This study was designed to evaluate the prevalence of antifungal resistance, genetic mechanisms associated with in vitro induction of azole and echinocandin resistance and genotyping of Candida krusei, which is intrinsically resistant to fluconazole and is recovered from clinical and nonclinical sources from different countries. Our results indicated that all the isolates were susceptible or had the wild phenotype (WT) to azoles, amphotericin B, and only 1.27% showed non-WT for flucytosine. Although 70.88% of the isolates were resistant to caspofungin, none of them were categorized as echinocandin-resistant as all were susceptible to micafungin and no FKS1 hot spot 1 (HS1) or HS2 mutations were detected. In vitro induction of azole and echinocandin resistance confirmed the rapid development of resistance at low concentrations of fluconazole (4 μg/ml), voriconazole (0.06 μg/ml), and micafungin (0.03 μg/ml), with no difference between clinical and nonclinical isolates in the resistance development. Overexpression of ABC1 gene and FKS1 HS1 mutations were the major mechanisms responsible for azole and echinocandin resistance, respectively. Genotyping of our 79 isolates coupled with 217 other isolates from different sources and geography confirmed that the isolates belong to two main subpopulations, with isolates from human clinical material and Asia being more predominant in cluster 1, and environmental and animals isolates and those from Europe in cluster 2. Our results are of critical concern, since realizing that the C. krusei resistance mechanisms and their genotyping are crucial for guiding specific therapy and for exploring the potential infection source.
- MeSH
- antifungální látky farmakologie terapeutické užití MeSH
- azoly * farmakologie MeSH
- echinokandiny * farmakologie MeSH
- fungální léková rezistence genetika MeSH
- genotyp MeSH
- mikrobiální testy citlivosti MeSH
- Pichia MeSH
- prevalence MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
This article reports the first verified cases of infection by Trichophyton bullosum in Africa since the description of the fungus, isolated in 1933 from the coat of horses in Tunisia and Mali. We found the fungus in cutaneous samples obtained from donkeys suffering from severe dermatitis with areas of alopecia and scaling in the surroundings of Cairo (Egypt). Fungal elements (arthroconidia and hyphae) were seen at the microscopy of material collected by skin scraping and digested in NaOH. Fungal colonies grown on various culture media were identified through PCR and sequencing of the ITS rDNA region. Since the original report in Africa and the Middle East, only a few cases have been reported thus far in humans in France and two cases in horses in the Czech Republic and Japan. Trichophyton bullosum seems thus an infrequent cause of dermatophytosis. However, the actual prevalence of this pathogen may be underestimated due to the similarity with T. verrucosum, a predominant cause of infection in cattle, occasionally found on horses and donkeys. Indeed, the two fungi can be distinguished only via molecular methods, which are poorly employed in epidemiological studies on equine and bovine dermatophytosis. The present study results add to our knowledge on the ecology of this poorly explored dermatophyte, supporting the concept that equines are the primary hosts of T. bullosum and confirming the presence of this pathogen in Africa. At the same time, these are the first unequivocally documented infections in donkeys due to T. bullosum.
- MeSH
- Arthrodermataceae * genetika MeSH
- Equidae MeSH
- koně MeSH
- skot MeSH
- tinea * epidemiologie mikrobiologie veterinární MeSH
- Trichophyton genetika MeSH
- zvířata MeSH
- Check Tag
- skot MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- severní Afrika MeSH
Tento návrh doporučeného postupu laboratorní diagnostiky dermatomykóz byl vypracován na základě odborné diskuze členů Pracovní skupiny pro mykologii Společnosti pro lékařskou mikrobiologii České lékařské společnosti JEP (PSM SLM ČLS JEP). Vychází z dokumentu „Doporučený postup laboratorní diagnostiky dermatomykóz“ zveřejněného na webových stránkách SLM ČLS JEP 23. 6. 2020 k všeobecné odborné diskuzi. Dosud byly pokyny v této oblasti mykologické laboratorní diagnostiky omezeny pouze na informace v příručkách a neexistoval žádný ucelený a systematický dokument na uvedené téma. Tuto mezeru se členové PSM SLM ČLS JEP snažili zaplnit, a vzniklo tak doporučení, pokrývající všechny části dermatomykologické laboratorní problematiky, od způsobu získání kvalitní anamnézy, správného postupu při odběru vzorků, jejich vyšetřování konvenčními mikroskopickými a kultivačními technikami, až po interpretaci získaných výsledků. Do této základní osnovy byly začleněny informace o diagnostickém potenciálu nových, moderních technologií, zejména molekulárně genetických metod a hmotnostní spektrometrie. Nedávno došlo k vypracování standardní evropské metodiky pro testování citlivosti dermatofytů k antimykotikům, proto byla i tato problematika do doporučení zahrnuta. Je samozřejmě počítáno s budoucí periodickou revizí tohoto dokumentu na základě nových poznatků.
This draft of guidelines for the laboratory diagnosis of dermatomycoses was developed based on discussion among members of the Czech Society for Medical Microbiology Working Group on Mycology. The document Guidelines for the Laboratory Diagnosis of Dermatomycoses was published for discussion on the Czech Society for Medical Microbiology website on 23 March 2020. Until recently, recommendations concerning this area of laboratory diagnosis in mycology were only limited to information in manuals and no comprehensive and systematic document concerning these issues was available. In an effort to fill the gap, members of the working group developed recommendations covering various laboratory aspects of mycology, from obtaining a proper history, to adequate sampling techniques, sample analyses using conventional microscopy and culture techniques, to interpretation of results. Additional information was on the diagnostic potential of novel, modern technology, in particular molecular genetic methods and mass spectrometry. The recently developed European standards for testing the susceptibility of dermatophytes to antifungals were also included in the recommendations. The document will be regularly updated based on new findings.
The rising number of European hedgehogs (Erinaceus europaeus) admitted every year to wildlife rehabilitation centres might be a source of concern to animal and public health since transmissible diseases, such as dermatophytosis, can be easily disseminated. This study seeks to evaluate the frequency of dermatophyte detection in hedgehogs admitted to a wildlife rehabilitation centre located near Paris, France, and to assess the risk of contamination in the centre in order to adapt prevention measures. A longitudinal cohort study was performed on 412 hedgehogs hosted at the Wildlife Animal Hospital of the Veterinary College of Alfort from January to December 2016. Animals were sampled once a month for fungal culture. Dermatophyte colonies were obtained from 174 out of 686 skin samples (25.4%). Besides Trichophyton erinacei, Trichophyton mentagrophytes and Nannizzia gypsea were also found. Dermatophyte detection seemed to be associated with the presence of skin lesions, while more than one-third of T. erinacei-positive animals were asymptomatic carriers. Healing required several months of treatment with topical and systemic azoles, but dermatophytosis did not seem to reduce the probability of release. Daily disinfection procedures and early detection and treatment of infected and asymptomatic carriers succeeded in limiting dermatophyte transmission between hedgehogs and humans.
- MeSH
- divoká zvířata MeSH
- ježkovití MeSH
- kontrola infekčních nemocí MeSH
- lidé MeSH
- longitudinální studie MeSH
- mykologické určovací techniky metody MeSH
- nemocnice veterinární MeSH
- rizikové faktory MeSH
- tinea * přenos veterinární MeSH
- Trichophyton izolace a purifikace MeSH
- záchranná práce MeSH
- zoonózy * přenos prevence a kontrola MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Francie MeSH
Kryptické druhy sekce Fumigati, tzn. druhy podobné Aspergillus fumigatus, jsou stále častěji uváděny v literatuře jako původci invazivní aspergilózy (IA) u lidí i zvířat. Jejich odhalení a správná identifikace je důležitá, avšak ještě důležitější je stanovení citlivosti daného izolátu k antimykotikům (minimální inhibiční koncentrace, MIC) za použití vhodných metod. Pro tyto kryptické druhy jsou totiž často charakteristické zvýšené hodnoty MIC k lékům volby doporučeným pro terapii IA, jako je vorikonazol nebo amfotericin B.V našem sdělení uvádíme případ plicní aspergilózy u 63letého muže po transplantaci srdce. Jako původce infekce byl kultivačně prokázán a pomocí sekvenace DNA identifikován A. lentulus, se sníženou citlivostí k vorikonazolu a amfotericinu B. Citlivost k antifungálním látkám byla ověřena pomocí standardizované metodiky EUCAST-AFST. Terapie byla na základě získaných hodnot MIC cíleně změněna z vorikonazolu na posakonazol s výborným klinickým efektem. Pokud víme, naše kazuistika je prvním popsaným případem terapie A. lentulusposakonazolem a navíc úspěšným.
Cryptic species within the section Fumigati, that is Aspergillus fumigatus-like species, are increasingly reported in the literature as causative agents of invasive aspergillosis (IA) in both humans and animals. Their detection and proper identification are important, buteven more important is to determine the susceptibility profile (minimum inhibitory concentrations, MICs) of the isolate to antifungalsusing appropriate methods. Cryptic species often demonstrate elevated MICs to drugs recommended for IA therapy such as voriconazole or amphotericin B. Presented is a case of pulmonary aspergillosis in a 63-year-old male heart transplant recipient. Aspergilluslentuluswith reduced susceptibility to voriconazole and amphotericin B was identified as the causative agent of the infection using culture and DNA sequencing. Susceptibility to antifungals was confirmed by the standard EUCAST-AFST methods. Based on MIC values obtained in vitro, therapy was switched from voriconazole to posaconazole with excellent clinical effects. To the best of our knowledge, this is the first reported case of A. lentulusinfection treated with posaconazole and, moreover, a successful one.
Spontaneous invasive and chronic disseminated mycosis affected Hemigrammus pulcher kept in a public aquarium, and infection was manifested by inappetence, exophthalmia, erratic swimming, eroded scales, anaemia of the gills and abdominal distension. Internally, there was a grossly swollen swim bladder with a thickened wall filled with a dark mass. The body cavities contained a clear, light amber fluid and a swollen intestine which was full of a watery fluid containing small gas bubbles. Histopathology revealed a granulomatous inflammatory response with fungal hyphae in the lumen and wall of the swim bladder, hepatopancreas, spleen and kidneys with signs of nephrohydrosis. Exophiala pisciphila and Phaeophleospora hymenocallidicola were isolated from the swim bladder, abdominal cavity and gastrointestinal tract. The exogenous source of infection was probably the ample wooden decoration and plants inside the aquarium. Koch's postulates were fulfilled by re-isolation of both fungal species from fish artificially infected under laboratory conditions. As P. hymenocallidicola is less capable of defence against phagocytosis, E. pisciphila probably played a major role. Severe clinical manifestations with 100% mortality developed in two fish species infected by E. pisciphila. A significant increase in the plasma levels of amino acids was observed as a result of the activation of proteolysis.
- MeSH
- Ascomycota patogenita fyziologie MeSH
- Characidae * MeSH
- Exophiala patogenita fyziologie MeSH
- mykózy mikrobiologie patologie patofyziologie veterinární MeSH
- nemoci ryb mikrobiologie patologie patofyziologie MeSH
- vzdušné vaky mikrobiologie patologie patofyziologie MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Invasive fungal disease represents one of the severe complications in haematopoietic stem cell transplant recipients. We describe a case of a patient treated for relapse of chronic lymphoblastic leukaemia 6 years after HSCT. The patient was treated for invasive pulmonary aspergillosis but died 3 months later from multiple organ failures consisting of haemorrhagic necrotizing fungal pneumonia, refractory chronic hepatic graft versus host disease and cytomegalovirus hepatitis. Autopsy samples revealed histopathological evidence of fungal hyphae and an unusual Aspergillus nidulans-like species was isolated in pure culture. More precise identification was achieved by using scanning electron microscopy of ascospores and sequencing of calmodulin gene, and the isolate was subsequently re-identified as A. sublatus (section Nidulantes) and showed good in vitro susceptibility against all classes of antifungals. Commonly used ITS rDNA region and β-tubulin gene fail to discriminate A. sublatus from related pathogenic species, especially A. quadrilineatus and A. nidulans. Although this is the first case of proven IPA attributed to A. sublatus, we demonstrated that at least some previously reported infections due to A. quadrilineatus were probably caused by this cryptic species.
- MeSH
- antifungální látky aplikace a dávkování MeSH
- Aspergillus klasifikace cytologie genetika izolace a purifikace MeSH
- chronická lymfatická leukemie komplikace MeSH
- cytomegalovirové infekce komplikace diagnóza MeSH
- DNA fungální chemie genetika MeSH
- fatální výsledek MeSH
- fylogeneze MeSH
- invazivní plicní aspergilóza diagnóza farmakoterapie mikrobiologie patologie MeSH
- kalmodulin genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- mezerníky ribozomální DNA chemie genetika MeSH
- mikrobiální testy citlivosti MeSH
- mikroskopie elektronová rastrovací MeSH
- nemoc štěpu proti hostiteli komplikace diagnóza MeSH
- příjemce transplantátu MeSH
- sekvenční analýza DNA MeSH
- shluková analýza MeSH
- transplantace hematopoetických kmenových buněk škodlivé účinky MeSH
- tubulin genetika MeSH
- virová hepatitida u lidí komplikace diagnóza MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- kongresy jako téma MeSH
- mykologie * MeSH
- Publikační typ
- zprávy MeSH
