Clinical Distribution and Drug Susceptibility Characterization of Invasive Candida Isolates in a Tertiary Hospital of Xinjiang Province.

Objective: This study aims to investigate the clinical distribution characteristics and drug susceptibility profiles of invasive Candida isolates in a tertiary hospital in Urumqi. Methods: The examination was conducted on samples obtained from patients who were clinically diagnosed with invasive candidiasis in this hospital. A total of 109 strains of Candida strains were identified through the use of internal transcribed spacer (ITS) sequencing and fungal cultivation methods.The clinical distribution of the strains was analyzed. Antifungal drug susceptibility tests were performed using the Sensititre YO10 fungal drug susceptibility plate based on the micro-broth dilution method. Results: Candida albicans had the highest percentage (51.38%) among 109 Candida isolates, followed by C. glabrata (18.35%) and C. tropicalis (15.60%). The isolates were predominantly found in the respiratory department (41.28%), intensive care unit (ICU) (31.19%), and infection department (9.17%).The results of drug susceptibility tests indicated that amphotericin B, 5-fluorocytosine, and echinocandins exhibited good in vitro antifungal activity, with a susceptibility rate of over 96%. However, the azoles demonstrated low antifungal activity, especially posaconazole and voriconazole, which had high resistance rates of 64.71% for C. tropicalis and 70% for C. glabrata, respectively. Conclusion: In our hospital, Candida albicans was identified as the primary causal agent of invasive candidiasis. In terms of in vitro antifungal activity, echinocandins, amphotericin B, and 5-fluorocytosine demonstrated efficacy against invasive Candida infections. However, it was important to note that C. glabrata and C. tropicalis exhibited low susceptibility to azoles.

Retrospective Analysis of Tinea Capitis in Xinjiang, China.

Tinea capitis is a cutaneous infection of dermatophytes and predominant in children. It is one of common infectious diseases of children in Xinjiang, particularly in the southern Xinjiang. The aim of this study is to analyze the clinical and mycological characteristics of patients with tinea capitis in Xinjiang China. Medical records from 2010 to 2021, Mycology Laboratory Department of Dermatology in the First Affiliated Hospital of Xinjiang Medical University, retrospectively investigated the clinical and mycological characteristics of 198 patients with tinea capitis. Hairs have been obtained for fungal examination, and analysis with 20% KOH and Fungus Fluorescence Staining Solution has been conducted. Identification of fungi was using of morphological and molecular biological methods. Among total number of 198 patients, 189 (96%) were children with tinea capitis, of which 119 (63%) were male and 70 (37%) were female; 9 (4%) were adult patients with tinea capitis, of which 7 were female and 2 were male. Preschool children between the ages of 3 and 5 years had the highest distribution (54%), followed by those between the ages of 6 and 12 years (33%), the ages under 2 years (11%) and the ages of 13-15 years (2%) respectively. Among all patients, 135 (68.18%) were Uygur, 53 (26.77%) were Han, 5 (2.53%) were Kazak, 3 (1.52%) were Hui, 1 (0.5%) was Mongolian and nationality information of 1 patient (0.5%) is unknown. The indentification results of the isolates showed that 195 (98%) patients had single-species infections and 3 (2%) patients had double mixed infections. Among single-species infection patients, Microsporum canis (n = 82, 42.05%), Microsporum ferrugineum (n = 56, 28.72%) and Trichophyton mentagrophytes (n = 22, 11.28%) were the most prevalent species. Other dermatophytes included Trichophyton tonsurans (n = 12, 6.15%), Trichophyton violaceum (n = 10, 5.13%), Trichophyton schoenleinii (n = 9, 4.62%) and Trichophyton verrucosum (n = 4, 2.05%). Among 3 cases of mixed infections, 1 was M. canis + T. tonsurans (n = 1), and the other 2 were M.canis + T.mentagrophytes (n = 2). In conclusion, the majority of tinea capitis patients in Xinjiang, China are Uygur male children aged 3-5 years. M. canis was the most prevalent species causing tinea capitis in Xinjiang. These results provide useful information for the treatment and prevention of tinea capitis.

Characterisation of a clinical isolated Aspergillus lentulus strain using a Galleria mellonella infection model.

BACKGROUND: In recent years, the number of invasive aspergillus infection cases caused by Aspergillus lentulus (A. lentulus) has gradually increased and this fungus is usually difficult to distinguish from Aspergillus fumigatus in morphology. All of these presents a great challenge to the treatment of invasive fungal infections caused by A. lentulus. The present study aims to discuss the antifungal resistance, virulence and inflammatory factors' changes after the infection of larvae of A. lentulus separated from patients with chronic obstructive pulmonary disease (COPD) to reflect the host immune response. METHODS: A. lentulus isolated from COPD patients was identified by morphology and molecular biology, and its drug sensitivity was determined in vitro. Then the virulence factors and inflammatory response related factors of A. lentulus were determined by the model of A. lentulus infecting larvae. These were divided into three groups: A. lentulus standard strain, A. lentulus strain isolated from patients; PBS control. The infection model was formed by injecting the suspension of A. lentulus at a concentration of 1×106 CFU into larvae, in order to determine the (1,3)-ß-D-glucan and galactomannan levels, and determine the caspase-1 and TNF-α concentration in Galleria mellonella larvae by RT-PCR. RESULTS: The results revealed that A. lentulus had good sensitivity to itraconazole, voriconazole and micafungin, while (1,3)-ß-D-glucan was negative in the two groups. The level of galactomannan in the two groups was higher than that in the control group, and the difference was statistically significant (P<0.05). However, there was no statistical difference between the standard strain group and patient strain group (P>0.05). After the infection of larvae, caspase-1 and TNF-α in the Galleria mellonella larvae increased in the two groups, and these elevated levels were statistically significant in both groups (P<0.05). However, there was no significant difference between the two groups (P>0.05). CONCLUSIONS: There is no significant difference in virulence factor and host inflammatory response between A. lentulus isolated from COPD patients and standard strains. Galactomannan has more advantages in the early detection of A. lentulus invasive infection. Furthermore, the caspase-1-mediated inflammasome pathway may be involved in the host immune response to A. lentulus.

Molecular Identification and In Vitro Antifungal Susceptibility of Aspergillus Isolates Recovered from Otomycosis Patients in Western China.

Aspergillus species are the most common causative agents involved in otomycosis. In this study, 45 Aspergillus isolates were obtained from patients with otomycosis in western China during 2013-2016. The aim of this study is to identify the Aspergillus isolates to the species level by using ß-tubulin gene sequencing and to evaluate their in vitro susceptibility to nine antifungal drugs: amphotericin B, itraconazole, voriconazole, posaconazole, ravuconazole, isavuconazole, caspofungin, micafungin and anidulafungin according to CLSI M38-A2. Our results indicate that A. tubingensis (18/45) is the predominant Aspergillus species causing ear infections in western China, which is three times more than its sibling species A. niger (6/45) and A. welwitschiae (2/45). Other detected species were A. fumigatus (n = 8), A. terreus (n = 7) and A. flavus (n = 4). Antifungal susceptibility data indicate that triazoles and echinocandins are active against the most Aspergillus isolates. There are no significant differences in the susceptibility among A. niger, A. tubingensis and A. welwitschiae to each of the antifungals tested. One azole-resistant A. fumigatus isolate with a TR34/L98H mutation in the CYP51A gene and one posaconazole-resistant A. terreus isolate presented among the studied isolates. In conclusion, A. tubingensis is the most prevalent Aspergillus species causing otomycosis in western China. Posaconazole and echinocandins are potential drugs for treatment of otomycosis due to Aspergillus; however, in vivo efficacy remains to be determined.

Retrospective analysis of 122 patients with tinea capitis in a third-grade class-A hospital in Xinjiang from 2010 to 2018 / 中华皮肤科杂志

Objective:To analyze characteristics of and distribution of pathogenic fungi in patients with tinea capitis in the First Affiliated Hospital of Xinjiang Medical University from 2010 to 2018.Methods:Clinical data were collected from 122 tinea capitis patients with positive fungal culture results in Department of Dermatology, First Affiliated Hospital of Xinjiang Medical University from 2010 to 2018, and retrospectively analyzed. Fungal culture was carried out, and lactophenol cotton blue staining was performed for morphological identification of the fungal isolates.Results:Of the 122 patients with tinea capitis, 112 (91.8%) were children, including 70 (62.5%) males and 42 (37.5%) females, and there were 58 (51.79%) preschool children and 37 (33.04%) school-age children; 9 (7.38%) were adults, including 7 females and 2 males; 66 (54.1%) were of Uygur nationality, 46 (37.7%) of Han nationality, 5 (4.1%) of Kazakh nationality, 3 (2.46%) of Hui nationality, 1 (0.82%) of Mongolian nationality, and 1 of unknown nationality. The annual number of cases of tinea capitis was more than 20 from 2011 to 2013, and gradually decreased year by year from 2014 (≤ 13 cases/year) . All the patients were infected with a single fungal strain, and a total of 122 strains were identified, including 46 (37.7%) strains of Microsporum ferrugineum, 44 (36.07%) strains of Microsporum canis, 10 (8.2%) strains of Trichophyton violaceum, 9 (7.38%) strains of Trichophyton schoenleini, 6 (4.91%) strains of Trichophyton tonsurans, 4 (3.28%) strains of Trichophyton mentagrophytes, 3 (2.46%) strains of Trichophyton verrucosum. Microsporum ferrugineum (anthropophilic species) mostly affected patients of Uygur nationality (34 cases, 73.91%) , and Microsporum canis (zoophilic species) mostly affected patients of Han nationality (26 cases, 59.09%) . Conclusion:In the Department of Dermatology, First Affiliated Hospital of Xinjiang Medical University from 2010 to 2018, tinea capitis commonly affected male children of Uygur nationality, and Microsporum ferrugineum and Microsporum canis were the dominant pathogenic species.