BACKGROUND Fungal esophagitis(FE)is caused by fungal invasion of the esophageal mucosa.Under endoscopy,the esophageal mucosa shows edema,congestion,erosion,and ulceration,and bleeds easily when touched,and the surface...BACKGROUND Fungal esophagitis(FE)is caused by fungal invasion of the esophageal mucosa.Under endoscopy,the esophageal mucosa shows edema,congestion,erosion,and ulceration,and bleeds easily when touched,and the surface of the mucosa is covered with small white spots like"bean curd residue".Clinical cases showing typical FE under endoscopic imaging but negative esophageal mucosal brush(referred to as suspected FE)have increased the difficulty and challenge of clinical diagnosis and treatment.At present,the esophageal fungal flora of suspected case has not been thoroughly studied.AIM To characterize the fungal flora in FE,suspected FE,and the esophageal normal controls(NCs),and to identify marker species to improve detection of FE.METHODS This was a case-control study.A total of 19 patients with FE,16 with suspected FE,and 10 NCs were selected by endoscopy.The esophageal cell brush samples of each group were sequenced by internal transcribed spacer(ITS)1 and analyzed by bioinformatics.RESULTS In FE and suspected FE patients,species richness,species diversity and species evenness,as measured by the Chao1 index,Shannon index and Pielou index,were lower than in the NCs,and the comparison between the FE and NCs was the most significant(P<0.05).Compared with the NCs,the relative abundance of Candida in FE and suspected FE patients was significantly increased(P<0.001),while the relative abundance of Yarrowia was significantly decreased(P<0.05).Moreover,Yarrowia abundance in the FE group was significantly lower than in the NCs and suspected FE groups(P<0.001).The area under the curve for Candida in FE and suspected FE patients was 99.5%(P<0.05)and 81.3%(P<0.05),respectively.Finally,compared with FE patients,the relative abundance of Ascomycota and Candida in the esophageal flora of suspected FE patients was decreased,while the relative abundance of Yarrowia,Thermomyces and Pichia was increased.CONCLUSION ITS showed that composition of the fungal community was similar in the FE and suspected FE groups.ITS can be used as an auxiliary diagnostic method for FE and provide a theoretical basis for follow-up diagnosis and treatment.展开更多
Rapid increase in desertification is an environ-mental concern,especially for the health and sustainabil-ity of ecosystems in changing climates.How ecosystems respond to such changes may be partially understood by stu...Rapid increase in desertification is an environ-mental concern,especially for the health and sustainabil-ity of ecosystems in changing climates.How ecosystems respond to such changes may be partially understood by studying interactions and performance of critically impor-tant groups such as soil fungi functional groups.This study investigated variations in diversities of three soil fungi functional guilds(saprotrophic,symbiotic,pathogenic)and influencing abiotic factors in a Pinus densata forest on the southeast Tibetan Plateau where desertification is intense.The results indicate desertification significantly decreased the proportion of dominant fungal guild-symbiotic fungi(mean relative abundance decreasing from 97.0%to 68.3%),in contrast to saprotrophic fungi(increasing from 2.7%to 25.7%)and pathogenic(from 0.3%to 5.9%).Soil pH had the most significant impact on fungal community structure and negatively correlated with symbiotic fungal richness,which was significantly lower in arid soils,and positively correlated with saprotrophic and pathogenic fungal alpha-diversity,which were abundant.Different community struc-tures and regulators of the three fungi communities were observed,with pH,total phosphorus and ammonium(NH_(4)^(+))as the main determinants.This study links the biotic and abi-otic components during desertification and the interactions between them,and may be used as indicators of ecosystem health and for amendments to mitigate the effects of a chang-ing climate.展开更多
Introduction: Peanut pastes are food products resulting from artisanal or industrial processing, used in cooking in Africa in general and in Central African Republic in particular. These peanut pastes are often contam...Introduction: Peanut pastes are food products resulting from artisanal or industrial processing, used in cooking in Africa in general and in Central African Republic in particular. These peanut pastes are often contaminated by molds and filamentous fungi involved in the degradation of hygienic and organoleptic or even toxicological quality. This study aims to determine the epidemiological profile of molds contaminating peanut pastes sold on the Central African market. Methodology: This was a cross-sectional study carried out from June to September 2023. Samples of peanut pastes sold on Central African market were taken and analyzed at the National Laboratory of Clinical Biology and Public Health using the conventional microbiology method according to ISO 7954 standards. The data obtained were collected in the ODK 2023.3.1 application and analyzed with the Epi Info 7 software. A multivariate analysis by logistic regression, Ficher’s exact test, and chi<sup>2</sup> at the 5% threshold (p Penicillium sp.;11.25% of Mucor sp.;10.63% of Aspergillus terrei;3.13% of Aspergillus niger;1.25% of Aspergillus medullans;28.13% of Aspergillus flavus;2.50% of Aspergillus fumigatus. Peanut pastes stored beyond three days were more contaminated (94.19%). Conclusion: The results of this study made it possible to highlight strains of mold that impact the hygienic and organoleptic quality of peanut pastes sold at the Central African market. Most of the isolated strains were the Aspergillus flavus species which is recognized by its toxigenic effects. This species is much more incriminated in the contamination of foodstuffs with the production of the toxin which causes underlying pulmonary pathologies in humans.展开更多
Fungal keratitis is an important cause of corneal blindness in China, accounting for 45% of infectious keratitis. The main pathogenic bacteria include yeast, filamentous bacteria and nearly 100 kinds of fungi, which a...Fungal keratitis is an important cause of corneal blindness in China, accounting for 45% of infectious keratitis. The main pathogenic bacteria include yeast, filamentous bacteria and nearly 100 kinds of fungi, which are difficult to diagnose, difficult to treat and poor prognosis. When the infected fungal strains have strong virulence and poor drug sensitivity, it is easy to prolong the disease. Once the fungal infection involves the whole limbus and reaches the whole layer of the cornea, it will be followed by intraocular tissue infection such as anterior chamber, lens and vitreous body. When the infection is difficult to control and the visual function is seriously damaged, the enucleation of eye contents has to be performed, which causes irreversible harm to the patient’s appearance and physical and mental health. Therefore, in order to gain greater hope for the vision of patients with fungal keratitis, In recent years, with the continuous progress of clinical medicine and microbiological diagnostics, the treatment methods of fungal keratitis have been constantly updated. This article will briefly review the new progress in drug and surgical treatment of fungal keratitis in recent years to provide patients with better visual prognosis. .展开更多
Background: Antifungal resistance (AFR) is a global public health problem with devastating effects, especially among immunocompromised individuals. Addressing AFR requires a One Health approach including Antifungal St...Background: Antifungal resistance (AFR) is a global public health problem with devastating effects, especially among immunocompromised individuals. Addressing AFR requires a One Health approach including Antifungal Stewardship (AFS). This study aimed to comprehensively review global studies published on fungal infections and AFR and to recommend solutions to address this growing problem. Materials and Methods: This was a narrative review that was conducted using published papers on fungal infections, AFR, and AFS between January 1961 and March 2024. The literature was searched using PubMed, Google Scholar, Web of Science, and EMBASE. Results: This found that there has been an increase in fungal infections globally, especially among immunocompromised patients. Due to this increase in fungal infections, there has been a proportionate increase in the use of antifungal agents to prevent and treat fungal infections. This increased use of antifungal agents has worsened the problem of AFR contributing to increased morbidity and mortality. Globally, fungal infections have contributed to 150 million infections annually and 1.7 million deaths per year. By the year 2023, over 3.8 million people died from fungal infections. Addressing AFR remains a challenge because the treatment of antifungal-resistant infections is difficult. Finally, the treatment of fungal infections is a global challenge exacerbated by the limited number of antifungal agents to treat invasive fungal infections. Conclusion: The results of this study indicated that fungal infections and AFR are prevalent across humans, animals, agriculture, and the environment. Addressing this problem requires the provision of solutions such as improving the awareness of AFR, conducting further research on the discovery of new antifungal agents, and implementing AFS programs. If this global problem is not addressed, the morbidity and mortality associated with AFR will continue to rise in the future.展开更多
BACKGROUND Due to development of an immune-dysregulated phenotype,advanced liver disease in all forms predisposes patients to sepsis acquisition,including by opportunistic pathogens such as fungi.Little data exists on...BACKGROUND Due to development of an immune-dysregulated phenotype,advanced liver disease in all forms predisposes patients to sepsis acquisition,including by opportunistic pathogens such as fungi.Little data exists on fungal infection within a medical intensive liver unit(MILU),particularly in relation to acute on chronic liver failure.AIM To investigate the impact of fungal infections among critically ill patients with advanced liver disease,and compare outcomes to those of patients with bacterial infections.METHODS From our prospective registry of MILU patients from 2018-2022,we included 27 patients with culture-positive fungal infections and 183 with bacterial infections.We compared outcomes between patients admitted to the MILU with fungal infections to bacterial counterparts.Data was extracted through chart review.RESULTS All fungal infections were due to Candida species,and were most frequently blood isolates.Mortality among patients with fungal infections was significantly worse relative to the bacterial cohort(93%vs 52%,P<0.001).The majority of the fungal cohort developed grade 2 or 3 acute on chronic liver failure(ACLF)(90%vs 64%,P=0.02).Patients in the fungal cohort had increased use of vasopressors(96%vs 70%,P=0.04),mechanical ventilation(96%vs 65%,P<0.001),and dialysis due to acute kidney injury(78%vs 52%,P=0.014).On MILU admission,the fungal cohort had significantly higher Acute Physiology and Chronic Health Evaluation(108 vs 91,P=0.003),Acute Physiology Score(86 vs 65,P=0.003),and Model for End-Stage Liver Disease-Sodium scores(86 vs 65,P=0.041).There was no significant difference in the rate of central line use preceding culture(52%vs 40%,P=0.2).Patients with fungal infection had higher rate of transplant hold placement,and lower rates of transplant;however,differences did not achieve statistical significance.CONCLUSION Mortality was worse among patients with fungal infections,likely attributable to severe ACLF development.Prospective studies examining empiric antifungals in severe ACLF and associations between fungal infections and transplant outcomes are critical.展开更多
In this paper,managed forest(MF)and natural forest(NF)in the Huajiang Demonstration Zone of Guanling,Guizhou were selected as research objects,and cropland(CL)was taken as control.High-throughput sequencing technology...In this paper,managed forest(MF)and natural forest(NF)in the Huajiang Demonstration Zone of Guanling,Guizhou were selected as research objects,and cropland(CL)was taken as control.High-throughput sequencing technology was used to study the characteristics of fungal community composition and species diversity in the surface(0-10 cm)soil of each restoration measure,in order to reveal the dominant soil fungal groups and fungal community composition in karst rocky desertification areas,which was conducive to a more comprehensive understanding of the soil conditions of different vegetation restoration measures.Research has shown that vegetation restoration significantly affected the diversity of soil fungal community,with significant increases in Sob index,Ace index,and Chao index.The vegetation restoration has significantly changed the composition of fungal community.The dominant fungi in the CL topsoil are Sordariomycetes(62.28%),Dothideomycetes(12.34%),and Eurotiomycetes(9.12%);the dominant fungi in the MF soil are Sordariomycetes(45.05%),Dothideomycetes(14.74%),and Mortierellomycetes(10.40%);the dominant fungi in the NF soil are unclassified fungal community(26.38%),Sordariomycetes(19.78%),and Agaricomycetes(13.82%).Vegetation restoration has changed the key fungal groups in the soil.Sordariomycetes,Fusarium,and Setophoma are the key dominant fungal groups in CL soil;Dioszegia is key dominant fungal group in MF soil;c_unclassified_k_Fungi,p_unclassified_k_Fungi,o_unclassified_k_Fungi,f_unclassified_k_Fungi,g_unclassified_k_Fungi,Teichospora,and Diaporthe are key dominant fungal groups in NF soil.展开更多
Inflammatory bowel disease(IBD)is a chronic relapsing-remitting systemic disease of the gastrointestinal tract,characterized by an inflammatory process.Gut mycobiota community dysbiosis has been reported that is close...Inflammatory bowel disease(IBD)is a chronic relapsing-remitting systemic disease of the gastrointestinal tract,characterized by an inflammatory process.Gut mycobiota community dysbiosis has been reported that is closely related to the development of IBD.Our previous findings indicated that polyphenol of the inner shell(BPIS)from foxtail millet bran could restore the gut microbiome and inhibit the progress of colorectal cancer(CRC).In the present study,we studied the anti-inflammatory potential of BPIS in the dextran sodium sulfate(DSS)-induced mouse colitis model.Data suggested that BPIS alleviated experimental colitis by restoring body weight,colonic length and protecting the epithelial architecture from damage by DSS.Moreover,we found that BPIS strengthened the gut barrier function and inhibited the activation of Wnt1/β-catenin pathway.Gene sequence analysis indicated that BPIS remodeled the overall structure of the gut mycobiota from colitis mice toward that of the normal counterparts,including 1 phylum and 9 genera.Interestingly,BPIS significantly increased the abundance of Aspergillus ruber.It further verified that BPIS significantly promoted the growth of A.ruber in vitro.Collectively,BPIS has great potential to develop into an effective against IBD drug.展开更多
BACKGROUND Invasive fungal infections,particularly candidemia,pose significant clinical challenges globally.Understanding local epidemiology,species distribution,and antifungal susceptibility patterns is crucial for e...BACKGROUND Invasive fungal infections,particularly candidemia,pose significant clinical challenges globally.Understanding local epidemiology,species distribution,and antifungal susceptibility patterns is crucial for effective management despite regional variations.AIM To investigate the epidemiology,species distribution,antifungal susceptibility patterns,and associated risk factors of candidemia among patients in Bahrain from 2021 to 2023.METHODS This retrospective study analyzed demographic data,Candida species distribution,antifungal susceptibility profiles,and risk factors among candidemia patients treated at a tertiary care hospital in Bahrain over three years.Data was collected from medical records and analyzed using descriptive statistics.RESULTS A total of 430 candidemia cases were identified.The mean age of patients was 65.7 years,with a mortality rate of 85.5%.Candida albicans(C.albicans)was the most common species,followed by Candida parapsilosis,Candida tropicalis(C.tropicalis),and emerging multidrug-resistant Candida auris(C.auris).Antifungal susceptibility varied across species,with declining susceptibility to azoles observed,particularly among C.albicans and C.tropicalis.Major risk factors included central venous catheters,broad-spectrum antibiotics,and surgical procedures.CONCLUSION This study highlights the substantial burden of candidemia among older adults in Bahrain,characterized by diverse Candida species.It also concerns levels of antifungal resistance,notably in C.auris.The findings underscore the importance of local epidemiological surveillance and tailored treatment strategies to improve outcomes and mitigate the spread of multidrug-resistant Candida species.Future research should focus on molecular resistance mechanisms and optimizing therapeutic approaches to address this growing public health concern.展开更多
Background: Chronic ulcers are responsible for considerable morbidity and significantly contribute to the escalation in the cost of health care. Chronic leg ulcers (CLUs) are susceptible to microbial infections and se...Background: Chronic ulcers are responsible for considerable morbidity and significantly contribute to the escalation in the cost of health care. Chronic leg ulcers (CLUs) are susceptible to microbial infections and serious complications such as tissue necrosis and osteomyelitis, can result without the timely control of infections. Recent studies have also reported an increase in the association of fungal infections with chronic non-healing ulcers. Aim: To determine the prevalence of bacterial and fungal infections among patients reporting with chronic leg ulcers in participants without co-morbidities. Methods: A prospective cross-sectional study was conducted among patients with chronic leg ulcers at the National Reconstructive Plastic Surgery and Burns Centre, Korle-Bu Teaching Hospital (NRPS/BC-KBTH) and those who consented were enrolled. Characteristics of the wound as well as micro-organisms cultured from wound swabs were recorded. Results: A total of 50 participants were enrolled for the study with the mean (SD) age of 40.7 (10.7) years. Eighty percent of the participants presented with post traumatic leg ulcers with 80% being artisans and traders in the age group 31 - 50 years. There was no statistically significant association between sex and the organism cultured for post traumatic and cellulitis (p-value > 0.05). The prevalence of bacterial and fungal infection was 79.3% and 20.7% respectively. Pseudomonas species was the most isolated bacteria (61.5%) while Aspergillus niger was the most isolated fungi (41%). Conclusion: From this study, fungal infections should be included in managing chronic leg ulcers, especially among artisans, famers and gardeners even though there was a significantly higher burden of bacterial infections.展开更多
BACKGROUND Invasive fungal sinusitis(IFS)can present as a mild disease to life-threatening infection.A recent surge in cases was seen due to the coronavirus disease 2019(COVID-19)pandemic.Many patients require surgica...BACKGROUND Invasive fungal sinusitis(IFS)can present as a mild disease to life-threatening infection.A recent surge in cases was seen due to the coronavirus disease 2019(COVID-19)pandemic.Many patients require surgical debridement and hence imaging[contrast-enhanced computed tomography(CECT)of the paranasal sinuses(PNS)]to document the extent of the disease.However,there was no scoring system using CECT to describe the severity of IFS.This study proposes a computed tomography(CT)severity index(CTSI)to describe the severity of rhino-orbital-cerebral involvement in symptomatic COVID-19 patients and hypothesizes that higher CTSI correlates with disease severity and thus slow response/non-response to treatment.AIM To propose a scoring system using CECT to describe the severity of IFS and correlate it with clinical outcomes.METHODS A prospective study on 66 COVID-19 positive patients with CECT PNS done for IFS was performed.Split-bolus single-phase CT technique was used.Based on the extent of involvement,a CTSI was designed.Disease in four major subsite areas was assessed.Each subsite involvement was given points according to this model and then summated.Based on the final summated CTSI,the disease was classified as mild,moderate,or severe.Two subsets were subsequently analyzed including survival and death;and responders and non-responders.RESULTS The study cohort was 66 COVID-19-positive patients with suspected IFS with a median age of 48.5 years.Mild disease was noted in 34(51.52%),moderate in 28(42.42%),and severe disease in 4(6.06%)patients.There was a significant association of mortality and poor clinical response(P=0.02)with disease bilaterality.Laterality and CTSI were significant predictors of response to treatment.The mean CTSI of responders was 6.3,of non-responders was 12.9 and the response to treatment was significantly associated with CTSI(t-test,P<0.001).Receiver operating characteristic curve analysis(Liu method)to distinguish between responders and non-responders showed that the cut-off value for CTSI of 11 had a sensitivity of 78.26%and a specificity of 95.35%to predict response assessment.CONCLUSION CTSI can help in quantification of the disease burden,mapping out disease extent,triaging patients,and response assessment;especially patients with underlying comorbidities.A higher score would alert the clinician to initiate aggressive treatment,as severe disease correlates with slow response/non-response to the treatment.展开更多
The artemisinin accumulation in the hairy root cultures of Artemisia annua L. was enhanced via a treatment of three fungal elicitors separately ( Verticillium dahliae Kleb., Rhizopus stolonifer (Ehrenb. ex ...The artemisinin accumulation in the hairy root cultures of Artemisia annua L. was enhanced via a treatment of three fungal elicitors separately ( Verticillium dahliae Kleb., Rhizopus stolonifer (Ehrenb. ex Fr.) Vuill and Colletotrichum dematium (Pers.) Grove). Among these three elicitors, V. dahliae had the highest inducing efficiency, but none of them manifests any noticeable effects on the cell growth of the hairy root cultures. The artemisinin content of the hairy root cultures treated with V. dahliae elicitor was 1.12 mg/g DW, which was 45% higher than the control (0.77 mg/g DW). The results showed that elicitation was dependent on the elicitor concentration, the incubation period and the physiological stage at which the hairy root cultures were treated. In addition, the authors found that for V. dahliae , the optimum concentration was 0.4 mg carbohydrate per millilitre medium, the strongest response of A. annua hairy root cultures to the elicitation was at the late exponential growth stage, and the highest artemisinin content of the hairy root cultures was on the 4th day post treatment.展开更多
基金Supported by Hebei Province 2023 Annual Medical Science Research Project,No.20230597Hebei Province 2024 Annual Medical Applicable Technology Tracking Project,No.GZ2024017.
文摘BACKGROUND Fungal esophagitis(FE)is caused by fungal invasion of the esophageal mucosa.Under endoscopy,the esophageal mucosa shows edema,congestion,erosion,and ulceration,and bleeds easily when touched,and the surface of the mucosa is covered with small white spots like"bean curd residue".Clinical cases showing typical FE under endoscopic imaging but negative esophageal mucosal brush(referred to as suspected FE)have increased the difficulty and challenge of clinical diagnosis and treatment.At present,the esophageal fungal flora of suspected case has not been thoroughly studied.AIM To characterize the fungal flora in FE,suspected FE,and the esophageal normal controls(NCs),and to identify marker species to improve detection of FE.METHODS This was a case-control study.A total of 19 patients with FE,16 with suspected FE,and 10 NCs were selected by endoscopy.The esophageal cell brush samples of each group were sequenced by internal transcribed spacer(ITS)1 and analyzed by bioinformatics.RESULTS In FE and suspected FE patients,species richness,species diversity and species evenness,as measured by the Chao1 index,Shannon index and Pielou index,were lower than in the NCs,and the comparison between the FE and NCs was the most significant(P<0.05).Compared with the NCs,the relative abundance of Candida in FE and suspected FE patients was significantly increased(P<0.001),while the relative abundance of Yarrowia was significantly decreased(P<0.05).Moreover,Yarrowia abundance in the FE group was significantly lower than in the NCs and suspected FE groups(P<0.001).The area under the curve for Candida in FE and suspected FE patients was 99.5%(P<0.05)and 81.3%(P<0.05),respectively.Finally,compared with FE patients,the relative abundance of Ascomycota and Candida in the esophageal flora of suspected FE patients was decreased,while the relative abundance of Yarrowia,Thermomyces and Pichia was increased.CONCLUSION ITS showed that composition of the fungal community was similar in the FE and suspected FE groups.ITS can be used as an auxiliary diagnostic method for FE and provide a theoretical basis for follow-up diagnosis and treatment.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDB31000000)the Second Tibetan Plateau Scientific Expedition and Research Program(No.2019QZKK0307)+1 种基金the Key Project of the Open Competition in Jiangsu Forestry(No.LYKJ[2022]01)the Jiangsu Social Development Project(BE2022792).
文摘Rapid increase in desertification is an environ-mental concern,especially for the health and sustainabil-ity of ecosystems in changing climates.How ecosystems respond to such changes may be partially understood by studying interactions and performance of critically impor-tant groups such as soil fungi functional groups.This study investigated variations in diversities of three soil fungi functional guilds(saprotrophic,symbiotic,pathogenic)and influencing abiotic factors in a Pinus densata forest on the southeast Tibetan Plateau where desertification is intense.The results indicate desertification significantly decreased the proportion of dominant fungal guild-symbiotic fungi(mean relative abundance decreasing from 97.0%to 68.3%),in contrast to saprotrophic fungi(increasing from 2.7%to 25.7%)and pathogenic(from 0.3%to 5.9%).Soil pH had the most significant impact on fungal community structure and negatively correlated with symbiotic fungal richness,which was significantly lower in arid soils,and positively correlated with saprotrophic and pathogenic fungal alpha-diversity,which were abundant.Different community struc-tures and regulators of the three fungi communities were observed,with pH,total phosphorus and ammonium(NH_(4)^(+))as the main determinants.This study links the biotic and abi-otic components during desertification and the interactions between them,and may be used as indicators of ecosystem health and for amendments to mitigate the effects of a chang-ing climate.
文摘Introduction: Peanut pastes are food products resulting from artisanal or industrial processing, used in cooking in Africa in general and in Central African Republic in particular. These peanut pastes are often contaminated by molds and filamentous fungi involved in the degradation of hygienic and organoleptic or even toxicological quality. This study aims to determine the epidemiological profile of molds contaminating peanut pastes sold on the Central African market. Methodology: This was a cross-sectional study carried out from June to September 2023. Samples of peanut pastes sold on Central African market were taken and analyzed at the National Laboratory of Clinical Biology and Public Health using the conventional microbiology method according to ISO 7954 standards. The data obtained were collected in the ODK 2023.3.1 application and analyzed with the Epi Info 7 software. A multivariate analysis by logistic regression, Ficher’s exact test, and chi<sup>2</sup> at the 5% threshold (p Penicillium sp.;11.25% of Mucor sp.;10.63% of Aspergillus terrei;3.13% of Aspergillus niger;1.25% of Aspergillus medullans;28.13% of Aspergillus flavus;2.50% of Aspergillus fumigatus. Peanut pastes stored beyond three days were more contaminated (94.19%). Conclusion: The results of this study made it possible to highlight strains of mold that impact the hygienic and organoleptic quality of peanut pastes sold at the Central African market. Most of the isolated strains were the Aspergillus flavus species which is recognized by its toxigenic effects. This species is much more incriminated in the contamination of foodstuffs with the production of the toxin which causes underlying pulmonary pathologies in humans.
文摘Fungal keratitis is an important cause of corneal blindness in China, accounting for 45% of infectious keratitis. The main pathogenic bacteria include yeast, filamentous bacteria and nearly 100 kinds of fungi, which are difficult to diagnose, difficult to treat and poor prognosis. When the infected fungal strains have strong virulence and poor drug sensitivity, it is easy to prolong the disease. Once the fungal infection involves the whole limbus and reaches the whole layer of the cornea, it will be followed by intraocular tissue infection such as anterior chamber, lens and vitreous body. When the infection is difficult to control and the visual function is seriously damaged, the enucleation of eye contents has to be performed, which causes irreversible harm to the patient’s appearance and physical and mental health. Therefore, in order to gain greater hope for the vision of patients with fungal keratitis, In recent years, with the continuous progress of clinical medicine and microbiological diagnostics, the treatment methods of fungal keratitis have been constantly updated. This article will briefly review the new progress in drug and surgical treatment of fungal keratitis in recent years to provide patients with better visual prognosis. .
文摘Background: Antifungal resistance (AFR) is a global public health problem with devastating effects, especially among immunocompromised individuals. Addressing AFR requires a One Health approach including Antifungal Stewardship (AFS). This study aimed to comprehensively review global studies published on fungal infections and AFR and to recommend solutions to address this growing problem. Materials and Methods: This was a narrative review that was conducted using published papers on fungal infections, AFR, and AFS between January 1961 and March 2024. The literature was searched using PubMed, Google Scholar, Web of Science, and EMBASE. Results: This found that there has been an increase in fungal infections globally, especially among immunocompromised patients. Due to this increase in fungal infections, there has been a proportionate increase in the use of antifungal agents to prevent and treat fungal infections. This increased use of antifungal agents has worsened the problem of AFR contributing to increased morbidity and mortality. Globally, fungal infections have contributed to 150 million infections annually and 1.7 million deaths per year. By the year 2023, over 3.8 million people died from fungal infections. Addressing AFR remains a challenge because the treatment of antifungal-resistant infections is difficult. Finally, the treatment of fungal infections is a global challenge exacerbated by the limited number of antifungal agents to treat invasive fungal infections. Conclusion: The results of this study indicated that fungal infections and AFR are prevalent across humans, animals, agriculture, and the environment. Addressing this problem requires the provision of solutions such as improving the awareness of AFR, conducting further research on the discovery of new antifungal agents, and implementing AFS programs. If this global problem is not addressed, the morbidity and mortality associated with AFR will continue to rise in the future.
文摘BACKGROUND Due to development of an immune-dysregulated phenotype,advanced liver disease in all forms predisposes patients to sepsis acquisition,including by opportunistic pathogens such as fungi.Little data exists on fungal infection within a medical intensive liver unit(MILU),particularly in relation to acute on chronic liver failure.AIM To investigate the impact of fungal infections among critically ill patients with advanced liver disease,and compare outcomes to those of patients with bacterial infections.METHODS From our prospective registry of MILU patients from 2018-2022,we included 27 patients with culture-positive fungal infections and 183 with bacterial infections.We compared outcomes between patients admitted to the MILU with fungal infections to bacterial counterparts.Data was extracted through chart review.RESULTS All fungal infections were due to Candida species,and were most frequently blood isolates.Mortality among patients with fungal infections was significantly worse relative to the bacterial cohort(93%vs 52%,P<0.001).The majority of the fungal cohort developed grade 2 or 3 acute on chronic liver failure(ACLF)(90%vs 64%,P=0.02).Patients in the fungal cohort had increased use of vasopressors(96%vs 70%,P=0.04),mechanical ventilation(96%vs 65%,P<0.001),and dialysis due to acute kidney injury(78%vs 52%,P=0.014).On MILU admission,the fungal cohort had significantly higher Acute Physiology and Chronic Health Evaluation(108 vs 91,P=0.003),Acute Physiology Score(86 vs 65,P=0.003),and Model for End-Stage Liver Disease-Sodium scores(86 vs 65,P=0.041).There was no significant difference in the rate of central line use preceding culture(52%vs 40%,P=0.2).Patients with fungal infection had higher rate of transplant hold placement,and lower rates of transplant;however,differences did not achieve statistical significance.CONCLUSION Mortality was worse among patients with fungal infections,likely attributable to severe ACLF development.Prospective studies examining empiric antifungals in severe ACLF and associations between fungal infections and transplant outcomes are critical.
基金Supported by National Natural Science Foundation of China (42177446,41601584)Guizhou Provincial Science and Technology Fund (Qiankehe[2017]1417)Guizhou Normal University (Qianshixinmiao[2022]28).
文摘In this paper,managed forest(MF)and natural forest(NF)in the Huajiang Demonstration Zone of Guanling,Guizhou were selected as research objects,and cropland(CL)was taken as control.High-throughput sequencing technology was used to study the characteristics of fungal community composition and species diversity in the surface(0-10 cm)soil of each restoration measure,in order to reveal the dominant soil fungal groups and fungal community composition in karst rocky desertification areas,which was conducive to a more comprehensive understanding of the soil conditions of different vegetation restoration measures.Research has shown that vegetation restoration significantly affected the diversity of soil fungal community,with significant increases in Sob index,Ace index,and Chao index.The vegetation restoration has significantly changed the composition of fungal community.The dominant fungi in the CL topsoil are Sordariomycetes(62.28%),Dothideomycetes(12.34%),and Eurotiomycetes(9.12%);the dominant fungi in the MF soil are Sordariomycetes(45.05%),Dothideomycetes(14.74%),and Mortierellomycetes(10.40%);the dominant fungi in the NF soil are unclassified fungal community(26.38%),Sordariomycetes(19.78%),and Agaricomycetes(13.82%).Vegetation restoration has changed the key fungal groups in the soil.Sordariomycetes,Fusarium,and Setophoma are the key dominant fungal groups in CL soil;Dioszegia is key dominant fungal group in MF soil;c_unclassified_k_Fungi,p_unclassified_k_Fungi,o_unclassified_k_Fungi,f_unclassified_k_Fungi,g_unclassified_k_Fungi,Teichospora,and Diaporthe are key dominant fungal groups in NF soil.
基金supported by the National Natural Science Foundation of China(U23A20526,32072220,32270420)Shanxi Province 136 Revitalization Medical Project Construction Funds(general surgery department),Science Foundation(202103021224011).
文摘Inflammatory bowel disease(IBD)is a chronic relapsing-remitting systemic disease of the gastrointestinal tract,characterized by an inflammatory process.Gut mycobiota community dysbiosis has been reported that is closely related to the development of IBD.Our previous findings indicated that polyphenol of the inner shell(BPIS)from foxtail millet bran could restore the gut microbiome and inhibit the progress of colorectal cancer(CRC).In the present study,we studied the anti-inflammatory potential of BPIS in the dextran sodium sulfate(DSS)-induced mouse colitis model.Data suggested that BPIS alleviated experimental colitis by restoring body weight,colonic length and protecting the epithelial architecture from damage by DSS.Moreover,we found that BPIS strengthened the gut barrier function and inhibited the activation of Wnt1/β-catenin pathway.Gene sequence analysis indicated that BPIS remodeled the overall structure of the gut mycobiota from colitis mice toward that of the normal counterparts,including 1 phylum and 9 genera.Interestingly,BPIS significantly increased the abundance of Aspergillus ruber.It further verified that BPIS significantly promoted the growth of A.ruber in vitro.Collectively,BPIS has great potential to develop into an effective against IBD drug.
文摘BACKGROUND Invasive fungal infections,particularly candidemia,pose significant clinical challenges globally.Understanding local epidemiology,species distribution,and antifungal susceptibility patterns is crucial for effective management despite regional variations.AIM To investigate the epidemiology,species distribution,antifungal susceptibility patterns,and associated risk factors of candidemia among patients in Bahrain from 2021 to 2023.METHODS This retrospective study analyzed demographic data,Candida species distribution,antifungal susceptibility profiles,and risk factors among candidemia patients treated at a tertiary care hospital in Bahrain over three years.Data was collected from medical records and analyzed using descriptive statistics.RESULTS A total of 430 candidemia cases were identified.The mean age of patients was 65.7 years,with a mortality rate of 85.5%.Candida albicans(C.albicans)was the most common species,followed by Candida parapsilosis,Candida tropicalis(C.tropicalis),and emerging multidrug-resistant Candida auris(C.auris).Antifungal susceptibility varied across species,with declining susceptibility to azoles observed,particularly among C.albicans and C.tropicalis.Major risk factors included central venous catheters,broad-spectrum antibiotics,and surgical procedures.CONCLUSION This study highlights the substantial burden of candidemia among older adults in Bahrain,characterized by diverse Candida species.It also concerns levels of antifungal resistance,notably in C.auris.The findings underscore the importance of local epidemiological surveillance and tailored treatment strategies to improve outcomes and mitigate the spread of multidrug-resistant Candida species.Future research should focus on molecular resistance mechanisms and optimizing therapeutic approaches to address this growing public health concern.
文摘Background: Chronic ulcers are responsible for considerable morbidity and significantly contribute to the escalation in the cost of health care. Chronic leg ulcers (CLUs) are susceptible to microbial infections and serious complications such as tissue necrosis and osteomyelitis, can result without the timely control of infections. Recent studies have also reported an increase in the association of fungal infections with chronic non-healing ulcers. Aim: To determine the prevalence of bacterial and fungal infections among patients reporting with chronic leg ulcers in participants without co-morbidities. Methods: A prospective cross-sectional study was conducted among patients with chronic leg ulcers at the National Reconstructive Plastic Surgery and Burns Centre, Korle-Bu Teaching Hospital (NRPS/BC-KBTH) and those who consented were enrolled. Characteristics of the wound as well as micro-organisms cultured from wound swabs were recorded. Results: A total of 50 participants were enrolled for the study with the mean (SD) age of 40.7 (10.7) years. Eighty percent of the participants presented with post traumatic leg ulcers with 80% being artisans and traders in the age group 31 - 50 years. There was no statistically significant association between sex and the organism cultured for post traumatic and cellulitis (p-value > 0.05). The prevalence of bacterial and fungal infection was 79.3% and 20.7% respectively. Pseudomonas species was the most isolated bacteria (61.5%) while Aspergillus niger was the most isolated fungi (41%). Conclusion: From this study, fungal infections should be included in managing chronic leg ulcers, especially among artisans, famers and gardeners even though there was a significantly higher burden of bacterial infections.
基金Supported by All India Institute of Medical Sciences,New Delhi,No.A-COVID-80.
文摘BACKGROUND Invasive fungal sinusitis(IFS)can present as a mild disease to life-threatening infection.A recent surge in cases was seen due to the coronavirus disease 2019(COVID-19)pandemic.Many patients require surgical debridement and hence imaging[contrast-enhanced computed tomography(CECT)of the paranasal sinuses(PNS)]to document the extent of the disease.However,there was no scoring system using CECT to describe the severity of IFS.This study proposes a computed tomography(CT)severity index(CTSI)to describe the severity of rhino-orbital-cerebral involvement in symptomatic COVID-19 patients and hypothesizes that higher CTSI correlates with disease severity and thus slow response/non-response to treatment.AIM To propose a scoring system using CECT to describe the severity of IFS and correlate it with clinical outcomes.METHODS A prospective study on 66 COVID-19 positive patients with CECT PNS done for IFS was performed.Split-bolus single-phase CT technique was used.Based on the extent of involvement,a CTSI was designed.Disease in four major subsite areas was assessed.Each subsite involvement was given points according to this model and then summated.Based on the final summated CTSI,the disease was classified as mild,moderate,or severe.Two subsets were subsequently analyzed including survival and death;and responders and non-responders.RESULTS The study cohort was 66 COVID-19-positive patients with suspected IFS with a median age of 48.5 years.Mild disease was noted in 34(51.52%),moderate in 28(42.42%),and severe disease in 4(6.06%)patients.There was a significant association of mortality and poor clinical response(P=0.02)with disease bilaterality.Laterality and CTSI were significant predictors of response to treatment.The mean CTSI of responders was 6.3,of non-responders was 12.9 and the response to treatment was significantly associated with CTSI(t-test,P<0.001).Receiver operating characteristic curve analysis(Liu method)to distinguish between responders and non-responders showed that the cut-off value for CTSI of 11 had a sensitivity of 78.26%and a specificity of 95.35%to predict response assessment.CONCLUSION CTSI can help in quantification of the disease burden,mapping out disease extent,triaging patients,and response assessment;especially patients with underlying comorbidities.A higher score would alert the clinician to initiate aggressive treatment,as severe disease correlates with slow response/non-response to the treatment.
文摘The artemisinin accumulation in the hairy root cultures of Artemisia annua L. was enhanced via a treatment of three fungal elicitors separately ( Verticillium dahliae Kleb., Rhizopus stolonifer (Ehrenb. ex Fr.) Vuill and Colletotrichum dematium (Pers.) Grove). Among these three elicitors, V. dahliae had the highest inducing efficiency, but none of them manifests any noticeable effects on the cell growth of the hairy root cultures. The artemisinin content of the hairy root cultures treated with V. dahliae elicitor was 1.12 mg/g DW, which was 45% higher than the control (0.77 mg/g DW). The results showed that elicitation was dependent on the elicitor concentration, the incubation period and the physiological stage at which the hairy root cultures were treated. In addition, the authors found that for V. dahliae , the optimum concentration was 0.4 mg carbohydrate per millilitre medium, the strongest response of A. annua hairy root cultures to the elicitation was at the late exponential growth stage, and the highest artemisinin content of the hairy root cultures was on the 4th day post treatment.