Host-driven subspeciation in the hedgehog fungus, Trichophyton erinacei, an emerging cause of human dermatophytosis.

Trichophyton erinacei is a main cause of dermatophytosis in hedgehogs and is increasingly reported from human infections worldwide. This pathogen was originally described in the European hedgehog (Erinaceus europaeus) but is also frequently found in the African four-toed hedgehog (Atelerix albiventris), a popular pet animal worldwide. Little is known about the taxonomy and population genetics of this pathogen despite its increasing importance in clinical practice. Notably, whether there are different populations or even cryptic species associated with different hosts or geographic regions is not known. To answer these questions, we collected 161 isolates, performed phylogenetic and population-genetic analyses, determined mating-type, and characterised morphology and physiology. Multigene phylogeny and microsatellite analysis supported T. erinacei as a monophyletic species, in contrast to highly incongruent single-gene phylogenies. Two main subpopulations, one specific mainly to Atelerix and second to Erinaceus hosts, were identified inside T. erinacei, and slight differences in the size of microconidia and antifungal susceptibilities were observed among them. Although the process of speciation into two lineages is ongoing in T. erinacei, there is still gene flow between these populations. Thus, we present T. erinacei as a single species, with notable intraspecies variability in genotype and phenotype. The data from wild hedgehogs indicated that sexual reproduction in T. erinacei and de novo infection of hedgehogs from soil are probably rare events and that clonal horizontal spread strongly dominates. The molecular typing approach used in this study represents a suitable tool for further epidemiological surveillance of this emerging pathogen in both animals and humans. The results of this study also highlighted the need to use a multigene phylogeny ideally in combination with other independent molecular markers to understand the species boundaries of dermatophytes. Citation: Cmoková A, Kolarík M, Guillot J, et al. 2022. Host-driven subspeciation in the hedgehog fungus, Trichophyton erinacei, an emerging cause of human dermatophytosis. Persoonia 48: 203-218. https://doi.org/10.3767/persoonia.2022.48.06.

Preemptive antimycotic treatment in critically ill patients in the Czech Republic.

The incidence of Candida afflictions in critically ill patients is still growing in the Czech Republic. We looked for a method that not only decreases Candida afflictions but also decreases treatment expenses. This method is preemptive therapy. Critically ill patients were determined by a risk score system. This system was based on summarizing all the risk factors in one patient. Patients who reach the risk score were randomized into groups A and B. Patients in group A were administered itraconazole; patients in group B were not administered any antimycotics. Results of the study show that preemptive treatment decreases Candida infection and Candidemia. A decrease of treatment expenses was reached by identifying the specific group of patients at risk using the risk score system and administering antimycotics.

[Preemptive antimycotic therapy in critically ill patients]. / Preemptivní antimykotická terapie kriticky nemocných.

This article presents the results of the first year of the grant study that deal with preemptive treatment of yeast infection in surgical ICU. This research included patients with a large number of risk factors (ten and more). These risk factors indicated in the chart. 147 patients reached a score of ten and more points. This number was divided in two groups. In the first group there were 87 patients who received treatment of itraconazol by prescribed scheme. They were hospitalized in ICU for 11.6 days, on average. The first group did not display any positive hemoculture and also other microbial culture from intravenous cannula. No patients fell from ill candida sepsis. Itraconazol was not administered to the 60 patients, who were hospitalizated 11.8 days, on average. Positive hemoculture or yeast sepsis with connection invasive yeast infection was proven in six cases (10%). No patient died in direct connection with yeast infection in either groups. The presented results show a reduction in the number of developing yeast infections and mainly yeast sepsis in patients undergoing preemptive treatment with itraconazol.

[Occurrence of yeast infections at a surgical intensive care unit]. / Výskyt kvasinkových infekcí na chirurgické JIP.

The authors evaluate the occurrence of candida infections in the surgical intensive care unit (ICU) in a one-year period. From the group of 1798 patients hospitalized in a surgical ICU there are 50 patients (2.8%) with candida colonisation and even 56 patients (3.1%) with candida infection. The authors evaluate risk factors for development of candida infection, its etiologic agents and the most frequent site of infection. In addition to usual treatment the authors suggest pre-emptive therapy in patients with risk factors. In the one-year period, two patients died of multiorgan failure (MOF) in close connection with candida infection (sepsis). The mortality of the group with proved candida infection was 3.57%.

[Yeast infections in patients in a surgical intensive care unit]. / Kvasinkové infekce u pacientu na chirurgické JIP.

The authors evaluate importance of candida infections in a surgical ICU. They present recent survey of aetiology, pathogenesis, diagnostic methods, clinical manifestations and therapy of invasive candida infections. The aim of this article is especially to summarize risk factors of the candida infection development.

[Variation in manifestations of bronchopulmonary aspergillosis]. / Rozmanitost projevu bronchopulmonální aspergilózy.

Five cases of bronchopulmonary aspergillosis are scrutinized which showed no unambiguous account for any of 6 forms of the disease as described previously. Clinical signs, roentgenograms and bronchoscopy findings testified about the interaction between the aspergillus and the host being in accord with either the aspergilloma or chronical necrotizing pulmonary aspergillosis. Authors preclude the invasive symptomatology represents a developmental and likely initial phase in aspergilloma's onset. Apart from the disease progression, markedly extinctive signs of aspergilloma's activity have in contrast been detected after a period of its duration. In this case, the important signs are associated rather with the occurrence of other microorganisms whose participation was proved in 3 from 5 patients. Authors suggest also the immune status of those affected and the process invasiveness should be taken in mind in providing etiotropic treatment with the impact on the spectrum of microorganisms detected.

[Diagnostic bronchoscopy--mycologic and bacteriologic findings]. / Diagnostische Bronchoskopie--Mykologische und bakteriologische Befunde.

The authors studied the findings of mycotic and bacterial agents in the lower air passages of 122 patients with lung disease examined by bronchoscopy. The series represents a current profile of patients investigated at the Department of tuberculosis and respiratory diseases, Pardubice hospital within 17 months of the years 1982-1983. Bronchial swabs were compared with the findings in the swabs of the throat taken immediately before the endoscopic examination. Yeast organisms were isolated from the bronchi of 12 patients, and from the throats of 50 subjects examined. Amongst the agents isolated, Candida albicans showed the highest frequency of occurrence (68.0%). Isolation of Aspergillus fumigatus from the bronchi revealed pulmonary mycetoma in one case. Pathogenic and potentially pathogenic bacterial flora was isolated from the bronchial swabs in 40 subjects examined. A total of 47.5% findings belonged to patients suffering from inflammatory disease of the lower air passages. Isolations of Mycobacterium tuberculosis from the bronchial swabs of three subjects examined, where other cultivation examinations gave negative results, are considered by the authors as a contribution to the differential diagnosis in infiltrative disease of the lung. The value of examination of directed swabs at bronchoscopy by culture, the problems of contamination and the reliability of the results obtained are discussed.