Emerging fungal infections among children: A review on its clinical manifestations, diagnosis, and prevention

Shampoo-clay heals diaper rash faster than calendula officinalis

BACKGROUND

Diaper rash is one of the most common skin disorders of infancy and childhood. Some studies have shown that Shampoo-clay was effective to treat chronic dermatitis. Then, it is supposed that it may be effective in diaper rash; however, no published studies were found in this regard.

OBJECTIVES

This study aimed to compare the effects of Shampoo-clay (S.C) and Calendula officinalis (C.O) to improve infantile diaper rash.

PATIENTS AND METHODS

A randomized, double blind, parallel controlled, non-inferiority trial was conducted on 60 outpatient infants referred to health care centers or pediatric clinics in Khomein city and diagnosed with diaper rash. Patients were randomly assigned into two treatment groups including S.C group (n = 30) and C.O group (n = 30) by using one to one allocation ratio. The rate of complete recovery in three days was the primary outcome. Data was collected using a checklist and analyzed using t-test, Chi-square and Fisher's exact tests and risk ratio.

RESULTS

Totally, 93.3% of lesions in the S.C group healed in the first 6 hours, while this rate was 40% in C.O group (P < 0.001). The healing ratio for improvement in the first 6 hours was 7 times more in the S.C group. In addition, 90% of infants in the SC group and 36.7% in the C.O group were improved completely in the first 3 days (P < 0.001).

CONCLUSIONS

S.C was effective to heal diaper rash, and also had faster effects compared to C.O.

The effects of Bentonite and Calendula on the improvement of infantile diaper dermatitis

BACKGROUND

Diaper dermatitis is one of the most common skin disorders of infancy and childhood. The present study aimed to compare the effects of Bentonite and Calendula on the improvement of diaper dermatitis in infants.

MATERIALS AND METHODS

A double-blind randomized controlled trial, which was conducted on 60 out-patient infants referred to health care centers or pediatric clinics in Khomein city and diagnosed with diaper dermatitis. Data were collected by checklist and observation, and analyzed using t-test, Chi-square, and Fisher's exact test.

RESULTS

Mean (standard error) age of the total sample was 6.55 ± 0.69 months. Totally, 93.3% of lesions in the Bentonite group started its recovery in the first 6 h, while this rate was 40% in Calendula group (P < 0.001). Furthermore, 90% of infants in the Bentonite group and 36.7% in the Calendula group were improved completely in the first 3 days (P < 0.001).

CONCLUSION

Bentonite was effective on the improvement of diaper dermatitis, and also had faster effects compared with Calendula.

Design, synthesis, and structure-activity relationship studies of novel fused heterocycles-linked triazoles with good activity and water solubility

Triazoles with fused-heterocycle nuclei were designed and evaluated for their in vitro activity on the basis of the binding mode of albaconazole using molecular docking, along with SAR of antifungal triazoles. Tetrahydro-[1,2,4]triazolo[1,5-a]pyrazine and tetrahydro-thiazolo[5,4-c]pyridine nuclei were preferable to the other four fused-heterocycle nuclei investigated. Potent in vitro activity, broad spectrum and better water solubility were attained when triazoles containing nitrogen aromatic heterocycles were attached to these two nuclei. The most potent compounds 27aa and 45x, with low hERG inhibition and hepatocyte toxicity, both exhibited excellent activity against Candida, Cryptococcus, and Aspergillus spp., as well as selected fluconazole-resistant strains. A high water-soluble compound 58 (the disulfate salt of 45x) displayed unsatisfactory in vivo activity because of its poor PK profiles. Mice infected with C.alb. SC5314 and C.alb. 103 (fluconazole-resistant strain) and administered with 27aa displayed significantly improved survival rates. 27aa also showed favorable pharmacokinetic (PK) profiles.

Role of Ess1 in growth, morphogenetic switching, and RNA polymerase II transcription in Candida albicans

Candida albicans is a fungal pathogen that causes potentially fatal infections among immune-compromised individuals. The emergence of drug resistant C. albicans strains makes it important to identify new antifungal drug targets. Among potential targets are enzymes known as peptidyl-prolyl cis/trans isomerases (PPIases) that catalyze isomerization of peptide bonds preceding proline. We are investigating a PPIase called Ess1, which is conserved in all major human pathogenic fungi. Previously, we reported that C. albicans Ess1 is essential for growth and morphogenetic switching. In the present study, we re-evaluated these findings using more rigorous genetic analyses, including the use of additional CaESS1 mutant alleles, distinct marker genes, and the engineering of suitably-matched isogenic control strains. The results confirm that CaEss1 is essential for growth in C. albicans, but show that reduction of CaESS1 gene dosage by half (δ/+) does not interfere with morphogenetic switching. However, further reduction of CaEss1 levels using a conditional allele does reduce morphogenetic switching. We also examine the role of the linker α-helix that distinguishes C. albicans Ess1 from the human Pin1 enzyme, and present results of a genome-wide transcriptome analysis. The latter analysis indicates that CaEss1 has a conserved role in regulation of RNA polymerase II function, and is required for efficient termination of small nucleolar RNAs and repression of cryptic transcription in C. albicans.

Blue dye and red light, a dynamic combination for prophylaxis and treatment of cutaneous Candida albicans infections in mice

The objective of this study was to investigate photodynamic therapy (PDT), using blue dye and red light, for prophylaxis and treatment of cutaneous Candida albicans infections in mice. A mouse model of skin abrasion infected with C. albicans was developed by inoculating wounds measuring 1.2 cm by 1.2 cm with 10(6) or 10(7) CFU. The use of a luciferase-expressing strain of C. albicans allowed real-time monitoring of the extent of infection in mice noninvasively through bioluminescence imaging. The phenothiazinium salts toluidine blue O (TBO), methylene blue (MB), and new methylene blue (NMB) were compared as photosensitizers (PS) for the photodynamic inactivation of C. albicans in vitro. PDT in vivo was initiated either at 30 min or at 24 h after fungal inoculation to investigate the efficacies of PDT for both prophylaxis and treatment of infections. Light at 635 ± 15 nm or 660 ± 15 nm was delivered with a light dose of 78 J/cm(2) (for PDT at 30 min postinfection) or 120 J/cm(2) (for PDT at 24 h postinfection) in multiple exposures with bioluminescence imaging taking place after each exposure of light. In vitro studies showed that NMB was superior to TBO and MB as the PS in the photodynamic inactivation of C. albicans. The efficacy of PDT was related to the ratio of PS concentration to fungal cell density. PDT in vivo initiated either at 30 min or at 24 h postinfection significantly reduced C. albicans burden in the infected mouse skin abrasion wounds. These data suggest that PDT is a viable approach for prophylaxis and treatment of cutaneous C. albicans infections.