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2.
Pan Afr Med J ; 33: 198, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692732

RESUMO

Introduction: Epidemiology of these disorders, mainly caused by mycosis, is little known in the Ivory Coast. The aim of this study was to determine the different clinical aspects of intertrigos caused by fungal infections. Methods: We conducted a cross-sectional study in the Department of Clinical Dermatology at the University Hospital in Yopougon (Abidjan, Ivory Coast) from April to October 2012. The study involved the patients come to consultation with lesions in the folds suggesting a mycosis. Samples of serous fluid by swabbing or of scales by scrape cutting with the scalpel blade were performed at the level of the lesions. The fungal agents responsible for these lesions were identified after biological culture. Results: A total of 200 patients had lesions suggesting intertrigo caused by fungal infection. The average age of patients was 29.8 years (with a standard deviation of 11.1 years). Mycosis-related intertrigos accounted for 6.7% of reasons for consultation. A female predominance was observed (76.7%). Lesions mainly occurred in the groin area (40.8%) and in the intergluteal clefts (36.9%). The most observed symptoms were maceration (52.4%) followed by burning (18.4%). In 89.3% of cases, intertrigos were caused by yeasts, including Candida albicans (33%), and Candida parapsilosis(19.4%) which were predominant. Conclusion: Mycosis-related intertrigos mainly affect the young adults of female sex. Lesions mainly occur at the level of the inguinal folds and intergluteal clefts. The main etiological agents are yeasts (Candida).


Assuntos
Candidíase/epidemiologia , Intertrigo/epidemiologia , Micoses/epidemiologia , Adolescente , Adulto , Candida/isolamento & purificação , Candidíase/microbiologia , Criança , Pré-Escolar , Costa do Marfim , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Lactente , Intertrigo/microbiologia , Masculino , Pessoa de Meia-Idade , Micoses/microbiologia , Fatores Sexuais , Adulto Jovem
3.
J Basic Microbiol ; 59(11): 1092-1104, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31613011

RESUMO

Melanins are one of the great natural pigments produced by a wide variety of fungal species that promote fitness and cell survival in diverse hostile environments, including during mammalian infection. In this study, we sought to demonstrate the production of melanin in the conidia and hyphae of saprophytic fungi, including dematiaceous and hyaline fungi. We showed that a melanin-specific monoclonal antibody (MAb) avidly labeled the cell walls of hyphae and conidia, consistent with the presence of melanin in these structures, in 14 diverse fungal species. The conidia of saprophytic fungi were treated with proteolytic enzymes, denaturant, and concentrated hot acid to yield dark particles, which were shown to be stable free radicals, consistent with their identification as melanins. Samples obtained from patients with fungal keratitis due to Fusarium falciforme, Aspergillus fumigatus, Aspergillus flavus, Curvularia lunata, Exserohilum rostratum, or Fonsecaea pedrosoi were found to be intensely labeled by the melanin-specific MAb at the fungal hyphal cell walls. These results support the hypothesis that melanin is a common component that promotes survival under harsh conditions and facilitates fungal virulence. Increased understanding of the processes of melanization and the development of methods to interfere with pigment formation may lead to novel approaches to combat these complex pathogens that are associated with high rates of morbidity and mortality.


Assuntos
Fungos/metabolismo , Melaninas/biossíntese , Micoses/microbiologia , Anticorpos Monoclonais/imunologia , Parede Celular/metabolismo , Fungos/isolamento & purificação , Humanos , Hifas/isolamento & purificação , Hifas/metabolismo , Ceratite/microbiologia , Melaninas/imunologia , Esporos Fúngicos/isolamento & purificação , Esporos Fúngicos/metabolismo
4.
Medicine (Baltimore) ; 98(38): e17315, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31568018

RESUMO

Early differential diagnosis of bloodstream infections (BSIs) caused by different sources and species of bacteria in hospitalized patients is crucial for the timely targeted interventions including appropriate use of antibiotics. The aim of this study was to identify 9 biomarkers for the early differentiation of gram-negative-bloodstream infection (GN-BSI), gram-positive (GP)-BSI, and fungal-BSI.A prospective study was conducted for a total of 390 inpatients who underwent blood culture in the Chinese PLA General Hospital from September 2015 to March 2018. Patients with positive culture of a single pathogen were divided into GN-BSI, GP-BSI, and Fungal-BSI groups, and a culture-negative disease control group was also established. The serum levels of macrophage inflammatory protein 1ß (MIP-1ß), tumor necrosis factor α (TNF-α), interleukin (IL)-3, interferon (IFN)-γ, IL-17A, IL-4, IL-12p70, and P-selectin were detected and the NLR was calculated from routine blood test. Receiver-operating characteristic analysis was used to determine the efficacy of various indicators in the differential diagnosis of BSIs. Prediction and validation experiments on clinical patient samples (263 cases) were also performed.The level of IL-3 in the GP-BSI group was significantly higher than those in the other 3 groups. The level of IFN-γ in the fungal-BSI group was significantly higher than those in the other 3 groups. NLR, MIP-1ß, TNF-α, IL-17A, and IL3 exhibited some efficacy when distinguishing between GN-BSI and GP-BSI and NLR had the largest area under curve (AUC) (0.728), followed by MIP-1ß with an AUC of 0.679. IFN-γ and IL-3 exhibited some value in differential diagnosis between GN-BSI and Fungal-BSI. IL-3, MIP-1ß, TNF-α, IFN-γ, NLR, IL-17A, and IL-4 exhibited some value in distinguishing fungal-BSI and GP-BSI, with IL-3 had the largest AUC (0.722), followed by MIP-1ß with an AUC of 0.703.NLR and MIP-1ß may be valuable in differentiating GN-BSI from GP-BSI in hospitalized patients. IFN-γ and IL-3 may be helpful in differential diagnosis GN-BSI and fungal-BSI. IL-3 and MIP-1ß exhibited some diagnostic efficacy in distinguishing fungal-BSI and GP-BSI. Additionally, IL-3 with high serum level may be a marker for GP-BSI and IFN-γ with high serum level may be a valuable marker for the prediction of Fungal-BSI. The utility of these biomarkers to predict BSIs owing to different pathogens in hospitalized patients needs to be assessed in further studies.


Assuntos
Bacteriemia/diagnóstico , Quimiocina CCL4/sangue , Infecção Hospitalar/diagnóstico , Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Positivas/diagnóstico , Interferon gama/sangue , Interleucina-12/sangue , Interleucina-17/sangue , Interleucina-3/sangue , Interleucina-4/sangue , Micoses/diagnóstico , Proteínas NLR/sangue , Selectina-P/sangue , Fator de Necrose Tumoral alfa/sangue , Bacteriemia/sangue , Bacteriemia/microbiologia , Biomarcadores/sangue , Infecção Hospitalar/sangue , Infecção Hospitalar/microbiologia , Diagnóstico Diferencial , Feminino , Infecções por Bactérias Gram-Negativas/sangue , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Positivas/sangue , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/sangue , Micoses/microbiologia , Estudos Prospectivos
5.
Medicine (Baltimore) ; 98(41): e17535, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593129

RESUMO

Scedosporium genus as a significant emerging opportunist causes a broad spectrum of disease in not only immunosuppressed but also immunocompetent patients. The lung is one of the most commonly encountered sites of Scedosporium infection. Due to its very high levels of antifungal resistance, surgery has been recommended as an important part in the treatment of pulmonary Scedosporium spp infection, even in immunocompetent cases. However, whether lung surgery could help to reduce the risk of death in immunocompetent patients is not clear.We retrospectively retrieved the records of pulmonary infections with Scedosporium species in immunocompetent patients through a comprehensive literature search. The association of surgery on all-cause mortality was explored using binary logistic regression (BLR). Receiver operating characteristic (ROC) curve analysis was carried out to evaluate the capability of the model.The comprehensive searching strategy yielded 33 case reports and 3 case series in total, with 40 individual patients being included. The overall mortality was 12.50%. The fatality rate was 9.09% (2/22) in cases with surgery and 16.67% (3/18) in cases without surgery (odds ratio, 0.50; 95% confidence interval, 0.07-3.38; P = .48). Consistently, BLR analysis identified no statistical association between surgery and reduced mortality (odds ratio, 1.19; 95% confidence interval, 0.09-15.64; P = .89), after adjusting for age, gender, and antifungal chemotherapy. The area under the ROC curve was 0.88.For immunocompetent patients with pulmonary Scedosporium spp infection, surgical therapy may not be associated with reduced mortality. Surgical excision could be considered but is not imperative in this group of patients.


Assuntos
Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/cirurgia , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/cirurgia , Scedosporium/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , Farmacorresistência Fúngica/fisiologia , Feminino , Humanos , Hospedeiro Imunocomprometido/efeitos dos fármacos , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/mortalidade , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Micoses/tratamento farmacológico , Micoses/epidemiologia , Micoses/microbiologia , Micoses/mortalidade , Estudos Observacionais como Assunto , Cuidados Pós-Operatórios , Infecções Respiratórias/microbiologia , Infecções Respiratórias/mortalidade , Estudos Retrospectivos , Scedosporium/isolamento & purificação , Voriconazol/administração & dosagem , Voriconazol/uso terapêutico
6.
J Med Microbiol ; 68(11): 1664-1670, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31553302

RESUMO

Purpose. To assess in vitro activities of nine antifungal agents (amphotericin B, fluconazole, voriconazole, itraconazole, posaconazole, caspofungin, micafungin, terbinafine and 5-flucytosine) against 93 strains of rare pathogenic fungi and the combined effects of drug combinations against several multidrug-resistant fungi.Methodology. The broth microdilution method M38-A3 and M27-A4 from the Clinical and Laboratory Standards Institute and the checkerboard method were performed in this study.Results. Low MICs for fluconazole were observed in moulds including Tritirachium oryzae, Exophiala attenuata and yeasts. MICs for amphotericin B>2 µg ml-1 were found among Aspergillus nidulans, Fusarium napiforme, Trichoderma longibrachiatum, Tritirachium oryzae, Cunninghamella bertholletiae, Cunninghamella phaeospora, Conidiobolus coronatus, Exophiala attenuata, Ochroconis mirabilis and Rhinocladiella basitona. Multidrug resistance was observed in Microascus spp., Lomentospora prolificans and Pythium insidiosum.Conclusion. Our study illustrated in vitro drug susceptibilities of some rare pathogenic fungi, which provide data to guide clinical treatment of fungal infections.


Assuntos
Antifúngicos/farmacologia , Fungos/efeitos dos fármacos , Micoses/microbiologia , Anfotericina B/farmacologia , Farmacorresistência Fúngica , Fluconazol/farmacologia , Fungos/classificação , Fungos/genética , Fungos/isolamento & purificação , Humanos , Itraconazol/farmacologia , Testes de Sensibilidade Microbiana , Triazóis/farmacologia , Voriconazol/farmacologia
7.
Med. infant ; 26(3): 272-275, sept. 2019. Tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1026763

RESUMO

Introducción: En pacientes pediátricos quemados la osteomielitis fúngica es una complicación infrecuente que conduce a una significativa morbilidad. La información en la literatura está limitada a unos escasos reportes de casos. Objetivo: Describir las características clínicas, epidemiológicas y de evolución de niños quemados con osteomielitis fúngica. Métodos: Se llevo a cabo un estudio retrospectivo y descriptivo de pacientes mayores de 1 mes y menores de 18 años quemados con osteomielitis fúngica internados en el hospital Juan P. Garrahan, un hospital terciario en Buenos Aires, Argentina. Resultados: entre enero del 2007 y enero del 2017, de 600 niños quemados, 9 pacientes presentaron diagnóstico confirmado de osteomielitis fúngica. La mediana de edad fue de 42.5 meses (RIC, 27-118 meses) y la mediana de superficie quemada fue de 33.5% (RIC, 18.5-58%). La osteomielitis fue diagnosticada con una mediana de 30 días luego de la quemadura. Las localizaciones más frecuentes de osteomielitis fueron los miembros superiores y a nivel de calota. Los microorganismos aislados a partir del cultivo de hueso fueron: Fusarium spp. en tres pacientes, Mucor spp. en un paciente; Trichosporon asahii en un paciente; Cándida albicans en dos pacientes y Candida parapsilosis en dos pacientes. En dos casos la infección fúngica fue asociada con aislamientos bacteriano concomitante. Todos los pacientes presentaron hallazgos histopatológicos compatibles con osteomielitis. La mediana de tiempo de tratamiento fue de 44.5 días (RIC, 34.5- 65.5 días). Seis pacientes (67%) presentaron secuela motora. Conclusión: La osteomielitis fúngica fue infrecuente Candida spp. y Fusarium spp. fueron los hongos más comúnmente identificados. La secuela funcional fue frecuente (AU)


Introduction: In pediatric burn patients fungal osteomyelitis is a rare complication that leads to significant morbidity. Data in the literature are limited to sporadic case reports. Objective: To describe the clinical and epidemiological features and outcome in burned children with fungal osteomyelitis. Methods: A retrospective descriptive study was conducted in burn patients older than 1 month and younger than 18 years admitted to Hospital Juan P. Garrahan, a tertiary hospital in Buenos Aires, Argentina. Results: Between January 2007 and January 2017, of 600 burned children, nine had a confirmed diagnosis of fungal osteomyelitis. Median age was 42.5 months (IQR, 27-118 months) and median burn surface was 33.5% (IQR, 18.5-58%). Osteomyelitis was diagnosed at a median of 30 days after the burn. The most common location of osteomyelitis were the upper limbs and skull. The microorganisms isolated form bone cultures were Fusarium spp. in three patients, Mucor spp. in one patient; Trichosporon asahii in one patient; Candida albicans in two patients; and Candida parapsilosis in two patients. In two cases the funal infection was associated with concomitant bacterial isolation. In all patients, the histopathological findings were compatible with osteomyelitis. Median duration of treatment was 44.5 days (IQR, 34.5-65.5 days). Six patients (67%) had motor sequelae. Conclusion: Fungal osteomyelitis is a rare disease. Candida spp. and Fusarium spp. were most frequently identified fungi. Functional sequelae were common (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Osteomielite/diagnóstico , Osteomielite/etiologia , Osteomielite/epidemiologia , Queimaduras/complicações , Micoses/microbiologia , Candida/isolamento & purificação , Miose/tratamento farmacológico , Estudos Retrospectivos , Fusarium/isolamento & purificação , Antifúngicos/uso terapêutico
8.
BMC Infect Dis ; 19(1): 745, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455239

RESUMO

BACKGROUND: Due to the similar clinical, lung imaging, and pathological characteristics, talaromycosis is most commonly misdiagnosed as tuberculosis. This study aimed to identify the characteristics of talaromycosis pleural effusion (TMPE) and to distinguish TMPE from tuberculosis pleural effusion (TPE). METHODS: We enrolled 19 cases each of TMPE and TPE from Guangxi, China. Patients' clinical records, pleural effusion tests, biomarker test results, and receiver operating characteristic curves were analyzed. RESULTS: In total, 39.8% (65/163) of patients exhibited serous effusion, of whom 61 were non-human immunodeficiency virus (HIV)-infected patients; 68.85% of the non-HIV-infected patients (42/61) had TMPE. Thoracentesis was performed only in 19 patients, all of whom were misdiagnosed with tuberculosis and received long-term anti-tuberculosis treatment. In four of these patients, interleukin (IL)-23, IL-27, and interferon-gamma (IFN-γ) measurements were not performed since pleural effusion samples could not be collected because the effusion had been drained prior to the study. In the remaining 15 patients, pleural effusion samples were collected. Talaromyces marneffei was isolated from the pleural effusion and pleural nodules. Most TMPEs were characterized by yellowish fluid, with marked elevation of protein content and nucleated cell counts. However, neutrophils were predominantly found in TMPEs, and lymphocytes were predominantly found in TPEs (both p < 0.05). Adenosine deaminase (ADA) and IFN-γ levels in TMPEs were significantly lower than those in TPEs (all p < 0.05) and provided similar accuracies for distinguishing TMPEs from TPEs. IL-23 concentration in TMPEs was significantly higher than that in TPEs (p < 0.05), and it provided similar accuracy for diagnosing TMPEs. IL-27 concentrations in TMPEs were significantly lower than those in TPEs (all p < 0.05) but was not useful for distinguishing TMPE from TPE. CONCLUSIONS: Talaromycosis can infringe on the pleural cavity via the translocation of T. marneffei into the pleural space. Nonetheless, this phenomenon is still commonly neglected by clinicians. TMPE is a yellowish fluid with exudative PEs and predominant neutrophils. Higher neutrophil counts and IL-23 may suggest talaromycosis. Higher lymphocyte counts, ADA activity, and IFN-γ concentration may suggest tuberculosis.


Assuntos
Micoses/etiologia , Derrame Pleural/microbiologia , Tuberculose Pleural/diagnóstico , Adenosina Desaminase/metabolismo , Adolescente , Adulto , Idoso , Biomarcadores/metabolismo , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Interferon gama/metabolismo , Subunidade p19 da Interleucina-23/metabolismo , Interleucinas/metabolismo , Linfócitos/microbiologia , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Micoses/tratamento farmacológico , Micoses/microbiologia , Neutrófilos/microbiologia , Neutrófilos/patologia , Derrame Pleural/diagnóstico , Derrame Pleural/tratamento farmacológico , Curva ROC , Talaromyces/patogenicidade , Tuberculose Pleural/tratamento farmacológico , Tuberculose Pleural/etiologia
9.
Emerg Infect Dis ; 25(9): 1765-1768, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31441765

RESUMO

Talaromyces marneffei and other Talaromyces species can cause opportunistic invasive fungal infections. We characterized clinical Talaromyces isolates from patients in California, USA, a non-Talaromyces-endemic area, by a multiphasic approach, including multigene phylogeny, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and phenotypic methods. We identified 10 potentially pathogenic Talaromyces isolates, 2 T. marneffei.


Assuntos
Micoses/epidemiologia , Talaromyces/isolamento & purificação , Adulto , California/epidemiologia , Humanos , Masculino , Micoses/microbiologia , Filogenia , Talaromyces/genética
10.
Emerg Infect Dis ; 25(9): 1750-1751, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31441766

RESUMO

We describe emergomycosis in a patient in Uganda with HIV infection. We tested a formalin-fixed, paraffin-embedded skin biopsy to identify Emergomyces pasteurianus or a closely related pathogen by sequencing broad-range fungal PCR amplicons. Results suggest that emergomycosis is more widespread and genetically diverse than previously documented. PCR on tissue blocks may help clarify emergomycosis epidemiology.


Assuntos
Chrysosporium/isolamento & purificação , Infecções por HIV , Micoses/diagnóstico , Adulto , Antifúngicos/uso terapêutico , Chrysosporium/genética , Diagnóstico Diferencial , Feminino , Humanos , Itraconazol/uso terapêutico , Micoses/tratamento farmacológico , Micoses/microbiologia , Reação em Cadeia da Polimerase , Uganda
11.
Microbiol Res ; 227: 126298, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31421716

RESUMO

An increasing number of infections originating from probiotic use are reported worldwide, with the majority of such cases caused by the yeast Saccharomyces 'boulardii', a subtype of S. cerevisiae. Reliably linking infectious cases to probiotic products requires unequivocal genotyping data, however, these techniques are often time-consuming and difficult to implement in routine diagnostics. This leads to a widespread lack of genetic data regarding the origin of Saccharomyces infections. We propose a quick and reliable PCR-based protocol for the identification of S. 'boulardii' based on a combined analysis of interdelta fingerprinting and microsatellite typing. By applying various typing methods and our proposed method to the clinical yeast collection of a Hungarian hospital we show that probiotic origin is common among clinical Saccharomyces, and that the new multiplex method enables rapid and unequivocal identification of probiotic yeast infections. This method can be applied for the identification of yeast infection sources, helping decisions on probiotic use.


Assuntos
Reação em Cadeia da Polimerase Multiplex/métodos , Técnicas de Tipagem Micológica/métodos , Probióticos , Saccharomyces/genética , Saccharomyces/isolamento & purificação , DNA Fúngico/isolamento & purificação , Fungemia/microbiologia , Técnicas de Genotipagem , Humanos , Repetições de Microssatélites , Micoses/microbiologia , Saccharomyces/classificação , Saccharomyces/patogenicidade , Saccharomyces cerevisiae/classificação , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/isolamento & purificação
12.
J Vet Med Sci ; 81(9): 1348-1350, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31341135

RESUMO

A wild adult Eurasian scops owl (Otus scops), which was unable to fly, was rescued. Physical examination revealed a sticky exudate around the glottis. Heterophilic leukocytosis was identified through complete blood count, and radiography revealed a marked elevated density of posterior air sacs and inner cavities in both sides of the humerus and femur. Fungal cultures of samples taken from the owl suggested a respiratory fungal infection. Through molecular typing, the fungus was identified as Epicoccum nigrum. The owl was treated with oral itraconazole and broad-spectrum antibiotics. After one month, the inner cavities of pneumatic bones were slightly distinguishable by radiography and the owl started to fly well. Two months later, the air sac and all pneumatic bones displayed normal appearance.


Assuntos
Ascomicetos/isolamento & purificação , Doenças Ósseas/veterinária , Micoses/veterinária , Estrigiformes/microbiologia , Sacos Aéreos/microbiologia , Animais , Anti-Infecciosos/administração & dosagem , Antifúngicos/administração & dosagem , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/tratamento farmacológico , Doenças Ósseas/microbiologia , Itraconazol/administração & dosagem , Micoses/tratamento farmacológico , Micoses/microbiologia , República da Coreia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/veterinária
13.
BMC Pulm Med ; 19(1): 132, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319825

RESUMO

BACKGROUND: Culturing of bronchoalveolar lavage (BAL) fluid is a commonly used method for pathogen detection in pneumonia. However, the sensitivity is low, especially in patients pre-treated with anti-infective agents. The early detection of a pathogen is crucial for the outcome of respiratory tract infections. For bloodstream infections, a multiplex polymerase chain reaction (PCR) assay (SeptiFast®, SF) is available for improved pathogen detection from blood. OBJECTIVE: The aim of the present study was to determine whether the SF assay is applicable to the BAL of children with pulmonary infections and whether the frequency of pathogen detection is enhanced by the use of this multiplex PCR method. METHODS: We investigated 70 BAL samples of 70 children simultaneously by culture and multiplex PCR. The frequency of pathogen detection was compared. RESULTS: Pathogens were detected more frequently by SF than by culture (83% vs. 31%; p < 0.001). This advantage was shown for immunocompetent patients (p = 0.001) as well as for immunocompromised patients (p = 0.003). The majority (38/44; 86%) of the Gram positive cocci were only detected by SF. Fungal organisms were detected in 7/70 patients (10%) by SF and in 2/70 (3%) by culture (p = 0.125). CONCLUSION: Compared to conventional culture, the use of the SF assay on the BAL of children with pneumonia increases pathogen detection rates and therefore adds important information to guide anti-infective therapy.


Assuntos
Infecções Bacterianas/diagnóstico , Líquido da Lavagem Broncoalveolar/microbiologia , Micoses/diagnóstico , Adolescente , Adulto , Infecções Bacterianas/microbiologia , Criança , Pré-Escolar , Feminino , Fungos/isolamento & purificação , Fungos/patogenicidade , Cocos Gram-Positivos/isolamento & purificação , Cocos Gram-Positivos/patogenicidade , Humanos , Hospedeiro Imunocomprometido , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase Multiplex , Micoses/microbiologia , Pneumonia/diagnóstico , Pneumonia/microbiologia , Sensibilidade e Especificidade , Adulto Jovem
14.
J Zoo Wildl Med ; 50(2): 492-497, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31260222

RESUMO

Chytridiomycosis, an infectious disease caused by the fungus Batrachochytrium dendrobatidis (chytrid or Bd), has not been well studied in Oklahoma. This is of particular concern regarding the connection between seasonality and chytrid infection. To further investigate this connection, chytrid prevalence and infection load were quantified within amphibians in central Oklahoma from March to October, across two sites in Oklahoma Co. and two sites in Cleveland Co. The results show a trend between seasonality and chytrid, with spring and fall showing higher prevalence and summer showing lower prevalence, which coincides closely with the preferred chytrid growth temperatures. Additionally, periods of high rainfall in May 2015 are linked to increased chytrid prevalence, as has been suggested by other research. Additionally, species exhibiting high chytrid prevalence follow the results of previous studies: Blanchard's cricket frog (Acris blanchardi), American bullfrog (Rana catesbeiana), and southern leopard frog (Rana sphenocephala).


Assuntos
Anuros/microbiologia , Quitridiomicetos/isolamento & purificação , Animais , Micoses/epidemiologia , Micoses/microbiologia , Oklahoma/epidemiologia , Prevalência , Estações do Ano , Tempo (Meteorologia)
15.
Can J Microbiol ; 65(11): 814-822, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31265796

RESUMO

Peptidases secreted by a clinical high-virulence Scedosporium aurantiacum isolate (strain WM 06.482; CBS 136046) under normoxic and hypoxic conditions were separated via size-exclusion chromatography, and peptidase activities present in each fraction were determined using class-specific substrates. The fractions demonstrating peptidase activity were assessed for their effects on the attachment and viability of A549 human lung epithelial cells in vitro. Of the peptidases detected in the size-exclusion chromatography fractions, the elastase-like peptidase reduced cell viability, the chymotrypsin-like peptidase was associated with cell detachment, and the cysteine peptidases were able to abolish both cell attachment and viability. The loss of cell viability and attachment became more prominent with an increase in the peptidase activity and could also be specifically prevented by addition of class-specific peptidase inhibitors. Our findings indicate that peptidases secreted by S. aurantiacum can breach the human alveolar epithelial cell barrier and, thus, may have a role in the pathobiology of the organism.


Assuntos
Células Epiteliais/microbiologia , Proteínas Fúngicas/metabolismo , Micoses/microbiologia , Peptídeo Hidrolases/metabolismo , Scedosporium/enzimologia , Transporte Biológico , Proteínas Fúngicas/isolamento & purificação , Humanos , Peptídeo Hidrolases/isolamento & purificação , Scedosporium/metabolismo , Scedosporium/patogenicidade , Virulência
16.
J Microbiol Immunol Infect ; 52(5): 728-735, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302087

RESUMO

BACKGOUND: Conventional diagnosis of invasive fungal disease from blood cultures is often notoriously delayed and inadequately sensitive. We aimed to develop a universal primers-based polymerase chain reaction (PCR) assay and restriction fragment length polymorphisms (RFLP) for rapid identification of invasive fungal disease (IFD). METHODS: We evaluated 16 clinical fungal species using a combination of PCR assays with 3 different restriction endonucleases targeting various internal transcribed spacer (ITS) regions and high resolution melting analysis (HRMA). Serial samples from 75 patients suspected to have IFD were analyzed for clinical verification. RESULTS: We have designed a universal PCR capable of amplifying a portion of the 18S rRNA gene of 16 clinically important fungal species. The restriction patterns of most PCR products generated by EcoRI or double digested by ClaI and AvaI were different, except Aspergillus niger and Aspergillus flavus had a similar pattern, and Aspergillus fumigatus and Aspergillus terreus had a similar pattern. All these species had a unique melting curve shape using the HRMA. Both HRMA and universal PCR had adequate sensitivity, and all sixteen reference fungal species can be clearly distinguished by the universal PCR-RFLP-HRMA assay. With a reference library of 176 clinically relevant fungal strains, and 75 clinical samples from patients with suspicious IFD were tested, our assay identified 100% and 61.1% of isolates from the reference library and clinical samples, respectively. CONCLUSIONS: Universal PCR and RFLP coupled with HRMA could be a highly discriminative and useful molecular diagnostic that could enhance the current diagnostic, treatment, and surveillance methods of invasive fungal disease.


Assuntos
Primers do DNA , Enzimas de Restrição do DNA , Fungos/isolamento & purificação , Espécies Introduzidas , Técnicas de Tipagem Micológica/métodos , Micoses/microbiologia , Reação em Cadeia da Polimerase/métodos , Aspergilose/diagnóstico , Aspergilose/microbiologia , Aspergillus/classificação , Aspergillus/genética , Aspergillus/isolamento & purificação , Candida/classificação , Candida/genética , Candida/isolamento & purificação , DNA Fúngico/genética , Fungos/classificação , Fungos/genética , Humanos , Micoses/diagnóstico , Polimorfismo de Fragmento de Restrição , RNA Ribossômico 18S/genética , Sensibilidade e Especificidade
17.
Chin Med J (Engl) ; 132(16): 1909-1918, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31348027

RESUMO

BACKGROUND: Little study has investigated the differences between Talatomyces marneffei (T. marneffei) respiratory infection and tuberculosis and the prognostic factors of such infection. This study investigated the characteristics and prognostic factors of T. marneffei infections with respiratory lesions and the causes of misdiagnosis. METHODS: Clinical characteristics and prognoses of patients with T. marneffei infections with respiratory system lesion were investigated. T. marneffei diagnosis followed isolation from clinical specimens using standard culture, cytology, and histopathology. Survival curves were estimated by using Kaplan-Meier analysis, with log-rank test to compare differences in survival rates between groups. Univariate and multivariate Cox regression analyses were also performed to assess significant differences in clinical characteristics of overall survival. RESULTS: Of 126 patients diagnosed with T. marneffei infections, 63 (50.0%) had T. marneffei respiratory system infections; 38.1% (24/63) were misdiagnosed as having tuberculosis. Human immunodeficiency virus (HIV) infection, CD4/CD8 < 0.5, percentage of CD4 T cells <42.8%, and length of time from onset to confirmation of diagnosis >105 days were potential risk factors for poor prognoses. Length of time from onset to confirmation of diagnosis persisted as an independent predictor of all-cause mortality in multivariate analysis (odds ratio: 0.083, 95.0% confidence interval: 0.021-0.326, P < 0.001). However, the size of the lung lesions, dyspnea, thoracalgia, mediastinal lymphadenopathy, and pleural effusion did not significantly predict overall survival. There was no significant difference in prognosis according to the type of treatment. CONCLUSIONS: T. marneffei infections involving the respiratory system are common. The critical determinants of prognosis are HIV infection, CD4/CD8, percentage of CD4 T cells, type of treatment, and the time range from onset to confirmation of diagnosis. Rapid and accurate diagnosis is crucial for improving prognosis.


Assuntos
Sistema Respiratório/microbiologia , Talaromyces/patogenicidade , Adolescente , Adulto , Idoso , Antifúngicos/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Micoses/tratamento farmacológico , Micoses/microbiologia , Micoses/patologia , Prognóstico , Estudos Retrospectivos , Talaromyces/efeitos dos fármacos , Adulto Jovem
18.
Mycoses ; 62(10): 883-892, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31166635

RESUMO

The current knowledge of invasive Scopulariopsis/Microascus infection in lung transplantation has been derived from only four case reports. Although these fungi are uncommon compared with Aspergillus, they are highly resistant to the current antifungal agents, and the mortality is extremely high. To explore the risk factors, clinical manifestations, notable diagnostic characteristics and outcomes of positive Scopulariopsis/Microascus isolation in lung transplantation patients. We included all cases with positive Scopulariopsis/Microascus isolation from lower respiratory tracts or bronchial mucosa biopsies in our lung transplantation centre. Proven cases from the literature were added. Positive isolation occurred in 2% (3/157) in our centre. Four cases from the literature were added. The mortality could be considered as high as 80%, once the two cases of colonisation were excluded. The average interval between transplantation and positive isolation was 106 (19-131) days. A total of 57.1% of patients had experienced a combination of infection with Aspergillus or other fungi as well as long-term azole antifungal agent treatment before the positive isolation, which may be possible risk factors. The combination of micafungin, posaconazole and terbinafine may be an effective treatment. The peak time of positive isolation was consistent with that of some opportunistic pathogens, and the possible risk factors were the infection of other fungi as well as prior long-term azole antifungal administration. In addition to its high mortality, Scopulariopsis/Microascus was also highly resistant to common antifungal agents and the combination of two or three drugs for therapy was recommended.


Assuntos
Brônquios/microbiologia , Transplante de Pulmão/efeitos adversos , Pulmão/microbiologia , Micoses/diagnóstico , Micoses/patologia , Scopulariopsis/isolamento & purificação , Transplantados , Adulto , Idoso , Antifúngicos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/epidemiologia , Micoses/microbiologia , Prevalência , Fatores de Risco , Análise de Sobrevida , Adulto Jovem
19.
Food Chem ; 293: 263-270, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31151610

RESUMO

Gray mold caused by Botrytis cinerea is the most important disease in postharvest tomato fruit. Inducing resistance to fungal pathogens in the harvested fruit and vegetable is a promising approach to control postharvest losses. In the present study, the effect of l-glutamate on induction of resistance to B. cinerea and the underlying mechanisms were investigated. The results indicated that l-glutamate at 100 ppm was effective in reducing the gray mold of tomatoes after inoculation of the pathogen. Gene expressions of nine glutamate receptors, four pathogenesis-related proteins and the content of amino acids were affected by l-glutamate treatment. Furthermore, the metabolites of l-glutamate, including GABA, Met, Lys and Arg, could also induce significant resistance against B. cinerea in tomato fruit. Our findings suggested that l-glutamate treatment may represent a promising method for managing postharvest decay of tomato fruit.


Assuntos
Aminoácidos/metabolismo , Botrytis/efeitos dos fármacos , Ácido Glutâmico/farmacologia , Lycopersicon esculentum/imunologia , Micoses/prevenção & controle , Doenças das Plantas/prevenção & controle , Receptores de Glutamato/metabolismo , Resistência à Doença , Frutas/química , Lycopersicon esculentum/genética , Lycopersicon esculentum/microbiologia , Micoses/microbiologia , Doenças das Plantas/microbiologia , Proteínas de Plantas/genética , Regulação para Cima/efeitos dos fármacos
20.
Diagn Microbiol Infect Dis ; 95(2): 166-170, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31174994

RESUMO

The present study was to determine the in vitro activity of posaconazole (POS) against 385 Candida and 268 Aspergillus clinical isolates from China. We found that POS was active against 85.5% Candida and 94.4% Aspergillus isolates. Non-wild-type (non-WT) phenotype was found in a subset of Candida albicans (15.4%), Candida tropicalis (11.9%), Aspergillus fumigatus (4.1%), and Aspergillus flavus (17.4%) isolates. Cross-resistance to POS and other triazoles was seen. Gene sequencing showed that 4 C. albicans, 1 C. tropicalis, and 9 A. fumigatus isolates with cross-resistance to POS and other triazoles had mutations in ERG11 or CYP51A. In conclusion, POS has potent in vitro activity against most of Candida and Aspergillus isolates from China. Non-WT phenotype and those with cross-resistance to POS and other triazoles exist, frequently driven by mutations of ERG11 in Candida spp. and CYP51A in Aspergillus spp.


Assuntos
Aspergillus/efeitos dos fármacos , Candida/efeitos dos fármacos , Sistema Enzimático do Citocromo P-450/genética , Farmacorresistência Fúngica Múltipla/genética , Proteínas Fúngicas/genética , Micoses/microbiologia , Triazóis/farmacologia , Antifúngicos/farmacologia , Aspergillus/genética , Aspergillus/isolamento & purificação , Candida/genética , Candida/isolamento & purificação , China , Farmacorresistência Fúngica Múltipla/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Mutação
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