慢性阻塞性肺疾病合并肺部真菌感染51例

目的:探讨慢性阻塞性肺疾病(COPD)患者合并肺部真菌感染的临床特征。方法:对51例COPD患者合并肺部真菌感染采用回顾性的方法进行分析。结果:51例COPD患者合并肺部真菌感染患者临床均出现咳嗽、咳痰、气喘加重,发热22例,合并有心功能衰竭5例,呼吸衰竭16例。双肺均闻及干、湿罗音,胸部X线及胸部CT出现胸膜下密度增高结节实变影30例,痰液、血、胸水培养显示,白色念珠菌感染30例,热带念珠菌5例,光滑白色念珠菌1例,酵母菌4例,曲霉菌6例,未分类真菌1例。予以氟康唑、酮康唑、伊曲康唑、5-氟胞嘧啶等药治疗后,痊愈11例,显效19例,进步11例,死亡8例。结论:COPD患者,特别是老年患者长期使用广谱抗生素、激素及细胞毒性药物易合并以白色念珠菌为主肺部真菌感染,应定期进行痰液、血、胸水培养,以尽早做出诊断,进行抗真菌治疗。

综合ICU院内侵袭性真菌感染临床分析及菌群分布

目的:探讨当前综合重症加强病房(综合ICU)院内侵袭性真菌感染的临床状况,病原菌特性、分布,为临床治疗及减少真菌感染提供参考依据。方法:回顾性分析4年来真菌培养阳性住院患者病例资料,从患者年龄、病种、部位、菌种分布、易患因素等方面进行分析。结果:综合ICU中侵袭性真菌感染发生率7.64%;其中痰液检出率最高67.45%,其次尿液占9.90%;真菌感染以白色假丝酵母菌属占94.34%,是感染主要菌属,其中白色假丝酵母菌占51.89%,是感染主要菌种;易患因素主要有病情危重且复杂、应用侵入性监测和治疗手段、广谱抗菌药物的不合理使用、长期使用激素、老年患者合并糖尿病及慢性阻塞性肺部疾病等基础疾病等。结论:综合ICU侵袭性真菌感染近年呈上升趋势,其中白色假丝酵母菌是感染的主要病原菌,值得注意的是非白色假丝酵母菌和曲霉菌属引起的感染正在逐年增加,应重视早期诊断及合理治疗。

Analysis of infections in the first 3-month after living donor liver transplantation

AIM:To identify factors related to serious postoperative bacterial and fungal infections in the first 3 mo after living donor liver transplantation(LDLT).METHODS:In the present study,the data of 207 patients from 2004 to 2011 were reviewed.The pre-,intra-and post-operative factors were statistically analyzed.All transplantations were approved by the ethics committee of West China Hospital,Sichuan University.Patients with definitely preoperative infections and infections within 48 h after transplantation were excluded from current study.All potential risk factors were analyzed using univariate analyses.Factors significant at a P < 0.10 in the univariate analyses were involved in the multivariate analyses.The diagnostic accuracy of the identified risk factors was evaluated using receiver operating curve.RESULTS:The serious bacterial and fungal infection rates were 14.01% and 4.35% respectively.Enterococcus faecium was the predominant bacterial pathogen,whereas Candida albicans was the most common fungal pathogen.Lung was the most common infection site for both bacterial and fungal infections.Recipient age older than 45 years,preoperative hyponatremia,intensive care unit stay longer than 9 d,postoperative bile leak and severe hyperglycemia were independent risk factors for postoperative bacterial infection.Massive red blood cells transfusion and postoperative bacterial infection may be related to postoperative fungal infection.CONCLUSION:Predictive risk factors for bacterial and fungal infections were indentified in current study.Pre-,intra-and post-operative factors can cause postoperative bacterial and fungal infections after LDLT.

Gibbago trianthemae Simmons, a Biocontrol Agent of Horse Purslane Weed： Research and Prospect

Trianthema portulacastrum L. （commonly known as horse purslane） is a noxious weed of several economically important field crops in tropical regions of the world. An intensive work on the screening of the biocontrol agents was accomplished through in vitro epidemic study to control weed populations. The foliar disease symptoms on infected weed plants caused by fungal pathogens represented as round to irregular maroon spots with dark borders and the epidemic was identified as leaf spot disease. The pathogen allied with the infection of horse purslane was isolated from infectious propagules by inoculation of leaf bites on a nutrient medium, potato dextrose agar （PDA）. The causal agent of leaf spot was confirmed as Gibbago trianthemae Simmons by Koch＇s postulates. The mycoherbicide ability of G. trianthemae has been examined through visual （standard area diagram） and statistical methods （analysis of variance using the Microsoft Office Excel-Data Analysis Tool Pack 2007）. The results revealed that the pathogen causes significantly （P 〈 0.05） severe infection on host weed and destructs the weed population by leaf spot diseases. The findings of the research suggested that the isolate G. trianthemae is highly virulent and host-specific, and recommended for further studies as a promising biocontrol agent against horse purslane weed.

Evaluation of Sunlight and Humidity Protection of a Bioherbicide for Eichornia crassipes Biocontrol

C. piaropi （Cercospora piaropi） and A. zonatum （Acremonium zonatum） have proved to be effective in reducing water hyacinth growth. However, efficacy of these fungi in field is limited by the effect of solar UV （ultraviolet） light and desiccation. In this study, three compounds used as sunscreens and one seed plant that produce mucilage were tested for their effects on the infection produced by C. piaropi and A. zonatum inoculum under laboratory and field conditions. In laboratory conditions, TiO2 （titanium dioxide） and metamucil did not inhibit C. piaropi and A. zonatum viability. Moreover, the addition of TiO2 and metamucil to the inoculum suspension increased fungi infection. The protective effect of TiO2 and metamucil was more evident when the inoculum suspension was applied 4 h before sunset. These results suggest that addition of TiO2 and metamucil provides necessary humidity and solar protection for increasing C piaropi and A. zonatum infection on water hyacinth plants.

Immunoscintigraphy with ^99mTc-Besilesomab in Aid to Fusiariosis Detection in Patients with Relapsed Acute Myeloid Leukemia （AML）： A Case Report and Literature Review

The aim of this article is to emphasize the importance of nuclear medicine in fungal infection characterization through a case report. Case： patient female, with AML-M2, hospitalized with fever, dyspnea, nausea, myasthenia, abdominal pain and diarrhea. In the physical examination exacerbated lesion in abdominal wall and subcutaneous nodules in upper and lower limbs. The computed tomography of the chest evinced area of attenuation in ground-glass opacities in the middle lobe, tending to consolidation and bilateral nodular opacities with ground-glass halo which suggested an infiammatory/infectious process of fungal etiology. Immunoscintigraphy with ^99mTc-besilesomab （Scintimun） identified focal infectious processes in activity, scattered over cutaneous and subcutaneous tissues, predominantly in extremities. In blood culture test, there was a growth ofFusarium sp. There is a difficulty in the diagnosis of fungal infections, both in clinical and imaging methods. There is no specific method to reaching the target. In addition, fungal diseases can be divided into focally localized or disseminated infections. There is a greater difficulty in the diagnosis of immunocompromised individuals due to the deficiency of basic defense mechanisms. Scintimun （scintigraphy with besilesomab） is a useful tool of nuclear medicine in the diagnosis of infectious and inflammatory diseases to allow the image of the whole-body and in vivo detection of early pathological and physiological phenomena, even before anatomical alterations occur.

Genotyping and Antifungal Susceptibility Profile of Sequential Candida albicans Isolated from the Oral Cavity of HIV-Infected Individuals

Objective： The study aimed to evaluate the genotypic profiles of C. albicans （Candida albicans） sequentially isolated throughout the course of HIV infections, and to determine its MIC （minimal inhibitory concentrations） to AMB （amphotericin B）, FLC （fluconazole）, KTC （ketoconazole）, and ITC （itraconazole）. Design： samples were collected from the oral cavity of HIV-positive individuals during 4 years, with a sterilized swab. MIC was performed by using the microdilution method AFST/EUCAST. The genetic similarities within and between sequential clones of C. albicans were assessed by DNA fingerprinting using the random amplification ofpolymorphic DNA technique. Results： A total of 142 oral samples were isolated from 59 HIV-infected individuals who attempted up to five visits each, with or without symptoms of oropharyngeal candidiasis. Profile analysis revealed that yeasts isolated over sequential visits from symptomatic or asymptomatic individuals showed 78% or 87% relatedness, respectively. The degree of similarity among C. albicans was higher for isolates from colonization than for those from infection. Genetically identical C. albicans samples also formed connected subelusters in sequential visits. In regard to susceptibility profile, all isolates were susceptible to AMB, FLC, KTC, and ITC and maintained this pattern all along, no differences in MICs of any given antifungal compound were observed for sequential C. albicans isolates. Conclusions： These data suggest that genotype and susceptibility to antifimgal drugs were maintained over time in sequentially isolates of C. albicans colonization and a diverse evolutionary genetic trend in C. albicans sequentially isolated from the oral eandidiasis of HIV infected individuals.

Determination of the Time of Degradation Trifloxystrobines Fungicide Used in the Apples

Combating the powdery mildew of apples requires permanent intervention with chemical substances. Such interventions are imposed by the development cycle of this pathogen, which during its entire vegetation produces its vegetative reproduction organs-conidia which in turn cause continuous infections. For this purpose, a whole range of fungicides is applied every year, which in order to provide more successful protection is supplemented by new chemical components. One of the most common fungicides which have been largely applied recently in protection of apple cultivars from this disease caused by the pathogen Podosphaera leucotricha is a fungicide produced under the trademark ZATO WG 50, mainly composed of trifloxystrobin. This fungicide also provided the best results in combating this disease during our three-year-long experiment, when compared to other types of fungicides. Taking into account the biology of this pathogen, this fungicide should be introduced until the end of vegetation, which may raise suspicion of its degradation into the apple fruits. In our study, apart from measuring the intensity scale of infection with this disease, we also conducted analyses of the time needed for trifloxystrobin to degrade into the apple fruits, by accurately determining the time of its decomposition by its application into two different concentrations.

Differential Pathogenic Response in Strawberry Tissues and Organs by Colletotrichum acutatum

The susceptibility of different tissues and organs from strawberry plants, cv ＂Camarosa＂, to Colletotrichum acutatum was tested using a severity index based on infection response. Symptoms developed on inoculated tissues were characterized along 30 days. Flowers, except sepals, petioles and fruits were the most susceptible organs to the pathogen and they became necrotic tissues at 30 days post inoculation （dpi）. Also, well-developed acervuli, which produced masses of orange-pink spores, were observed on these infected organs. An asymptomatic stage or latency phase was observed in green and white strawberry fruits. In spite of they were inoculated anthracnose symptoms were observed only when they became red fruits. On the other hand, strawberry leaves and sepals were resistant to infection by C. acutatum and only small flecks or light brown spots were observed reaching a size of 1 to 5 mm at 30 dpi. Likewise, the susceptibility of stolons and crowns to C. acutatum was evaluated as intermediate at 30 dpi. Finally, the infection process of the fungus on strawberry leaves and petioles was studied using light and electron microscopy. Pre-penetration events were similar on both, leaves and petioles： However, differences between colonization of strawberry leaves and petioles by C. acutatum were observed.

Agroinfection of sweet potato by vacuum infiltration of an infectious sweepovirus

Sweepovirus is an important monopartite begomovirus that infects plants of the genus Ipomoea worldwide. Development of artificial infection methods for sweepovirus using agroinoculation is a highly efficient means of studying infectivity in sweet potato. Unlike other begomoviruses, it has proven difficult to infect sweet potato plants with sweepoviruses using infectious clones. A novel sweepovirus, called Sweet potato leaf curl virus-Jiangsu(SPLCV-JS), was recently identified in China. In addition, the infectivity of the SPLCV-JS clone has been demonstrated in Nicotiana benthamiana. Here we describe the agroinfection of the sweet potato cultivar Xushu 22 with the SPLCV-JS infectious clone using vacuum infiltration. Yellowing symptoms were observed in newly emerged leaves. Molecular analysis confirmed successful inoculation by the detection of viral DNA. A synergistic effect of SPLCV-JS and the heterologous betasatellite DNA-β of Tomato yellow leaf curl China virus isolate Y10(TYLCCNV-Y10) on enhanced symptom severity and viral DNA accumulation was confirmed. The development of a routine agroinoculation system in sweet potato with SPLCV-JS using vacuum infiltration should facilitate the molecular study of sweepovirus in this host and permit the evaluation of virus resistance of sweet potato plants in breeding programs.

Wheat Genetic Transformation as Efficient Tools to Fight against Fungal Diseases

Wheat ranks first among cereal crops cultivated in the world. In its production, diseases like powdery mildew, fusarium head blight and rusts caused by fungal pathogens represent a major problem. They produce different symptoms that cause severe crop damage by infecting the spikes, leaves, roots, stems and grains. They are causing losses both by reducing the quantity of the harvested crop and the quality of the product. Quality problems of the harvested product can be due to shrivelled seed, which are frequently found as a consequence of the infection by leaf pathogens, such as mildews, rusts and Septoria. Fusarium head blight is the major culprit for mycotoxin contamination from the harvested grain, causing economic losses and in the worst casing human and animal health problems. In severe epidemics, all these fungal diseases can significantly reduce yield. Resistance to fungi is beneficial not only from a commercial point of view （yield）, but also because of the reduced levels of mycotoxins. The integration of transgenic approaches offers a potential chemical-free and environment-friendly solution for controlling fungal pathogens. This is an essential asset for wheat world food security.

Clinical efficacy and safety of intravenous itraconazole in patients with invasive fungal infections in emergency intensive care unit

This study aimed to analyze the clinical efficacy and safety of itraconazole. We investigated 68 patients with invasive fungal infections（IFI） in emergency intensive care unit（EICU）. A retrospective analysis was performed in patients with IFI who were treated in the authors＇ institution, a grade III first class hospital in Beijing, China, between Feb. 2013 and Feb. 2015. The age of patients ranged from 35 to 90 years old with the mean age of（75.1±11.1） years old. The study population comprised 36 male and 32 female patients. Total response rate was 60.3%. The response rates in definitive diagnosis, clinical diagnosis and presumed diagnosis were 33.3%, 59.5% and 65.2%, respectively（P〈0.05）. The empirical treatment should be provided for patients with presumed diagnosis as earlier as possible. Eleven（16.2%） cases had adverse drug event（ADE） during treatment. The main signs were hepatic functional impairment and hypokalemia of ADE. The clinical efficacy and safety of intravenous itraconazole were precisely assessed. To reduce the adverse drug reaction（ADR）, hepatic and renal function and other biochemical criterion should be closely monitored.

Effects of cutting frequency and height on alkaloid production in endophyte-infected drunken horse grass (Achnatherum inebrians)

An evaluation was performed on the influence of mowing height (2.5,5.0 or 7.5 cm) and mowing frequency (weekly or fortnightly) on levels of ergot alkaloids (ergine and ergonovine) formed in drunken horse grass,Achnatherum inebrians,grown under greenhouse conditions.Samples were taken monthly and alkaloids were extracted and analyzed by reverse-phase HPLC.Alkaloid levels increased more or less linearly with plant age over the first four months following establishment.Levels were higher in samples cut fortnightly compared to those cut weekly,and were higher when plants were cut at a mowing height of 7.5 cm vs.2.5 cm.In most cases,the highest alkaloid levels observed were almost three times those of the lowest.If plant protection applications are developed for the endophytic fungus,Neotyphodium gansuense,it will be necessary to be aware of the potential role of plant husbandry practices (e.g.,defoliation frequency and intensity) for reducing or enhancing levels of plant alkaloids.Similar husbandry factors may affect alkaloid levels in other Neotyphodium-grass associations,which would be interesting for further study.

Effects of cadmium stress on seed germination and seedling growth of Elymus dahuricus infected with the Neotyphodium endophyte

Various cadmium （Cd） concentrations （0, 50, 100, 200 and 300 μmol L-1） affected Elymus dahuricus seed germination, seed- ling growth, antioxidative enzymes activities （AEA）, and amounts of malondialdehyde （MDA） and proline present. These in- fluences were determined for separate E. dahuricus cohorts known to be either infected （E＋） or non-infected （E-） by a Neo- typhodium endophyte. Under high Cd concentrations （100, 200 and 300 lamol L-l）, E＋ specimens showed a significantly （P〈0.05） higher germination rate and index, as well as higher values for shoot length, root length and dry biomass. However, the germination rate and index, root length and dry weight did not show a significant （P〈0.05） difference under the low Cd concentrations （0 and 50 μmol L^-1）. AEA and proline content increased, as did MDA content, in the E＋ （vs. E-） specimens under high Cd concentrations. There was no significant （P〉0.05） difference under low Cd concentrations. Endophyte infection was concluded to be of benefit to E. dahuricus exposed to high Cd concentrations.

Biosynthesis and combinatorial biosynthesis of antifungal nucleoside antibiotics

There is an urgent need for new antifungal agents to treat or combat fungal infection in humans and plants.Antifungal nucleoside antibiotics are an important family of natural products with distinctive structural features.Understanding their biosynthetic machinery is of great importance for the improvement of antibiotics titers.More importantly,it is a requisite for combinatorial biosynthesis to create hybrid nucleoside antibiotics.We herein focus on findings on the natural and designed biosynthesis of this important family of nucleoside antibiotics.

In vivo gene expression profiling of the entomopathogenic fungus Beauveria bassiana elucidates its infection stratagems in Anopheles mosquito

The use of entomopathogenic fungi to control mosquitoes is a promising tool for reducing vector-borne disease transmission. To better understand infection stratagems of insect pathogenic fungi, we analyzed the global gene expression profiling of Beauveria bassiana at 36, 60, 84 and 108 h after topical infection of Anopheles stephensi adult mosquitoes using RNA sequencing （RNA-Seq）. A total of 5,354 differentially expressed genes （DEGs） are identified over the course of fungal infection. When the fungus grows on the mosquito cuticle, up-regulated DEGs include adhesion-related genes involved in cuticle attachment, Pthl l-like GPCRs hypothesized to be involved in host recognition, and extracellular enzymes involved in the degradation and penetration of the mosquito cuticle. Once in the mosquito hemocoel, the fungus evades mosquito immune system probably through up-regulating expression of 13-1,3-glucan degrading enzymes and chitin synthesis enzymes for remodeling of cell walls. Moreover, six previous unknown SSCP （small secreted cysteine-rich proteins） are significantly up-regulated, which may serve as ＂effectors＂ to suppress host defense responses. B. bassiana also induces large amounts of antioxidant genes to mitigate host-generated exogenous oxidative stress. At late stage of infection, B. bassiana activates a broad spectrum of genes including nutrient degrading enzymes, some transporters and metabolism pathway components, to exploit mosquito tissues and hemolymph as a nutrient source for hyphal growth. These findings establish an important framework of knowledge for further comprehensive elucidation of fungal pathogenesis and molecular mechanism of Beauveria-mosquito interactions.

Fungal spondylodiscitis in a patient recovered from H7N9 virus infection:a case study and a literature review of the differences between Candida and Aspergillus spondylodiscitis

To report a rare case of fungal spondylodiscitis in a patient recovered from H7N9 virus infection and perform a literature review of the different characteristics of Candida and Aspergillus spondylodiscitis, we reviewed cases of spondylodiscitis caused by Candida and Aspergillus species. Data, including patients＇ information, patho- genic species, treatment strategy, outcomes, and relapses, were collected and summarized. The characteristics of Canclida and Aspergillus spondylodiscitis were compared to see if any differences in clinical features, management, or consequences could be detected. The subject of the case study was first misdiagnosed as having a vertebral tumor, and then, following open biopsy, was diagnosed as having fungal spondylodiscitis. The patient made a good recovery following radical debridement. Seventy-seven additional cases of Candida spondylodiscitis and 94 cases of Asper- gillus spondylodiscitis were identified in the literature. Patients with Candida spondylodiscitis tended to have a better outcome than patients with Aspergillus spondylodiscitis （cure rate 92.3% vs. 70.2%）. Candida was found more fre- quently （47.8%） than Aspergillus （26.7%） in blood cultures, while neurological deficits were observed more often in patients with Aspergillus spondylodiscitis （43.6% vs. 25.6%）. Candida spinal infections were more often treated by radical debridement （60.5% vs. 39.6%）. Patients with Candida spondylodiscitis have better outcomes, which may be associated with prompt recognition, radical surgical debridement, and azoles therapy. A good outcome can be ex- pected in fungal spondylodiscitis with appropriate operations and anti-fungal drugs.

Invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients: single center experiences of 12 years

Invasive fungal infection （IFI） is a growing cause of morbidity and mortality among patients after allogeneic hematopoietic stem cell transplantation （allo-HSCT）. We retrospectively reviewed the records of 408 patients un- dergoing alIo-HSCTs during the period November 1998 to December 2009, analyzed the incidence and risk factors of IFI, and examined the impact of IFI on overall survival. A total of 92 （22.5%） episodes suffered proven or probable IFI （4 patients were proven, 88 patients were probable）. Candida was the most common pathogen for early IFI, and mold was the most frequent causative organism for late IFI. A prior history of IFI, human leukocyte antigen （HLA） mismatch, long-time neutropenia, and acute graft-versus-host-disease （GVHD） were risk factors for early IFI. A prior history of IFI, corticosteroid therapy, cytomegalovirus （CMV） disease, and chronic GVHD were risk factors for late IFI. IFI-related mortality was 53.26%. The 12-year overall survival （OS） rate for IFI was significantly lower than that of patients without IFI （41.9% vs. 63.6%, P〈0.01）.

Overexpression of GhPFN2 enhances protection against Verticillium dahliae invasion in cotton

Growing evidence indicates that actin cytoskeleton is involved in plant innate immune responses, but the functional mechanism remains largely unknown. Here, we investigated the behavior of a cotton profilin gene （GhPFN2） in response to Verticillium dahliae invasion, and evaluated its contribution to plant defense against this soil-borne fungal pathogen. GhPFN2 expression was up-regulated when cotton root was inoculated with V. dahliae, and the actin architecture was reorganized in the infected root cells, with a clear increase in the density of filamentous actin and the extent of actin btmdling. Compared to the wild type, GhPFN2-overexpressing cotton plants showed enhanced protection against V. dahliae infection and the actin cytoskeleton organization in root epidermal cells was clearly altered, which phenocopied that of the wild-type （WT） root cells challenged with V. dahliae. These results provide a solid line of evidence important for defense against V. dahliae infection. showing that actin cytoskeleton reorganization involving GhPFN2 is

Phospholipid/protein co-mediated assembly of Cu_(2)O nanoparticles for specific inhibition of growth and biofilm formation of pathogenic fungi

As the increasing number of the individuals suffering from AIDs,chemotherapy,and radiotherapy,pathogenic fungi,which may rapidly grow and invade the host tissues in these immune-compromised patients,is becoming great threat to human health.In this study,we constructed a novel fungal pathogen-responsive assembly of cuprous oxide(Cu_(2)O)nanoparticles(NPs)for specific targeting and inhibiting growth and biofilm formation of the representative fungal pathogen,Candida albicans(C.albicans).This assembly was formed by coating the initial Cu_(2)O NPs with both phosphatidylethanolamine(PE)and bovine serum albumin(BSA),followed by hydrophobic/electrostatic interaction-driven formation of the Cu_(2)O-PE-BSA microaggregates.The formed microaggregates could be induced for disassembly by the fungal pathogen C.albicans,leading to close binding of the NPs to the cell wall of the pathogen.Both confocal microscopy and viability assays showed that the assembly strongly inhibited growth and biofilm formation of the pathogen,but had extreme low toxicity to mammalian cells.In vivo mouse wound model further revealed that the assembly had high capacity of healing the fungus-infected wounds and reduced the fungal burden of the wound tissues.This study sheds a novel light on facile development of pathogen-responsive nano-assemblies for efficient and safe antifungal therapy.