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1.
Dis Aquat Organ ; 147: 1-12, 2021 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-34734569

RESUMO

Emerging infectious diseases are a threat to biodiversity and have taken a large toll on amphibian populations worldwide. The chytrid fungi Batrachochytrium dendrobatidis (Bd) and B. salamandrivorans (Bsal), and the iridovirus Ranavirus (Rv), are of concern as all have contributed to amphibian declines. In central and eastern Europe, their geographical and host distributions and main environmental drivers determining prevalence are poorly known. We screened over 1000 amphibians from natural and captive populations in Poland for the presence of Bd, Bsal and Rv. In wild amphibian populations, we found that Bd is widespread, present in 46 out of 115 sampled localities as well as 2 captive colonies, and relatively common with overall prevalence at 14.4% in 9 species. We found lower prevalence of Rv at 2.4%, present in 11 out of 92 sampling sites, with a taxonomic breadth of 8 different amphibian species. Bsal infection was not detected in any individuals. In natural populations, Pelophylax esculentus and Bombina variegata accounted for 75% of all Bd infections, suggesting a major role for these 2 species as pathogen reservoirs in Central European freshwater habitats. General linear models showed that climatic as well as landscape features are associated with Bd infection in Poland. We found that higher average annual temperature constrains Bd infection, while landscapes with numerous water bodies or artificial elements (a surrogate for urbanization) increase the chances of infection. Our results show that a combination of climatic and landscape variables may drive regional and local pathogen emergence.


Assuntos
Quitridiomicetos , Doenças Transmissíveis Emergentes , Micoses , Anfíbios , Animais , Anuros , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/veterinária , Micoses/epidemiologia , Micoses/veterinária , Polônia/epidemiologia
2.
Infect Dis Clin North Am ; 35(4): 1027-1053, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34752219

RESUMO

Invasive fungal infections are an important cause of morbidity and mortality in hospitalized patients and in the immunocompromised population. This article reviews the current epidemiology of nosocomial fungal infections in adult patients, with an emphasis on invasive candidiasis (IC) and invasive aspergillosis (IA). Included are descriptions of nosocomial infections caused by Candida auris, an emerging pathogen, and IC- and IA-associated with coronavirus disease 2019. The characteristics and availability of newer nonculture-based tests for identification of nosocomial fungal pathogens are discussed. Recently published recommendations and guidelines for the control and prevention of these nosocomial fungal infections are summarized.


Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Micoses/epidemiologia , Micoses/prevenção & controle , Antifúngicos/uso terapêutico , COVID-19/complicações , COVID-19/epidemiologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/etiologia , Fungos/classificação , Fungos/patogenicidade , Humanos , Hospedeiro Imunocomprometido , Controle de Infecções/normas , Micoses/diagnóstico , Micoses/etiologia , Fatores de Risco , SARS-CoV-2
3.
J Infect Public Health ; 14(11): 1720-1726, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34700291

RESUMO

Being considered minor vexations, fungal infections hinder the life of about 15% of the world population superficially, with rare threats to life in case of invasive sepsis. A significant rise in the intrusive mycoses due to machiavellian fungal species is observed over the years due to increased pathology and fatality in people battling life-threatening diseases. Individuals undergoing therapy with immune suppressive drugs plus recovering from viral infections have shown to develop fungal sepsis as secondary infections while recovering or after. Currently, the whole world is fighting against the fright of Coronavirus disease (COVID-19), and corticosteroids being the primitive therapeutic to combat the COVID-19 inflammation, leads to an immune-compromised state, thereby allowing the not so harmful fungi to violate the immune barrier and flourish in the host. A wide range of fungal co-infection is observed in the survivors and patients of COVID-19. Fungal species of Candida, Aspergillus and Mucorales, are burdening the lives of COVID-19 patients/survivors in the form of Yellow/Green, White and Black fungus. This is the first article of its kind to assemble note on fungal infections seen in the current human health scenario till date and provides a strong message to the clinicians, researchers and physicians around the world "non-pathological fungus should not be dismissed as contaminants, they can quell immunocompromised hosts".


Assuntos
COVID-19 , Micoses , Humanos , Micoses/epidemiologia , Pandemias , SARS-CoV-2 , Sobreviventes
4.
PLoS One ; 16(10): e0258801, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34695141

RESUMO

The epidemiology of Nosema spp. in honey bees, Apis mellifera, may be affected by winter conditions as cold temperatures and differing wintering methods (indoor and outdoor) provide varying levels of temperature stress and defecation flight opportunities. Across the Canadian Prairies, including Alberta, the length and severity of winter vary among geographic locations. This study investigates the seasonal pattern of Nosema abundance in two Alberta locations using indoor and outdoor wintering methods and its impact on bee population, survival, and commercial viability. This study found that N. ceranae had a distinct seasonal pattern in Alberta, with high spore abundance in spring, declining to low levels in the summer and fall. The results showed that fall Nosema monitoring might not be the best indicator of treatment needs or future colony health outcomes. There was no clear pattern for differences in N. ceranae abundance by location or wintering method. However, wintering method affected survival with colonies wintered indoors having lower mortality and more rapid spring population build-up than outdoor-wintered colonies. The results suggest that the existing Nosema threshold should be reinvestigated with wintering method in mind to provide more favorable outcomes for beekeepers. Average Nosema abundance in the spring was a significant predictor of end-of-study winter colony mortality, highlighting the importance of spring Nosema monitoring and treatments.


Assuntos
Criação de Abelhas/métodos , Abelhas/crescimento & desenvolvimento , Micoses/epidemiologia , Nosema/patogenicidade , Estações do Ano , Temperatura , Alberta/epidemiologia , Animais , Abelhas/microbiologia , Micoses/microbiologia , Nosema/isolamento & purificação
5.
Front Immunol ; 12: 715023, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34659204

RESUMO

Emerging evidence has unveiled the secondary infection as one of the mortal causes of post-SARS-CoV-2 infection, but the factors related to secondary bacterial or fungi infection remains largely unexplored. We here systematically investigated the factors that might contribute to secondary infection. By clinical examination index analysis of patients, combined with the integrative analysis with RNA-seq analysis in the peripheral blood mononuclear cell isolated shortly from initial infection, this study showed that the antibiotic catabolic process and myeloid cell homeostasis were activated while the T-cell response were relatively repressed in those with the risk of secondary infection. Further monitoring analysis of immune cell and liver injury analysis showed that the risk of secondary infection was accompanied by severe lymphocytopenia at the intermediate and late stages and liver injury at the early stages of SARS-CoV-2. Moreover, the metagenomics analysis of bronchoalveolar lavage fluid and the microbial culture analysis, to some extent, showed that the severe pneumonia-related bacteria have already existed in the initial infection.


Assuntos
Infecções Bacterianas/epidemiologia , COVID-19/patologia , Coinfecção/epidemiologia , Coinfecção/mortalidade , Micoses/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/mortalidade , Líquido da Lavagem Broncoalveolar/microbiologia , Contagem de Linfócito CD4 , Feminino , Humanos , Leucócitos Mononucleares/imunologia , Fígado/lesões , Fígado/virologia , Linfopenia/imunologia , Masculino , Pessoa de Meia-Idade , Micoses/mortalidade , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/imunologia , Linfócitos T/imunologia
6.
Curr Opin Otolaryngol Head Neck Surg ; 29(6): 510-516, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34545860

RESUMO

PURPOSE OF REVIEW: Allergic fungal rhinosinusitis (AFRS) is a debilitating condition for children. Despite there being several reviews on this topic in the adult population, there is a paucity of reviews of AFRS in the pediatric literature. This article reviews the recent evidence of pediatric AFRS with the aim to optimize outcomes of pediatric patients with this condition. RECENT FINDINGS: AFRS is clinically characterized by nasal polyposis, a type I hypersensitivity to fungal epitopes, very thick eosinophilic mucin, and peripheral eosinophilia. Pediatric AFRS has similar clinical characteristics to that in adults but is thought to have a more aggressive nature, with higher serum immunoglobulin E and more frequently bone erosion and malformation of facial bones. Diagnosis of pediatric AFRS is made by using the Bent and Kuhn's criteria developed for adult AFRS. The mainstay of treatment is surgery followed by postoperative corticosteroids. Adjunctive therapies, including topical/oral antifungal agents, allergen immunotherapy and biologics may improve outcomes in pediatric AFRS, but to date the current evidence is limited. SUMMARY: To optimize the outcome of pediatric AFRS, adequate and early diagnosis and treatment are essential. Appropriate and comprehensive endoscopic sinus surgery to open the sinuses, remove the fungal burden of disease and improve access of the sinuses to postoperative topical corticosteroid remains the standard of care.


Assuntos
Micoses , Pólipos Nasais , Seios Paranasais , Rinite Alérgica , Sinusite , Adulto , Criança , Humanos , Micoses/diagnóstico , Micoses/epidemiologia , Micoses/terapia , Pólipos Nasais/patologia , Rinite Alérgica/diagnóstico , Rinite Alérgica/epidemiologia , Rinite Alérgica/terapia , Sinusite/diagnóstico , Sinusite/epidemiologia , Sinusite/terapia
7.
Malawi Med J ; 33(1): 21-27, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-34422230

RESUMO

Background: Superficial fungal infections (SFIs) are prevalent among schoolchildren and result in significant morbidities that may lead to school absenteeism or school drop-out and hence setback in the education of the child. Differences exist in the epidemiology and pattern of SFIs among children in various geographical locations. Community-based studies on diseases are a true reflection of their pattern in that locality. There are no recent studies on this regard in south-east Nigeria despite the high prevalence reported in the country. Aim: This study aimed to determine the epidemiology and pattern of SFIs among children in rural and urban communities in Enugu, south-east Nigeria, for evidence-based effective interventions in this region. Methods: A comparative and descriptive cross-sectional study of primary school children from three randomly selected urban communities and three randomly selected rural communities was conducted. The sample size was determined with use of the formula for comparison of two proportions. A total of 1662 pupils were recruited through a multistage sampling method, with 831 from urban primary school populations and 831 from rural primary school populations. Data were analysed with IBM SPSS Statistics version 24. Results: Of the 1662 children recruited, 748 had SFIs, with 502 (60.4%) seen in urban communities and 246 (29.6%) seen in rural communities. Tinea capitis was the most prevalent SFI (73.7%), and there was a statistically significant difference between urban (40.3%) and rural (26.1%) communities (P<0.001). The prevalence of SFIs was higher among urban female and rural male pupils. Children aged 9-12 years and 5-8 years were most commonly affected in the urban and rural communities, respectively. The personal hygiene of the children was poor in both communities. Conclusion: Emphasis on health education for SFIs and good personal hygiene will reduce the incidence of SFIs in the communities, especially among urban dwellers, which will encourage school attendance, concentration in class and child education.


Assuntos
Micoses/epidemiologia , Tinha do Couro Cabeludo/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Nigéria/epidemiologia , Prevalência , População Rural , Instituições Acadêmicas , População Urbana
8.
J Breath Res ; 15(4)2021 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-34464944

RESUMO

The evidence that severe coronavirus disease 2019 (COVID-19) is a risk factor for development of mycotic respiratory infection with an increased mortality is rising. Immunosuppressed are among the most susceptible patients andAspergillusspecies is the most feared superinfection. In this study we evaluated mycotic isolation prevalence on bronchoalveolar lavage (BAL) of patients who underwent bronchoscopy in search of severe acute respiratory coronavirus 2 (SARS-CoV-2) RNA. Moreover, we described the clinical characteristics and main outcomes of these patients. We included 118 patients, 35.9% of them were immunosuppressed for different reasons: in 23.7% we isolated SARS-CoV-2 RNA, in 33.1% we identified at least one mycotic agent and both in 15.4%. On BAL we observed in three casesAspergillusspp, in six casesPneumocystisand in 32Candidaspp. The prevalence of significant mold infection was 29.3% and 70.7% of cases were false positive or clinically irrelevant infections. In-hospital mortality of patients with fungal infection was 15.3%. The most frequent computed tomography (CT) pattern, evaluated with the Radiological Society of North America consensus statement, among patients with a mycotic pulmonary infection was the atypical one (p< 0.0001). Mycotic isolation on BAL may be interpreted as an innocent bystander, but its identification could influence the prognosis of patients, especially in those who need invasive investigations during the COVID-19 pandemic; BAL plays a fundamental role in resolving clinical complex cases, especially in immunosuppressed patients independently from radiological features, without limiting its role in ruling out SARS-CoV-2 infection.


Assuntos
Lavagem Broncoalveolar , COVID-19/diagnóstico , COVID-19/epidemiologia , Micoses/diagnóstico , Micoses/epidemiologia , Nasofaringe/microbiologia , SARS-CoV-2 , Idoso , Idoso de 80 Anos ou mais , COVID-19/virologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Micoses/microbiologia , Nasofaringe/virologia , Pandemias , Prevalência , Prognóstico , RNA Viral/análise , RNA Viral/genética , RNA Viral/isolamento & purificação , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação
9.
Sci Rep ; 11(1): 17383, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34462470

RESUMO

Amphibian chytridiomycosis, caused by the fungus Batrachochytrium dendrobatidis (Bd), has caused the greatest known loss of biodiversity due to an infectious disease. We used Bd infection data from quantitative real-time PCR (qPCR) assays of amphibian skin swabs collected across Chile during 2008-2018 to model Bd occurrence with the aim to determine bioclimatic and anthropogenic variables associated with Bd infection. Also, we used Bd presence/absence records to identify geographical Bd high-risk areas and compare Bd prevalence and infection loads between amphibian families, ecoregions, and host ecology. Data comprised 4155 Bd-specific qPCR assays from 162 locations across a latitudinal gradient of 3700 km (18º to 51ºS). Results showed a significant clustering of Bd associated with urban centres and anthropogenically highly disturbed ecosystems in central-south Chile. Both Bd prevalence and Bd infection loads were higher in aquatic than terrestrial amphibian species. Our model indicated positive associations of Bd prevalence with altitude, temperature, precipitation and human-modified landscapes. Also, we found that macroscale drivers, such as land use change and climate, shape the occurrence of Bd at the landscape level. Our study provides with new evidence that can improve the effectiveness of strategies to mitigate biodiversity loss due to amphibian chytridiomycosis.


Assuntos
Anfíbios/microbiologia , Batrachochytrium/genética , Altitude , Animais , Batrachochytrium/isolamento & purificação , Chile , DNA Fúngico/análise , DNA Fúngico/metabolismo , Ecossistema , Modelos Lineares , Micoses/epidemiologia , Micoses/microbiologia , Micoses/patologia , Micoses/veterinária , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Análise Espacial , Temperatura
10.
Dis Aquat Organ ; 145: 145-157, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34196284

RESUMO

Disease monitoring is an essential step in translocation projects, specifically in amphibians where emerging pathogens such as the chytrid fungus Batrachochytrium dendrobatidis (Bd) are linked to population declines. The eastern hellbender Cryptobranchus alleganiensis is a large, fully aquatic salamander experiencing precipitous range-wide population declines; however, the role Bd plays in these declines is unclear. To augment declining hellbender populations and determine effects of translocation on Bd prevalence, we conducted a translocation study of wild adult hellbenders from 2 source streams with abundant hellbender populations to 2 streams with declining populations in east Tennessee, USA. In 2018, we implanted radio transmitters into 30 hellbenders and sampled them periodically for Bd until 17 of the 30 hellbenders were translocated in 2019. We attempted to recapture translocated hellbenders approximately every 45 d for 3 mo to determine Bd prevalence post-release. We used qPCR to detect Bd and quantify zoospore loads on positive samples. Hellbenders had a pre-translocation Bd prevalence of 50% (15 of 30), which decreased to 10% (1 of 10) post-translocation. The average zoospore load for positive samples was 73.63 ± 30.82, and no hellbenders showed signs of chytridiomycosis throughout the study. Although we detected no significant effect of translocation on Bd prevalence, we observed a reduction in Bd prevalence post-release. Our results indicate that translocation did not lead to an increase in pathogen prevalence in translocated wild adult hellbenders, suggesting that chytrid did not impact the success of short-term translocations of eastern hellbenders in the Blue Ridge ecoregion.


Assuntos
Quitridiomicetos , Micoses , Anfíbios , Animais , Batrachochytrium , Micoses/epidemiologia , Micoses/veterinária , Prevalência , Urodelos
11.
Future Microbiol ; 16: 919-925, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34319168

RESUMO

In the absence of potent antimicrobial agents, it is estimated that bacterial infections could cause millions of deaths. The emergence of COVID-19, its complex pathophysiology and the high propensity of patients to coinfections has resulted in therapeutic regimes that use a cocktail of antibiotics for disease management. Suboptimal antimicrobial stewardship in this era and the slow pace of drug discovery could result in large-scale drug resistance, narrowing future antimicrobial therapeutics. Thus, judicious use of current antimicrobials is imperative to keep up with existing and emerging infectious pathogens. Here, we provide insights into the potential implications of suboptimal antimicrobial stewardship, resulting from the emergence of COVID-19, on the spread of antimicrobial resistance.


Assuntos
Gestão de Antimicrobianos/métodos , Infecções Bacterianas , COVID-19/epidemiologia , Coinfecção , Micoses , Anti-Infecciosos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Coinfecção/tratamento farmacológico , Coinfecção/epidemiologia , Desinfecção das Mãos , Humanos , Micoses/tratamento farmacológico , Micoses/epidemiologia
12.
Sci Rep ; 11(1): 13240, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34168204

RESUMO

Zimbabwe currently faces several healthcare challenges, most notably HIV and associated infections including tuberculosis (TB), malaria and recently outbreaks of cholera, typhoid fever and COVID-19. Fungal infections, which are also a major public health threat, receive considerably less attention. Consequently, there is dearth of data regarding the burden of fungal diseases in the country. We estimated the burden of fungal diseases in Zimbabwe based on published literature and 'at-risk' populations (HIV/AIDS patients, survivors of pulmonary TB, cancer, chronic obstructive pulmonary disease, asthma and patients receiving critical care) using previously described methods. Where there was no data for Zimbabwe, regional, or international data was used. Our study revealed that approximately 14.9% of Zimbabweans suffer from fungal infections annually, with 80% having tinea capitis. The annual incidence of cryptococcal meningitis and Pneumocystis jirovecii pneumonia in HIV/AIDS were estimated at 41/100,000 and 63/100,000, respectively. The estimated prevalence of recurrent vulvovaginal candidiasis (RVVC) was 2,739/100,000. The estimated burden of fungal diseases in Zimbabwe is high in comparison to other African countries, highlighting the urgent need for increased awareness and surveillance to improve diagnosis and management.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Micoses/epidemiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Incidência , Masculino , Prevalência , Fatores de Risco , Zimbábue
13.
Microb Pathog ; 158: 105018, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34098021

RESUMO

This study aimed to determine the prevalence, the causative agents, clinical features, and the risk factors associated with the fungal rhinosinusitis in a tertiary health center with a view to providing valid grounds that may guide healthcare professionals to effectively prevent, control, and treat fungal infections. All patients were subjected to diagnostic nasal endoscopy and CT scan of paranasal sinuses and FRS were confirmed by routine and complementary mycological and molecular methods. The inclusion criteria for invasive FRS were: confirmed diagnosis of IFRS according to the guidelines of the EORTC/MSG criteria (i.e., clinical, microbiological, and histological evidence of invasive fungal infection). From a total of 512 suspected patients, FRS was confirmed in 108 cases (21.1%). Our results showed FB (38/108; 35.2%) is the most common form of FRS followed by AIFRS (33/108; 30.6%), AFS (32/108; 29.6%), and CIFRS (5/108; 4.6%). A. flavus and Rhizopus oryzae were the most common causes of infection in AFS, FB, CIFRS, and AIFRS, respectively. Univariate analysis of variables predictive of AIFRS revealed 3 variables significantly associated with AIFRS. These included mucosal abnormalities of the middle turbinate and septum, and specifically, necrosis of the middle turbinate (P < .0001). Microbiological cultures, although useful for mycological speciation, are less sensitive. Furthermore, we used molecular methods to confirm the identity of some isolates that were not detectable using routine methods. Our data showed that the molecular methods and histologic diagnosis in all patients were more sensitive than the unenhanced sinus CT scan, and conventional microbiological methods.


Assuntos
Micoses , Sinusite , Fungos/genética , Humanos , Micoses/diagnóstico por imagem , Micoses/epidemiologia , Nariz , Sinusite/diagnóstico por imagem , Tomografia Computadorizada por Raios X
14.
BMC Infect Dis ; 21(1): 514, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074256

RESUMO

BACKGROUND: Talaromyces marneffei (TM) bloodstream infection is common in Acquired Immunodeficiency Syndrome (AIDS) patients with extreme immunodeficiency in Southeast Asia and South China, however, clinical case study on TM bloodstream infection is scarce. We retrospectively analyzed the clinical characteristics of TM bloodstream infection in hospitalized AIDS patients and determined the outcomes of hospitalization after diagnosis in our hospital over the past 5 years. METHODS: From January 2015 to July 2020, 87 cases of TM detected by blood culture in patients admitted to our center were collected. The admission complaints, blood cells, biochemistry, CD4 and CD8 cell counts and 1,3-ß-D-glucan (BDG), procalcitonin (PCT), CRP level on the day of blood culture test, and outcomes during hospitalization were analyzed. Logistic regression analysis was performed for the risk factors for poor prognosis (60 cases). Spearman correlation analysis was used to analyze the correlation between peripheral blood cells, albumin and the time required for TM turnaround in blood culture. The difference was statistically significant when the P value was < 0.05. RESULTS: A total of 87 patients were collected, with a median age of 34 years, a median hemoglobin of 94 g/L and CD4 count of 7/µl. The rate of TM bloodstream infection among all in-hospital patients increased from 0.99% in 2015 to 2.09% in 2020(half year). Patients with TM bloodstream infection with CD8 count < 200/µl had a 12.6-fold higher risk of poor prognosis than those with CD8 count > 200/µl (p = 0.04), and those with BDG < 100 pg/mL had a 34.9-fold higher risk of poor prognosis than those with BDG > 100 pg/mL (p = 0.01). CONCLUSIONS: TM bloodstream infection is becoming more common in advanced AIDS patients in endemic areas. For those patients with extremely low CD4 and CD8 cell counts below 200/µl is with an increased risk of poor prognosis.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Fungemia/epidemiologia , Micoses/epidemiologia , Talaromyces/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Adulto , China/epidemiologia , Feminino , Fungemia/diagnóstico , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico , Prognóstico , Estudos Retrospectivos , Fatores de Risco
15.
Curr Opin Organ Transplant ; 26(4): 440-444, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074940

RESUMO

PURPOSE OF REVIEW: This review examines recent cases and updated literature on emerging or newly resistant fungal infections in solid organ transplantation. RECENT FINDINGS: Candida auris, a newly described candida capable of drug resistance and persistence in the environment, is a growing concern with both published cases on donor-derived transmission and a hospital outbreak involving liver transplant recipients. Infections with non-albicans candida species are also increasing in incidence in SOT recipients, leading to increasing antifungal resistance and higher mortality. Aspergillus usti has emerged in immunocompromised patients on antifungal prophylaxis. Cryptococcus species continue to be responsible for a number of infections in SOT recipients. Dimorphic fungi, endemic to geographic areas and responsible for sporadic infections in SOT recipients are noted to have an expanding geographic area. Emergomyces are newly classified groups of five species of dimorphic fungi noted to disseminated disease in immunocompromised patients including SOT recipients. SUMMARY: Emerging fungal species and the development of resistance in well entrenched fungal pathogens impacts SOT recipients and those caring for them. Knowledge of these trends aids in the successful identification and optimal treatment of these challenging conditions.


Assuntos
Micoses , Transplante de Órgãos , Antifúngicos/uso terapêutico , Candida , Fungos , Humanos , Micoses/tratamento farmacológico , Micoses/epidemiologia , Transplante de Órgãos/efeitos adversos
16.
Rev Iberoam Micol ; 38(2): 75-83, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34148786

RESUMO

In recent years, immunodeficiency condition has experienced a rise among children, who are at risk of invasive fungal infections (IFI) due to their health condition. Cancer, non-malignant hematological diseases, as primary immunodeficiencies, hematopoietic stem cell transplantation (HSCT), extreme prematurity, or critically ill condition in Pediatric Intensive Care Unit (PICU) are some immunosuppressive situations in children. The use of oncologic therapies, including immunotherapy and monoclonal antibodies, for the treatment of the aforementioned health conditions has led to an increase in morbidity and mortality rates of IFI in children. The underlying diseases and their management, comorbidities, the diagnostic tests used (both molecular and imaging), as well as the treatment used can be significantly different between adult patients and children admitted to PICU or with cancer. In pediatrics, the treatment of IFI is based primarily on pharmacokinetic studies performed in adults. In higher risk patients prophylaxis should be considered and, in the case of an IFI diagnosis, an antifungal treatment should be administered as early as possible, supported by the reversion of the immune dysfunction and surgery when appropriate.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Infecções Fúngicas Invasivas , Micoses , Antifúngicos/uso terapêutico , Criança , Humanos , Hospedeiro Imunocomprometido , Infecções Fúngicas Invasivas/diagnóstico , Infecções Fúngicas Invasivas/tratamento farmacológico , Infecções Fúngicas Invasivas/epidemiologia , Micoses/diagnóstico , Micoses/tratamento farmacológico , Micoses/epidemiologia , Estudos Retrospectivos
17.
Dis Aquat Organ ; 144: 133-142, 2021 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-33955851

RESUMO

Complex interactions among hosts, pathogens, and the environment affect the vulnerability of amphibians to the emergence of infectious diseases such as chytridiomycosis, caused by Batrachochytrium dendrobatidis (Bd). Boana curupi is a forest-dwelling amphibian endemic to the southern Atlantic Forest of South America, a severely fragmented region. Here, we evaluated whether abiotic factors (including air and water temperature, relative air humidity, and landscape) are correlated with chytrid infection intensity and prevalence in B. curupi. We found individuals infected with Bd in all populations sampled. Prevalence ranged from 25-86%, and the infection burden ranged from 1 to over 130000 zoospore genomic equivalents (g.e.) (mean ± SD: 4913 ± 18081 g.e.). The infection load differed among populations and was influenced by forest cover at scales of 100, 500, and 1000 m, with the highest infection rates recorded in areas with a higher proportion of forest cover. Our results suggest that the fungus is widely distributed in the populations of B. curupi in southern Brazil. Population and disease monitoring are necessary to better understand the relationships between host, pathogen, and environment, especially when, as in the case of B. curupi, threatened species are involved.


Assuntos
Quitridiomicetos , Micoses , Anfíbios , Animais , Anuros , Brasil/epidemiologia , Florestas , Micoses/epidemiologia , Micoses/veterinária
18.
PLoS One ; 16(5): e0251170, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33956882

RESUMO

INTRODUCTION: The recovery of other pathogens in patients with SARS-CoV-2 infection has been reported, either at the time of a SARS-CoV-2 infection diagnosis (co-infection) or subsequently (superinfection). However, data on the prevalence, microbiology, and outcomes of co-infection and superinfection are limited. The purpose of this study was to examine the occurrence of co-infections and superinfections and their outcomes among patients with SARS-CoV-2 infection. PATIENTS AND METHODS: We searched literature databases for studies published from October 1, 2019, through February 8, 2021. We included studies that reported clinical features and outcomes of co-infection or superinfection of SARS-CoV-2 and other pathogens in hospitalized and non-hospitalized patients. We followed PRISMA guidelines, and we registered the protocol with PROSPERO as: CRD42020189763. RESULTS: Of 6639 articles screened, 118 were included in the random effects meta-analysis. The pooled prevalence of co-infection was 19% (95% confidence interval [CI]: 14%-25%, I2 = 98%) and that of superinfection was 24% (95% CI: 19%-30%). Pooled prevalence of pathogen type stratified by co- or superinfection were: viral co-infections, 10% (95% CI: 6%-14%); viral superinfections, 4% (95% CI: 0%-10%); bacterial co-infections, 8% (95% CI: 5%-11%); bacterial superinfections, 20% (95% CI: 13%-28%); fungal co-infections, 4% (95% CI: 2%-7%); and fungal superinfections, 8% (95% CI: 4%-13%). Patients with a co-infection or superinfection had higher odds of dying than those who only had SARS-CoV-2 infection (odds ratio = 3.31, 95% CI: 1.82-5.99). Compared to those with co-infections, patients with superinfections had a higher prevalence of mechanical ventilation (45% [95% CI: 33%-58%] vs. 10% [95% CI: 5%-16%]), but patients with co-infections had a greater average length of hospital stay than those with superinfections (mean = 29.0 days, standard deviation [SD] = 6.7 vs. mean = 16 days, SD = 6.2, respectively). CONCLUSIONS: Our study showed that as many as 19% of patients with COVID-19 have co-infections and 24% have superinfections. The presence of either co-infection or superinfection was associated with poor outcomes, including increased mortality. Our findings support the need for diagnostic testing to identify and treat co-occurring respiratory infections among patients with SARS-CoV-2 infection.


Assuntos
COVID-19/epidemiologia , Coinfecção/epidemiologia , Superinfecção/epidemiologia , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/mortalidade , Infecções Bacterianas/terapia , COVID-19/mortalidade , COVID-19/terapia , Coinfecção/mortalidade , Coinfecção/terapia , Hospitalização , Humanos , Micoses/epidemiologia , Micoses/mortalidade , Micoses/terapia , Prevalência , SARS-CoV-2/isolamento & purificação , Superinfecção/mortalidade , Superinfecção/terapia , Resultado do Tratamento , Viroses/epidemiologia , Viroses/mortalidade , Viroses/terapia
20.
Indian J Med Res ; 153(3): 311-319, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33906993

RESUMO

Fungal diseases have not been taken seriously in public health agendas as well as research priorities, despite of globally causing an estimated two million deaths every year, and the emergence of many troublesome fungal pathogens like Candida auris, azole resistant Aspergillus fumigatus, terbinafine and azole resistant dermatophytes, and zoonotic sporotrichosis in humans. Fungi are also responsible for huge losses of agricultural products and stored crops as well as recent massive and unexpected mortality in animals caused by white-nose syndrome in the bats and Chytridiomycosis in amphibians. This review aims to underscore the need for collaborative, multisectoral, and trans-disciplinary approach to include the One Health approach as an essential component of surveillance, prevention, and control of globally emerging fungal diseases. Rigorous evidence based surveillance of the environment as well as strengthening rapid and quality diagnosis of fungal diseases can save millions of lives and reduce significant morbidity.


Assuntos
Micoses , Saúde Única , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Aspergillus fumigatus , Azóis , Farmacorresistência Fúngica , Humanos , Micoses/epidemiologia
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