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1.
Biomed Res Int ; 2022: 6095441, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937405

RESUMO

Background: Fungal infection in the lungs can cause fungal infectious diseases. This disease develops rapidly and involves a wide range. Pathogenic fungi are also more serious types of pathogenic bacteria. If it invades deep organs and tissues, it will endanger life, so it needs timely diagnosis. Aim: To investigate the diagnostic value of serum soluble myeloid cell triggering receptor-1 (sTREM-1), procalcitonin (PCT), and 1,3-ß-D glucan detection in immune related lung disease complicated with fungal infection. Methods: In this study, a case-control study was conducted. 50 patients with immune-related pulmonary disease complicated with fungal infection (infection group) diagnosed by sputum culture in our hospital from January 2017 to December 2021 were selected as the control group, and 50 patients with immune-related pulmonary disease without fungal infection were selected as the control group. The levels of sTREM-1, PCT, and 1,3-ß-D glucan were compared in the two groups. The receiver operating characteristic (ROC) was used to analyze the value of the three indicators in the diagnosis of immune-related pulmonary disease complicated with fungal infection, and the changes of the three indicators before and after treatment were compared. Results: The levels of sTREM-1, PCT, and 1,3-ß-D glucan in the infection group were higher than those in the control group (P < 0.05). The levels of sTREM-1, PCT, and 1,3-ß-D glucan in the infection group after treatment were significantly lower than those before treatment (P < 0.05). The AUC value of sTREM-1 in the diagnosis of immune-related pulmonary diseases complicated with fungal infection was 0.980, the sensitivity was 97.11%, and the specificity was 83.06%. The AUC value of PCT in the diagnosis of immune-related pulmonary diseases complicated with fungal infection was 0.860, the sensitivity was 80.00%, and the specificity was 72.41%. The AUC value of 1,3-ß-D glucan in the diagnosis of immune-related pulmonary diseases complicated with fungal infection was 0.993, the sensitivity was 98.74%, and the specificity was 99.16%. The levels of sTREM-1, PCT, and 1,3-ß-D glucan in the infection group after treatment were considerably lower than those before treatment, and the difference was statistically significant (P < 0.05). Conclusion: The detection of sTREM-1, PCT, and 1,3-ß-D glucan levels has high clinical value for the diagnosis of immune-related pulmonary diseases complicated with fungal infection.


Assuntos
Doenças do Sistema Imunitário , Pneumopatias , Micoses , beta-Glucanas , Biomarcadores , Proteína C-Reativa/análise , Estudos de Casos e Controles , Humanos , Pulmão/química , Micoses/complicações , Micoses/diagnóstico , Células Mieloides , Pró-Calcitonina , Estudos Prospectivos , Receptor Gatilho 1 Expresso em Células Mieloides
2.
Arch Microbiol ; 204(9): 539, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927385

RESUMO

103 bacterial isolates obtained from 8 ethnomedicinal plants in Manipur, India were studied for antifungal and plant growth promoting (PGP) activities. Forty-six (46), out of 62 antifungal isolates, showed potent activities against R. solani. Since R. solani (RS), a sheath blight pathogen, threatens rice yields worldwide, the present study was aimed at discovering promising bioinoculants with anti-RS and PGP potential on rice. Twenty-nine (29) endophytic isolates exhibiting promising anti-RS and PGP activities were subjected to seed vigor assays on rice (var. Jatra) and 16 were found to enhance rice seedling vigour by 70% or more over the control. Four (4) strains, Streptomyces sp. (AcRz21), Alkalihalobacillus sp. (PtL11), Bacillus sp. (TgIb5), and Priestia sp. (TgIb12) with the highest vigor indices were studied for growth promotion of rice in field conditions under pathogen-challenged and pathogen-free conditions. These bioactive strains were able to significantly enhance root and shoot biomass and reduce lesion heights caused by R. solani.


Assuntos
Micoses , Oryza , Streptomyces , Antifúngicos/farmacologia , Endófitos , Índia , Oryza/microbiologia , Doenças das Plantas/microbiologia , Doenças das Plantas/prevenção & controle , Rhizoctonia
3.
Nat Microbiol ; 7(8): 1127-1140, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35918423

RESUMO

Coronavirus disease 2019 (COVID-19)-associated invasive fungal infections are an important complication in a substantial number of critically ill, hospitalized patients with COVID-19. Three groups of fungal pathogens cause co-infections in COVID-19: Aspergillus, Mucorales and Candida species, including Candida auris. Here we review the incidence of COVID-19-associated invasive fungal infections caused by these fungi in low-, middle- and high-income countries. By evaluating the epidemiology, clinical risk factors, predisposing features of the host environment and immunological mechanisms that underlie the pathogenesis of these co-infections, we set the scene for future research and development of clinical guidance.


Assuntos
COVID-19 , Coinfecção , Infecções Fúngicas Invasivas , Micoses , Candida , Coinfecção/epidemiologia , Humanos , Micoses/epidemiologia
4.
Front Cell Infect Microbiol ; 12: 915049, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35782139

RESUMO

One of the most significant challenges in the treatment of fungal infections is the relatively long turnaround time (TAT) required for fungal species identification. The length of TAT to identification can impact patient clinical outcomes by delaying appropriate targeted therapy. Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) has demonstrated exceptional utility in the rapid identification of bacteria and yeasts in the clinical microbiology laboratory. The capability of MALDI-TOF MS for rapid identification of clinical isolates presents an opportunity for significant advancement in the identification of filamentous molds. In this study, we employed a diagnostic algorithm using MALDI-TOF MS for the rapid identification of filamentous molds in order to assess the impact of this technology on TATs. The majority of isolates included in this study were able to be identified by MALDI-TOF MS (78%). Further, these isolates were identified in less than three days from first detection of colony growth. This study demonstrates the utility of MALDI-TOF MS in the rapid identification of filamentous molds in the clinical mycology laboratory.


Assuntos
Fungos , Micoses , Algoritmos , Humanos , Lasers , Micoses/diagnóstico , Micoses/microbiologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos
6.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 44(3): 440-445, 2022 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-35791942

RESUMO

Objective To analyze the clinicopathological characteristics of lymphadenitis caused by Talaromyces marneffei (TM).Method s The clinical data,pathological features,pathogen examination,and treatment of 15 cases of TM-caused lymphadenitis were analyzed retrospectively.Results The 15 cases included 14 males and 1 females,who were aged 26-67 years,with an average age of (49.1±11.87) years.The 15 cases,including 13 cases of acquired immunodeficiency syndrome and 2 cases of diabetes mellitus,were accompanied by superficial lymph node enlargement in the neck and supraclavicular,axillary,and inguinal regions.The structure of cord-like lymph node tissue punctured by thick needle was completely or partially replaced by inflammatory lesions. Under microscope,8 cases showed mainly diffuse infiltration of phagocytes with pathogens;5 cases presented mainly extensive coagulation necrosis with a small amount of pathogens and nuclear debris;2 cases were characterized by small nodular hyperplasia of fibroblasts,formation of granulomatous structure,and scattered distribution of a few multinucleated giant cells.The pathogens were relatively consistent in size and shape,which were round,oval or sausage-shaped and clustered like mulberry.Diastase periodic acid-Schiff staining and hexamine silver staining highlighted the bacterial structure with transverse septum.TM growth was detected in the blood,alveolar lavage fluid,sputum or lymph node extract fungal culture of the 15 patients.Owing to the adequate antifungal treatment in time,these 15 patients were discharged after their conditions were improved.Conclusion Lymphadenitis is one of the major manifestations of the systemic invasion of TM at the late stage,which is tended to be misdiagnosed.Through core needle biopsy of lymph node,it can be diagnosed as soon as possible to avoid delayed treatment and improve the cure rate.


Assuntos
Linfadenite , Micoses , Talaromyces , Adulto , Idoso , Biópsia com Agulha de Grande Calibre , Feminino , Humanos , Linfadenite/diagnóstico , Linfadenite/microbiologia , Masculino , Pessoa de Meia-Idade , Micoses/complicações , Estudos Retrospectivos
7.
An Acad Bras Cienc ; 94(2): e20210189, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35830082

RESUMO

Few antifungals available today are effective in treating biofilms. Thus, it is urgent to discover new compounds, such as natural products, that provide improvements to existing treatments or the development of new antifungal therapies. This study aimed to perform a comparative analysis between the green propolis extract (PE) and its by-product, a waste of propolis extract (WPE) through a screening with Candida sp., Fusarium sp. and Trichophyton sp. The antifungal property of PE and WPE was assessed by the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) determination in planktonic cells. The influence of both extracts on the inhibition of biofilm formation in these fungi was also tested. The WPE MIC and MFC values (68.75 to 275.0 µg/mL) were three to twelve times lower than the values obtained for PE (214.06 to 1712.5 µg/mL). PE was more efficient than WPE in inhibiting the biofilm initial phase, especially in C. albicans. Meanwhile, WPE had dose-dependent behavior for the three fungi, being more effective on filamentous ones. Both PE and WPE showed excellent antifungal activity on planktonic cells and demonstrated great efficacy for inhibiting biofilm formation in the three fungi evaluated.


Assuntos
Micoses , Própole , Antifúngicos/farmacologia , Biofilmes , Candida albicans , Humanos , Testes de Sensibilidade Microbiana , Plâncton , Extratos Vegetais/farmacologia , Própole/farmacologia
8.
Fungal Biol ; 126(8): 480-487, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35851140

RESUMO

Eutypa dieback and Esca are serious fungal grapevine trunk diseases (GTDs). Eutypa dieback is caused by Eutypa lata (Elata), and is often associated Phaeoacremonium minimum (Pmin), and Phaeomoniella chlamydospora (Pch) which are also important contributors to Esca disease. Understanding the complex pathogenesis mechanisms used by these causative fungi may potentially lead targeted treatments for GTDs in the future. Elata has been reported as a wood decay "soft rot" fungus and understanding of Elata's pathogenesis chemistries can aid in controlling GTDs. Recent work that suggests that Pmin and Pch may contribute to pathogenesis by stimulating hydroxyl radical generation via secretion of low molecular weight phenolic metabolites. Building on these findings, we tested a hypothesis that antioxidants and chelators, and biocontrol agents that have been reported to secrete antioxidants and low molecular weight chelators, may inhibit the growth and activity of these fungi. Butylated hydroxy anisole (BHA) and butylated hydroxytoluene (BHT) were tested as antioxidant/chelators. BHA was found to be a highly effective control measure for the three pathogenic fungi tested at concentrations >0.5 mM. The biocontrol species Bacillus subtilis and Hypocrea (Trichoderma) atroviride were also tested, with both H. atroviride and B. subtilis effectively inhibiting growth of the three GTD fungi.


Assuntos
Micoses , Vitis , Antioxidantes/farmacologia , Hidroxianisol Butilado , Fungos , Quelantes de Ferro/farmacologia , Doenças das Plantas/microbiologia , Doenças das Plantas/prevenção & controle , Espécies Reativas de Oxigênio , Vitis/microbiologia
9.
Curr Microbiol ; 79(9): 259, 2022 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-35852635

RESUMO

Vishniacozyma victoriae NPCC 1263 was selected for this work because of the active antagonistic effect over several fungi in postharvest organic pears. Yeast biomass production was carried out in a 15 L stirred-tank bioreactor with 12 L of working volume at 20 °C and 300 rpm and 0.64 vvm of aeration. The selected production medium was based on cheese whey powder and salts. The present study aims to evaluate the possibility of using an inexpensive growth substrate for production of added value products (yeast biomass), this innovation also requires evaluate biocontrol efficacy of yeast against fungal diseases of pears in semi-commercial assays. The yeast biomass was collected, cold stored for 60 days (Treatment 1) and 15 days (Treatment 2) and sprayed on the pears in semi-commercial level testing assays. After 180 days of postharvest conservation, significant reduction of fungal infection by Penicillium expansum, Botrytis cinerea and Cladosporium sp. was observed. The Treatment 1 reduced total diseases incidence by 71%, instead Treatment 2 reduced it by 92%. The effect of spray application on the yeast viability with different cold storage was tested. These work provides information on the bench-scale bioreactor yeast production using a new low-cost medium, viability and biocontrol efficacy of Vishniacozyma victoriae in controlling common diseases affecting pears in semi-commercial assays.


Assuntos
Basidiomycota , Micoses , Penicillium , Pyrus , Frutas/microbiologia , Doenças das Plantas/microbiologia , Doenças das Plantas/prevenção & controle , Pyrus/microbiologia , Saccharomyces cerevisiae
10.
Molecules ; 27(13)2022 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-35807386

RESUMO

Respiratory mycosis is a major health concern, due to the expanding population of immunosuppressed and immunocompromised patients and the increasing resistance to conventional antifungals and their undesired side-effects, thus justifying the development of new therapeutic strategies. Plant metabolites, namely essential oils, represent promising preventive/therapeutic strategies due to their widely reported antifungal potential. However, regarding fungal infections of the respiratory tract, information is disperse and no updated compilation on current knowledge is available. Therefore, the present review aims to gather and systematize relevant information on the antifungal effects of several essential oils and volatile compounds against the main type of respiratory mycosis that impact health care systems. Particular attention is paid to Aspergillus fumigatus, the main pathogen involved in aspergillosis, Candida auris, currently emerging as a major pathogen in certain parts of the world, and Cryptococcus neoformans, one of the main pathogens involved in pulmonary cryptococcosis. Furthermore, the main mechanisms of action underlying essential oils' antifungal effects and current limitations in clinical translation are presented. Overall, essential oils rich in phenolic compounds seem to be very effective but clinical translation requires more comprehensive in vivo studies and human trials to assess the efficacy and tolerability of these compounds in respiratory mycosis.


Assuntos
Antifúngicos , Micoses , Óleos Voláteis , Doenças Respiratórias , Antifúngicos/farmacologia , Aspergillus fumigatus , Candida auris , Cryptococcus neoformans , Humanos , Micoses/tratamento farmacológico , Óleos Voláteis/farmacologia , Fenóis/farmacologia , Óleos Vegetais/farmacologia , Doenças Respiratórias/tratamento farmacológico , Doenças Respiratórias/microbiologia
11.
J Cutan Med Surg ; 26(1_suppl): 3S-23S, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35819172

RESUMO

The IL-17 signalling pathway is a major target in treatment of plaque psoriasis. IL-17 signalling contributes to chronic inflammation and epidermal hyperplasia seen in psoriatic lesions. Blocking the IL-17 signalling cascade is an effective method in treating this disease. However, IL-17 also plays a role in the immunological protection against fungal infections and therefore, patients on IL-17 biologics experience an increased rate of fungal infections, specifically Candida albicans. It is prudent that patients and physicians are aware of this risk and understand how to recognize and manage Candida infections. In this review, we examine the Candida infection rates associated with IL-17 biologics, both in clinical trials and real-world practice. We discuss common presentations associated with various types of candidiasis and propose a recommended management approach to treating these infections.


Assuntos
Produtos Biológicos , Micoses , Psoríase , Produtos Biológicos/efeitos adversos , Humanos , Micoses/complicações , Micoses/tratamento farmacológico , Psoríase/complicações , Psoríase/tratamento farmacológico
12.
AAPS PharmSciTech ; 23(6): 206, 2022 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-35896903

RESUMO

Fungal infections are considered one of the most serious conditions as their occurrence has increased lately. Fungi like Candida, Fusarium, and Aspergillus species mostly affect immunocompromised patients as they are considered opportunistic pathogens. These infections can be superficial, cutaneous, subcutaneous, or systemic fungal infections that require specific treatment. There is a wide variety of antifungal drugs that can be used to cure fungal infections; however, most of them have many systemic side effects due to their physicochemical characteristics and high toxicity profile. Hence, the current review focuses on various advanced vesicular carriers with high biocompatibility that can encapsulate the antifungal drugs owing to increase their efficacy and limit the undesirable side effects. These advanced systems can manage stability, solubility, bioavailability, safety, and effectiveness issues present in conventional systems.


Assuntos
Antifúngicos , Micoses , Administração Cutânea , Antifúngicos/uso terapêutico , Candida , Fungos , Humanos , Micoses/tratamento farmacológico
13.
J Med Microbiol ; 71(7)2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35819894

RESUMO

Hypothesis/Gap Statement. The impacts of increased biomarker testing on antifungal prescribing have not yet been fully examined in a real-life setting.Objectives. Biomarkers for invasive fungal disease (IFD) have been shown to reduce antifungal prescriptions in neutropaenic haemato-oncology patients. Our study aimed to assess the real-life impacts of introducing a novel biomarker-based pathway, incorporating serum galactomannan and Aspergillus PCR, for pyrexial haemato-oncology admissions.Methods. Patients with neutropaenic fever were identified prospectively after introduction of the new pathway from 2013-2015. A historical group of neutropaenic patients who had blood cultures taken from 2009-2012 was generated for comparison. Clinical details, including demographics, underlying diagnosis, investigations, radiology and antimicrobial treatment were obtained.Results. Prospective data from 308 patients were compared to retrospective data from 302 patients. The proportion of patients prescribed an antifungal medication was unchanged by the pathway (P=0.79), but the pattern was different, with more patients receiving targeted antifungals (P=0.04). A negative serum galactomannan test was not sufficient evidence to withhold therapy, with 17.2% of these episodes felt to have possible or probable IFD using the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) criteria. There was no difference in 30-day mortality (P=0.21) or 1-year mortality (P=0.57) following introduction of the pathway.Conclusions. Biomarkers can be used safely as part of a multidisciplinary approach to the diagnosis of IFD in neutropaenic haemato-oncology patients. Whilst they do not necessarily result in antifungal therapy being withheld, they can allow more confident diagnosis of IFD and more specific antifungal therapy in selected cases.


Assuntos
Infecções Fúngicas Invasivas , Micoses , Neoplasias , Antifúngicos/uso terapêutico , Biomarcadores/análise , Humanos , Infecções Fúngicas Invasivas/diagnóstico , Infecções Fúngicas Invasivas/tratamento farmacológico , Micoses/diagnóstico , Neoplasias/complicações , Estudos Prospectivos , Estudos Retrospectivos
14.
Proc Biol Sci ; 289(1978): 20220586, 2022 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-35858072

RESUMO

Many endangered amphibian species survive in captive breeding facilities, but there have been few attempts to reintroduce captive-born individuals to rebuild wild populations. We conducted a soft-release trial of limosa harlequin frogs, Atelopus limosus, which are highly susceptible to the amphibian chytrid fungus Batrachochytrium dendrobatidis (Bd), to understand changes associated with the transition from captivity to the wild. Specifically, we assessed changes in body condition, skin-associated bacterial communities and disease status after release. Frogs were housed individually in field mesocosms and monitored for 27 days. Body condition did not significantly change in the mesocosms, and was similar to, or higher than, that of wild conspecifics at day 27. The skin bacteria of captive-born frogs, based on 16S rRNA gene amplicons, became similar to that of wild conspecifics after 27 days in mesocosms. Prevalence of Bd in wild conspecifics was 13-27%, and 15% of the A. limosus in mesocosms became infected with Bd, but no mortality of infected frogs was observed. We conclude that mesocosms are suitable for systematically and repeatedly monitoring amphibians during release trials, and that body condition, the skin microbiome, and Bd status can all change within one month of placement of captive-born individuals back into the wild.


Assuntos
Quitridiomicetos , Micoses , Animais , Anuros/genética , Bactérias , Bufonidae/genética , Quitridiomicetos/genética , Micoses/microbiologia , Micoses/veterinária , Melhoramento Vegetal , RNA Ribossômico 16S/genética , Pele/microbiologia
15.
F1000Res ; 11: 30, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35811795

RESUMO

Background: Diagnosis of co-infections with multiple pathogens among hospitalized coronavirus disease 2019 (COVID-19) patients can be jointly challenging and essential for appropriate treatment, shortening hospital stays and preventing antimicrobial resistance. This study proposes to investigate the burden of bacterial and fungal co-infections outcomes on COVID-19 patients. It is a single center cross-sectional study of hospitalized COVID-19 patients at Beit-Jala hospital in Palestine. Methods: The study included 321 hospitalized patients admitted to the ICU between June 2020 and March 2021 aged ≥20 years, with a confirmed diagnosis of COVID-19 via reverse transcriptase-polymerase chain reaction assay conducted on a nasopharyngeal swab. The patient's information was gathered using graded data forms from electronic medical reports. Results: The diagnosis of bacterial and fungal infection was proved through the patient's clinical presentation and positive blood or sputum culture results. All cases had received empirical antimicrobial therapy before the intensive care unit (ICU) admission, and different regimens during the ICU stay. The rate of bacterial co-infection was 51.1%, mainly from gram-negative isolates ( Enterobacter species and K.pneumoniae). The rate of fungal co-infection caused by A.fumigatus was 48.9%, and the mortality rate was 8.1%. However, it is unclear if it had been attributed to SARS-CoV-2 or coincidental. Conclusions: Bacterial and fungal co-infection is common among COVID-19 patients at the ICU in Palestine, but it is not obvious if these cases are attributed to SARS-CoV-2 or coincidental, because little data is available to compare it with the rates of secondary infection in local ICU departments before the pandemic. Comprehensively, those conclusions present data supporting a conservative antibiotic administration for severely unwell COVID-19 infected patients. Our examination regarding the impacts of employing antifungals to manage COVID-19 patients can work as a successful reference for future COVID-19 therapy.


Assuntos
Infecções Bacterianas , COVID-19 , Coinfecção , Micoses , Árabes , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , COVID-19/epidemiologia , Coinfecção/epidemiologia , Estudos Transversais , Hospitais , Humanos , Unidades de Terapia Intensiva , Micoses/tratamento farmacológico , Micoses/epidemiologia , Micoses/microbiologia , Estudos Retrospectivos , SARS-CoV-2
16.
BMJ Case Rep ; 15(7)2022 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-35790323

RESUMO

A woman in her 30s had robotic pyeloplasty done for right ureteropelvic junction obstruction. Incidentally she developed dengue viral fever starting on postoperative day 1 itself, which progressed to dengue haemorrhagic shock by 1 week, complicating pyeloplasty due to pelvicalyceal haematoma. Dengue associated shock was superimposed with subsequent gram-negative bacterial sepsis, further complicated later with Trichosporon fungal sepsis. She was managed under multidisciplinary care, involving urology, infectious disease and ICU care. Her diagnostic and difficult management issues due to these rare sequential medical issues in an otherwise usually uncomplicated postsurgical phase are discussed along with short review of literature. This case highlights the importance of early diagnosis, timely supportive care and appropriate management in such tropical infections with significant associated mortality.


Assuntos
Bacteriemia , Dengue , Micoses , Sepse , Choque Hemorrágico , Trichosporon , Dengue/complicações , Dengue/diagnóstico , Feminino , Humanos , Sepse/diagnóstico
17.
PLoS Med ; 19(7): e1004049, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35853024

RESUMO

BACKGROUND: Injecting-related bacterial and fungal infections are associated with significant morbidity and mortality among people who inject drugs (PWID), and they are increasing in incidence. Following hospitalization with an injecting-related infection, use of opioid agonist treatment (OAT; methadone or buprenorphine) may be associated with reduced risk of death or rehospitalization with an injecting-related infection. METHODS AND FINDINGS: Data came from the Opioid Agonist Treatment Safety (OATS) study, an administrative linkage cohort including all people in New South Wales, Australia, who accessed OAT between July 1, 2001 and June 28, 2018. Included participants survived a hospitalization with injecting-related infections (i.e., skin and soft-tissue infection, sepsis/bacteremia, endocarditis, osteomyelitis, septic arthritis, or epidural/brain abscess). Outcomes were all-cause death and rehospitalization for injecting-related infections. OAT exposure was classified as time varying by days on or off treatment, following hospital discharge. We used separate Cox proportional hazards models to assess associations between each outcome and OAT exposure. The study included 8,943 participants (mean age 39 years, standard deviation [SD] 11 years; 34% women). The most common infections during participants' index hospitalizations were skin and soft tissue (7,021; 79%), sepsis/bacteremia (1,207; 14%), and endocarditis (431; 5%). During median 6.56 years follow-up, 1,481 (17%) participants died; use of OAT was associated with lower hazard of death (adjusted hazard ratio [aHR] 0.63, 95% confidence interval [CI] 0.57 to 0.70). During median 3.41 years follow-up, 3,653 (41%) were rehospitalized for injecting-related infections; use of OAT was associated with lower hazard of these rehospitalizations (aHR 0.89, 95% CI 0.84 to 0.96). Study limitations include the use of routinely collected administrative data, which lacks information on other risk factors for injecting-related infections including injecting practices, injection stimulant use, housing status, and access to harm reduction services (e.g., needle exchange and supervised injecting sites); we also lacked information on OAT medication dosages. CONCLUSIONS: Following hospitalizations with injection drug use-associated bacterial and fungal infections, use of OAT is associated with lower risks of death and recurrent injecting-related infections among people with opioid use disorder.


Assuntos
Bacteriemia , Endocardite , Micoses , Sepse , Abuso de Substâncias por Via Intravenosa , Adulto , Analgésicos Opioides/efeitos adversos , Austrália , Estudos de Coortes , Endocardite/induzido quimicamente , Endocardite/complicações , Endocardite/tratamento farmacológico , Feminino , Humanos , Masculino , Micoses/induzido quimicamente , Micoses/tratamento farmacológico , Micoses/epidemiologia , New South Wales/epidemiologia , Tratamento de Substituição de Opiáceos , Sepse/tratamento farmacológico , Sepse/epidemiologia , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/tratamento farmacológico , Abuso de Substâncias por Via Intravenosa/epidemiologia
18.
Rev Iberoam Micol ; 39(2): 54-56, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35788316

RESUMO

BACKGROUND: Trichosporon asahii, an emerging fungal pathogen, has been frequently associated with invasive infections in critically ill patients. CASE REPORT: A 74-year-old male patient diagnosed with COVID-19 was admitted to an Intensive Care Unit (ICU). During hospitalization, the patient displayed episodes of bacteremia by Staphylococcus haemolyticus and a possible urinary tract infection by T. asahii. While the bacterial infection was successfully treated using broad-spectrum antibiotics, the fungal infection in the urinary tract was unsuccessfully treated with anidulafungin and persisted until the patient died. CONCLUSIONS: With the evolving COVID-19 pandemic, invasive fungal infections have been increasingly reported, mainly after taking immunosuppressant drugs associated with long-term broad-spectrum antibiotic therapy. Although Candida and Aspergillus are still the most prevalent invasive fungi, T. asahii and other agents have emerged in critically ill patients. Therefore, a proper surveillance and diagnosing any fungal infection are paramount, particularly in COVID-19 immunocompromised populations.


Assuntos
COVID-19 , Micoses , Trichosporon , Tricosporonose , Infecções Urinárias , Idoso , Antifúngicos/uso terapêutico , Basidiomycota , Estado Terminal , Humanos , Masculino , Micoses/tratamento farmacológico , Micoses/microbiologia , Pandemias , Tricosporonose/diagnóstico , Tricosporonose/tratamento farmacológico , Tricosporonose/microbiologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia
19.
PLoS One ; 17(7): e0271795, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35901069

RESUMO

OBJECTIVES: The prevalence of fungal secondary infections among COVID-19 patients and efficacy of antifungal therapy used in such patients is still unknown. Hence, we conducted this study to find the prevalence of fungal secondary infections among COVID-19 patients and patient outcomes in terms of recovery or all-cause mortality following antifungal therapy (AFT) in such patients. METHODS: We performed a comprehensive literature search in PubMed®, Scopus®, Web of Sciences™, The Cochrane Library, ClinicalTrial.gov, MedRxiv.org, bioRxiv.org, and Google scholar to identify the literature that used antifungal therapy for the management fungal secondary infections in COVID-19 patients. We included case reports, case series, prospective & retrospective studies, and clinical trials. Mantel Haenszel random-effect model was used for estimating pooled risk ratio for required outcomes. RESULTS: A total of 33 case reports, 3 case series, and 21 cohort studies were selected for final data extraction and analysis. The prevalence of fungal secondary infections among COVID-19 patients was 28.2%. Azoles were the most commonly (65.1%) prescribed AFT. Study shows that high survival frequency among patients using AFT, received combination AFT and AFT used for >28 days. The meta-analysis showed, no significant difference in all-cause mortality between patients who received AFT and without AFT (p = 0.17), between types of AFT (p = 0.85) and the duration of AFT (p = 0.67). CONCLUSION: The prevalence of fungal secondary infections among COVID-19 patients was 28.2%. The survival frequency was high among patients who used AFT for fungal secondary infections, received combination AFT and AFT used for >28 days. However, meta-analysis results found that all-cause mortality in COVID-19 patients with fungal secondary infections is not significantly associated with type and duration of AFT, mostly due to presence of confounding factors such as small number of events, delay in diagnosis of fungal secondary infections, presence of other co-infections and multiple comorbidities.


Assuntos
COVID-19 , Coinfecção , Micoses , Antifúngicos/uso terapêutico , COVID-19/epidemiologia , Coinfecção/tratamento farmacológico , Fluconazol/uso terapêutico , Humanos , Micoses/complicações , Micoses/tratamento farmacológico , Micoses/epidemiologia , Estudos Prospectivos , Estudos Retrospectivos
20.
Med Mycol ; 60(8)2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35867978

RESUMO

Fungal infections have increased in the last years, particularly associated to an increment in the number of immunocompromised individuals and the emergence of known or new resistant species, despite the difficulties in the often time-consuming diagnosis. The controversial efficacy of the currently available strategies for their clinical management, apart from their high toxicity and severe side effects, has renewed the interest in the research and development of new broad antifungal alternatives. These encompass vaccines and passive immunization strategies with monoclonal antibodies (mAbs), recognizing ubiquitous fungal targets, such as fungal cell wall ß-1,3-glucan polysaccharides, which could be used in early therapeutic intervention without the need for the diagnosis at species level. As additional alternatives, based on the Dectin-1 great affinity to ß-1,3-glucan, our group developed broad antibody-like Dectin1-Fc(IgG)(s) from distinct subclasses (IgG2a and IgG2b) and compared their antifungal in vitro and passive immunizations in vivo performances. Dectin1-Fc(IgG2a) and Dectin1-Fc(IgG2b) demonstrated high affinity to laminarin and the fungal cell wall by ELISA, flow cytometry, and microscopy. Both Dectin-1-Fc(IgG)(s) inhibited Histoplasma capsulatum and Cryptococcus neoformans growth in a dose-dependent fashion. For Candida albicans, such inhibitory effect was observed with concentrations as low as 0.098 and 0.049 µg/ml, respectively, which correlated with the impairment of the kinetics and lengths of germ tubes in comparison to controls. Previous opsonization with Dectin-1-Fc(IgG)(s) enhanced considerably the macrophage antifungal effector functions, increasing the fungi macrophages interactions and significantly reducing the intraphagosome fungal survival, as lower CFUs were observed. The administration of both Dectin1-Fc(IgG)(s) reduced the fungal burden and mortality in murine histoplasmosis and candidiasis models, in accordance with previous evaluations in aspergillosis model. These results altogether strongly suggested that therapeutic interventions with Dectin-1-Fc(IgG)(s) fusion proteins could directly impact the innate immunity and disease outcome in favor of the host, by direct neutralization, opsonization, phagocytosis, and fungal elimination, providing interesting information on the potential of these new strategies for the control of invasive fungal infections. LAY SUMMARY: Mycoses have increased worldwide, and new efficient therapeutics are needed. Passive immunizations targeting universally the fungal cell would allow early interventions without the species-level diagnosis. Lectins with affinity to carbohydrates could be used to engineer 'antibody-like' strategies.


Assuntos
Infecções Fúngicas Invasivas , Micoses , Doenças dos Roedores , Animais , Antifúngicos/farmacologia , Imunoglobulina G , Infecções Fúngicas Invasivas/veterinária , Lectinas Tipo C/metabolismo , Camundongos , Micoses/veterinária
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