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1.
PLoS One ; 19(6): e0305228, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38870137

RESUMO

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


Assuntos
Batrachochytrium , Urodelos , Animais , Japão , Urodelos/microbiologia , Batrachochytrium/genética , Filogenia , Variação Genética , Biodiversidade , Quitridiomicetos/genética , Micoses/microbiologia , Micoses/veterinária , Micoses/epidemiologia , População do Leste Asiático
2.
J Zoo Wildl Med ; 55(2): 453-461, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38875202

RESUMO

Chytridiomycosis caused by Batrachochytrium dendrobatidis (Bd) has been documented in greater sirens (Siren lacertina) in the wild and in the pet trade. This study evaluated the use of terbinafine-impregnated implants for chytridiomycosis prophylaxis in greater sirens exposed to Bd. Implants were placed intracoelomically in both control (blank implant, n = 4) and treatment (24.5 mg of terbinafine implant, n = 4) groups. Sirens were exposed to Bd zoospores via 24-h immersion bath at 1 and 2 mon postimplant placement. Blood was collected monthly for plasma terbinafine levels, and skin swabs were collected weekly for Bd quantitative PCR. Animals with terbinafine implants had detectable concentrations of plasma terbinafine ranging from 17 to 102 ng/ml. Only one terbinafine-implanted animal had a peak concentration above the published minimum inhibitory concentration for terbinafine against Bd zoospores (63 ng/ml); however, it is unknown how plasma terbinafine concentrations relate to concentrations in the skin. There was no difference between the two treatment groups in clinical signs or Bd clearance rate, and no adverse effects from implants were observed. These findings indicate using intracoelomic drug implants for drug delivery in amphibians is safe; however, terbinafine efficacy in preventing Bd chytridiomycosis in sirens remains unclear. Further investigation of the use of intracoelomic implants and identification of effective drugs and doses in other amphibian species against Bd and other infectious diseases is warranted, as this may provide a practical method for long-term drug delivery in wildlife.


Assuntos
Antifúngicos , Terbinafina , Terbinafina/administração & dosagem , Terbinafina/uso terapêutico , Terbinafina/farmacologia , Animais , Projetos Piloto , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Antifúngicos/farmacocinética , Implantes de Medicamento , Batrachochytrium/efeitos dos fármacos , Masculino , Micoses/veterinária , Micoses/tratamento farmacológico , Anfíbios
3.
J Zoo Wildl Med ; 55(2): 540-546, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38875213

RESUMO

This report describes Schizangiella infections in colubrid and viperid snakes. A captive eastern ratsnake (Pantherophis alleghaniensis) was presented for a large intraoral mass associated with the mandible. The mass was debulked and histologic examination revealed severe, granulomatous stomatitis with intralesional fungi exhibiting morphologic features consistent with Schizangiella serpentis. PCR and sequencing of affected tissues confirmed S. serpentis. Because of declining health, the ratsnake was euthanized and postmortem examination identified a disseminated S. serpentis infection involving the skeletal musculature, lung, kidney, mesentery, and mandible. A wild-caught timber rattlesnake (Crotalus horridus) was presented for cutaneous lesions, weakness, and lethargy and later died. Postmortem examination revealed a mass-like structure in the esophagus characterized by high numbers of Schizangiella-like fungi associated with extensive granulomatous inflammation; the snake also had cutaneous mycosis suggestive of ophidiomycosis. This is the first report to document the unique morphologic features of S. serpentis in tissues and the presentation of schizangiellosis in snakes. Schizangiellosis should be considered as a differential diagnosis for nodular lesions involving the oral cavity and/or the gastrointestinal tract of snakes.


Assuntos
Crotalus , Animais , Colubridae , Micoses/veterinária , Micoses/microbiologia , Micoses/patologia , Micoses/diagnóstico , Thelazioidea/isolamento & purificação , Animais de Zoológico , Masculino , Feminino , Serpentes Peçonhentas
4.
Methods Mol Biol ; 2813: 205-217, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38888780

RESUMO

COVID-19 pandemic has heightened the interest toward diagnosis and treatment of infectious diseases. Nuclear medicine, with its powerful scintigraphic, single photon emission computer tomography (SPECT), and positron emission tomography (PET) imaging modalities, has always played an important role in diagnosis of infections and distinguishing them from the sterile inflammation. In addition to the clinically available radiopharmaceuticals, there has been a decades-long effort to develop more specific imaging agents with some examples being radiolabeled antibiotics and antimicrobial peptides for bacterial imaging, radiolabeled antifungals for fungal infections imaging, radiolabeled pathogen-specific antibodies, and molecular engineered constructs. In this chapter, we discuss some examples of the work published in the last decade on developing nuclear imaging agents for bacterial, fungal, and viral infections to generate more interest among nuclear medicine community toward conducting clinical trials of these novel probes, as well as toward developing novel radiotracers for imaging infections.


Assuntos
COVID-19 , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Compostos Radiofarmacêuticos/química , Humanos , COVID-19/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , SARS-CoV-2 , Infecções Bacterianas/diagnóstico por imagem , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/diagnóstico , Micoses/diagnóstico por imagem , Micoses/diagnóstico , Micoses/tratamento farmacológico
6.
Arch Microbiol ; 206(7): 293, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38850421

RESUMO

Fungal infections are incurring high risks in a range from superficial mucosal discomforts (such as oropharyngeal candidiasis and vulvovaginal candidiasis) to disseminated life-threatening diseases (such as invasive pulmonary aspergillosis and cryptococcal meningitis) and becoming a global health problem in especially immunodeficient population. The major obstacle to conquer fungal harassment lies in the presence of increasing resistance to conventional antifungal agents used in newly clinically isolated strains. Although recombinant cytokines and mono-/poly-clonal antibodies are added into antifungal armamentarium, more effective antimycotic drugs are exceedingly demanded. It is comforting that the development of fungal vaccines and adjuvants opens up a window to brighten the prospective way in the diagnosis, prevention and treatment of fungal assaults. In this review, we focus on the progression of several major fungal vaccines devised for the control of Candida spp., Aspergillus spp., Cryptococcus spp., Coccidioides spp., Paracoccidioides spp., Blastomyces spp., Histoplasma spp., Pneumocystis spp. as well as the adjuvants adopted. We then expound the interaction between fungal vaccines/adjuvants and host innate (macrophages, dendritic cells, neutrophils), humoral (IgG, IgM and IgA) and cellular (Th1, Th2, Th17 and Tc17) immune responses which generally experience immune recognition of pattern recognition receptors, activation of immune cells, and clearance of invaded fungi. Furthermore, we anticipate an in-depth understanding of immunomodulatory properties of univalent and multivalent vaccines against diverse opportunistic fungi, providing helpful information in the design of novel fungal vaccines and adjuvants.


Assuntos
Adjuvantes Imunológicos , Vacinas Fúngicas , Micoses , Vacinas Fúngicas/imunologia , Humanos , Micoses/prevenção & controle , Micoses/imunologia , Animais , Fungos/imunologia
7.
Med Mycol J ; 65(2): 33-38, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38825528

RESUMO

Antifungal stewardship (AFS), compared with antimicrobial stewardship (AS), requires more advanced knowledge, skills, and multidisciplinary collaboration in its implementation. Therefore, fewer facilities are performing AFS compared with AS. At our hospital, we started AS and AFS in 2014. Our AFS programs include the following: i) interventions for patients with yeast-positive blood cultures, ii) introduction of a conditional antifungal notification system, and iii) commencement of AS team rounds. AFS for filamentous fungi includes bronchoscopy and microbial identification, including genetic and drug susceptibility testing. These AFS activities have improved several processes and outcome measures. However, our AFS team has faced several problems owing to the impact of COVID-19. This review introduces the practice of AFS, which we initiated at our hospital in 2014, and presents the current problems.


Assuntos
Antifúngicos , Gestão de Antimicrobianos , Hospitais Universitários , Humanos , Antifúngicos/uso terapêutico , Antifúngicos/farmacologia , Gestão de Antimicrobianos/métodos , Japão , COVID-19 , SARS-CoV-2/efeitos dos fármacos , Micoses/tratamento farmacológico
8.
Ital J Pediatr ; 50(1): 113, 2024 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-38853280

RESUMO

The purpose of this study was to review the literature on the clinical use of voriconazole (VRC) in pediatric patients. MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library were searched from January 1, 2000, to August 15, 2023 for relevant clinical studies on VRC use in pediatric patients. Data were collected based on inclusion and exclusion criteria, and a systematic review was performed on recent research related to the use of VRC in pediatric patients. This systematic review included a total of 35 observational studies among which there were 16 studies investigating factors influencing VRC plasma trough concentrations (Ctrough) in pediatric patients, 14 studies exploring VRC maintenance doses required to achieve target range of Ctrough, and 11 studies focusing on population pharmacokinetic (PPK) research of VRC in pediatric patients. Our study found that the Ctrough of VRC were influenced by both genetic and non-genetic factors. The optimal dosing of VRC was correlated with age in pediatric patients, and younger children usually required higher VRC doses to achieve target Ctrough compared to older children. Establishing a PPK model for VRC can assist in achieving more precise individualized dosing in children.


Assuntos
Antifúngicos , Voriconazol , Voriconazol/administração & dosagem , Humanos , Antifúngicos/administração & dosagem , Criança , Relação Dose-Resposta a Droga , Micoses/tratamento farmacológico
9.
Int J Mol Sci ; 25(11)2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38892165

RESUMO

Human mycoses cover a diverse field of fungal diseases from skin disorders to systemic invasive infections and pose an increasing global health problem based on ineffective treatment options, the hampered development of new efficient drugs, and the emergence of resistant fungal strains. Niclosamide is currently applied for the treatment of worm infections. Its mechanisms of action, which include the suppression of mitochondrial oxidative phosphorylation (also known as mitochondrial uncoupling), among others, has led to a repurposing of this promising anthelmintic drug for the therapy of further human diseases such as cancer, diabetes, and microbial infections. Given the urgent need to develop new drugs against fungal infections, the considerable antifungal properties of niclosamide are highlighted in this review. Its chemical and pharmacological properties relevant for drug development are also briefly mentioned, and the described mitochondria-targeting mechanisms of action add to the current arsenal of approved antifungal drugs. In addition, the activities of further salicylanilide-based niclosamide analogs against fungal pathogens, including agents applied in veterinary medicine for many years, are described and discussed for their feasibility as new antifungals for humans. Preliminary structure-activity relationships are determined and discussed. Various salicylanilide derivatives with antifungal activities showed increased oral bioavailabilities when compared with niclosamide. The simple synthesis of salicylanilide-based drugs also vouchsafes a broad and cost-effective availability for poorer patient groups. Pertinent literature is covered until 2024.


Assuntos
Antifúngicos , Niclosamida , Salicilanilidas , Niclosamida/farmacologia , Salicilanilidas/farmacologia , Salicilanilidas/química , Antifúngicos/farmacologia , Antifúngicos/química , Humanos , Animais , Relação Estrutura-Atividade , Fungos/efeitos dos fármacos , Micoses/tratamento farmacológico , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo
10.
BMC Infect Dis ; 24(1): 605, 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38898444

RESUMO

BACKGROUND PAECILOMYCES: and Penicillium are considered as rare opportunistic pathogens in immunocompromised hosts, and pneumonia caused by Paecilomyces and Penicillium is rare. In this study, we present first case of severe pneumonia with pleural effusion caused by co-infection of Paecilomyces variotii (P. variotii) and Penicillium oxalicum (P. oxalicum) in a 66-year-old female with poorly controlled type 2 diabetes. CASE PRESENTATION: A 56-year-old woman patient presented to hospital for nausea, poor appetite, and vomiting for one day. On the second day of admission, blood culture and renal puncture fluid culture grew multidrug-resistant Escherichia coli (imipenem/cilastatin sensitive), and she received combination therapy with imipenem/cilastatin (1 g, every 8 h) and vancomycin (0.5 g, every 12 h). On the fourth day, she developed symptoms of respiratory failure. Pulmonary computed tomography (CT) showed an increase in pneumonia compared to before, with minor pleural effusion on both sides. Two fungi were isolated repeatedly from BALF culture, which were confirmed as P. variotii and P. oxalicum by Internal transcribed spacer (ITS) sequencing. Her pleural effusion was completely absorbed, pneumonia symptoms have significantly improved and discharged with receiving liposomal amphotericin B treatment for four weeks. CONCLUSIONS: It is worth noting that clinicians and laboratory personnel should not simply consider Paecilomyces and Penicillium species as contaminants, especially in immunocompromised patients. Early fungal identification and antifungal drug sensitivity are crucial for clinical drug selection and patient prognosis.


Assuntos
Coinfecção , Diabetes Mellitus Tipo 2 , Paecilomyces , Penicillium , Derrame Pleural , Humanos , Feminino , Penicillium/isolamento & purificação , Derrame Pleural/microbiologia , Derrame Pleural/tratamento farmacológico , Pessoa de Meia-Idade , Idoso , Diabetes Mellitus Tipo 2/complicações , Coinfecção/microbiologia , Coinfecção/tratamento farmacológico , Paecilomyces/isolamento & purificação , Pneumonia/microbiologia , Pneumonia/tratamento farmacológico , Micoses/microbiologia , Micoses/tratamento farmacológico , Hospedeiro Imunocomprometido , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico
12.
Dis Aquat Organ ; 158: 123-132, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38813853

RESUMO

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


Assuntos
Clima , Micoses , Animais , Micoses/veterinária , Micoses/epidemiologia , Micoses/microbiologia , Uruguai/epidemiologia , Batrachochytrium/genética , Anuros/microbiologia , Quitridiomicetos/isolamento & purificação
13.
Dis Aquat Organ ; 158: 173-178, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38813857

RESUMO

Working with aquatic organisms often requires handling multiple individuals in a single session, potentially resulting in cross-contamination by live pathogens or DNA. Most researchers address this problem by disposing of gloves between animals. However, this generates excessive waste and may be impractical for processing very slippery animals that might be easier to handle with cotton gloves. We tested methods to decontaminate cotton or nitrile gloves after contamination with cultured Batrachochytrium dendrobatidis (Bd) or after handling heavily Bd-infected Xenopus laevis with layered cotton and nitrile gloves. Bleach eliminated detectable Bd DNA from culture-contaminated nitrile gloves, but gloves retained detectable Bd DNA following ethanol disinfection. After handling a Bd-infected frog, Bd DNA contamination was greatly reduced by removal of the outer cotton glove, after which either bleach decontamination or ethanol decontamination followed by drying hands with a paper towel lowered Bd DNA below the detection threshold of our assay. These results provide new options to prevent pathogen or DNA cross-contamination, especially when handling slippery aquatic organisms. However, tradeoffs should be considered when selecting an animal handling procedure, such as the potential for cotton gloves to abrade amphibian skin or disrupt skin mucus. Disposing of gloves between animals should remain the gold standard for maintaining biosecurity in sensitive situations.


Assuntos
Descontaminação , Luvas Protetoras , Animais , Descontaminação/métodos , Luvas Protetoras/microbiologia , Batrachochytrium , DNA Fúngico , Micoses/veterinária , Micoses/prevenção & controle , Micoses/microbiologia
14.
Diagn Microbiol Infect Dis ; 109(3): 116337, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38718662

RESUMO

Lecanicillium dimorphum and Lecanicillium psalliotae are fungi that exist naturally in plants or insects, and are generally considered non-pathogenic to humans. However, in this case, we cultured Lecanicillium from the synovial fluid of a patient, and identified it through genome sequencing and sequence alignment as Lecanicillium dimorphum or Lecanicillium psalliotae. Due to the conservation of sequences, we can only identify the genus and not the species. There are very few reports on the human infection and pathogenicity of these two fungi, and this case also cannot completely prove that the pathogenic agent is this fungus. But this case also holds clinical significance, as the discovery of Lecanicillium in a human sample can alert the clinician to the presence of an uncommon mold with unclear clinical significance.


Assuntos
Hypocreales , Micoses , Humanos , Hypocreales/isolamento & purificação , Hypocreales/genética , Hypocreales/classificação , Micoses/microbiologia , Micoses/diagnóstico , Líquido Sinovial/microbiologia , Masculino , Filogenia , Análise de Sequência de DNA , DNA Fúngico/genética
15.
BMC Infect Dis ; 24(1): 506, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773459

RESUMO

BACKGROUND: The sharp increase in fungal infections, insufficient diagnostic and treatment capabilities for fungal infections, poor prognosis of patients with fungal infections as well as the increasing drug resistance of fungi are serious clinical problems. It is necessary to explore the implementation and evaluation methods of antifungal stewardship (AFS) to promote the standardized use of antifungal drugs. METHODS: The AFS programme was implemented at a tertiary first-class hospital in China using a plan-do-check-act (PDCA) quality management tool. A baseline investigation was carried out to determine the utilization of antifungal drugs in pilot hospitals, analyse the existing problems and causes, and propose corresponding solutions. The AFS programme was proposed and implemented beginning in 2021, and included various aspects, such as team building, establishment of regulations, information construction, prescription review and professional training. The management effectiveness was recorded from multiple perspectives, such as the consumption of antifungal drugs, the microbial inspection rate of clinical specimens, and the proportion of rational prescriptions. The PDCA management concept was used for continuous improvement to achieve closed-loop management. RESULTS: In the first year after the implementation of the AFS programme, the consumption cost, use intensity and utilization rate of antifungal drugs decreased significantly (P < 0.01). The proportion of rational antifungal drug prescriptions markedly increased, with the proportion of prescriptions with indications increasing from 86.4% in 2019 to 97.0% in 2022, and the proportion of prescriptions with appropriate usage and dosage increased from 51.9 to 87.1%. In addition, after the implementation of the AFS programme, physicians' awareness of the need to complete microbial examinations improved, and the number of fungal cultures and serological examinations increased substantially. Statistics from drug susceptibility tests revealed a decrease in the resistance rate of Candida to fluconazole. CONCLUSION: This study indicated that the combination of AFS and the PDCA cycle could effectively reduce antifungal consumption and promote the rational use of antifungal drugs, providing a reference for other health care systems to reduce the overuse of antifungal drugs and delay the progression of fungal resistance.


Assuntos
Antifúngicos , Gestão de Antimicrobianos , Micoses , Centros de Atenção Terciária , Antifúngicos/uso terapêutico , Humanos , China , Micoses/tratamento farmacológico , Micoses/microbiologia , Farmacorresistência Fúngica , Uso de Medicamentos/normas , Uso de Medicamentos/estatística & dados numéricos
16.
Environ Microbiol Rep ; 16(3): e13274, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38775382

RESUMO

The pathogenic fungus Batrachochytrium dendrobatidis has caused declines of amphibians worldwide. Yet our understanding of how water quality influences fungal pathogenicity is limited. Here, we reviewed experimental studies on the effect of water quality on this pathogen to determine which parameters impacted disease dynamics consistently. The strongest evidence for protective effects is salinity which shows strong antifungal properties in hosts at natural levels. Although many fungicides had detrimental effects on the fungal pathogen in vitro, their impact on the host is variable and they can worsen infection outcomes. However, one fungicide, epoxiconazole, reduced disease effects experimentally and likely in the field. While heavy metals are frequently studied, there is weak evidence that they influence infection outcomes. Nitrogen and phosphorous do not appear to impact pathogen growth or infection in the amphibian host. The effects of other chemicals, like pesticides and disinfectants on infection were mostly unclear with mixed results or lacking an in vivo component. Our study shows that water chemistry does impact disease dynamics, but the effects of specific parameters require more investigation. Improving our understanding of how water chemistry influences disease dynamics will help predict the impact of chytridiomycosis, especially in amphibian populations affected by land use changes.


Assuntos
Anfíbios , Batrachochytrium , Qualidade da Água , Animais , Batrachochytrium/efeitos dos fármacos , Anfíbios/microbiologia , Micoses/microbiologia , Micoses/veterinária , Micoses/prevenção & controle , Salinidade , Fungicidas Industriais/farmacologia , Quitridiomicetos/efeitos dos fármacos , Quitridiomicetos/patogenicidade , Praguicidas/farmacologia , Desinfetantes/farmacologia , Antifúngicos/farmacologia
17.
J Med Chem ; 67(10): 8420-8444, 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38718180

RESUMO

Faced with increasingly serious fungal infections and drug resistance issues, three different series of novel dual-target (programmed death ligand 1/14 α-demethylase) compounds were constructed through the fragment combination pathway in the study. Their chemical structures were synthesized, characterized, and evaluated. Among them, preferred compounds 10c-1, 17b-1, and 18b-2 could efficiently exert their antifungal and antidrug-resistant fungal ability through blocking ergosterol biosynthesis, inducing the upregulation of reactive oxygen species level, and triggering apoptosis. Especially, compound 18b-2 exhibited the synergistic function of fungal inhibition and immune activation. Moreover, the covalent organic framework carrier was also generated based on the acidic microenvironment of fungal infection to improve the bioavailability and targeting of preferred compounds; this finally accelerated the body's recovery rate.


Assuntos
Antifúngicos , Antifúngicos/farmacologia , Antifúngicos/síntese química , Antifúngicos/química , Humanos , Animais , Testes de Sensibilidade Microbiana , Relação Estrutura-Atividade , Espécies Reativas de Oxigênio/metabolismo , Apoptose/efeitos dos fármacos , Inibidores de 14-alfa Desmetilase/farmacologia , Inibidores de 14-alfa Desmetilase/química , Inibidores de 14-alfa Desmetilase/síntese química , Micoses/tratamento farmacológico , Camundongos , Candida albicans/efeitos dos fármacos , Ergosterol/metabolismo , Estrutura Molecular
18.
Nefrologia (Engl Ed) ; 44(2): 173-179, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38697695

RESUMO

INTRODUCTION AND OBJECTIVES: The efficacy of fluconazole as a prophylactic strategy in patients with chronic kidney disease (CKD) on peritoneal dialysis (PD) with prior antibiotic exposure is controversial in the current literature. This study aimed to compare a strategy of fluconazole prophylaxis versus no-prophylaxis for patients in PD on antibiotics for previous episodes of peritonitis. MATERIALS AND METHODS: We performed a systematic review and meta-analysis of observational studies and randomized controlled trials (RCTs) comparing fluconazole prophylaxis with no prophylaxis for PD-related peritonitis. The search was conducted on PubMed, EMBASE, and Cochrane Central in January 23, 2023. The outcome of interest was the occurrence of fungal peritonitis (FP). RESULTS: We included six studies (1 RCT, 5 observational) with 4515 occurrences of peritonitis, of which 1098 (24.8%) received fluconazole prophylaxis in variable doses, whereas 3417 (75.6%) did not receive prophylaxis during peritonitis episodes. Overall, fluconazole prophylaxis was associated with a lower incidence of FP (OR 0.22; 95% CI 0.12-0.41; p<0.001; I2=0%). Subgroup analysis of studies that administered daily doses of fluconazole also demonstrated a reduced incidence of FP in patients who received antifungal prophylaxis (OR 0.31; CI 0.14-0.69; p=0.004; I2=0%). CONCLUSIONS: In this meta-analysis of 4515 episodes of PD-related peritonitis, prophylaxis with fluconazole significantly reduced episodes of FP as compared with no antifungal prophylaxis.


Assuntos
Antifúngicos , Fluconazol , Diálise Peritoneal , Peritonite , Humanos , Fluconazol/uso terapêutico , Diálise Peritoneal/efeitos adversos , Peritonite/prevenção & controle , Peritonite/etiologia , Antifúngicos/uso terapêutico , Micoses/prevenção & controle , Estudos Observacionais como Assunto , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como Assunto , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia
19.
Ecol Lett ; 27(5): e14431, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38712705

RESUMO

There is a rich literature highlighting that pathogens are generally better adapted to infect local than novel hosts, and a separate seemingly contradictory literature indicating that novel pathogens pose the greatest threat to biodiversity and public health. Here, using Batrachochytrium dendrobatidis, the fungus associated with worldwide amphibian declines, we test the hypothesis that there is enough variance in "novel" (quantified by geographic and phylogenetic distance) host-pathogen outcomes to pose substantial risk of pathogen introductions despite local adaptation being common. Our continental-scale common garden experiment and global-scale meta-analysis demonstrate that local amphibian-fungal interactions result in higher pathogen prevalence, pathogen growth, and host mortality, but novel interactions led to variable consequences with especially virulent host-pathogen combinations still occurring. Thus, while most pathogen introductions are benign, enough variance exists in novel host-pathogen outcomes that moving organisms around the planet greatly increases the chance of pathogen introductions causing profound harm.


Assuntos
Batrachochytrium , Interações Hospedeiro-Patógeno , Animais , Batrachochytrium/genética , Batrachochytrium/fisiologia , Anuros/microbiologia , Anfíbios/microbiologia , Micoses/veterinária , Micoses/microbiologia , Adaptação Fisiológica , Filogenia
20.
BMC Infect Dis ; 24(1): 473, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38711014

RESUMO

BACKGROUND: The incidence of Talaromyces marneffei (T. marneffei) infection has increased in recent years with the development of organ transplantation and the widespread use of immunosuppressive agents. However, the lack of clinical suspicion leading to delay or misdiagnosis is an important reason for the high mortality rate in non-human immunodeficiency virus (HIV) and non-endemic population. Herein, we report a case of disseminated T. marneffei infection in a non-HIV and non-endemic recipient after renal transplant, who initially presented with skin rashes and subcutaneous nodules and developed gastrointestinal bleeding. CASE PRESENTATION: We describe a 54-year-old renal transplantation recipient presented with scattered rashes, subcutaneous nodules and ulcerations on the head, face, abdomen, and right upper limb. The HIV antibody test was negative. The patient had no obvious symptoms such as fever, cough, etc. Histopathological result of the skin lesion sites showed chronic suppurative inflammation with a large number of fungal spores. Subsequent fungal culture suggested T. marneffei infection. Amphotericin B deoxycholate was given for antifungal treatment, and there was no deterioration in the parameters of liver and kidney function. Unfortunately, the patient was soon diagnosed with gastrointestinal bleeding, gastrointestinal perforation and acute peritonitis. Then he rapidly developed multiple organ dysfunction syndrome and abandoned treatment. CONCLUSIONS: The risk of fatal gastrointestinal bleeding can be significantly increased in kidney transplant patients with T. marneffei infection because of the long-term side effects of post-transplant medications. Strengthening clinical awareness and using mNGS or mass spectrometry technologies to improve the detection rate and early diagnosis of T. marneffei are crucial for clinical treatment in non-HIV and non-endemic population.


Assuntos
Transplante de Rim , Micoses , Talaromyces , Transplantados , Humanos , Masculino , Pessoa de Meia-Idade , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Ácido Desoxicólico , Dermatomicoses/diagnóstico , Dermatomicoses/microbiologia , Dermatomicoses/tratamento farmacológico , Combinação de Medicamentos , Evolução Fatal , Transplante de Rim/efeitos adversos , Micoses/diagnóstico , Micoses/tratamento farmacológico , Micoses/microbiologia , Talaromyces/isolamento & purificação
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