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1.
Dis Aquat Organ ; 159: 15-27, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39087616

ABSTRACT

The chytrid Batrachochytrium dendrobatidis (Bd) is a widespread fungus causing amphibian declines across the globe. Although data on Bd occurrence in Eastern Europe are scarce, a recent species distribution model (SDM) for Bd reported that western and north-western parts of Ukraine are highly suitable to the pathogen. We verified the SDM-predicted range of Bd in Ukraine by sampling amphibians across the country and screening for Bd using qPCR. A total of 446 amphibian samples (tissue and skin swabs) from 11 species were collected from 36 localities. We obtained qPCR-positive results for 33 samples including waterfrogs (Pelophylax esculentus complex) and fire- and yellow-bellied toads (Bombina spp.) from 8 localities. We found that Bd-positive localities had significantly higher predicted Bd habitat suitability than sites that were pathogen-free. Amplification and sequencing of the internal transcribed spacer (ITS) region of samples with the highest Bd load revealed matches with ITS haplotypes of the globally distributed BdGPL strain, and a single case of the BdASIA-2/BdBRAZIL haplotype. We found that Bd was non-randomly distributed across Ukraine, with infections present in the western and north-central forested peripheries of the country with a relatively cool, moist climate. On the other hand, our results suggest that Bd is absent or present in low abundance in the more continental central, southern and eastern regions of Ukraine, corroborating the model-predicted distribution of chytrid fungus. These areas could potentially serve as climatic refugia for Bd-susceptible amphibian hosts.


Subject(s)
Batrachochytrium , Mycoses , Ukraine/epidemiology , Animals , Mycoses/veterinary , Mycoses/epidemiology , Mycoses/microbiology , Batrachochytrium/genetics , Batrachochytrium/isolation & purification , Amphibians/microbiology , Models, Biological , Chytridiomycota/isolation & purification , Chytridiomycota/genetics
2.
Clin Exp Med ; 24(1): 144, 2024 Jul 03.
Article in English | MEDLINE | ID: mdl-38960977

ABSTRACT

The primary objective of this study was to assess the incidence, timing, risk factors of fungal infections (FIs) within 3 months after liver transplantation (LT). The secondary objective was to evaluate the impact of FIs on outcomes. Four hundred and ten patients undergoing LT from January 2015 until January 2023 in a tertiary university hospital were included in the present retrospective cohort study to investigate the risk factors of FIs and to assess the impacts of FIs on the prognosis of LT recipients using logistic regression. The incidence of FIs was 12.4% (51/410), and median time from LT to the onset of FIs was 3 days. By univariate analysis, advanced recipient age, prolonged hospital stay prior to LT, high Model for End Stage Liver Disease (MELD) score, use of broad-spectrum antibiotics, and elevated white blood cell (WBC) count, increased operating time, massive blood loss and red blood cell transfusion, elevated alanine aminotransferase on day 1 and creatinine on day 3 after LT, prolonged duration of urethral catheter, prophylactic antifungal therapy, the need for mechanical ventilation and renal replacement therapy were identified as factors of increased post-LT FIs risk. Multivariate logistic regression analysis identified that recipient age ≥ 55 years[OR = 2.669, 95%CI: 1.292-5.513, P = 0.008], MELD score at LT ≥ 22[OR = 2.747, 95%CI: 1.274-5.922, P = 0.010], pre-LT WBC count ≥ 10 × 109/L[OR = 2.522, 95%CI: 1.117-5.692, P = 0.026], intraoperative blood loss ≥ 3000 ml [OR = 2.691, 95%CI: 1.262-5.738, P = 0.010], post-LT duration of urethral catheter > 4 d [OR = 3.202, 95%CI: 1.553-6.602, P = 0.002], and post-LT renal replacement therapy [OR = 5.768, 95%CI: 1.822-18.263, P = 0.003] were independently associated with the development of post-LT FIs. Post-LT prophylactic antifungal therapy ≥ 3 days was associated with a lower risk of the development of FIs [OR = 0.157, 95%CI: 0.073-0.340, P < 0.001]. As for clinical outcomes, FIs had a negative impact on intensive care unit (ICU) length of stay ≥ 7 days than those without FIs [OR = 3.027, 95% CI: 1.558-5.878, P = 0.001] but had no impact on hospital length of stay and 1-month all-cause mortality after LT. FIs are frequent complications after LT and the interval between the onset of FIs and LT was short. Risk factors for post-LT FIs included high MELD score at LT, advanced recipient age, pre-LT WBC count, massive intraoperative blood loss, prolonged post-LT duration of urethral catheter, and the need for post-LT renal replacement therapy. However, post-LT prophylactic antifungal therapy was independently associated with the reduction in the risk of FIs. FIs had a significant negative impact on ICU length of stay.


Subject(s)
Liver Transplantation , Mycoses , Humans , Liver Transplantation/adverse effects , Middle Aged , Male , Female , Retrospective Studies , Risk Factors , Mycoses/epidemiology , Mycoses/prevention & control , Mycoses/etiology , Adult , Incidence , Aged , Postoperative Complications , Prognosis , Tertiary Care Centers , Treatment Outcome , Length of Stay
3.
Proc Biol Sci ; 291(2027): 20241157, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39081176

ABSTRACT

Outbreaks of emerging infectious diseases are influenced by local biotic and abiotic factors, with host declines occurring when conditions favour the pathogen. Deterioration in the population of the micro-endemic Tanzanian Kihansi spray toad (Nectophrynoides asperginis) occurred after the construction of a hydropower dam, implicating habitat modification in this species decline. Population recovery followed habitat augmentation; however, a subsequent outbreak of chytridiomycosis caused by Batrachochytrium dendrobatidis (Bd) led to the spray toad's extinction in the wild. We show using spatiotemporal surveillance and mitogenome assembly of Bd from archived toad mortalities that the outbreak was caused by invasion of the BdCAPE lineage and not the panzootic lineage BdGPL. Molecular dating reveals an emergence of BdCAPE across southern Africa overlapping with the timing of the spray toad's extinction. That our post-outbreak surveillance of co-occurring amphibian species in the Udzungwa Mountains shows widespread infection by BdCAPE yet no signs of ill-health or decline suggests these other species can tolerate Bd when environments are stable. We conclude that, despite transient success in mitigating the impact caused by dams' construction, invasion by BdCAPE caused the ultimate die-off that led to the extinction of the Kihansi spray toad.


Subject(s)
Batrachochytrium , Extinction, Biological , Genome, Mitochondrial , Mycoses , Animals , Mycoses/veterinary , Mycoses/epidemiology , Mycoses/microbiology , Anura/microbiology , Tanzania , Bufonidae/microbiology , Chytridiomycota/physiology
4.
Med Mycol ; 62(6)2024 Jun 27.
Article in English | MEDLINE | ID: mdl-38935909

ABSTRACT

The World Health Organization, in response to the growing burden of fungal disease, established a process to develop a fungal pathogen priority list. This systematic review aimed to evaluate the epidemiology and impact of infections caused by Talaromyces marneffei, Coccidioides species, and Paracoccidioides species. PubMed and Web of Sciences databases were searched to identify studies published between 1 January 2011 and 23 February 2021 reporting on mortality, complications and sequelae, antifungal susceptibility, preventability, annual incidence, and trends. Overall, 25, 17, and 6 articles were included for T. marneffei, Coccidioides spp. and Paracoccidioides spp., respectively. Mortality rates were high in those with invasive talaromycosis and paracoccidioidomycosis (up to 21% and 22.7%, respectively). Hospitalization was frequent in those with coccidioidomycosis (up to 84%), and while the duration was short (mean/median 3-7 days), readmission was common (38%). Reduced susceptibility to fluconazole and echinocandins was observed for T. marneffei and Coccidioides spp., whereas >88% of T. marneffei isolates had minimum inhibitory concentration values ≤0.015 µg/ml for itraconazole, posaconazole, and voriconazole. Risk factors for mortality in those with talaromycosis included low CD4 counts (odds ratio 2.90 when CD4 count <200 cells/µl compared with 24.26 when CD4 count <50 cells/µl). Outbreaks of coccidioidomycosis and paracoccidioidomycosis were associated with construction work (relative risk 4.4-210.6 and 5.7-times increase, respectively). In the United States of America, cases of coccidioidomycosis increased between 2014 and 2017 (from 8232 to 14 364/year). National and global surveillance as well as more detailed studies to better define sequelae, risk factors, outcomes, global distribution, and trends are required.


Subject(s)
Antifungal Agents , Coccidioides , Paracoccidioides , Talaromyces , World Health Organization , Talaromyces/isolation & purification , Talaromyces/classification , Talaromyces/drug effects , Humans , Paracoccidioides/isolation & purification , Paracoccidioides/drug effects , Paracoccidioides/classification , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Coccidioides/isolation & purification , Coccidioides/classification , Coccidioides/drug effects , Mycoses/epidemiology , Mycoses/microbiology , Mycoses/mortality , Paracoccidioidomycosis/epidemiology , Paracoccidioidomycosis/microbiology , Paracoccidioidomycosis/drug therapy , Coccidioidomycosis/epidemiology , Coccidioidomycosis/microbiology , Microbial Sensitivity Tests
5.
Med Mycol ; 62(6)2024 Jun 27.
Article in English | MEDLINE | ID: mdl-38935914

ABSTRACT

Recognizing the growing global burden of fungal infections, the World Health Organization established a process to develop a priority list of fungal pathogens (FPPL). In this systematic review, we aimed to evaluate the epidemiology and impact of infections caused by Fusarium spp., Scedosporium spp., and Lomentospora prolificans to inform the first FPPL. PubMed and Web of Sciences databases were searched to identify studies published between January 1, 2011 and February 23, 2021, reporting on mortality, complications and sequelae, antifungal susceptibility, preventability, annual incidence, and trends. Overall, 20, 11, and 9 articles were included for Fusarium spp., Scedosporium spp., and L. prolificans, respectively. Mortality rates were high in those with invasive fusariosis, scedosporiosis, and lomentosporiosis (42.9%-66.7%, 42.4%-46.9%, and 50.0%-71.4%, respectively). Antifungal susceptibility data, based on small isolate numbers, showed high minimum inhibitory concentrations (MIC)/minimum effective concentrations for most currently available antifungal agents. The median/mode MIC for itraconazole and isavuconazole were ≥16 mg/l for all three pathogens. Based on limited data, these fungi are emerging. Invasive fusariosis increased from 0.08 cases/100 000 admissions to 0.22 cases/100 000 admissions over the time periods of 2000-2009 and 2010-2015, respectively, and in lung transplant recipients, Scedosporium spp. and L. prolificans were only detected from 2014 onwards. Global surveillance to better delineate antifungal susceptibility, risk factors, sequelae, and outcomes is required.


Subject(s)
Antifungal Agents , Fusarium , Microbial Sensitivity Tests , Scedosporium , Humans , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Fusarium/drug effects , Fusarium/isolation & purification , Scedosporium/drug effects , Scedosporium/isolation & purification , Scedosporium/classification , World Health Organization , Mycoses/epidemiology , Mycoses/microbiology , Fusariosis/microbiology , Fusariosis/epidemiology , Ascomycota/drug effects , Invasive Fungal Infections
6.
PLoS One ; 19(6): e0305228, 2024.
Article in English | MEDLINE | ID: mdl-38870137

ABSTRACT

The chytrid fungus Batrachochytrium salamandrivorans [Bsal] is causing declines in the amphibian populations. After a decade of mapping the pathogen in Europe, where it is causing dramatic outbreaks, and North America, where its arrival would affect to the salamander's biodiversity hotspot, little is known about its current status in Asia, from presumably is native. Japan has several species considered as potential carriers, but no regulation is implemented against Bsal spreading. Previous Bsal known presence detected various cases on the Okinawa Island, southwestern Japan. Previous studies on its sister species, B. dendrobatidis presented a high genomic variation in this area and particularly on Cynops ensicauda. Here, we have done the largest monitoring to date in Japan on the Cynops genus, focusing on Okinawa Island and updating its distribution and providing more information to unravel the still unknown origin of Bsal. Interestingly, we have provided revealing facts about different detectability depending on the used molecular techniques and changes in its Japanese distribution. All in all, the Bsal presence in Japan, together with its low variability in the sequenced amplicons, and the lack of apparent mortalities, may indicate that this part of Asia has a high diversity of chytrids.


Subject(s)
Batrachochytrium , Urodela , Animals , Japan , Urodela/microbiology , Batrachochytrium/genetics , Phylogeny , Genetic Variation , Biodiversity , Chytridiomycota/genetics , Mycoses/microbiology , Mycoses/veterinary , Mycoses/epidemiology , East Asian People
7.
Future Microbiol ; 19(11): 1027-1040, 2024.
Article in English | MEDLINE | ID: mdl-38904325

ABSTRACT

The emergence of fungal pathogens and changes in the epidemiological landscape are prevalent issues in clinical mycology. Reports of resistance to antifungals have been reported. This review aims to evaluate molecular and nonmolecular mechanisms related to antifungal resistance. Mutations in the ERG genes and overexpression of the efflux pump (MDR1, CDR1 and CDR2 genes) were the most reported molecular mechanisms of resistance in clinical isolates, mainly related to Azoles. For echinocandins, a molecular mechanism described was mutation in the FSK genes. Furthermore, nonmolecular virulence factors contributed to therapeutic failure, such as biofilm formation and selective pressure due to previous exposure to antifungals. Thus, there are many public health challenges in treating fungal infections.


[Box: see text].


Subject(s)
Antifungal Agents , Drug Resistance, Fungal , Fungi , Mycoses , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Drug Resistance, Fungal/genetics , Humans , Mycoses/microbiology , Mycoses/drug therapy , Mycoses/epidemiology , Fungi/drug effects , Fungi/genetics , Fungi/pathogenicity , Biofilms/drug effects , Biofilms/growth & development , Mutation , Fungal Proteins/genetics , Fungal Proteins/metabolism , Azoles/pharmacology , Azoles/therapeutic use , Microbial Sensitivity Tests , Virulence Factors/genetics , Echinocandins/pharmacology , Echinocandins/therapeutic use
8.
J Infect Public Health ; 17(7): 102453, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38820897

ABSTRACT

BACKGROUND: The presence of bacterial and fungal coinfections plays an important role in the mortality of patients with coronavirus 2019 (COVID-19). We compared data from the 3 years before and 3 years after the COVID-19 pandemic outbreak to evaluate its effect on the traits of bacterial and fungal diseases. METHODS: We retrospectively collected and analyzed data on positive respiratory tract samples (n = 13,133 samples from 7717 patients) and blood cultures (n = 23,652 from 9653 patients) between 2017 and 2022 from the Clinical Center of the University of Szeged, Hungary. We also evaluated antimicrobial susceptibility test results derived from 169,020 respiratory samples and 549,729 blood cultures to gain insight into changes in antimicrobial resistance. RESULTS: The most common respiratory pathogen in the pre-COVID era was Pseudomonas aeruginosa, whereas Candida albicans was the most frequent during the pandemic. The number of respiratory isolates of Acinetobacter baumannii was also markedly increased. In blood cultures, Staphylococcus epidermidis, Escherichia coli, and S. aureus were dominant during the study period, and A. baumannii was widespread in blood cultures during the pandemic years. Resistance to ofloxacin, penicillin, piperacillin-tazobactam, ceftazidime, cefepime, imipenem, ceftolozane-tazobactam, and itraconazole increased significantly in the COVID era. CONCLUSIONS: During the COVID-19 pandemic, there were changes in the prevalence of respiratory and blood culture pathogens at the Clinical Center of the University of Szeged. C. albicans became the predominant respiratory pathogen, and the number of A. baumannii isolates increased dramatically. Additionally, antimicrobial resistance notably increased during this period.


Subject(s)
COVID-19 , Tertiary Care Centers , Humans , COVID-19/epidemiology , Hungary/epidemiology , Retrospective Studies , SARS-CoV-2 , Coinfection/microbiology , Coinfection/epidemiology , Microbial Sensitivity Tests , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Mycoses/epidemiology , Mycoses/microbiology , Mycoses/drug therapy , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , Bacteria/drug effects , Bacteria/isolation & purification , Bacteria/classification , Respiratory Tract Infections/microbiology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/virology , Respiratory Tract Infections/drug therapy , Drug Resistance, Bacterial
9.
Int J Infect Dis ; 145: 107078, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38697606

ABSTRACT

OBJECTIVES: Estimates of secondary infections are variedly reported, with few studies done in Australia. We investigated the occurrence and impact of secondary infections complicating COVID-19 and post-COVID-19 admissions in Victoria, Australia, 2020-2023. METHODS: We used linked population-wide data sets and specific International Classification of Disease, 10th Revision codes to identify and estimate the occurrence of secondary infections. Using hospital/intensive care unit length of stay in negative binomial regression and mortality, we examined the impact of secondary infections. RESULTS: Secondary infections were identified in 6.9% (13,467 of 194,660) of COVID-19 and post-COVID-19 admissions: 6.0% (11,651 of 194,660) bacterial, 0.9% (1691 of 194,660) viral, and 0.2% (385 of 194,660) fungal. Prevalence was highest during the pre-Delta (10.4%) and Omicron-BA2 (8.1%) periods. Sepsis and pneumonia were the most reported syndromes; the occurrence of sepsis declined gradually over time. The odds of secondary infections were higher among the ≥70-year-olds (adjusted odds ratio (aOR) 3.76, 95% confidence interval [CI] 3.43-4.14, vs 20-29-year-olds), individuals with chronic conditions (aOR 3.15, 95% CI 2.88-3.45, vs those without), the unvaccinated (aOR 1.59, 95% CI 1.45-1.75), and the lowest socioeconomic group (aOR 1.12, 95% CI 1.05-1.19). Patients with secondary infections had 2.43 times longer hospital length of stay and 9.60 times longer intensive care unit length of stay than those without secondary infections. The mortality risk was 2.17 times higher in those with secondary infections. CONCLUSIONS: Secondary infections occurred in 69 per 1000 COVID-19-associated hospital admissions in Victoria, mostly in high-risk groups, and were associated with severe outcomes.


Subject(s)
COVID-19 , Hospitalization , SARS-CoV-2 , Humans , COVID-19/epidemiology , COVID-19/mortality , Victoria/epidemiology , Female , Male , Risk Factors , Aged , Middle Aged , Prevalence , Adult , Hospitalization/statistics & numerical data , Young Adult , Adolescent , Length of Stay/statistics & numerical data , Aged, 80 and over , Coinfection/epidemiology , Child, Preschool , Infant , Child , Intensive Care Units/statistics & numerical data , Sepsis/epidemiology , Sepsis/mortality , Bacterial Infections/epidemiology , Bacterial Infections/mortality , Mycoses/epidemiology , Infant, Newborn
10.
Medicine (Baltimore) ; 103(19): e38084, 2024 May 10.
Article in English | MEDLINE | ID: mdl-38728514

ABSTRACT

Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis, characterized by excessive immune responses to environmental molds or fungi. The diagnosis and classification of AFRS into systemic and local types remain clinically challenging due to overlapping characteristics. This study investigated the prevalence of AFRS, its manifestation and associated factors in systemic and local AFRS. A total of 200 patients diagnosed with fungal rhinosinusitis underwent both skin provocation tests (SPT) and nasal provocation tests (NPT) to confirm AFRS and classify systemic and local types. Patients were considered to have AFRS if either the SPT or NPT was positive. Among these, patients with systemic AFRS were those who had a SPT positive. Local AFRS was when patients had a negative SPT and a positive NPT. Medical history, serum total IgE level, nasal endoscopy examinations, and CT scans were also recorded. Most patients were female (65.8%), with a mean age of 55.6 years (SD = 14.4). Based on the SPT and NPT results, 31% of patients (n = 62) were diagnosed with AFRS. Among these, 54.8% (n = 34) had systemic AFRS, while 45.2% (n = 28) had local AFRS. Patients with AFRS exhibited significantly higher levels of total IgE, eosinophils, and more pronounced signs and symptoms compared to those without AFRS. However, no statistically significant differences were observed between patients with systemic AFRS and those with local AFRS. AFRS was prevalent in our study. Among patients with AFRS, both systemic AFRS and local AFRS were also prevalent. While allergic indicators and clinical presentations can aid in AFRS diagnosis, minimal distinctions were observed between systemic and local AFRS. A comprehensive assessment incorporating both local and systemic allergic responses through provocation tests, such as a combination of skin and nasal tests, is imperative for optimizing AFRS diagnosis and management.


Subject(s)
Rhinitis, Allergic , Sinusitis , Skin Tests , Humans , Female , Male , Sinusitis/immunology , Sinusitis/microbiology , Sinusitis/complications , Sinusitis/epidemiology , Sinusitis/diagnosis , Middle Aged , Rhinitis, Allergic/immunology , Rhinitis, Allergic/epidemiology , Rhinitis, Allergic/complications , Rhinitis, Allergic/diagnosis , Adult , Aged , Nasal Provocation Tests , Immunoglobulin E/blood , Prevalence , Mycoses/immunology , Mycoses/epidemiology , Mycoses/diagnosis , Mycoses/complications , Allergic Fungal Sinusitis
11.
Emerg Infect Dis ; 30(6): 1077-1087, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38781681

ABSTRACT

Scedosporium spp. and Lomentospora prolificans are emerging non-Aspergillus filamentous fungi. The Scedosporiosis/lomentosporiosis Observational Study we previously conducted reported frequent fungal vascular involvement, including aortitis and peripheral arteritis. For this article, we reviewed 7 cases of Scedosporium spp. and L. prolificans arteritis from the Scedosporiosis/lomentosporiosis Observational Study and 13 cases from published literature. Underlying immunosuppression was reported in 70% (14/20) of case-patients, mainly those who had solid organ transplants (10/14). Osteoarticular localization of infection was observed in 50% (10/20) of cases; infections were frequently (7/10) contiguous with vascular infection sites. Scedosporium spp./Lomentospora prolificans infections were diagnosed in 9 of 20 patients ≈3 months after completing treatment for nonvascular scedosporiosis/lomentosporiosis. Aneurysms were found in 8/11 aortitis and 6/10 peripheral arteritis cases. Invasive fungal disease--related deaths were high (12/18 [67%]). The vascular tropism of Scedosporium spp. and L. prolificans indicates vascular imaging, such as computed tomography angiography, is needed to manage infections, especially for osteoarticular locations.


Subject(s)
Mycoses , Scedosporium , Humans , Scedosporium/isolation & purification , France/epidemiology , Male , Middle Aged , Aged , Female , Mycoses/microbiology , Mycoses/epidemiology , Mycoses/diagnosis , Adult , Antifungal Agents/therapeutic use , Aged, 80 and over , Invasive Fungal Infections
12.
Surg Infect (Larchmt) ; 25(4): 272-290, 2024 May.
Article in English | MEDLINE | ID: mdl-38700753

ABSTRACT

Background: Improvements in liver transplant (LT) outcomes are attributed to advances in surgical techniques, use of potent immunosuppressants, and rigorous pre-LT testing. Despite these improvements, post-LT infections remain the most common complication in this population. Bacteria constitute the most common infectious agents, while fungal and viral infections are also frequently encountered. Multi-drug-resistant bacterial infections develop because of polymicrobial overuse and prolonged hospital stays. Immediate post-LT infections are commonly caused by viruses. Conclusions: Appropriate vaccination, screening of both donor and recipients before LT and antiviral prophylaxis in high-risk individuals are recommended. Antimicrobial drug resistance is common in high-risk LT and associated with poor outcomes; epidemiology and management of these cases is discussed. Additionally, we also discuss the effect of coronavirus disease 2019 (COVID-19) infection and monkeypox in the LT population.


Subject(s)
COVID-19 , Liver Transplantation , Transplant Recipients , Humans , Bacterial Infections/epidemiology , Bacterial Infections/drug therapy , Bacterial Infections/prevention & control , COVID-19/epidemiology , Liver Transplantation/adverse effects , Mycoses/epidemiology , Mycoses/drug therapy , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , SARS-CoV-2 , Virus Diseases/epidemiology , Virus Diseases/prevention & control
13.
Cancer Epidemiol ; 91: 102593, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38815484

ABSTRACT

INTRODUCTION: Acute myeloid leukemia patients are at high risk for infections, which contribute to increased mortality rates of up to 70%. The use of antimicrobial prophylaxis has been shown to significantly lower rates of infection. Therefore, this retrospective study aimed to evaluate the effect of two agents that showed effective results in the literature, levofloxacin and fluconazole, as prophylaxis strategies in AML patients. METHODOLOGY: A total of 85 AML patients' medical records treated with a 7+3 induction chemotherapy protocol in the Cancer Hospital of Uberlândia from 2017 to 2021 were screened and their data was collected. Within these patients, groups for analysis were created based on whether the acting physician included an antibacterial or antifungal prophylaxis protocol during induction. Contingency tables with χ² and odds ratio tests were realized to verify associations between prophylaxis and infection. Additionally, Kaplan-Meier curves with Cox regression were developed to analyze survival. RESULTS: The use of prophylaxis with either fluconazole or levofloxacin did not lower rates of infection, as those who with prophylaxis did not demonstrate significant differences when compared to those without (20.3-29.7%, and 12.3-23.3%, respectively). Patients who suffered a bacterial infection during induction were shown to have lower overall survival, with a similar trend seen in fungal infections. CONCLUSION: Bacterial and fungal infections were associated with higher rates of induction mortality and lower overall survival, and prophylaxis using fluconazole and levofloxacin did not present any significant difference in preventing these infections in this study, contrasting results found in the literature. The individuality of each treatment center should be taken into consideration and future studies should be realized to better determine the most effective methods and agents for prophylaxis.


Subject(s)
Antifungal Agents , Fluconazole , Leukemia, Myeloid, Acute , Levofloxacin , Humans , Fluconazole/administration & dosage , Fluconazole/therapeutic use , Levofloxacin/therapeutic use , Levofloxacin/administration & dosage , Leukemia, Myeloid, Acute/drug therapy , Female , Male , Retrospective Studies , Middle Aged , Aged , Antifungal Agents/therapeutic use , Antifungal Agents/administration & dosage , Adult , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/administration & dosage , Antibiotic Prophylaxis/methods , Bacterial Infections/prevention & control , Bacterial Infections/epidemiology , Mycoses/prevention & control , Mycoses/epidemiology , Induction Chemotherapy/methods , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Young Adult
14.
Lancet Gastroenterol Hepatol ; 9(8): 745-757, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38754453

ABSTRACT

Cirrhosis is an immune dysfunction state, and as such, patients with cirrhosis are susceptible to bacterial, fungal, and viral infections. Because of infection, these patients have a propensity to develop multiorgan failure, which is associated with high mortality. Bacterial infections are the most prevalent type of infection in patients with cirrhosis, with the prevalence of bacterial infections in patients admitted for an acute decompensating event ranging from 24% to 29%. Together with invasive fungal infections, bacterial infections are the most severe. Multidrug-resistant organisms have been evolving at a rapid and alarming rate around the world, which presents enormous challenges. The development of effective measures for the prevention, early detection, and treatment of infections in patients with cirrhosis is challenging, given the rising incidence of infections in this patient population.


Subject(s)
Liver Cirrhosis , Humans , Liver Cirrhosis/complications , Bacterial Infections/epidemiology , Bacterial Infections/complications , Bacterial Infections/drug therapy , Mycoses/epidemiology
15.
Med Mycol ; 62(7)2024 Jul 04.
Article in English | MEDLINE | ID: mdl-38744661

ABSTRACT

The second international meeting on endemic mycoses of the Americas (IMEMA) and the first international symposium on implantation mycoses (ISIM) took place in Santiago del Estero, Argentina, on September 25-27, 2023. The conference provided a platform for researchers, clinicians, and experts to discuss the latest developments in the field of endemic and implantation mycoses. Topics included epidemiology, diagnostic advances, treatment strategies, and the impact of environmental factors on the spread of these fungal diseases. IMEMA and ISIM contributed to the regional discourse on the mycoses, emphasizing the importance of international cooperation in addressing these public health challenges.


IMEMA/ISIM, held in Santiago del Estero, Argentina, convened experts to discuss endemic and implantation mycoses, covering topics such as epidemiology, diagnostics, treatment, and advocacy. The event highlighted ongoing efforts in combating these diseases.


Subject(s)
Endemic Diseases , Mycoses , Humans , Mycoses/epidemiology , Mycoses/microbiology , Americas/epidemiology , Argentina/epidemiology , Prosthesis-Related Infections/microbiology , Prosthesis-Related Infections/epidemiology
16.
Perm J ; 28(2): 78-85, 2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38745453

ABSTRACT

BACKGROUND: Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis (CRS) that has previously been associated with younger age and Black patients. However, the role of demographic and socioeconomic factors in AFRS severity remains to be fully elucidated. OBJECTIVE: The objective of this study was to determine whether demographic and socioeconomic factors are associated with incidence of AFRS, as well as with disease severity in Northern California. METHODS: A retrospective cohort study was conducted of adult patients with AFRS and CRS from 2010 to 2019. AFRS was determined by the Bent and Kuhn criteria, and severity was assessed by radiographic evidence of cranioorbital invasion and other clinical parameters. Chi-square and t-test were used to assess demographic and socioeconomic differences between AFRS and CRS cohorts, and multivariable logistic regression was used to assess risk factors for severe AFRS. RESULTS: Black patients represented 26.2% (55/210 patients) of the AFRS group and 4.9% (842/17,300 patients) of the CRS group, with pairwise comparison of race/ethnicity categories showing that the AFRS group had significantly higher proportions of Black race/ethnicity compared with other race/ethnicities (p < 0.01). AFRS and CRS groups differed significantly by age, with mean ages of 48.7 and 51.0 years, respectively (p = 0.04). There were no significant differences in gender, Medicaid status, comorbidities, and socioeconomic status measures. Multivariate logistic regression showed that Black patients had higher odds of having severe AFRS (adjusted odds ratio = 2.29; 95% confidence interval: 1.18-4.45). CONCLUSION: AFRS has a unique predilection for Black patients, and severe disease is also more likely in this population.


Subject(s)
Rhinitis, Allergic , Sinusitis , Sociodemographic Factors , Humans , Male , Female , Sinusitis/microbiology , Sinusitis/epidemiology , Middle Aged , California/epidemiology , Retrospective Studies , Adult , Rhinitis, Allergic/epidemiology , Rhinitis, Allergic/microbiology , Risk Factors , Socioeconomic Factors , Severity of Illness Index , Incidence , Mycoses/epidemiology , Aged , Chronic Disease , Age Factors , Allergic Fungal Sinusitis
17.
PLoS One ; 19(5): e0298591, 2024.
Article in English | MEDLINE | ID: mdl-38758948

ABSTRACT

Amphibians globally suffer from emerging infectious diseases like chytridiomycosis caused by the continuously spreading chytrid fungi. One is Batrachochytrium salamandrivorans (Bsal) and its disease ‒ the 'salamander plague' ‒ which is lethal to several caudate taxa. Recently introduced into Western Europe, long distance dispersal of Bsal, likely through human mediation, has been reported. Herein we study if Alpine salamanders (Salamandra atra and S. lanzai) are yet affected by the salamander plague in the wild. Members of the genus Salamandra are highly susceptible to Bsal leading to the lethal disease. Moreover, ecological modelling has shown that the Alps and Dinarides, where Alpine salamanders occur, are generally suitable for Bsal. We analysed skin swabs of 818 individuals of Alpine salamanders and syntopic amphibians at 40 sites between 2017 to 2022. Further, we compiled those with published data from 319 individuals from 13 sites concluding that Bsal infections were not detected. Our results suggest that the salamander plague so far is absent from the geographic ranges of Alpine salamanders. That means that there is still a chance to timely implement surveillance strategies. Among others, we recommend prevention measures, citizen science approaches, and ex situ conservation breeding of endemic salamandrid lineages.


Subject(s)
Batrachochytrium , Mycoses , Urodela , Animals , Batrachochytrium/genetics , Batrachochytrium/pathogenicity , Mycoses/veterinary , Mycoses/microbiology , Mycoses/epidemiology , Urodela/microbiology , Communicable Diseases, Emerging/microbiology , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/veterinary , Salamandra/microbiology , Europe/epidemiology , Chytridiomycota
18.
Dis Aquat Organ ; 158: 123-132, 2024 May 30.
Article in English | MEDLINE | ID: mdl-38813853

ABSTRACT

The amphibian chytrid fungus Batrachochytrium dendrobatidis (Bd) causes chytridiomycosis, a disease among the main causes of amphibian declines worldwide. However, Bd studies on Neotropical amphibians from temperate areas are scarce. We present a comprehensive survey of Bd in Uruguay, in temperate central eastern South America, carried out between 2006 and 2014. Skin swabs of 535 specimens of 21 native and exotic frogs were tested by PCR. We used individual-level data to examine the relationship between infection, climatic variables, and their effects on body condition and the number of prey items found in stomach contents. Infection was widespread in free-ranging anurans with an overall prevalence of 41.9%, detected in 15 native species, wild American bullfrogs Aquarana catesbeiana, and captive specimens of Ceratophrys ornata and Xenopus laevis. Three haplotypes of the Bd ITS region were identified in native amphibians, all belonging to the global panzootic lineage (BdGPL), of which only one was present in exotic hosts. Despite high infection frequencies in different anurans, we found no evidence of morbidity or mortality attributable to chytridiomycosis, and we observed no discernible impact on body condition or consumed prey. Climatic conditions at the time of our surveys suggested that the chance of infection is associated with monthly mean temperature, mean humidity, and total precipitation. Temperatures below 21°C combined with moderate humidity and pronounced rainfall may increase the likelihood of infection. Multiple haplotypes of BdGPL combined with high frequencies of infection suggest an enzootic pattern in native species, underscoring the need for continued monitoring.


Subject(s)
Climate , Mycoses , Animals , Mycoses/veterinary , Mycoses/epidemiology , Mycoses/microbiology , Uruguay/epidemiology , Batrachochytrium/genetics , Anura/microbiology , Chytridiomycota/isolation & purification
19.
PLoS One ; 19(4): e0298515, 2024.
Article in English | MEDLINE | ID: mdl-38669238

ABSTRACT

White-nose syndrome (WNS) is an infectious disease that disrupts hibernation in bats, leading to premature exhaustion of fat stores. Though we know WNS does impact reproduction in hibernating female bats, we are unsure how these impacts are exacerbated by local climate factors. We compiled data from four southeastern U.S. states and used generalized linear mixed effects models to compare effects of WNS, pre-hibernation climate variables, and winter duration on the number of reproductive females in species across the range of WNS susceptibility. We predicted we would see a decline in the number of reproductive females in WNS-susceptible species, with the effect exaggerated by longer winter durations and pre-hibernation climate variables that lead to reductions in foraging. We found that the number of reproductive females in WNS-susceptible species was positively correlated with pre-hibernation local climate conditions conducive to foraging; however, WNS-susceptible species experienced an overall decline with the presence of WNS and as winter duration increased. Our long-term dataset provides evidence that pre-hibernation climate, specifically favorable summer weather conditions for foraging, greatly influences the reproduction, regardless of WNS status.


Subject(s)
Chiroptera , Climate , Hibernation , Reproduction , Seasons , Animals , Female , Chiroptera/physiology , Hibernation/physiology , Mycoses/veterinary , Mycoses/epidemiology , Reproduction/physiology
20.
Environ Health Perspect ; 132(4): 42001, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38648197

ABSTRACT

Rising temperatures and extreme weather are setting the stage for increases in fungal diseases. As new pathogenic fungi emerge and known threats spread and evolve, scientists and decision makers are responding.


Subject(s)
Climate Change , Mycoses , Humans , Mycoses/epidemiology , Fungi
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