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Scientific Reports Jun 2024Dermatophytes show a wide geographic distribution and are the main causative agents of skin fungal infections in many regions of the world. Recently, their resistance to...
Dermatophytes show a wide geographic distribution and are the main causative agents of skin fungal infections in many regions of the world. Recently, their resistance to antifungal drugs has led to an obstacle to effective treatment. To address the lack of dermatophytosis data in Iraq, this study was designed to investigate the distribution and prevalence of dermatophytes in the human population and single point mutations in squalene epoxidase gene (SQLE) of terbinafine resistant isolates. The identification of 102 dermatophytes isolated from clinical human dermatophytosis was performed through morphological and microscopic characteristics followed by molecular analysis based on ITS and TEF-1α sequencing. Phylogeny was achieved through RAxML analysis. CLSI M38-A2 protocol was used to assess antifungal susceptibility of the isolates to four major antifungal drugs. Additionally, the presence of point mutations in SQLE gene, which are responsible for terbinafine resistance was investigated. Tinea corporis was the most prevalent clinical manifestation accounting for 37.24% of examined cases of dermatophytosis. Based on ITS, T. indotineae (50.98%), T. mentagrophytes (19.61%), and M. canis (29.41%) was identified as an etiologic species. T. indotineae and T. mentagrophytes strains were identified as T. interdigitale based on TEF-1α. Terbinafine showed the highest efficacy among the tested antifungal drugs. T. indotineae and T. mentagrophytes showed the highest resistance to antifungal drugs with MICs of 2-4 and 4 μg/mL, while M. canis was the most susceptible species. Three of T. indotineae isolates showed mutations in SQLE gene PheLeu substitution. A non-previously described point mutation, PheLeu was identified in T. indotineae and mutations LysAsn, PheLeu and LeuPhe were diagnosed in T. mentagrophytes XVII. The results of mutation analysis showed that PheLeu was a destabilizing mutation; protein stability has decreased with variations in pH, and point mutations affected the interatomic interaction, resulting in bond disruption. These results could help to control the progression of disease effectively and make decisions regarding the selection of appropriate drugs for dermatophyte infections.
Topics: Humans; Antifungal Agents; Iraq; Point Mutation; Tinea; Drug Resistance, Fungal; Microbial Sensitivity Tests; Male; Arthrodermataceae; Female; Squalene Monooxygenase; Adult; Phylogeny; Terbinafine; Middle Aged; Adolescent; Young Adult; Child; Fungal Proteins; Aged
PubMed: 38830918
DOI: 10.1038/s41598-024-63425-w -
CMAJ : Canadian Medical Association... Jun 2024
Topics: Humans; Male; Alopecia; Child; Tinea; Scalp; Antifungal Agents; Scalp Dermatoses
PubMed: 38830674
DOI: 10.1503/cmaj.231613-f -
Saudi Medical Journal Jun 2024To assess the risk variables related to the types of candidemia for each patient, who was admitted into the intensive care unit regardless of the patient with or without...
OBJECTIVES
To assess the risk variables related to the types of candidemia for each patient, who was admitted into the intensive care unit regardless of the patient with or without complete diagnosis of COVID-19, during the period of March 2019 to December 2022.
METHODS
The evaluation comparison of demographic and clinical data of COVID-19 positive and negative patients with candidemia confirmed in blood, 113 cases were assessed. Variables such as gender, age, age of hospitalization, history of hospitalization, concurrently infection, The acute physiology and chronic health evaluation-II scores, comorbidity checking, intubation, central venous catheter use, parenteral nutrition use, steroid use, antibiotic use, lymphopenia, and laboratory variables were evaluated. species distribution, antifungal susceptibility in blood culture were determined.
RESULTS
Coronavirus disease-19 was present in 62.8% of cases confirmed candidemia, and these cases were significantly different from COVID-19 negative cases. Significance was found in more intubation, central venous catheter use, parenteral nutrition, and steroid therapy in Group 2. There was no significance with species distribution and associated infection. In total, COVID-19 positive had higher hemoglobin, aspartate aminotransferase, alanine transaminase, and white blood cell levels, which may be associated with the possibility of revealing and controlling candidemia.
CONCLUSION
and () are the species seen in infected COVID-19 patients, while C. parapsilosis and are found in non-COVID-19 ones. Risk factors were intubation, parenteral nutrition, central venous catheter, and steroid in the COVID-19 group.
Topics: Humans; Candidemia; Risk Factors; Male; Female; Intensive Care Units; COVID-19; Middle Aged; Candida; Aged; Adult; Parenteral Nutrition; Candida albicans; Antifungal Agents; SARS-CoV-2; Candida tropicalis
PubMed: 38830660
DOI: 10.15537/smj.2024.45.6.20240102 -
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 -
Frontiers in Cellular and Infection... 2024Sporotrichosis is a subcutaneous mycosis caused by fungi of the genus sp. Phenotypic and genotypic differences have been associated with their geographic distribution,... (Review)
Review
INTRODUCTION
Sporotrichosis is a subcutaneous mycosis caused by fungi of the genus sp. Phenotypic and genotypic differences have been associated with their geographic distribution, virulence, or clinical manifestation of sporotrichosis. In the past decade, the interest in identifying species of the sp. has been increasing, due to its epidemiological importance and, in consequence, is important to know how to preserve them for future studies, in culture collection.
AIMS
The purposes of this study were to analyze the global distribution of environmental isolates and/or causal agents of sporotrichosis identified by polyphasic taxonomy, with mandatory use of molecular identification, and to evaluate the percentages and distribution of isolates stored in culture collections.
METHODS
A systematic review of articles on animal and human sporotrichosis and/or environmental isolation of the fungus, from 2007 to 2023, was done. Results: Our results demonstrated that, , , and were the most identified species. With respect to the deposit and maintenance of species, we observed that only 17% of the strains of sp. isolated in the world are preserved in a culture collection.
CONCLUSIONS
This systematic review confirmed a difficulty in obtaining the frequency of species stored in culture collection and insufficient data on the molecular identification mainly of animal sporotrichosis and isolation of sp. in environmental samples.
Topics: Sporothrix; Sporotrichosis; Animals; Humans; Environmental Microbiology; Preservation, Biological
PubMed: 38828263
DOI: 10.3389/fcimb.2024.1382508 -
International Journal of Nanomedicine 2024Due to its prevalence, recurrence, and the emergence of drug-resistance, vaginitis significantly impacts the well-being of women. Although cinnamon essential oil (CEO)...
BACKGROUND
Due to its prevalence, recurrence, and the emergence of drug-resistance, vaginitis significantly impacts the well-being of women. Although cinnamon essential oil (CEO) possesses antifungal activity, its hydrophobic properties limit its clinical application.
PURPOSE
To overcome this challenge, a nanoemulsification technology was employed to prepare cinnamon essential oil-nanoemulsion (CEO@NE), and its therapeutic efficacy and action mechanism for vaginitis was investigated in vivo and in vitro.
MATERIALS AND METHODS
CEO@NE, composed of 4% CEO, 78% distilled water, and 18% Tween 80, was prepared by ultrasonic nanoemulsification. The physical properties, anti- activity, cytotoxicity, immunomodulatory potential and storage stability of CEO@NE were explored. Subsequently, the effect of intravaginal CEO@NE treatment on vaginitis was investigated in mice. To comprehend the possible mechanism of CEO@NE, an analysis was conducted to ascertain the production of intracellular reactive oxygen species (ROS) in .
RESULTS
CEO@NE, with the droplet size less than 100 nm and robust storage stability for up to 8 weeks, exhibited comparable anti- activity with CEO. CEO@NE at the concentration lower than 400 μg/mL had no cytotoxic and immunomodulatory effects on murine splenocytes. Intravaginal treatment of CEO@NE (400 μg/mL, 20 μL/day/mouse for 5 consecutive days) curbed colonization, ameliorated histopathological changes, and suppressed inflammatory cytokine production in mice intravaginally challenged with . Notably, this treatment preserved the density of vaginal lactic acid bacteria (LAB) crucial for vaginal health. Co-culturing with CEO@NE revealed concentration-dependent augmentation of intracellular ROS generation and ensuing cell death. In addition, co-culturing LPS-stimulated murine splenocytes with CEO@NE yielded a decrease in the generation of cytokines.
CONCLUSION
This discovery provides insight into the conceivable antifungal and anti-inflammatory mechanisms of CEO@NE to tackle vaginitis. CEO@NE offers a promising avenue to address the limitations of current treatments, providing novel strategy for treating vaginitis.
Topics: Female; Animals; Oils, Volatile; Candidiasis, Vulvovaginal; Candida albicans; Antifungal Agents; Mice; Administration, Intravaginal; Cinnamomum zeylanicum; Emulsions; Reactive Oxygen Species; Humans; Nanoparticles; Mice, Inbred BALB C
PubMed: 38828194
DOI: 10.2147/IJN.S458593 -
Journal of Radiology Case Reports May 2023The reported incidence of blastomycosis is increasing in certain regions of the United States. The diagnosis is primarily made via urine antigen testing, culture, or...
The reported incidence of blastomycosis is increasing in certain regions of the United States. The diagnosis is primarily made via urine antigen testing, culture, or cytology smear. The differential diagnosis for blastomycosis includes pneumonia, tuberculosis, and non-infectious pulmonary disease. Clinical context and epidemiologic exposure play a crucial role in diagnosis. However, the differential can expand significantly if there is disseminated central nervous system involvement, especially if pulmonary manifestations are not seen. Imaging begins to play a vital role when differentiating disseminated blastomycosis from other etiologies such as malignancy. Herein we present a case of a 58-year-old male who presented with seizures and right sided gaze preference found to have disseminated central nervous system blastomycosis. In this article, we will discuss symptoms and imaging findings of disseminated blastomycosis to help guide diagnosis and management.
Topics: Humans; Male; Blastomycosis; Middle Aged; Diagnosis, Differential; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Antifungal Agents; Central Nervous System Fungal Infections
PubMed: 38828027
DOI: 10.3941/jrcr.v17i12.5167 -
Clinical, Cosmetic and Investigational... 2024Restricted pagetoid reticulosis, also known as Woringer-Kolopp disease, represents a rare cutaneous lymphoproliferative disorder categorized as an isolated variant of...
Restricted pagetoid reticulosis, also known as Woringer-Kolopp disease, represents a rare cutaneous lymphoproliferative disorder categorized as an isolated variant of mycosis fungoides. This report presents a case involving limited pagetoid reticulosis affecting the right upper extremity in a 25-year-old female. The patient had been experiencing plaques on the right upper extremity for a decade. Dermatologic examination revealed well-defined scaly plaques on the right forearm, surrounded by hyperpigmented patches. Skin histopathology demonstrated atypical mononuclear cell infiltration in the lower part of the epidermis, forming nests. Immunohistochemistry indicated CD3+, CD4+, CD5+, CD7+, CD8+, CD30+, and Ki-67-positive staining. Additionally, CD20, CD79α, and PD-1 were negative. Monoclonal rearrangement of T-cells was identified in TCR β and TCR γ through clonality assessment. The diagnosis of limited paget-like reticulocyte hyperplasia was established, leading to surgical resection. A review of the literature affirmed the variable immunophenotype of pagetoid reticulosis, with atypical cells exhibiting four types: (1) CD3+, CD4+, CD8+-type; (2) CD3+, CD4-, CD8+-type; (3) CD3+, CD4-, CD8-type; and (4) CD3+, CD4+, CD8+-type-relatively uncommon in the restrictive type. This case report details the clinical features, histologic and morphologic characteristics, immunohistochemical phenotype, diagnosis, and differential diagnosis of a rare CD3+, CD4+, CD8+ limited pagetoid reticulosis. The lesion was surgically resected, and the patient underwent a 3-year follow-up to observe its prognosis.
PubMed: 38827631
DOI: 10.2147/CCID.S462966 -
Medical Mycology Journal 2024Antifungal stewardship (AFS), compared with antimicrobial stewardship (AS), requires more advanced knowledge, skills, and multidisciplinary collaboration in its... (Review)
Review
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.
Topics: Humans; Antifungal Agents; Antimicrobial Stewardship; Hospitals, University; Japan; COVID-19; SARS-CoV-2; Mycoses
PubMed: 38825528
DOI: 10.3314/mmj.24.003 -
Medical Mycology Journal 2024Mucormycosis is a fungal infectious disease caused by Rhizopus oryzae and other members of the order Mucorales, and it is known as one of the most lethal fungal...
Mucormycosis is a fungal infectious disease caused by Rhizopus oryzae and other members of the order Mucorales, and it is known as one of the most lethal fungal infections. Early diagnosis of mucormycosis improves prognosis because of limited effective treatments and the rapid progression of the disease. On the other hand, the lack of characteristic clinical findings in mucormycosis and the challenge of early definitive diagnosis make early treatment difficult. Our goal was to establish a serodiagnostic method to detect Rhizopus specific antigen (RSA), and we have developed a diagnostic kit by Enzyme-linked immuno-sorbent assay (ELISA) using a monoclonal antibody against this antigen. RSA increased over time in the serum and alveolar lavage fluid of R. oryzae-infected mice. RSA was also detected in serum and alveolar fluid, even at an early stage (Day 1), when the tissue invasion of R. oryzae mycelium was not histopathologically detectable in the lungs of R. oryzae-infected mice. Further evaluation is needed to determine the feasibility of using this assay in clinical practice.
Topics: Mucormycosis; Animals; Mice; Enzyme-Linked Immunosorbent Assay; Antigens, Fungal; Rhizopus oryzae; Biomarkers; Bronchoalveolar Lavage Fluid; Disease Models, Animal; Antibodies, Monoclonal; Rhizopus; Lung; Humans; Serologic Tests
PubMed: 38825527
DOI: 10.3314/mmj.24.002