Úlcera da Córnea/microbiologia , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/microbiologia , Metarhizium/isolamento & purificação , Adulto , Antifúngicos/uso terapêutico , Transplante de Córnea , Úlcera da Córnea/patologia , Úlcera da Córnea/terapia , Infecções Oculares Fúngicas/patologia , Infecções Oculares Fúngicas/terapia , França , Humanos , Masculino , Técnicas Microbiológicas , Resultado do Tratamento
8.
Emerg Infect Dis ; 20(9): 1490-7, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25148074

RESUMO

Pneumocystis jirovecii pneumonia (PCP) in patients without AIDS is increasingly common. We conducted a prospective cohort study of consecutive patients with proven PCP; of 544 patients, 223 (41%) had AIDS (AIDS patients) and 321 (59%) had other immunosuppressive disorders (non-AIDS patients). Fewer AIDS than non-AIDS patients required intensive care or ventilation, and the rate of hospital deaths--17.4% overall--was significantly lower for AIDS versus non-AIDS patients (4% vs. 27%; p<0.0001). Multivariable analysis showed the odds of hospital death increased with older age, receipt of allogeneic bone marrow transplant, immediate use of oxygen, need for mechanical ventilation, and longer time to treatment; HIV-positive status or receipt of a solid organ transplant decreased odds for death. PCP is more often fatal in non-AIDS patients, but time to diagnosis affects survival and is longer for non-AIDS patients. Clinicians must maintain a high index of suspicion for PCP in immunocompromised patients who do not have AIDS.


Assuntos
Pneumocystis carinii , Pneumonia por Pneumocystis/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adulto , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Razão de Chances , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/tratamento farmacológico , Estudos Prospectivos , Fatores de Risco
10.
J Fungi (Basel) ; 9(9)2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37755008

RESUMO

Interactions between different kingdoms of microorganisms in humans are common but not well described. A recent analysis of the mycobiome has described the presence of different fungi and their positive and/or negative interactions with bacteria and other fungi. In chronic respiratory diseases, these different microorganisms form mixed biofilms to live inside. The interactions between Gram-negative bacteria and filamentous fungi in these biofilms have attracted more attention recently. In this review, we analyse the microbiota of the respiratory tract of healthy individuals and patients with chronic respiratory disease. Additionally, we describe the regulatory mechanisms that rule the mixed biofilms of Aspergillus fumigatus and Gram-negative bacteria and the effects of this biofilm on clinical presentations.

11.
Clin Microbiol Infect ; 29(5): 652.e9-652.e15, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36509375

RESUMO

OBJECTIVES: To determine the epidemiological cut-off values (ECVs) of ten antifungal agents in a wide range of yeasts and Aspergillus spp. using gradient concentration strips. METHODS: The minimum inhibitory concentrations for amphotericin B, anidulafungin, caspofungin, micafungin, flucytosine, fluconazole, itraconazole, isavuconazole, posaconazole, and voriconazole, determined with gradient concentration strips at 35 French microbiology laboratories between 2002 and 2020, were retrospectively collected. Then, the ECVs were calculated using the iterative method and a cut-off value of 97.5%. RESULTS: Minimum inhibitory concentrations were available for 17 653 clinical isolates. In total, 48 ECVs (including 32 new ECVs) were determined: 29 ECVs for frequent yeast species (e.g. Candida albicans and itraconazole/flucytosine, and Candida glabrata species complex [SC] and flucytosine) and rare yeast species (e.g. Candida dubliniensis, Candida inconspicua, Saccharomyces cerevisiae, and Cryptococcus neoformans) and 19 ECVs for Aspergillusflavus SC, Aspergillusfumigatus SC, Aspergillusnidulans SC, Aspergillusniger SC, and Aspergillusterreus SC. CONCLUSIONS: These ECVs can be added to the already available gradient concentration strip-specific ECVs to facilitate minimum inhibitory concentration interpretation and streamline the identification of nonwild type isolates.


Assuntos
Antifúngicos , Itraconazol , Humanos , Antifúngicos/farmacologia , Itraconazol/farmacologia , Flucitosina , Saccharomyces cerevisiae , Estudos Retrospectivos , Filogenia , Fluconazol/farmacologia , Aspergillus , Testes de Sensibilidade Microbiana , Farmacorresistência Fúngica
12.
Mycopathologia ; 173(2-3): 183-6, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22042634

RESUMO

Histoplasmosis is an infectious disease caused by the inhalation of Histoplasma capsulatum spores, a fungus encountered in many diverse areas around the world. Although this infection is often asymptomatic, it may become dramatic in immunocompromised patients. In November 2005, an endocarditis due to Histoplasma capsulatum was diagnosed in a French woman treated for rheumatoid arthritis and who had traveled to South America 2 years earlier. We confirmed the biological diagnosis by mycological, serological, and histological methods. In spite of receiving the appropriate treatment, the patient died 3 months later of cardiac insufficiency. We report here this additional case of Histoplasma endocarditis, by hoping to help rapid and accurate diagnosis of such infections in their early stages of development, in non-endemic areas.


Assuntos
Artrite Reumatoide/tratamento farmacológico , Endocardite/microbiologia , Histoplasma/isolamento & purificação , Histoplasmose/microbiologia , Artrite Reumatoide/complicações , Endocardite/etiologia , Evolução Fatal , Feminino , França , Histoplasmose/etiologia , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Pessoa de Meia-Idade , Viagem
13.
J Fungi (Basel) ; 8(5)2022 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-35628788

RESUMO

Members of Fusarium solani species complex (FSSC) are cosmopolitan filamentous fungi responsible for invasive fungal infections in immunocompromised patients. Despite the treatment recommendations, many strains show reduced sensitivity to voriconazole. The objective of this work was to investigate the potential relationship between azole susceptibility and mutations in CYP51 protein sequences. Minimal inhibitory concentrations (MICs) for azole antifungals have been determined using the CLSI (Clinical and Laboratory Standards Institute) microdilution method on a panel of clinical and environmental strains. CYP51A, CYP51B and CYP51C genes for each strain have been sequenced using the Sanger method. Amino acid substitutions described in multiple azole-resistant Aspergillus fumigatus (mtrAf) strains have been sought and compared with other Fusarium complexes' strains. Our results show that FSSC exhibit point mutations similar to those described in mtrAf. Protein sequence alignments of CYP51A, CYP51B and CYP51C have highlighted different profiles based on sequence similarity. A link between voriconazole MICs and protein sequences was observed, suggesting that these mutations could be an explanation for the intrinsic azole resistance in the genus Fusarium. Thus, this innovative approach provided clues to understand low azole susceptibility in FSSC and may contribute to improving the treatment of FSSC infection.

14.
Microorganisms ; 10(11)2022 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-36422340

RESUMO

Fusarium is a phytopathogenic fungus involved in human pathology and is present in space stations. It is essential to understand the effects of microgravity on the physiology of this fungus to determine the potential risks to the health of crew members and to propose the necessary countermeasures. This study aimed to determine changes in the physiological parameters of the Fusarium solani species complex under simulated microgravity generated using a random positioning machine (RPM) and phenotypic approaches. We observed increased growth, spore production, and germination while biofilm production was reduced under RPM exposure. These in vitro data show the importance of further studying this fungus as it has been repeatedly demonstrated that microgravity weakens the immune system of astronauts.

15.
Parasite ; 29: 55, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36426934

RESUMO

Cases of intestinal microsporidiosis infection are underestimated and affect both immunocompromized and immunocompetent patients. Real-time PCR is superseding microscopic examination for its diagnosis in medical analysis laboratories. However, few manufacturers include microsporidia in their PCR panel for the diagnosis of infectious gastroenteritis. Here, we evaluated the performances of the real-time PCR assays microsporidia generic and microsporidia typing (Bio-Evolution, France) on the Rotor-Gene Q real-time PCR cycler (Qiagen, France). We included 45 negative and 44 positive stool samples for Enterocytozoon bieneusi (n = 34, with various genotypes), Encephalitozoon intestinalis (n = 4), Encephalitozoon hellem (n = 4), and Encephalitozoon cuniculi (n = 2). We also studied a four-year survey of an inter-laboratory quality control program including 9 centers that used this commercial assay. Sensitivity and specificity of the microsporidia generic assay were 86.4% and 93.3%, respectively. Encephalitozoon hellem and Encephalitozoon cuniculi were detected by the microsporidia generic PCR assay but not by the microsporidia typing PCR assay. These results were consistent with the results of the inter-laboratory quality control program. In conclusion, Bio-Evolution Real-time PCR assays are useful tools for intestinal microsporidiosis, but negative results for microsporidia typing assays require supplementary analyses to confirm E. hellem or E. cuniculi infections.


Title: Évaluation des tests de PCR en temps réel Bio-Evolution Microsporidia generic et typing pour le diagnostic de la microsporidiose intestinale. Abstract: Les microsporidioses intestinales sont des infections sous-estimées affectant à la fois les patients immunodéprimés et immunocompétents. Le diagnostic microscopique en laboratoire médical est aujourd'hui supplanté par la PCR en temps réel. Cependant, peu de fabricants incluent les microsporidies dans leurs panels PCR pour le diagnostic des gastro-entérites infectieuses. Ici, nous avons évalué les performances des tests PCR en temps réel microsporidia generic et microsporidia typing (Bio-Evolution, France) sur le thermocycleur PCR en temps réel Rotor-Gene Q (Qiagen, France). Nous avons inclus 45 échantillons de selles négatifs et 44 échantillons positifs pour Enterocytozoon bieneusi (n = 34, avec divers génotypes), Encephalitozoon intestinalis (n = 4), Encephalitozoon hellem (n = 4) et Encephalitozoon cuniculi (n = 2). Nous avons également analysé les résultats sur 4 ans d'un programme de contrôle qualité inter-laboratoires dont 9 centres ont utilisé ces kits commerciaux. La sensibilité et la spécificité du kit microsporidia generic étaient respectivement de 86,4 % et 93,3 %. Encephalitozoon hellem et E. cuniculi ont été détectés par le kit microsporidia generic mais pas par le kit microsporidia typing. Ces résultats étaient cohérents avec ceux du programme de contrôle de qualité inter-laboratoires. En conclusion, les tests de PCR en temps réel Bio-Evolution sont des outils intéressants pour la microsporidiose intestinale, mais un résultat négatif pour le test de typage microsporidia nécessite une analyse supplémentaire pour confirmer les infections à E. hellem ou E. cuniculi.


Assuntos
Enterocytozoon , Microsporídios , Microsporidiose , Humanos , Microsporídios/genética , Reação em Cadeia da Polimerase em Tempo Real , Microsporidiose/diagnóstico , Enterocytozoon/genética
16.
J Clin Microbiol ; 49(4): 1681-3, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21270214
17.
Med Mycol ; 49(8): 864-71, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21612563

RESUMO

Cryptococcosis is a common opportunistic systemic mycosis caused by members of the encapsulated yeast genus Cryptococcus. The aetiological agents of the disease are classified into two species, i.e., Cryptococcus neoformans (serotypes A, D, and AD) affecting mainly immunocompromised patients and Cryptococcus gattii (serotypes B and C) usually found in immunocompetent individuals. Limited data exist on Cryptococcus infections in French Guiana, the department with the highest HIV incidence in the French territories. A retrospective study between January 1998 and December 2008 was performed on all patients with cryptococcosis, admitted to hospitals in French Guiana. Epidemiological data, clinical forms and diagnosis methods were studied. Of the 43 patients with cryptococcosis, 29 (67.4%) had HIV infections. Among the HIV-negative patients, two (4.7%) presented identified risk factors for cryptococcosis. This study has shown a high frequency of patients with HTLV-1 positive serology (12.1%). C. neoformans var. grubii was recovered with a frequency of 77.3% and was mainly isolated from patients with AIDS (13/17), whereas C. gattii (22.7%) was strictly isolated from HIV-negative patients with no apparent risk factors. Despite a socio-economic environment closer to western countries, the overall epidemiology of cryptococcosis in French Guiana is more similar to that found in South America, particularly with reference to the serotypes of the causative yeasts. Indeed, French Guiana presents an especially high proportion of cases caused by C. gattii, which may explain the significant incidence of this disease, particularly in HIV-negative and immunocompetent patients.


Assuntos
Criptococose/epidemiologia , Cryptococcus gattii/isolamento & purificação , Cryptococcus neoformans/isolamento & purificação , Soropositividade para HIV/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Fungos/sangue , Antígenos de Fungos/líquido cefalorraquidiano , Criança , Pré-Escolar , Criptococose/diagnóstico , Criptococose/microbiologia , Cryptococcus gattii/classificação , Cryptococcus gattii/imunologia , Cryptococcus neoformans/classificação , Cryptococcus neoformans/imunologia , Demografia , Feminino , Guiana Francesa/epidemiologia , Soronegatividade para HIV , Humanos , Hospedeiro Imunocomprometido , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sorotipagem , Adulto Jovem
18.
J Glob Antimicrob Resist ; 25: 171-180, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33798742

RESUMO

OBJECTIVES: Today, the increase of invasive fungal infections and the emergence of resistant strains are observed in medical practice. New antifungals are expected, and the plant world offers a panel of potentially active molecules. CIN-102 is a mixture of seven different compounds of plant origin developed from the formulation of cinnamon essential oil. METHODS: The in vitro activity of CIN-102 was characterised against Aspergillus spp., Fusarium spp. and Scedosporium spp. by studying the minimum inhibitory concentration (MIC), inoculum effect, germination inhibition, fungal growth, post-antifungal effect (PAFE) and synergy. RESULTS: MICs determined for the three genera followed a unimodal distribution and their mean values ranged from 62-250 µg/mL. CIN-102 demonstrated an inoculum effect similar to voriconazole and amphotericin B, 100% inhibition of spore germination and a PAFE. CONCLUSION: CIN-102 has significant activity against filamentous fungi involved in human pathologies and should be further explored as a potential new treatment. Other studies regarding its mechanisms of action as well as animal investigations are awaited.


Assuntos
Antifúngicos , Fungos , Anfotericina B , Antifúngicos/farmacologia , Benzoatos , Cinamatos , Combinação de Medicamentos , Humanos , Terpenos
19.
J Med Microbiol ; 70(9)2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34491156

RESUMO

Introduction. The increase of invasive fungal infections (IFIs) and associated treatment failure in populations at risk is driving us to look for new treatments.Hypothesis. The CIN-102 compound, derived from cinnamon essential oil, could be a new antifungal class with an activity, in particular, on strains resistant to current antifungals but also on biofilms, a factor of virulence and resistance of fungi.Aim. The aim of this study is to show the activity of CIN-102 on various strains resistant to current antifungals, on the biofilm and to determine the possibility of resistance induced with this compound.Methodology. We studied the MIC of CIN-102 and of current antifungals (voriconazole and amphotericin B) using CLSI techniques against eight different strains of three genera of filamentous fungi involved in IFIs and having resistance phenotypes to current antifungals. We also determined their effects on biofilm formation, and the induced resistance by voriconazole (VRC) and CIN-102.Results. MIC values determined for CIN-102 were between 62.5 and 250 µg ml-1. We demonstrated the antifungal effect of CIN-102 on biofilm, and more particularly on its formation, with 100 % inhibition achieved for most of the strains. CIN-102 at a sub-inhibitory concentration in the medium did not induce resistance in our strains, even after 30 generations.Conclusions. In this study we show that CIN-102 is effective against resistant filamentous fungi and against biofilm formation. In addition, our strains did not acquire a resistance phenotype against CIN-102 over time, unlike with VRC. CIN-102 is therefore an interesting candidate for the treatment of IFIs, including in cases of therapeutic failure linked to resistance, although further studies on its efficacy, safety and mechanism of action are needed.


Assuntos
Antifúngicos/farmacologia , Benzoatos/farmacologia , Biofilmes/efeitos dos fármacos , Cinamatos/farmacologia , Fungos/efeitos dos fármacos , Micoses , Terpenos/farmacologia , Anfotericina B/farmacologia , Combinação de Medicamentos , Humanos , Testes de Sensibilidade Microbiana , Micoses/tratamento farmacológico , Micoses/microbiologia , Voriconazol/farmacologia
20.
J Infect Public Health ; 13(8): 1089-1093, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32580917

RESUMO

BACKGROUND: Fusarium is an environmental mold that causes deep or superficial mycosis in immunocompromised or immunocompetent patients respectively. METHODS: This epidemiological study evaluated the frequency of Fusarium infections in our university hospital center in France over a decade from 2007 to 2016 and its representativeness in the main clinical infections. RESULTS: A total of 715 Fusarium sp. were isolated from various sampling sites. Fusarium was detected in 0.47% of blood cultures, 31.1% of ophthalmic samples, and 8.48% of nail samples. The frequency of Fusarium infections was stable over this decade. CONCLUSIONS: The main Fusarium species complexes recorded in this study were Fusarium oxysporum species complex and Fusarium solani species complex, indicating the importance of Fusarium as a fungal agent that should be considered in clinical practice. A focus on invasive fusarioses shows that they all occur in hematology patients.


Assuntos
Fusariose , Fusarium , Antifúngicos/uso terapêutico , França/epidemiologia , Fusariose/tratamento farmacológico , Fusariose/epidemiologia , Fusariose/microbiologia , Fusariose/prevenção & controle , Humanos , Prevalência , Fatores de Risco
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