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Iranian Journal of Microbiology Apr 2024Amphotericin B is a broad-spectrum antifungal agent commonly used to treat infection. was isolated from patients reported to be intrinsically resistant to amphotericin...
BACKGROUND AND OBJECTIVES
Amphotericin B is a broad-spectrum antifungal agent commonly used to treat infection. was isolated from patients reported to be intrinsically resistant to amphotericin B, encoded by the ERG2 and ERG11 genes. However, there have been limited studies concerning amphotericin B-resistant in Indonesia. The objective of this study is to explore the phenotypic and genotypic characteristics (ERG2 and ERG11) of isolated from the ICU of a referral hospital in Indonesia.
MATERIALS AND METHODS
Identification and susceptibility tests were conducted using VITEK2. Thereafter, DNA was extracted and amplified using conventional PCR followed by DNA sequencing (Sanger method).
RESULTS
The results of the phenotypic susceptibility test showed that all were resistant to amphotericin B. ERG2 and ERG11 sequences showed the same amino acid sequence and corresponded to references that are resistant to amphotericin B.
CONCLUSION
The resistant properties of against amphotericin B found in this study require further exploration, including comparing resistant and sensitive to amphotericin B. In addition, it is necessary to analyze other genes besides ERG2 and ERG11.
PubMed: 38854988
DOI: 10.18502/ijm.v16i2.15363 -
Biomedicine & Pharmacotherapy =... Jul 2024
PubMed: 38852000
DOI: 10.1016/j.biopha.2024.116890 -
Journal of Ophthalmic Inflammation and... Jun 2024To report a case of endogenous endophthalmitis caused by the dematiaceous fungus Cladophialophora devriesii.
PURPOSE
To report a case of endogenous endophthalmitis caused by the dematiaceous fungus Cladophialophora devriesii.
METHODS
Observational case report and literature review.
CASE PRESENTATION
A 73-year-old female with a history of chronic obstructive pulmonary disease presented with a red and painful left eye. Examination revealed anterior segment inflammation and vitritis, indicative of endophthalmitis. She underwent core vitrectomy and intravitreal injection of vancomycin and amphotericin B. The vitreous sample showed inflammatory cells and fungal hyphae, and systemic amphotericin B and itraconazole were commenced for fungal endophthalmitis. Targeted amplification of the sample for bacterial DNA (V2-V3 region of 16 S rDNA) was negative, but fungal DNA targets (ITS1 and ITS2) were present, and their sequences were consistent with Cladophialophora devriesii. Phenotypic characterisation and sequencing of ITS1 and ITS2, carried out on cultured fungus from the sample, also revealed Cladophialophora devriesii. She received repeated intravitreal injections of voriconazole, and based on the antifungal susceptibility results, her systemic medication was changed to posaconazole. After 12 months, the eye showed no signs of inflammation, and posaconazole therapy was discontinued. After 3 months without antifungal medication, the inflammation recurred, and she was restarted on antifungal therapy for an additional 20 months. Another recurrence occurred 3 months after discontinuation of treatment, and a repeat vitreous sample confirmed the presence of Cladophialophora devriesii. She was started on isavuconazole, but developed seclusio pupillae and painful secondary glaucoma. Due to the duration and severity of the infection, the eye was enucleated. Histopathology revealed persistent fungal elements at the ciliary processes and the posterior lens surface.
CONCLUSIONS
This second reported case of endogenous endophthalmitis caused by Cladophialophora devriesii illustrates the role of vitreous sampling and molecular methods in diagnosis and treatment of fungal endophthalmitis. Despite early diagnosis and prolonged local and systemic antifungal therapy, it was not possible to achieve long-term control of the fungal infection.
PubMed: 38836962
DOI: 10.1186/s12348-024-00408-y -
International Journal of Nanomedicine 2024[This corrects the article DOI: 10.2147/IJN.S387681.].
[This corrects the article DOI: 10.2147/IJN.S387681.].
PubMed: 38836009
DOI: 10.2147/IJN.S480398 -
Parasites, Hosts and Diseases May 2024Naegleria fowleri invades the brain and causes a fatal primary amoebic meningoencephalitis (PAM). Despite its high mortality rate of approximately 97%, an effective...
Naegleria fowleri invades the brain and causes a fatal primary amoebic meningoencephalitis (PAM). Despite its high mortality rate of approximately 97%, an effective therapeutic drug for PAM has not been developed. Approaches with miltefosine, amphotericin B, and other antimicrobials have been clinically attempted to treat PAM, but their therapeutic efficacy remains unclear. The development of an effective and safe therapeutic drug for PAM is urgently needed. In this study, we investigated the anti-amoebic activity of Pinus densiflora leaf extract (PLE) against N. fowleri. PLE induced significant morphological changes in N. fowleri trophozoites, resulting in the death of the amoeba. The IC50 of PLE on N. fowleri was 62.3±0.95 μg/ml. Alternatively, PLE did not significantly affect the viability of the rat glial cell line C6. Transcriptome analysis revealed differentially expressed genes (DEGs) between PLE-treated and non-treated amoebae. A total of 5,846 DEGs were identified, of which 2,189 were upregulated, and 3,657 were downregulated in the PLE-treated amoebae. The DEGs were categorized into biological process (1,742 genes), cellular component (1,237 genes), and molecular function (846 genes) based on the gene ontology analysis, indicating that PLE may have dramatically altered the biological and cellular functions of the amoeba and contributed to their death. These results suggest that PLE has anti-N. fowleri activity and may be considered as a potential candidate for the development of therapeutic drugs for PAM. It may also be used as a supplement compound to enhance the therapeutic efficacy of drugs currently used to treat PAM.
Topics: Naegleria fowleri; Plant Extracts; Pinus; Plant Leaves; Animals; Rats; Antiprotozoal Agents; Cell Line; Trophozoites; Brain; Gene Expression Profiling; Central Nervous System Protozoal Infections; Inhibitory Concentration 50; Cell Survival
PubMed: 38835258
DOI: 10.3347/PHD.23103 -
Infection and Drug Resistance 2024Infection caused by the sp is extremely rare. We report the first case of fungal keratitis caused by () in a 63-year-old man with a history of exposed to hot oil two...
Infection caused by the sp is extremely rare. We report the first case of fungal keratitis caused by () in a 63-year-old man with a history of exposed to hot oil two weeks ago who developed keratitis. Direct examination of confocal microscopy and corneal scrapings showed fungal hyphae and isolates were identified by morphology and by sequencing the internal transcribed spacer region of ribosomal DNA. The in vitro antifungal susceptibilities of the case strain were tested for five antifungal agents. The results showed that the infectious agent was resistant towards fluconazole, caspofungin and amphotericin B; itraconazole and voriconazole were highly effective against . He was diagnosed with keratitis and treated with oral itraconazole and natamycin eyedrops. After one month of treatment, the lesion gradually improved, with the best-corrected visual acuity improving to 0.8.
PubMed: 38832107
DOI: 10.2147/IDR.S468800 -
Lakartidningen Jun 2024This text discusses a rare case of soft tissue infection caused by the fungus Saksenaea in a young, immunocompetent woman following an all-terrain vehicle accident...
This text discusses a rare case of soft tissue infection caused by the fungus Saksenaea in a young, immunocompetent woman following an all-terrain vehicle accident abroad. Despite initial treatment, her wound worsened, necessitating multiple surgical revisions and aggressive antifungal therapy with liposomal Amphotericin B. The interdisciplinary collaboration among orthopedic surgeons, infectious disease specialists, and plastic surgeons played a vital role in her successful treatment. Prompt identification of the fungus and immediate intervention were crucial. This case emphasizes the importance of awareness among healthcare providers regarding this rare condition and underscores the significance of early diagnosis and timely surgical and medical interventions for a positive outcome.
Topics: Humans; Female; Antifungal Agents; Immunocompetence; Amphotericin B; Accidents, Traffic; Mucormycosis; Soft Tissue Infections; Invasive Fungal Infections; Adult; Mucorales
PubMed: 38828641
DOI: No ID Found -
Infection and Drug Resistance 2024Azole resistance in poses a significant challenge in the management of invasive aspergillosis. This study aimed to investigate the antifungal susceptibility and...
PURPOSE
Azole resistance in poses a significant challenge in the management of invasive aspergillosis. This study aimed to investigate the antifungal susceptibility and mutation profiles of isolates in Malaysia.
PATIENTS AND METHODS
Sixty clinical isolates were collected and subjected to antifungal susceptibility testing (AFST) and molecular analysis. The antifungal susceptibility testing was performed according to CLSI M38 guideline. The geometric mean (GM) minimum inhibitory concentration (MIC), MIC/MIC for voriconazole, itraconazole, posaconazole, amphotericin B, and isavuconazole against in non-invasive cases and invasive cases were calculated. In addition, the presence of mutations was also identified.
RESULTS
The present study revealed an overall resistance rate of 6.7% among the isolates. In non-invasive cases, isavuconazole and posaconazole demonstrated the lowest GM MIC of 0.08 µg/mL. Following them were itraconazole, voriconazole, and amphotericin B with concentrations of 0.15µg/mL, 0.16µg/mL and 0.90µg/mL, respectively. Similarly, in invasive cases, isavuconazole and posaconazole exhibited the lowest GM MIC of 0.09µg/mL. Following them were itraconazole, voriconazole, and amphotericin B with concentrations of 0.14µg/mL, 0.17µg/mL and 0.80µg/mL, respectively. Genotypic analysis revealed various mutations, including F46Y, M172V, N248K, R34L, V244A, V244S, and E427K. However, not all mutations corresponded to antifungal resistance.
CONCLUSION
The majority of clinical isolates demonstrated susceptibility to the antifungal agents tested, with isavuconazole and posaconazole demonstrating the lowest MIC values. However, mutations were discovered without a consistent correlation to antifungal resistance, emphasising the need for additional research.
PubMed: 38828376
DOI: 10.2147/IDR.S452619 -
Journal of Family Medicine and Primary... Apr 2024To analyze the potential predisposing factors and clinical presentation of mucormycosis in patients with COVID-19.
AIM
To analyze the potential predisposing factors and clinical presentation of mucormycosis in patients with COVID-19.
MATERIAL AND METHODS
Medical records of 141 patients with COVID-19-associated mucormycosis (CAM) treated at a tertiary care center in Bihar were reviewed. The predisposing factors, clinical features, and imaging findings of mucormycosis were analyzed.
RESULTS
The median age was 48 years (IQR, 43-60). A total of 58 patients developed concurrent CAM and 83 post-CAM. The median interval between COVID-19 and onset of CAM symptoms was 15 days (IQR, 9-16). A total of 80 patients received at-home treatment for COVID-19, and 73 had mild-to-moderate disease. While 61 patients received in-hospital treatment, 57 had severe disease. At presentation, 131 patients had hyperglycemia: 64 type 2 diabetes mellitus (DM) and 67 new-onset DM. The history of glucocorticoid use for COVID-19 was present in 125 patients; 47% were administered at home without monitoring plasma glucose. The common presenting features were toothache, periocular or facial pain, and edema. Rhino-orbital mucormycosis was the most common. Imaging revealed rhinosinusitis in all patients, including pansinusitis (68%), pterygopalatine fossa involvement (21%), cavernous sinus thrombosis (38%), brain abscess (8%), and infarct (4%). All patients received intravenous liposomal amphotericin B, and surgical debridement was performed in 113.
CONCLUSION
COVID-19 patients with hyperglycemia are at risk of developing CAM, irrespective of the severity. Timely recognition of symptoms and prompt initiation of therapy by primary healthcare physicians are imperative for enhancing outcomes. Additionally, glucocorticoid overuse should be avoided, and close monitoring for hyperglycemia development is warranted.
PubMed: 38827672
DOI: 10.4103/jfmpc.jfmpc_1259_23 -
Journal of Family Medicine and Primary... Apr 2024SARS-COV virus operates as a significant risk factor for invasive fungal aspergillosis and mucormycosis. Successful management of this fulminant infection requires early...
BACKGROUND
SARS-COV virus operates as a significant risk factor for invasive fungal aspergillosis and mucormycosis. Successful management of this fulminant infection requires early recognition of the disease and aggressive medical or surgical interventions to prevent the high morbidity and mortality associated with the disease process.
AIMS AND OBJECTIVE OF THE STUDY
1. To isolate and identify different species of fungi among acute rhinosinusitis patients. 2. To assess the association of risk factors causing fungal rhinosinusitis. 3. To assess the changing trend in fungal rhinosinusitis during the COVID era.
MATERIAL AND METHODS
This is a retrospective observational study conducted from May 2020 to October 2022, attending the ENT department and relevant data were collected from the medical records department of ABVIMS and Dr RML Hospital, New Delhi, a Tertiary Care Referral Centre in India. The major risk factors studied were age, gender, COVID-19 infection and underlying diseases (such as diabetes mellitus, ischaemic heart disease, hypertension, malignancies, chronic kidney DISEASES, etc.); details of corticosteroid use of all patients were recorded in the datasheet. The pandemic data was divided into three distinct time periods/waves/eras, i.e., first, second, and third waves, each of which included ten months, to examine the changing trend in fungal rhinosinusitis in the pandemic era of COVID-19.
RESULTS
A total of 412 patients out of which 236 patients were clinically diagnosed with fungal sinusitis based on revised EORTC criteria. The most common site involved was the orbit with paranasal sinus and eye 86/236 (36.4%), followed by involvement of nasal and paranasal sinus alone 68/236 (28.8%). The most prevalent age range affected was 40 to 50 years. The most commonly associated comorbidity was diabetes mellitus (DM) in 176 (74.5%), followed by head and neck malignancies in 22 (9.32%) patients. Thirty-eight (50.6%) species and 18 (24%) were the most common isolated fungal species on culture, followed by spp. 14 (18.6%) and 5 (6.6%) in the period. In the second wave of COVID, there was a surge in cases 36 (45%) and after the second wave, the cases increased by 14 (19%) during Jan-Oct 2022.
CONCLUSION
With the continuing coronavirus pandemic, there is an unprecedented and discernible rise in the prevalence of acute invasive fungal sinusitis certainly a spike in cases of Aspergillus infection was observed, probably due to unprecedented usage of Amphotericin B for the treatment of mucormycosis during the third wave This underlines the importance of the need to tailor our treatment protocol as per the etiological agents hence the right antifungal drugs combined with urgent surgical procedures on a case-to-case basis may certainly increase the chances of survival.
PubMed: 38827671
DOI: 10.4103/jfmpc.jfmpc_871_23