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Gupta P, Meher MK, Tripathi S, Poluri KM. Nanoformulations for dismantling fungal biofilms: The latest arsenals of antifungal therapy. Mol Aspects Med 2024; 98:101290. [PMID: 38945048 DOI: 10.1016/j.mam.2024.101290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 06/26/2024] [Indexed: 07/02/2024]
Abstract
Globally, fungal infections have evolved as a strenuous challenge for clinicians, particularly in patients with compromised immunity in intensive care units. Fungal co-infection in Covid-19 patients has made the situation more formidable for healthcare practitioners. Surface adhered fungal population known as biofilm often develop at the diseased site to elicit antifungal tolerance and recalcitrant traits. Thus, an innovative strategy is required to impede/eradicate developed biofilm and avoid the formation of new colonies. The development of nanocomposite-based antibiofilm solutions is the most appropriate way to withstand and dismantle biofilm structures. Nanocomposites can be utilized as a drug delivery medium and for fabrication of anti-biofilm surfaces capable to resist fungal colonization. In this context, the present review comprehensively described different forms of nanocomposites and mode of their action against fungal biofilms. Amongst various nanocomposites, efficacy of metal/organic nanoparticles and nanofibers are particularly emphasized to highlight their role in the pursuit of antibiofilm strategies. Further, the inevitable concern of nanotoxicology has also been introduced and discussed with the exigent need of addressing it while developing nano-based therapies. Further, a list of FDA-approved nano-based antifungal formulations for therapeutic usage available to date has been described. Collectively, the review highlights the potential, scope, and future of nanocomposite-based antibiofilm therapeutics to address the fungal biofilm management issue.
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Affiliation(s)
- Payal Gupta
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India; Department of Biotechnology, Graphic Era (Demmed to be Unievrsity), Dehradun, 248001, Uttarakhand, India
| | - Mukesh Kumar Meher
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Shweta Tripathi
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India
| | - Krishna Mohan Poluri
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India; Centre for Nanotechnology, Indian Institute of Technology Roorkee, Roorkee, 247667, Uttarakhand, India.
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Finsterer J, Scorza FA. COVID-19 reduces immune competence and precipitates superinfections. J Family Med Prim Care 2024; 13:2787-2788. [PMID: 39071013 PMCID: PMC11272030 DOI: 10.4103/jfmpc.jfmpc_1432_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 07/30/2024] Open
Abstract
Objectives Whether infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be complicated by immune suppression is under debate, but the following case suggests decreased immune competence during and after a SARS-CoV-2 infection. Case Report The patient is a 50-year-old woman with a previous history of transient hyperthyroidism, allergy against ambrosia, and burn-out syndrome, who experienced a mild infection with SARS-CoV-2 during which she developed candida pharyngitis, which was successfully treated with miconazole. Twenty-eight days after clinical recovery from the SARS-CoV-2 infection, she developed right-sided zoster oticus with vestibular neuronitis and was successfully treated with acyclovir. Conclusions The case suggests that infection with SARS-CoV-2 can weaken immune competence and precipitate the development of candidiasis and focal infection with the zoster virus. Even mild infections with SARS-CoV-2 may be complicated by immune-compromise and immune-concomitant superinfections, which is why coronavirus disease 2019 (COVID-19) patients should strengthen their immune system not only during but also after the infection.
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Affiliation(s)
- Josef Finsterer
- Department of Neurology, Neurology and Neurophysiology Center, Vienna, Austria
| | - Fulvio A. Scorza
- Disciplina de Neurociência, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, Brasil
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Chen H, Yu L, Wang L, Zhang J, Yan X, Jiang Y. Demographic characteristics and risk factors for invasive fungal sinusitis in the context of COVID-19: A systematic review and meta-analysis. Int J Infect Dis 2024; 144:107054. [PMID: 38614232 DOI: 10.1016/j.ijid.2024.107054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/09/2024] [Accepted: 04/09/2024] [Indexed: 04/15/2024] Open
Abstract
OBJECTIVES To identify the demographic characteristics and potential risk factors of invasive fungal sinusitis (IFS) patients with Coronavirus Disease in 2019 (COVID-19). METHODS Web of Science, Embase, the Cochrane Library, and PubMed were searched from database inception to August 2023 using the combination of medical searching heading terms "invasive fungal sinusitis" and "COVID-19" and their free words. The research protocol was registered on PROSPERO (CRD42023467175). RESULTS A total of 53 studies were included. The mean age of IFS patients with COVID-19 was 53.72 (95% credible interval [CI]: 51.08, 56.36), with 66% males (95% CI: 0.62, 0.70), and 81% diabetes (95% CI: 0.77, 0.86). The mean time from COVID-19 diagnosis to IFS onset was 19.09 days (95% CI: 16.96, 21.22). The percentage of patients with COVID-19 PCR positivity was 33% (95% CI: 0.21, 0.45). Overall, 71% of patients receiving steroid therapy during COVID-19 infection (95% CI: 0.63, 0.78). The odds ratio of diabetes mellitus, steroid administration, and COVID-19 PCR positivity were 6.09, 2.21, and 1.82, respectively. COVID-19 infection did not affect the IFS stage. CONCLUSION IFS patients with COVID-19 had an average age of 53.72 years and were predominantly males, with a mean interval of 19.09 days from COVID-19 diagnosis to IFS onset. Diabetes, steroid administration, and COVID-19 PCR positivity were risk factors.
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Affiliation(s)
- Han Chen
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Longgang Yu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Lin Wang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jisheng Zhang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xudong Yan
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yan Jiang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
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de Matos Silva S, Echeverri CR, Mendes-Giannini MJS, Fusco-Almeida AM, Gonzalez A. Common virulence factors between Histoplasma and Paracoccidioides: Recognition of Hsp60 and Enolase by CR3 and plasmin receptors in host cells. CURRENT RESEARCH IN MICROBIAL SCIENCES 2024; 7:100246. [PMID: 39022313 PMCID: PMC11253281 DOI: 10.1016/j.crmicr.2024.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Over the last two decades, the incidence of Invasive Fungal Infections (IFIs) globally has risen, posing a considerable challenge despite available antifungal therapies. Addressing this, the World Health Organization (WHO) prioritized research on specific fungi, notably Histoplasma spp. and Paracoccidioides spp. These dimorphic fungi have a mycelial life cycle in soil and a yeast phase associated with tissues of mammalian hosts. Inhalation of conidia and mycelial fragments initiates the infection, crucially transforming into the yeast form within the host, influenced by factors like temperature, host immunity, and hormonal status. Survival and multiplication within alveolar macrophages are crucial for disease progression, where innate immune responses play a pivotal role in overcoming physical barriers. The transition to pathogenic yeast, triggered by increased temperature, involves yeast phase-specific gene expression, closely linked to infection establishment and pathogenicity. Cell adhesion mechanisms during host-pathogen interactions are intricately linked to fungal virulence, which is critical for tissue colonization and disease development. Yeast replication within macrophages leads to their rupture, aiding pathogen dissemination. Immune cells, especially macrophages, dendritic cells, and neutrophils, are key players during infection control, with macrophages crucial for defense, tissue integrity, and pathogen elimination. Recognition of common virulence molecules such as heat- shock protein-60 (Hsp60) and enolase by pattern recognition receptors (PRRs), mainly via the complement receptor 3 (CR3) and plasmin receptor pathways, respectively, could be pivotal in host-pathogen interactions for Histoplasma spp. and Paracoccidioides spp., influencing adhesion, phagocytosis, and inflammatory regulation. This review provides a comprehensive overview of the dynamic of these two IFIs between host and pathogen. Further research into these fungi's virulence factors promises insights into pathogenic mechanisms, potentially guiding the development of effective treatment strategies.
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Affiliation(s)
- Samanta de Matos Silva
- Laboratory of Mycology, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Nucleous of Proteomics, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Basic and Applied Microbiology Group (MICROBA), School of Microbiology, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Carolina Rodriguez Echeverri
- Laboratory of Mycology, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Nucleous of Proteomics, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Basic and Applied Microbiology Group (MICROBA), School of Microbiology, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Maria José Soares Mendes-Giannini
- Laboratory of Mycology, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Nucleous of Proteomics, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
| | - Ana Marisa Fusco-Almeida
- Laboratory of Mycology, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Nucleous of Proteomics, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
| | - Angel Gonzalez
- Basic and Applied Microbiology Group (MICROBA), School of Microbiology, Universidad de Antioquia (UdeA), Medellín, Colombia
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Niu X, Al-Hatmi AMS, Vitale RG, Lackner M, Ahmed SA, Verweij PE, Kang Y, de Hoog S. Evolutionary trends in antifungal resistance: a meta-analysis. Microbiol Spectr 2024; 12:e0212723. [PMID: 38445857 PMCID: PMC10986544 DOI: 10.1128/spectrum.02127-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 02/06/2024] [Indexed: 03/07/2024] Open
Abstract
The present paper includes a meta-analysis of literature data on 318 species of fungi belonging to 34 orders in their response to 8 antifungal agents (amphotericin B, caspofungin, fluconazole, itraconazole, ketoconazole, posaconazole, terbinafine, and voriconazole). Main trends of MIC results at the ordinal level were visualized. European Committee on Antimicrobial Susceptibility Testing and Clinical & Laboratory Standards Institute (CLSI) clinical breakpoints were used as the staff gauge to evaluate MIC values ranging from resistance to susceptibility, which were subsequently compared with a phylogenetic tree of the fungal kingdom. Several orders (Hypocreales, Microascales, and Mucorales) invariably showed resistance. Also the basidiomycetous orders Agaricales, Polyporales, Sporidiales, Tremellales, and Trichosporonales showed relatively high degrees of azole multi-resistance, while elsewhere in the fungal kingdom, including orders with numerous pathogenic and opportunistic species, that is, Onygenales, Chaetothyiales, Sordariales, and Malasseziales, in general were susceptible to azoles. In most cases, resistance vs susceptibility was consistently associated with phylogenetic distance, members of the same order showing similar behavior. IMPORTANCE A kingdom-wide the largest set of published wild-type antifungal data comparison were analyzed. Trends in resistance in taxonomic groups (monophyletic clades) can be compared with the phylogeny of the fungal kingdom, eventual relationships between fungus-drug interaction and evolution can be described.
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Affiliation(s)
- Xueke Niu
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education of Guizhou & Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Sciences, Guizhou Medical University, Guiyang, China
- Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Abdullah M. S. Al-Hatmi
- Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
- Natural & Medical Science Research Center, University of Nizwa, Nizwa, Oman
| | - Roxana G. Vitale
- Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
- Unidad de Parasitología, Sector Micología, Hospital J.M. Ramos Mejía, Buenos Aires, Argentina
| | - Michaela Lackner
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Sarah A. Ahmed
- Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Paul E. Verweij
- Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Yingqian Kang
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education of Guizhou & Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Sciences, Guizhou Medical University, Guiyang, China
| | - Sybren de Hoog
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education of Guizhou & Key Laboratory of Microbiology and Parasitology of Education Department of Guizhou, School of Basic Medical Sciences, Guizhou Medical University, Guiyang, China
- Center of Expertise in Mycology of Radboud University Medical Center/Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
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López-Herrero R, Sánchez-de Prada L, Tamayo-Velasco A, Heredia-Rodríguez M, Bardají Carrillo M, Jorge Monjas P, de la Varga-Martínez O, Resino S, Sarmentero-López de Quintana G, Gómez-Sánchez E, Tamayo E. Epidemiology of fungal infection in COVID 19 in Spain during 2020 and 2021: a nationwide study. Sci Rep 2024; 14:5203. [PMID: 38433130 PMCID: PMC10909879 DOI: 10.1038/s41598-024-54340-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/12/2024] [Indexed: 03/05/2024] Open
Abstract
We realize a nationwide population-based retrospective study to analyze the characteristics and risk factors of fungal co-infections in COVID-19 hospitalized patients as well as describe their causative agents in the Spanish population in 2020 and 2021. Data were obtained from records in the Minimum Basic Data Set of the National Surveillance System for Hospital Data in Spain, provided by the Ministry of Health, and annually published with two years lag. The assessment of the risk associated with the development of healthcare-associated fungal co-infections was assessed using an adjusted logistic regression model. The incidence of fungal co-infection in COVID-19 hospitalized patients was 1.41%. The main risk factors associated were surgery, sepsis, age, male gender, obesity, and COPD. Co-infection was associated with worse outcomes including higher in-hospital and in ICU mortality, and higher length of stay. Candida spp. and Aspergillus spp. were the microorganisms more frequent. This is the first study analyzing fungal coinfection at a national level in hospitalized patients with COVID-19 in Spanish population and one of the few studies available that demonstrate that surgery was an independent risk factor of Aspergillosis coinfection in COVID-19 patients.
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Affiliation(s)
- R López-Herrero
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005, Valladolid, Spain
| | - L Sánchez-de Prada
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Microbiology Department, Hospital Universitario Río Hortega, 47012, Valladolid, Spain
| | - A Tamayo-Velasco
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain.
- Haematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - M Heredia-Rodríguez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Complejo Asistencial Universitario de Salamanca, 37007, Salamanca, Spain
| | - M Bardají Carrillo
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
| | - P Jorge Monjas
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005, Valladolid, Spain
| | - O de la Varga-Martínez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Department of Anesthesiology, Hospital Universitario Infanta Leonor, 28031, Madrid, Spain
| | - S Resino
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - G Sarmentero-López de Quintana
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
| | - E Gómez-Sánchez
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005, Valladolid, Spain
| | - E Tamayo
- BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005, Valladolid, Spain
- Anesthesiology and Critical Care Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain
- Department of Surgery, Faculty of Medicine, Universidad de Valladolid, 47005, Valladolid, Spain
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Hasanzadeh M, Ahmadpour E, Mahami-Oskouei M, Musavi S, Parsaei M, Sarafraz N, Spotin A. Genetic diversity and seroprevalence of Toxoplasma gondii in COVID‑19 patients; a first case-control study in Iran. BMC Infect Dis 2024; 24:42. [PMID: 38172676 PMCID: PMC10763165 DOI: 10.1186/s12879-023-08964-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Toxoplasmosis is a serious or life-threatening disease in immunosuppressed patients and pregnant women. This study examined the likely association between Toxoplasma gondii infection and COVID-19 patients with moderate illness. METHODS Seventy blood samples were collected from patients at the Health Reference Laboratory of Tabriz, Northwest Iran from April 2021 to September 2021. In addition, 70 healthy subjects of the same age (37 ± 15 years) and sex distribution were ethnically matched. Sera samples were examined for the detection of anti-Toxoplasma antibodies using ELISA. Nested-PCR targets were amplified based on the B1 and GRA6 genes. GRA6 amplicons were subjected to sequencing and phylogenetic analysis. RESULTS The seroprevalence of toxoplasmosis based on IgG titer was 35.7% in the COVID‑19 patients and 27.1% in the control group, representing not to be associated with the Toxoplasma seropositivity in COVID‑19 patients (P = 0.18) compared to healthy subjects. Anti-T. gondii IgM was not found in any of the patients and healthy individuals. According to PCR amplification of the B1 and GRA6 genes, the frequency of T. gondii in COVID-19 patients was 14.2% (10/70). However, no T. gondii infection was detected in the healthy group. The CD4+T cell count was relatively lower in toxoplasmosis-infected patients (430-450 cells/mm3) than in control group (500-1500 cells/mm3). High genetic diversity (Hd: 0.710) of the type I strain of T. gondii was characterized in the patients. Present results showed that consumption of raw vegetables and close contact with stray cats can increase the transmission of T. gondii to COVID-19 patients (P < 0.01). CONCLUSIONS The current study revealed that T. gondii type I infection is unequivocally circulating among the COVID-19 patients in Tabriz; However, no significant association was observed between the occurrence of Toxoplasma and the severity of COVID-19. To make more accurate health decisions, multicenter investigations with a larger sample size of different ethnic groups of the Iranian population are needed.
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Affiliation(s)
- Mehdi Hasanzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Parasitology and Mycology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Ahmadpour
- Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Mahami-Oskouei
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Parasitology and Mycology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Musavi
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of medical science, Tabriz, Iran
| | - Mahdi Parsaei
- Vice chancellor for health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazila Sarafraz
- Vice chancellor for health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adel Spotin
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Parasitology and Mycology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Rocha VDFD, da Silva EN, Azevedo J, Ribeiro MT, Reis MG, Barros TF, Reis JN. The impact of COVID-19 on microbiological profile and antibiotic consumption in ICU: a retrospective study in an infectious disease hospital in Brazil. Braz J Infect Dis 2024; 28:103705. [PMID: 38065221 PMCID: PMC10764251 DOI: 10.1016/j.bjid.2023.103705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has triggered crises in the public health sector that have complex and multifaceted interrelationships with antimicrobial resistance. It is important to evaluate the impact of COVID-19 on microbiological profile, antibiotic and alcohol gel consumption in Intensive Care Units (ICU). METHODS This is a retrospective study undertaken in an infectious disease hospital located in Bahia/Brazil during three periods: from March 2019 to February 2020; from March 2020 to February 2021; and from March 2021 to February 2022. It was evaluated the incidence density of Candida spp and of multidrug-resistant Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species (ESKAPE group) in blood, urine and tracheal secretion isolated 48 h after the patient's admission to the ICU, as well as the use of alcohol gel (in milliliters) and consumption of antibiotics in Defined Daily Dose (DDD) per 1,000 ICU patient-days in the previous year and in the first two years of COVID-19 pandemic. RESULTS There was an increase in Candida spp. (5.81, p < 0.001, IRR = 10.47, 95 % CI 2.57‒42.62) and in carbapenem-resistant A. baumannii in clinical cultures (4.71, p < 0.001, IRR = 8.46, 95 % CI 2.07‒34.60), the latter mainly in tracheal secretions (3.18, p= 0.02, IRR = 11.47, 95 % CI 1.58‒83.39). A rise in the consumption of ceftriaxone and piperacillin-tazobactam, along with an increase in the utilization of alcohol gel were observed. CONCLUSION The shifting microbiological profile can be attributed to both the unique characteristics of patients with COVID-19 and the adjustments made to healthcare facilities' structural and work routines. Understanding these changes is essential in addressing the accelerated impact of antimicrobial resistance during the pandemic. Therefore, conducting thorough reviews of institutional practices and routines becomes critical in mitigating the consequences of antimicrobial resistance and its implications for patient care.
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Affiliation(s)
- Verônica de França Diniz Rocha
- Instituto Gonçalo Moniz (FIOCRUZ), Biotecnologia em Saúde e Medicina Investigativa, Salvador, BA, Brazil; Instituto Couto Maia, Salvador, BA, Brazil
| | | | - Jailton Azevedo
- Universidade Federal da Bahia, Instituto de Ciência da Saúde, Salvador, BA, Brazil
| | - Marcelo Teles Ribeiro
- Instituto Couto Maia, Salvador, BA, Brazil; Universidade Federal da Bahia, Instituto de Ciência da Saúde, Salvador, BA, Brazil
| | - Mitermayer Galvão Reis
- Instituto Gonçalo Moniz (FIOCRUZ), Laboratório de Patologia e Biologia Molecular, Salvador, BA, Brazil; Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brazil; Yale University, Yale School of Public Health, New Haven, United States
| | - Tania Fraga Barros
- Universidade Federal da Bahia, Faculdade de Farmácia, Salvador, BA, Brazil
| | - Joice Neves Reis
- Instituto Gonçalo Moniz (FIOCRUZ), Laboratório de Patologia e Biologia Molecular, Salvador, BA, Brazil; Universidade Federal da Bahia, Faculdade de Farmácia, Salvador, BA, Brazil.
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9
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Aydın S, Mert A, Yılmaz M, Al Maslamani M, Rahimi BA, Ayoade F, El-Kholy A, Belitova M, Sengel BE, Jalal S, Albayrak A, Alatawi JA, Szabo BG, Ganeshan RS, Nsutebu E, Poojary A, Akkoyunlu Y, Alkan S, Elik DB, Eser-Karlidag G, Santos L, Moroti R, Altın N, Gürbüz E, Ulusoy TÜ, Sipahi OR, Çaşkurlu H, Esmaoğlu A, Lakatos B, El-Sayed NM, Marıno A, Cascio A, Mihai A, Dumitru IM, Pshenichnaya N, Ripon RK, Makek MJ, Rashid N, Baljić R, Dascalu C, Sincan G, Kızmaz YU, Madendere B, Erdem H. Understanding clinical outcomes and factors influencing mortality in intensive care unit patients with COVID-19-associated candidemia. Mycoses 2024; 67:e13687. [PMID: 38214425 DOI: 10.1111/myc.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND During the COVID pandemic, research has shown an increase in candidemia cases following severe COVID infection and the identification of risk factors associated with candidemia. However, there is a lack of studies that specifically explore clinical outcomes and mortality rates related to candidemia after COVID infection. OBJECTIVES The aim of this international study was to evaluate the clinical outcomes and identify factors influencing mortality in patients who developed candidemia during their COVID infection. PATIENTS/METHODS This study included adult patients (18 years of age or older) admitted to the intensive care unit (ICU) and diagnosed with COVID-associated candidemia (CAC). The research was conducted through ID-IRI network and in collaboration with 34 medical centres across 18 countries retrospectively, spanning from the beginning of the COVID pandemic until December 2021. RESULTS A total of 293 patients diagnosed with CAC were included. The median age of the patients was 67, and 63% of them were male. The most common Candida species detected was C. albicans. The crude 30-day mortality rate was recorded at 62.4%. The logistic regression analysis identified several factors significantly impacting mortality, including age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.07, p < .0005), SOFA score (OR 1.307, 95% CI 1.17-1.45, p < .0005), invasive mechanical ventilation (OR 7.95, 95% CI 1.44-43.83, p < .017) and duration of mechanical ventilation (OR 0.98, 95% CI 0.96-0.99, p < .020). CONCLUSIONS By recognising these prognostic factors, medical professionals can customise their treatment approaches to offer more targeted care, leading to improved patient outcomes and higher survival rates for individuals with COVID-associated candidemia.
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Affiliation(s)
- Selda Aydın
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University Medical Faculty, Istanbul, Turkey
| | - Ali Mert
- Department of Internal Medicine, Istanbul Medipol University Medical Faculty, Istanbul, Turkey
| | - Mesut Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University Medical Faculty, Istanbul, Turkey
| | - Muna Al Maslamani
- Department of Infectious Disease, Hamad Medical Corporation and Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | - Bilal Ahmad Rahimi
- Department of Pediatrics, Kandahar University Faculty of Medicine, Kandahar, Afghanistan
| | - Folusakin Ayoade
- Division of Infectious Diseases, Department of Medicine, University of Miami, Miami, Florida, USA
| | - Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Maya Belitova
- Department of Anesthesiology and Intensive Care, University Hospital Queen Giovanna - ISUL, Medical University of Sofia, Sofia, Bulgaria
| | - Buket Erturk Sengel
- Department of Infectious Disease and Clinical Microbiology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Sabah Jalal
- Department of Internal Medicine, Salmaniya Medical Center, Manama, Bahrain
| | - Ayşe Albayrak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | | | - Balint Gergely Szabo
- South Pest Central Hospital, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
- Semmelweis University, Budapest, Hungary
| | - Ramesh Shankar Ganeshan
- Tropical and Infectious Disease Division, Sheikh Shakhbout Medical City, Abu Dhabi, The United Arab Emirates
| | - Emmanuel Nsutebu
- Tropical and Infectious Disease Division, Sheikh Shakhbout Medical City, Abu Dhabi, The United Arab Emirates
| | - Aruna Poojary
- Department of Clinical Microbiologia, Breach Candy Hospital Trust, Mumbai, India
| | - Yasemin Akkoyunlu
- Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Sevil Alkan
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Dilşah Başkol Elik
- Department of Infectious Diseases & Clinical Microbiology, Ege School of Medicine, Izmir, Turkey
| | - Gulden Eser-Karlidag
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | - Lurdes Santos
- Infectious Diseases Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ruxandra Moroti
- National Institute for Infectious Diseases "Prof. Dr. Matei Bals", Bucharest, Romania
| | - Nilgün Altın
- Department of Infectious Diseases, Dıskapı Yıldırım Beyazıt Training and Research Hospital, University of Health Science Turkey, Istanbul, Turkey
| | - Esra Gürbüz
- Department of Infectious Diseases, Van Training and Research Hospital, University of Health Science Turkey, Van, Turkey
| | - Tülay Ünver Ulusoy
- Department of Infectious Diseases, Dıskapı Yıldırım Beyazıt Training and Research Hospital, University of Health Science Turkey, Istanbul, Turkey
| | - Oğuz Reşat Sipahi
- Department of Infectious Diseases & Clinical Microbiology, Ege School of Medicine, Izmir, Turkey
| | - Hülya Çaşkurlu
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Aliye Esmaoğlu
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Botond Lakatos
- South Pest Central Hospital, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | | | - Andrea Marıno
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) - Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Palermo, Italy
| | - Alexandru Mihai
- National Institute for Infectious Diseases "Prof. Dr. Matei Bals", Bucharest, Romania
| | - Irina Magdalena Dumitru
- Clinical Infectious Diseases Hospital Constanta, Ovidius University of Constanta, Constanta, Romania
| | | | - Rezaul Karim Ripon
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Mateja Jankovic Makek
- University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Rusmir Baljić
- Unit for Infectious Disease, Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Cosmin Dascalu
- National Institute for Infectious Diseases "Prof. Dr. Matei Bals", Bucharest, Romania
| | - Gülden Sincan
- Department of Haematology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Yeşim Uygun Kızmaz
- Department of Infectıous Diseases and Clinical Microbiology, Istanbul Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Berk Madendere
- Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Hakan Erdem
- Department of Infectious Diseases, Bahrain Oncology Centre, King Hamad University Hospital, Al Sayh, Bahrain
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, Turkish Health Sciences University, Ankara, Turkey
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10
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Ulloque-Badaracco JR, Copaja-Corzo C, Hernandez-Bustamante EA, Cabrera-Guzmán JC, Huayta-Cortez MA, Carballo-Tello XL, Seminario-Amez RA, Hueda-Zavaleta M, Benites-Zapata VA. Fungal infections in patients after recovering from COVID-19: a systematic review. Ther Adv Infect Dis 2024; 11:20499361241242963. [PMID: 38706456 PMCID: PMC11070125 DOI: 10.1177/20499361241242963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/13/2024] [Indexed: 05/07/2024] Open
Abstract
Background and aims The presence of fungal infections has been described in patients after recovering from COVID-19. This study aims to conduct a systematic review of studies that reported fungal infections (Mucor spp., Pneumocystis jirovecii, or Aspergillus spp.) in adults after recovering from COVID-19. Methods We performed a systematic review through PubMed, Web of Science, OVID-Medline, Embase, and Scopus. The study selection process was performed independently and by at least two authors. We performed a risk of bias assessment using the Newcastle-Ottawa Scale for cohort and case-control studies, and the Joanna Briggs Institute's Checklists for Case Series and Case Reports. Results The systematic search found 33 studies meeting all inclusion criteria. There was a total population of 774 participants, ranging from 21 to 87 years. From them, 746 developed a fungal infection. In 19 studies, Mucor spp. was reported as the main mycosis. In 10 studies, P. jirovecii was reported as the main mycosis. In seven studies, Aspergillus spp. was reported as the main mycosis. Regarding the quality assessment, 12 studies were classified as low risk of bias and the remaining studies as high risk of bias. Conclusion Patients' clinical presentation and prognosis after recovering from COVID-19 with fungal infection differ from those reported patients with acute COVID-19 infection and those without COVID-19 infection.
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Affiliation(s)
| | | | - Enrique A. Hernandez-Bustamante
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru
| | | | | | | | | | | | - Vicente A. Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
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11
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Lass-Flörl C, Steixner S. The changing epidemiology of fungal infections. Mol Aspects Med 2023; 94:101215. [PMID: 37804792 DOI: 10.1016/j.mam.2023.101215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/19/2023] [Accepted: 09/21/2023] [Indexed: 10/09/2023]
Abstract
Invasive fungal diseases are common complications in critically ill patients and in those with significant underlying imbalanced immune systems. Fungal co-, and/or super-infections are emerging and have become a rising concern within the last few years. In Europe, cases of candidiasis and aspergillosis dominate, followed by mucormycosis in India. Epidemiological studies show an increasing trend in the incidence of all three entities. Parallel to this, a shift within the underlying fungal pathogens is observed. More non-albicans Candida infections and aspergillosis with cryptic species are on the rise; cryptic species may cover intrinsic resistance to azoles and other antifungal drugs. The recent COVID-19 pandemic led to a significantly increasing incidence of invasive fungal diseases among hospitalized patients.
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Affiliation(s)
- Cornelia Lass-Flörl
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, A-6020, Innsbruck, Austria.
| | - Stephan Steixner
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, A-6020, Innsbruck, Austria
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12
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de Souza CAT, Ponce CC, Klautau GB, Costa AN, Queiroz W, Patzina RA, Benard G, Lindoso JAL. Can COVID-19 impact the natural history of paracoccidioidomycosis? Insights from an atypical chronic form of the mycosis. Rev Inst Med Trop Sao Paulo 2023; 65:e57. [PMID: 38055375 PMCID: PMC10691805 DOI: 10.1590/s1678-9946202365057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/10/2023] [Indexed: 12/08/2023] Open
Abstract
Paracoccidioidomycosis (PCM) is a systemic fungal infection caused by Paracoccidioides spp. It can occur as an acute/subacute form (A/SAF), a chronic form (CF) and rarely as a mixed form combining the features of the two aforementioned forms in an immunocompromised patient. Here, we report a 56-year-old male patient with CF-PCM who presented with atypical manifestations, including the development of an initial esophageal ulcer, followed by central nervous system (CNS) lesions and cervical and abdominal lymphatic involvement concomitant with severe SARS-CoV-2 infection. He was HIV-negative and had no other signs of previous immunodeficiency. Biopsy of the ulcer confirmed its mycotic etiology. He was hospitalized for treatment of COVID-19 and required supplemental oxygen in the intensive unit. The patient recovered without the need for invasive ventilatory support. Investigation of the extent of disease during hospitalization revealed severe lymphatic involvement typical of A/SAF, although the patient`s long history of high-risk exposure to PCM, and lung involvement typical of the CF. Esophageal involvement is rare in non-immunosuppressed PCM patients. CNS involvement is also rare. We suggest that the immunological imbalance caused by the severe COVID-19 infection may have contributed to the patient developing atypical severe CF, which resembles the PCM mixed form of immunosuppressed patients. Severe COVID-19 infection is known to impair the cell-mediated immune response, including the antiviral response, through T-lymphopenia, decreased NK cell counts and T-cell exhaustion. We hypothesize that these alterations would also impair antifungal defenses. Our case highlights the potential influence of COVID-19 on the course of PCM. Fortunately, the patient was timely treated for both diseases, evolving favorably.
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Affiliation(s)
| | - Cesar Cilento Ponce
- Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo,
Brazil
- Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil
| | - Gisele Burlamaqui Klautau
- Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo,
Brazil
- Santa Casa de São Paulo, Faculdade de Medicina, São Paulo, São
Paulo, Brazil
| | - André Nathan Costa
- Universidade de São Paulo, Faculdade de Medicina, Departamento de
Cardio-Pneumologia, São Paulo, São Paulo, Brazil
| | - Wladimir Queiroz
- Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo,
Brazil
| | | | - Gil Benard
- Universidade de São Paulo, Faculdade de Medicina, Instituto de
Medicina Tropical de São Paulo, Laboratório de Micologia Médica (LIM-53), São Paulo,
São Paulo, Brazil
| | - José Angelo Lauletta Lindoso
- Instituto de Infectologia Emilio Ribas, São Paulo, São Paulo,
Brazil
- Universidade de São Paulo, Faculdade de Medicina, Instituto de
Medicina Tropical de São Paulo, Laboratório de Protozoologia (LIM-49), São Paulo,
São Paulo, Brazil
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13
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Khavandegar A, Siami Z, Goudarzi S, Rasooli A, Ettehad Y. Investigation of microbial coinfection in 453 septic COVID-19 patients admitted to hospital; a retrospective study. Future Sci OA 2023; 9:FSO884. [PMID: 37752919 PMCID: PMC10518821 DOI: 10.2144/fsoa-2023-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/17/2023] [Indexed: 09/28/2023] Open
Abstract
Aim We evaluated the rate of COVID-19 microbial coinfection in an Iranian population. Methods In this single-center, retrospective observational study, we evaluated 453 septic COVID-19 patients for possible coinfection in an Iranian hospital. Results Overall, 211 (46.57%) cases died due to COVID-19 complications. Positive respiratory secretion and blood cultures were reported in 99 (21.9%) and 19 (4.2%) cases. Klebsiella species were the most commonly isolated microorganisms in respiratory (n = 50, 50.5%) and blood (n = 10, 52.6%) specimens. After adjustment for underlying disorders, positive respiratory microbial cultures significantly increase the odds of developing death, intubation, and ICU admission and negatively impact healthy discharge (P < 0.05). Conclusion Coinfections with bacteria and fungi independently contribute to poor outcomes in septic COVID-19 patients.
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Affiliation(s)
- Armin Khavandegar
- Sina Trauma & Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Siami
- Infectious Disease Department, Alborz University of Medical Sciences, Karaj, Iran
- Department of Infectious Diseases & Tropical Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sogand Goudarzi
- Department of Anesthesiology & Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Aziz Rasooli
- Department of Emergency Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Yeganeh Ettehad
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
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14
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San Martín Andrade D, Cárdenas Amendaño CA, Solórzano Cuenca AB, Ulloa Pacheco JM, Medina-Sotomayor P. [Candida albicans: risk factor in covid-19 patients]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 10:e132. [PMID: 38390607 PMCID: PMC10880693 DOI: 10.21142/2523-2754-1004-2022-132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/02/2022] [Indexed: 02/24/2024] Open
Abstract
The Candida Albicans fungus in our body can cause various conditions and will depend directly on the systemic condition of the host. Patients with COVID-19 who have previously presented this fungus can increase the likelihood of morbidity and mortality, since this microorganism can be located in areas that correspond to the respiratory system, generating a functional deficit. If not treated timely, it will proliferate into the blood and digestive system. Many patients with respiratory difficulties on account of this condition require mechanical ventilation to combat it. Objective To relate the presence of Candida Albicans as an aggravating factor in patients with COVID-19. Materials and methods: A literature review took place using the Redalyc, Scielo, PubMed, Research gate, Science direct, Google Scholar databases. The inclusion criteria used were: articles in English and Spanish, along with articles published from 2020 up to date. There were 65 scientific articles that met the search criteria and were analyzed. The analysis determined that oral candidiasis negatively affects patients with COVID-19 infection, increasing the risk of admission to the ICU with the use of artificial ventilators.
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Affiliation(s)
- Daniela San Martín Andrade
- Carrera de Odontologia de la Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , Universidad Católica de Cuenca Carrera de Odontologia Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
| | - Cristopher Andrés Cárdenas Amendaño
- Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , , Universidad Católica de Cuenca Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
| | - Allison Brigitte Solórzano Cuenca
- Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , , Universidad Católica de Cuenca Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
| | - Johanna Maribel Ulloa Pacheco
- Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , , Universidad Católica de Cuenca Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
| | - Priscilla Medina-Sotomayor
- Carrera de Odontologia de la Universidad Catolica de Cuenca. Campus Universitario Azogues, Ecuador. , Universidad Católica de Cuenca Carrera de Odontologia Universidad Catolica de Cuenca Campus Universitario Azogues Ecuador
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15
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Huertas MG, Rodríguez M, Castro P, Cruz SD, Cifuentes EA, Yepes AF, Zambrano MM, Baldión AM. Description of the colonizing mycobiota of endotracheal tubes from patients admitted to two intensive care units in Bogotá, Colombia. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:181-193. [PMID: 37721909 PMCID: PMC10586799 DOI: 10.7705/biomedica.6884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/15/2023] [Indexed: 09/20/2023]
Abstract
Introduction. Medical device colonization by pathogenic microorganisms is a risk factor for increasing infections associated with health care and, consequently, the morbidity and mortality of intubated patients. In Colombia, fungal colonization of endotracheal tubes has not been described, and this information could lead to new therapeutic options for the benefit of patients. Objective. To describe the colonizing fungi of the endotracheal tubes from patients in the intensive care unit, along with its antifungal sensitivity profile. Materials and methods. We conducted a descriptive, observational study in two health centers for 12 months. Endotracheal tubes were collected from patients in intensive care units. Samples were processed for culture, fungi identification, and antifungal sensitivity profile assessment. Results. A total of 121 endotracheal tubes, obtained from 113 patients, were analyzed: 41.32 % of the tubes were colonized by Candida albicans (64.62%), C. non‑albicans (30.77%), Cryptococcus spp. (3.08%) or molds (1.54%). All fungi evaluated showed a high sensitivity to antifungals, with a mean of 91%. Conclusion. Fungal colonization was found in the endotracheal tubes of patients under invasive mechanical ventilation. The antifungal sensitivity profile in these patients was favorable. A clinical study is required to find possible correlations between the colonizing microorganisms and infectivity.
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Affiliation(s)
- Mónica Gabriela Huertas
- Genética Molecular, Corporación CorpoGen, Bogotá, D.C., Colombia; Escuela de Medicina, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia.
| | - Miguel Rodríguez
- Departamento de Patología y Laboratorios, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, D.C., Colombia.
| | - Patricia Castro
- Departamento de Patología y Laboratorios, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, D.C., Colombia.
| | - Sergio Danilo Cruz
- Departamento de Patología y Laboratorios, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, D.C., Colombia.
| | | | - Andrés Felipe Yepes
- Departamento de Patología y Laboratorios, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, D.C., Colombia.
| | | | - Ana Margarita Baldión
- Departamento de Patología y Laboratorios, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, D.C., Colombia.
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16
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Sharma B, Nonzom S. Mucormycosis and Its Upsurge During COVID-19 Epidemic: An Updated Review. Curr Microbiol 2023; 80:322. [PMID: 37592083 DOI: 10.1007/s00284-023-03430-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 07/26/2023] [Indexed: 08/19/2023]
Abstract
Although mucormycosis may have reached an epidemic situation during the COVID-19 pandemic, the term was much more familiar even before the COVID-19 period. The year 2020 showed an outbreak of novel coronavirus (SARS-CoV-2) which affected millions of people all over the world. One of the noticeable complications observed to be associated with this disease is mucormycosis. It is an opportunistic infection caused by members of the Order Mucorales existing worldwide and has been commonly reported as a laboratory contaminant for a long time. However, nowadays due to the changes in the host environment, they have been emerging as potent opportunistic pathogens responsible for causing primary infections or coinfections with other diseases eventually resulting in morbidity and even mortality in severe cases. Although immunocompromised patients are more susceptible to this infection, few cases have been reported in immunocompetent individuals. Various risk factors which are responsible for the acquisition of mucormycosis include diabetes mellitus type 2, ketoacidosis, hematological malignancies, organ transplants, and chemotherapy recipients. Among the various etiological agents, Rhizopus is found to be the most common, and rhino-cerebral to be the most frequent clinical presentation. As far as pathogenesis is concerned, host cell invasion, thrombosis, and necrosis are the main events in the progression of this disease. The aim of the present review is to address a complete spectrum of mucormycosis and COVID-19-associated mucormycosis (CAM) in a single article. Both global and Indian scenarios of mucormycosis are taken into account while framing this review.
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Affiliation(s)
- Bharti Sharma
- Department of Botany, University of Jammu, Jammu, Jammu and Kashmir, 180006, India
| | - Skarma Nonzom
- Department of Botany, University of Jammu, Jammu, Jammu and Kashmir, 180006, India.
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17
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Acharya S, Behera SK, Purohit S, Sahu A, Panda BB, Behera S. COVID-19-Associated Rhino-Orbital Mucormycosis in a Tertiary Health Care Center in Odisha, India. Cureus 2023; 15:e43811. [PMID: 37731437 PMCID: PMC10508707 DOI: 10.7759/cureus.43811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/22/2023] Open
Abstract
Background Mucormycosis is an opportunistic infection that mainly affects immunocompromised individuals, including those with uncontrolled diabetes, malignancies, or those who have exposure to high-dose corticosteroids for a long time. Western Odisha, India, witnessed a significant rise in post-COVID-19 rhino-orbital mucormycosis (ROM), which created a need for comprehensive research on post-COVID-19 ROM. Objective This study aimed to investigate the prevalence, clinical characteristics, and outcomes of post-COVID-19 ROM in a tertiary care hospital in Western Odisha, India, with the objective of understanding ROM as a nationally notifiable disease. Subjects and methods A prospective hospital-based study was conducted. Mucormycosis cases were reported within the period, from May 17, 2021, to July 31, 2021, including all post-COVID-19 patients who exhibited clinical manifestations of mucormycosis. Patients with histopathologically negative reports of mucormycosis were excluded. Results Of the 35 included, 25 were diagnosed with ROM. The age group of 46-50 years showed a predominance (n=6), with a mean age of 50.53 years. The male-to-female ratio was 2:1. Specifically, 88% of the patients included had diabetes mellitus, 8% had chronic kidney diseases, 8% had sepsis, and 4% had hypertension. ROM was the predominant manifestation (60%, n=15), with the majority presenting with orbital cellulitis (80%), followed by unilateral orbital apex syndrome (12%), bilateral orbital apex syndrome (4%), ophthalmic vein involvement (4%), and osteomyelitis of the maxillary sinus (4%). Irrigation of the wound was performed, and all 25 ROM patients received IV liposomal amphotericin B (L-AMB). Conclusion Post-COVID-19 status with elevated blood sugar levels was a major risk factor for ROM. Early diagnosis, debridement, L-AMB, retrobulbar AMB deoxycholate, and exenteration are the possible solutions.
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Affiliation(s)
- Souvagini Acharya
- Department of Otolaryngology, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
| | - Sulin K Behera
- Department of Microbiology, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
| | - Somy Purohit
- Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
| | - Alaka Sahu
- Department of Pathology, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
| | - Braja B Panda
- Department of Radiodiagnositic, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
| | - Sharmistha Behera
- Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research, Sambalpur, IND
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18
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Cocio TA, Siqueira LPM, Riciluca KCT, Gimenes VMF, de Andrade TS, Benard G, Martínez R, Bollela VR. Significance of Aspergillus spp. isolation in defining cases of COVID-19 Associated Pulmonary Aspergillosis - CAPA. Braz J Infect Dis 2023; 27:102793. [PMID: 37507102 PMCID: PMC10407263 DOI: 10.1016/j.bjid.2023.102793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
COVID-19-Associated Pulmonary Aspergillosis (CAPA) is a relatively common complication in patients with severe forms of the disease caused by the SARS-CoV-2 virus. Diagnosing and confirming CAPA is challenging. In this study, Aspergillus spp. isolation in respiratory specimens from patients with COVID-19 was evaluated for identifying cases of CAPA. In 2020‒2021, 17 Aspergillus spp. were isolated from 15 COVID-19 patients admitted to a university hospital in Brazil. Patient records were retrospectively reviewed to obtain clinical-epidemiological data and other markers of Aspergillus spp. infection and then compared with the ECMM/ISHAM criteria for defining CAPA. Probable CAPA was defined in 5/10 patients, who had Aspergillus spp. isolated from Bronchoalveolar Lavage (BAL) or a positive galactomannan blood test. Additionally, anti-Aspergillus antibodies were detected in two of these patients, during active or follow-up phases of CAPA. In another seven patients with Aspergillus spp. isolated from tracheobronchial aspirate or sputum, CAPA was presumed, mainly due to deterioration of clinical conditions and new lung imaging suggestive of fungal infection. Antifungal agents to control CAPA, particularly voriconazole, were used in 9/15 cases. In cases of probable CAPA and remaining patients, clinical conditions and comorbidities were similar, with lethality being high, at 60% and 71%, respectively. The number of CAPA cases defined by scientific criteria was lower than that assumed in the clinical context. This was largely due to the lack of BAL collection for fungal culture and the non-intensive use of other markers of invasive aspergillosis. The isolation of Aspergillus spp. in different respiratory specimens should alert clinicians to the diagnosis of CAPA.
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Affiliation(s)
- Tiago Alexandre Cocio
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica, Ribeirão Preto, SP, Brazil; Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, Laboratório de Investigação Médica (LIM53), São Paulo, SP, Brazil.
| | - Lumena Pereira Machado Siqueira
- Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, Laboratório de Investigação Médica (LIM53), São Paulo, SP, Brazil
| | | | - Viviane Mazo Favero Gimenes
- Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, Laboratório de Investigação Médica (LIM53), São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Odontologia, Programa de Pós-Graduação em Diagnostico Bucal, Radiologia Odontológica e Imagiologia, São Paulo, SP, Brazil
| | | | - Gil Benard
- Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, Laboratório de Investigação Médica (LIM53), São Paulo, SP, Brazil
| | - Roberto Martínez
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica, Ribeirão Preto, SP, Brazil
| | - Valdes Roberto Bollela
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica, Ribeirão Preto, SP, Brazil
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Skóra M, Obłoza M, Tymecka M, Kalaska B, Gurgul M, Kamiński K. Studies on Antifungal Properties of Methacrylamido Propyl Trimethyl Ammonium Chloride Polycations and Their Toxicity In Vitro. Microbiol Spectr 2023; 11:e0084423. [PMID: 37166300 PMCID: PMC10269872 DOI: 10.1128/spectrum.00844-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/20/2023] [Indexed: 05/12/2023] Open
Abstract
The biological activity of polycations is usually associated with their biocidal properties. Their antibacterial features are well known, but in this work, observations on the antifungal properties of macromolecules obtained by methacrylamido propyl trimethyl ammonium chloride (MAPTAC) polymerization are presented. The results, not previously reported, make it possible to correlate antifungal properties directly with the structure of the macromolecule, in particular the molecular mass. The polymers described here have antifungal activity against some filamentous fungi. The strongest effect occurs for polymers with a mass of about 0.5 mDa which have confirmed activity against the multidrug-resistant species Scopulariopsis brevicaulis, Fusarium oxysporum, and Fusarium solani, as well as the dermatophytes Trichophyton mentagrophytes, Trichophyton rubrum, Trichophyton interdigitale, and Trichophyton tonsurans. In addition, this publication describes the effects of these macromolecular systems on serum and blood components and provides a preliminary assessment of toxicity on cell lines of skin-forming cells, i.e., fibroblasts and keratinocytes. Additionally, using a Franz diffusion chamber, a negligibly low transport of the active polymer through the skin was demonstrated, which is a desirable effect for externally applied antifungal drugs. IMPORTANCE Infectious diseases are a very big medical, social, and economic problem. Even before the COVID-19 pandemic, certain infections were among of the most common causes of death. The difficulties in the treatment of infectious diseases concern in particular fungal diseases, against which we have only a few classes of drugs represented by a few substances. The publication presents the preliminary results of the in vitro antifungal activity studies of four MAPTAC polymers on different fungal species and their cytotoxicity to human cells (fibroblasts and keratinocytes). The paper also compares these properties with analogous ones of two commonly used antifungal drugs, ciclopirox and terbinafine.
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Affiliation(s)
- Magdalena Skóra
- Department of Infections Control and Mycology, Chair of Microbiology, Jagiellonian University Medical College, Cracow, Poland
| | | | - Małgorzata Tymecka
- Doctoral School of Exact and Natural Sciences, Faculty of Chemistry, Jagiellonian University, Cracow, Poland
| | - Bartlomiej Kalaska
- Department of Pharmacodynamics, Medical University of Białystok, Białystok, Poland
| | | | - Kamil Kamiński
- Faculty of Chemistry, Jagiellonian University, Cracow, Poland
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20
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Lavrentieva A, Kaimakamis E, Voutsas V, Bitzani M. An observational study on factors associated with ICU mortality in Covid-19 patients and critical review of the literature. Sci Rep 2023; 13:7804. [PMID: 37179397 PMCID: PMC10182846 DOI: 10.1038/s41598-023-34613-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
The novel pandemic caused by SARS-CoV-2 has been associated with increased burden on healthcare system. Recognizing the variables that independently predict death in COVID-19 is of great importance. The study was carried out prospectively in a single ICU in northern Greece. It was based on the collection of data during clinical practice in 375 adult patients who were tested positive for SARS-CoV-2 between April 2020 and February 2022. All patients were intubated due to acute respiratory insufficiency and received Invasive Mechanical Ventilation. The primary outcome was ICU mortality. Secondary outcomes were 28-day mortality and independent predictors of mortality at 28 days and during ICU hospitalization. For continuous variables with normal distribution, t-test was used for means comparison between two groups and one-way ANOVA for multiple comparisons. When the distribution was not normal, comparisons were performed using the Mann-Whitney test. Comparisons between discrete variables were made using the x2 test, whereas the binary logistic regression was employed for the definition of factors affecting survival inside the ICU and after 28 days. Of the total number of patients intubated due to COVID-19 during the study period, 239 (63.7%) were male. Overall, the ICU survival was 49.6%, whereas the 28-day survival reached 46.9%. The survival rates inside the ICU for the four main viral variants were 54.9%, 50.3%, 39.7% and 50% for the Alpha, Beta, Delta and Omicron variants, respectively. Logistic regressions for outcome revealed that the following parameters were independently associated with ICU survival: wave, SOFA @day1, Remdesivir use, AKI, Sepsis, Enteral Insufficiency, Duration of ICU stay and WBC. Similarly, the parameters affecting the 28-days survival were: duration of stay in ICU, SOFA @day1, WBC, Wave, AKI and Enteral Insufficiency. In this observational cohort study of critically ill COVID-19 patients we report an association between mortality and the wave sequence, SOFA score on admission, the use of Remdesivir, presence of AKI, presence of gastrointestinal failure, sepsis and WBC levels. Strengths of this study are the large number of critically ill COVID-19 patients included, and the comparison of the adjusted mortality rates between pandemic waves within a two year-study period.
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Affiliation(s)
- Athina Lavrentieva
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
| | - Evangelos Kaimakamis
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece.
| | - Vassileios Voutsas
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
| | - Militsa Bitzani
- 1st Intensive Care Unit, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
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21
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Markowska-Szczupak A, Paszkiewicz O, Yoshiiri K, Wang K, Kowalska E. Can photocatalysis help in the fight against COVID-19 pandemic? CURRENT OPINION IN GREEN AND SUSTAINABLE CHEMISTRY 2023; 40:100769. [PMID: 36846296 PMCID: PMC9942773 DOI: 10.1016/j.cogsc.2023.100769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Mould fungi are serious threats to humans and animals (allergen) and might be the main cause of COVID-19-associated pulmonary aspergillosis. The common methods of disinfection are not highly effective against fungi due to the high resistance of fungal spores. Recently, photocatalysis has attracted significant attention towards antimicrobial action. Outstanding properties of titania photocatalysts have already been used in many areas, e.g., for building materials, air conditioner filters, and air purifiers. Here, the efficiency of photocatalytic methods to remove fungi and bacteria (risk factors for Severe Acute Respiratory Syndrome Coronavirus 2 co-infection) is presented. Based on the relevant literature and own experience, there is no doubt that photocatalysis might help in the fight against microorganisms, and thus prevent the severity of COVID-19 pandemic.
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Affiliation(s)
- Agata Markowska-Szczupak
- Department of Chemical and Process Engineering, West Pomeranian University of Technology in Szczecin, Piastow 42, 71-065 Szczecin, Poland
| | - Oliwia Paszkiewicz
- Department of Chemical and Process Engineering, West Pomeranian University of Technology in Szczecin, Piastow 42, 71-065 Szczecin, Poland
| | - Kenta Yoshiiri
- Institute for Catalysis (ICAT), Hokkaido University, N21, W10, 001-0021 Sapporo, Japan
- Graduate School of Environmental Science, Hokkaido University, N10, W5, 060-0810 Sapporo, Japan
| | - Kunlei Wang
- Institute for Catalysis (ICAT), Hokkaido University, N21, W10, 001-0021 Sapporo, Japan
| | - Ewa Kowalska
- Institute for Catalysis (ICAT), Hokkaido University, N21, W10, 001-0021 Sapporo, Japan
- Graduate School of Environmental Science, Hokkaido University, N10, W5, 060-0810 Sapporo, Japan
- Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387 Krakow, Poland
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22
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Lak M, Jafari Naeini S, Omidi Farzin A, Hekmat M, Gharib A. A young woman with pulmonary embolism, myocarditis and fungal endocarditis after COVID-19 infection: a case report. Future Cardiol 2023; 19:241-247. [PMID: 37345647 DOI: 10.2217/fca-2023-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023] Open
Abstract
A young woman with a history of COVID-19 infection and concomitant visual problems was admitted with exacerbation of dyspnea. Upon admission, pulmonary embolism, myocarditis and fungal endocarditis were detected, probably due to persistent underlying inflammation. She underwent surgical replacement of the tricuspid valve and antifungal treatment.
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Affiliation(s)
- Mehran Lak
- Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Jafari Naeini
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Omidi Farzin
- Department of Cardiovascular Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Manoochehr Hekmat
- Department of Cardiovascular Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atoosa Gharib
- Pathology Department, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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23
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Tehrani S, Fekri S, Demirci H, Nourizadeh AM, Kashefizadeh A, Shahrbaf MA, Keyvanfar A, Maghsoudi Nejad F. Coincidence of Candida Endophthalmitis, and Aspergillus and Pneumocystis jirovecii Pneumonia in a COVID-19 Patient: Case Report. Ocul Immunol Inflamm 2023:1-4. [PMID: 36952481 DOI: 10.1080/09273948.2023.2188224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is associated with immune system dysfunction and makes patients vulnerable to opportunistic infections. This report presents a patient with a history of COVID-19, suffering from opportunistic infections. CASE DESCRIPTION We reported a 64-year-old man complaining of progressive visual loss in his left eye, who had previously been hospitalized for three weeks due to COVID-19. In the ophthalmologic assessment, large foci of dense subretinal and intraretinal infiltrations involving the macula were observed (compatible with endogenous fungal endophthalmitis). Real-time PCR result of intraocular fluid was positive for Candida spp. During subsequent hospitalization, the patient also suffered from fever and productive coughs (manifestations of pneumonia caused by Aspergillus fumigatus and Pneumocystis jirovecii). In response to antibiotic therapy, the fever and coughs subsided, and the ocular examination revealed a dramatic decrease in the size of retinal infiltrations. CONCLUSIONS In patients with severe COVID-19, long-term ICU admission and immunosuppressive drugs lead to immune system dysfunction and make the patient more susceptible to opportunistic infections. Consequently, fungal pathogens such as Aspergillus, Pneumocystis jirovecii, and Candida spp. may cause infection in different body organs. Thus, clinicians should be alert and have clinical suspicion to diagnose accurately and manage patients accordingly.
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Affiliation(s)
- Shabnam Tehrani
- Department of Infectious Disease, Labbafinejad Clinical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahba Fekri
- Department of Ophthalmology, Labbafinejad Clinical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hakan Demirci
- Department of Ophthalmology and Visual Science, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Alireza Kashefizadeh
- Department of Internal Medicine, Labbafinejad Clinical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Amirreza Keyvanfar
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Maghsoudi Nejad
- Department of Infectious Disease, Labbafinejad Clinical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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24
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Huamani-Córdova JM, Hueda-Zavaleta M, Vargas-Bellina V, Simbron-Ribbeck L, Chong-Chinchay KDR, Gómez de la Torre JC, Benítes-Zapata VA. Cerebral Cryptococcosis Associated with CD4+ T-lymphocytopenia in Non-HIV Patients after SARS-CoV-2 Infection: Case Series in a Specialized Institute in Lima, Peru. Trop Med Infect Dis 2023; 8:tropicalmed8030182. [PMID: 36977183 PMCID: PMC10056744 DOI: 10.3390/tropicalmed8030182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/29/2023] Open
Abstract
Cases of cryptococcosis have been reported in patients with COVID-19. The majority are in patients with severe symptoms or who received immunosuppressants. However, there is still no clear association between COVID-19 and cryptococcosis. We report eight cases of cerebral cryptococcosis associated with CD4+ T lymphocytopenia in non-HIV patients after SARS-CoV-2 infection. The median age was 57 years and 5/8 were male. In addition, 2/8 of patients had diabetes, and 8/8 had a history of mild COVID-19, with a median of 75 days before diagnosis of cerebral cryptococcosis. All patients denied having received prior immunosuppressive therapy. The most frequent symptoms were confusion (8/8), headache (7/8), vomiting (6/8), and nausea (6/8) All patients were diagnosed by isolating Cryptococcus in cerebrospinal fluid. The median CD4+ and CD8+ T lymphocytes were 247 and 173.5, respectively. Other causes of immunosuppression, such as HIV or HTLV infection, were excluded in all patients. Finally, three patients died, and one presented long-term visual and auditory sequelae. The CD4+/CD8+ T lymphocyte count normalized during follow-up in those patients who survived. We hypothesize that CD4+ T lymphocytopenia in the patients in this case series could increase the risk of cryptococcosis after SARS-CoV-2 infection.
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Affiliation(s)
| | - Miguel Hueda-Zavaleta
- Facultad de Ciencias de la Salud, Universidad Privada de Tacna, Tacna 23003, Peru;
- Hospital III Daniel Alcides Carrión—Essalud, Tacna 23000, Peru
| | | | | | | | | | - Vicente A. Benítes-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15024, Peru
- Correspondence:
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25
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Huang PH, Huang YT, Lee PH, Tseng CH, Liu PY, Liu CW. Diagnosis of Legionnaires' Disease Assisted by Next-Generation Sequencing in a Patient with COVID-19. Infect Drug Resist 2023; 16:355-362. [PMID: 36714349 PMCID: PMC9880021 DOI: 10.2147/idr.s396254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/03/2023] [Indexed: 01/21/2023] Open
Abstract
Coinfection in COVID-19 patients is associated with worsening outcome. Among patients with COVID-19, Legionella pneumophila, a common cause of pneumonia, has been reported as a co-occurring respiratory infection. A nonspecific clinical presentation, however, makes an early diagnosis difficult. Bronchoalveolar lavage fluid was collected from a patient suffering from COVID-19 and presenting with pneumonia and sent for metagenomic analysis. Differential abundance analysis was carried out by comparing each taxon reads per million between the bronchoalveolar lavage fluid sample and the negative control. Two replicates of metagenomic sequencing were conducted on bronchoalveolar lavage fluid samples. Within each replicated sequencing, one negative control was sequenced for comparison of taxon abundance in the BALF sample. In both replicates, Legionella pneumophila was the only taxon with significantly higher abundance when compared with the negative control. PCR of the bronchoalveolar further confirmed the presence of L. pneumophila. Several studies have estimated that the incidence of Legionnaires' disease co-infection in patients with COVID-19 infection is approximately 0% to 1.5%. There are some common characteristics of COVID-19 and co-infection with Legionnaires' disease, making it difficult to diagnose bacterial infection early. The diagnosis of these cases is important due to the different treatments used. Current diagnostic tests for Legionnaires' disease include conventional culture, urinary antigen for L. pneumophila serogroup 1, polymerase chain reaction, direct fluorescent antibody stain, and paired serology. The current study demonstrated that metagenomics is a promising approach that facilitated the diagnosis of Legionnaires' disease.
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Affiliation(s)
- Po-Hsiu Huang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yao-Ting Huang
- Department of Computer Science and Information Engineering, National Chung Cheng University, Chia-Yi, Taiwan
| | - Po-Hsin Lee
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chien-Hao Tseng
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Yu Liu
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan,Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan,Correspondence: Po-Yu Liu; Chia-Wei Liu, Tel +886 4 2359 2525, Fax +886 4 2359 2525 2111, Email ;
| | - Chia-Wei Liu
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
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26
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Singh S, Barbarino A, Youssef EG, Coleman D, Gebremariam T, Ibrahim AS. Protective Efficacy of Anti-Hyr1p Monoclonal Antibody against Systemic Candidiasis Due to Multi-Drug-Resistant Candida auris. J Fungi (Basel) 2023; 9:103. [PMID: 36675924 PMCID: PMC9860579 DOI: 10.3390/jof9010103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
Candida auris is a multi-drug-resistant fungal pathogen that can survive outside the host and can easily spread and colonize the healthcare environment, medical devices, and human skin. C. auris causes serious life-threatening infections (up to 60% mortality) in immunosuppressed patients staying in such contaminated healthcare facilities. Some isolates of C. auris are resistant to virtually all clinically available antifungal drugs. Therefore, alternative therapeutic approaches are urgently needed. Using in silico protein modeling and analysis, we identified a highly immunogenic and surface-exposed epitope that is conserved between C. albicans hyphal-regulated protein (Cal-Hyr1p) and Hyr1p/Iff-like proteins in C. auris (Cau-HILp). We generated monoclonal antibodies (MAb) against this Cal-Hyr1p epitope, which recognized several clinical isolates of C. auris representing all four clades. An anti-Hyr1p MAb prevented biofilm formation and enhanced opsonophagocytic killing of C. auris by macrophages. When tested for in vivo efficacy, anti-Hyr1p MAb protected 55% of mice against lethal systemic C. auris infection and showed significantly less fungal burden. Our study is highly clinically relevant and provides an effective alternative therapeutic option to treat infections due to MDR C. auris.
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Affiliation(s)
- Shakti Singh
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Ashley Barbarino
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
| | - Eman G. Youssef
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
| | - Declan Coleman
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
- Biology Department, Pomona College, Pomona, CA 91711, USA
| | - Teclegiorgis Gebremariam
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
| | - Ashraf S. Ibrahim
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, CA 90502, USA
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
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27
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Matouri R, Aboutalebian S, Nasri E, Sadeghi S, Rostami S, Fakhim H, Ghafel S, Hosseini M, Mousavi S, Rouhi F, Pestechian N, Mirhendi H. Molecular and microscopy detection of Pneumocystis jirovecii in hospitalized patients during the COVID-19 pandemic. Front Med (Lausanne) 2023; 10:1148320. [PMID: 37089605 PMCID: PMC10117983 DOI: 10.3389/fmed.2023.1148320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Early detection of Pneumocystis jirovecii as an opportunistic pathogen that may endanger predisposed persons, including COVID-19 patients, may help to choose the optimal management. Methods In this study, 585, including 530 COVID-19 patients, with clinical and radiological evidence of respiratory diseases, were investigated for P. jirovecii screening. Clinical specimens were examined by direct microscopy and PCR, and randomly selected positive PCR products were confirmed through DNA sequence analysis. Results Thirty-one (5.3%) samples were positive in P. jirovecii-specific nested-PCR, while by direct microscopic tests, Pneumocystis was observed in 22 (3.76%) samples. Males (61.7%) and patients over 50 years old (75.6%) were more commonly affected than others, and malaise and fatigue (84%), and wheezing (75%) were the most common symptoms, followed by fever (40.48%) and dyspnea (39.51%). Among the Pneumocystis-positive patients, three cases had coinfection with Aspergillus fumigatus, A. flavus, and A. niger (each n = 1), as documented by direct microscopy, culture, and species identification by PCR-sequencing. Conclusion Pneumocystis pneumonia is still a diagnostic challenge; therefore, additional large-scale studies are needed to clarify the epidemiology of the disease in immunocompromised or COVID-19 patients.
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Affiliation(s)
- Roya Matouri
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shima Aboutalebian
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elahe Nasri
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somayeh Sadeghi
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soodabeh Rostami
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Fakhim
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Safiyeh Ghafel
- Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Hosseini
- Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somayeh Mousavi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Faezeh Rouhi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nader Pestechian
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Mirhendi
- Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Mycology Reference Laboratory, Research Core Facilities Laboratory, Isfahan University of Medical Sciences, Isfahan, Iran
- *Correspondence: Hossein Mirhendi, ; orcid.org/0000-0002-1006-4169
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Muacevic A, Adler JR, Thwe H, Alam B, Awosika AO, Omole AE. Rhino-Orbital Cerebral Mucormycosis in a Non-diabetic Patient Following COVID-19 Infection: A Case Report and Literature Review. Cureus 2022; 14:e32884. [PMID: 36699798 PMCID: PMC9867915 DOI: 10.7759/cureus.32884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 12/24/2022] Open
Abstract
Rhino-orbital cerebral mucormycosis has been commonly seen during the coronavirus disease 2019 (COVID-19) pandemic. Several factors responsible for etiology and pathophysiology have been identified, among which corticosteroids and diabetes have contributed to the lion's share of the outbreak of mucormycosis. In this report, we discuss a case of a 41-year-old non-diabetic male with a recent convalescence from COVID-19 infection presented with gradual vision loss and loss of sensations in his right eye. He was found to have periorbital swelling, restriction of extraocular movements in all gazes, chemosis, ptosis of the right eye, and right maxillary sinus tenderness. His serum investigations, radiologic findings, and blood culture were indicative of rhino-orbital cerebral mucormycosis. He was started on systemic liposomal amphotericin B immediately and underwent aggressive surgical debridement. A high index of clinical suspicion, aggressive multifaceted management, and follow-up are needed to have successful outcomes, thereby lowering the morbidity of coronavirus-associated mucormycosis.
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Clinical Challenges of Emerging and Re-Emerging Yeast Infections in the Context of the COVID-19 Pandemic. Microorganisms 2022; 10:microorganisms10112223. [PMID: 36363816 PMCID: PMC9695014 DOI: 10.3390/microorganisms10112223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 11/12/2022] Open
Abstract
During the geological eras, some fungi, through adaptation and/or environmental/ecological pressure, interacted directly and indirectly with humans, through occasionally harmful interaction interdependent on the individual’s immunological condition. Infections caused by yeasts are underreported, subjugated, and underdiagnosed, and treatment is restricted to a few drugs, even after the significant progress of medicine and pharmacology. In the last centuries, antagonistically, there has been an exponential increase of immunocompromised individuals due to the use of immunosuppressive drugs such as corticosteroids, increased cases of transplants, chemotherapeutics, autoimmune diseases, neoplasms, and, more recently, coronavirus disease 2019 (COVID-19). This review aims to survey emerging and re-emerging yeast infections in the current clinical context. Currently, there is an immense clinical challenge for the rapid and correct diagnosis and treatment of systemic mycoses caused by yeasts due to the terrible increase in cases in the current context of COVID-19.
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Macias-Paz IU, Pérez-Hernández S, Tavera-Tapia A, Luna-Arias JP, Guerra-Cárdenas JE, Reyna-Beltrán E. Candida albicans the main opportunistic pathogenic fungus in humans. Rev Argent Microbiol 2022:S0325-7541(22)00084-0. [DOI: 10.1016/j.ram.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/03/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
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Potential inhibitory activity of phytoconstituents against black fungus: In silico ADMET, molecular docking and MD simulation studies. COMPUTATIONAL TOXICOLOGY 2022; 24:100247. [PMID: 36193218 PMCID: PMC9508704 DOI: 10.1016/j.comtox.2022.100247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022]
Abstract
Mucormycosis or “black fungus” has been currently observed in India, as a secondary infection in COVID-19 infected patients in the post-COVID-stage. Fungus is an uncommon opportunistic infection that affects people who have a weak immune system. In this study, 158 antifungal phytochemicals were screened using molecular docking against glucoamylase enzyme of Rhizopus oryzae to identify potential inhibitors. The docking scores of the selected phytochemicals were compared with Isomaltotriose as a positive control. Most of the compounds showed lower binding energy values than Isomaltotriose (-6.4 kcal/mol). Computational studies also revealed the strongest binding affinity of the screened phytochemicals was Dioscin (-9.4 kcal/mol). Furthermore, the binding interactions of the top ten potential phytochemicals were elucidated and further analyzed. In-silico ADME and toxicity prediction were also evaluated using SwissADME and admetSAR online servers. Compounds Piscisoflavone C, 8-O-methylaverufin and Punicalagin exhibited positive results with the Lipinski filter and drug-likeness and showed mild to moderate of toxicity. Molecular dynamics (MD) simulation (at 300 K for 100 ns) was also employed to the docked ligand-target complex to explore the stability of ligand-target complex, improve docking results, and analyze the molecular mechanisms of protein-target interactions.
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Salvador A, Veiga FF, Svidzinski TIE, Negri M. In vitro ability of Fusarium keratoplasticum to form biofilms in venous catheter. Microb Pathog 2022; 173:105868. [DOI: 10.1016/j.micpath.2022.105868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/10/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
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Al-Ani RM, Al Tameemi KM. COVID-19-related Rhino-orbital-cerebral Mucormycosis. Qatar Med J 2022; 2022:47. [PMID: 36258686 PMCID: PMC9574569 DOI: 10.5339/qmj.2022.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/16/2022] [Indexed: 11/06/2022] Open
Abstract
Background: There is an increasing number of COVID-19-related Rhino-orbital-cerebral mucormycosis (ROCM), especially from India. Objectives: To evaluate the demographic, clinical, radiological, and outcome of the COVID-19-related ROCM cases in a single center. Materials and Methods: The medical records of the patients with COVID-19-related ROCM were retrospectively reviewed. The study covered 22 months duration from March 2020 to December 2021 in Imam Hussain Medical City, Karbala city, Iraq. Results: Of the 14 patients with COVID-19-related ROCM, there were 71.4% males with a male-to-female ratio of 2.5:1. The median age was 61 years (age range: 27-80 years). There were 42.9% of patients with a history of being a current smoker. All patients had a history of DM, and 57.1% of patients had a history of hypertension. All patients were without a history of the previous episode of COVID-19 or taking the vaccine. The median duration from the COVID-19 diagnosis to the diagnosis of ROCM was 19 days (duration range of 10-40 days). Most of the cases were of severe type (57.1%). All of the patients were taking corticosteroid and oxygen therapy. Nasal obstruction, nasal discharge, cheek swelling, and necrotic tissue were clinical features in all patients. The majority of the cases were on the left side (71.4%). Stage 3 was found in 42.9%. Amphotericin B was used for all patients and surgical debridement in 13 cases. Five patients have died (35.7%). Conclusion: COVID-19-related ROCM is an aggressive disease associated with a high mortality rate of 35.7%. Early diagnosis and on-time initiation of treatment are recommended to get the best outcome.
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Affiliation(s)
- Raid M. Al-Ani
- College of Medicine, University of Anbar, Anbar, Iraq ,E-mail:
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Khalil FO, Taj MB, Ghonaim EM, Abed El-Sattar S, Elkhadry SW, El-Refai H, Ali OM, Elgawad ASA, Alshater H. Hydrothermal assisted biogenic synthesis of silver nanoparticles: A potential study on virulent candida isolates from COVID-19 patients. PLoS One 2022; 17:e0269864. [PMID: 36201485 PMCID: PMC9536612 DOI: 10.1371/journal.pone.0269864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/27/2022] [Indexed: 11/07/2022] Open
Abstract
Till now the exact mechanism and effect of biogenic silver nanoparticles on fungus is an indefinable question. To focus on this issue, the first time we prepared hydrothermal assisted thyme coated silver nanoparticles (T/AgNPs) and their toxic effect on Candida isolates were determined. The role of thyme (Thymus Vulgaris) in the reduction of silver ions and stabilization of T/AgNPs was estimated by Fourier transforms infrared spectroscopy, structure and size of present silver nanoparticles were detected via atomic force microscopy as well as high-resolution transmission electron microscopy. The biological activity of T/AgNPs was observed against Candida isolates from COVID-19 Patients. Testing of virulence of Candida species using Multiplex PCR. T/AgNPs proved highly effective against Candida albicans, Candida kruzei, Candida glabrata and MIC values ranging from 156.25 to 1,250 μg/mL and MFC values ranging from 312.5 to 5,000 μg/mL. The structural and morphological modifications due to T/AgNPs on Candida albicans were detected by TEM. It was highly observed that when Candida albicans cells were subjected to 50 and 100 μg/mL T/AgNPs, a remarkable change in the cell wall and cell membrane was observed.
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Affiliation(s)
- Fatma O. Khalil
- Clinical and Molecular Microbiology and Immunology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Muhammad B. Taj
- Division of Inorganic Chemistry, Institute of Chemistry, The Islamia University Bahawalpur, Bahawalpur, Pakistan
- * E-mail: (MBT); (OMA)
| | - Enas M. Ghonaim
- Clinical and Molecular Microbiology and Immunology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Shimaa Abed El-Sattar
- Clinical Biochemistry and Molecular Diagnostics, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Sally W. Elkhadry
- Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Hala El-Refai
- Clinical and Molecular Microbiology and Immunology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Omar M. Ali
- Department of Chemistry, Turabah University College, Turabah Branch, Taif University, Taif Saudi Arabia
- * E-mail: (MBT); (OMA)
| | - Ahmed Salah A. Elgawad
- Department of Clinical Pathology, National Liver Institute, Menoufia University Hospital, Menoufia University, Shebin El-Kom, Egypt
| | - Heba Alshater
- Department of Forensic Medicine and Clinical Toxicology, Menoufia University Hospital, Menoufia University, Shebin El-Kom, Egypt
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Liu A, Li Z, Su G, Li Y, Zhang Y, Liang J, Cheng X, Wang X, Li Y, Ye F. Mycotic infection as a risk factor for COVID-19: A meta-analysis. Front Public Health 2022; 10:943234. [PMID: 36159283 PMCID: PMC9489839 DOI: 10.3389/fpubh.2022.943234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023] Open
Abstract
More than 405 million people have contracted coronavirus disease 2019 (COVID-19) worldwide, and mycotic infection may be related to COVID-19 development. There are a large number of reports showing that COVID-19 patients with mycotic infection have an increased risk of mortality. However, whether mycotic infection can be considered a risk factor for COVID-19 remains unknown. We searched the PubMed and Web of Science databases for studies published from inception to December 27, 2021. Pooled effect sizes were calculated according to a random-effects model or fixed-effect model, depending on heterogeneity. We also performed subgroup analyses to identify differences in mortality rates between continents and fungal species. A total of 20 articles were included in this study. Compared with the controls, patients with mycotic infection had an odds ratio (OR) of 2.69 [95% confidence interval (CI): 2.22-3.26] for mortality and an OR of 2.28 (95% CI: 1.65-3.16) for renal replacement therapy (RRT). We also conducted two subgroup analyses based on continent and fungal species, and we found that Europe and Asia had the highest ORs, while Candida was the most dangerous strain of fungi. We performed Egger's test and Begg's test to evaluate the publication bias of the included articles, and the p-value was 0.423, which indicated no significant bias. Mycotic infection can be regarded as a risk factor for COVID-19, and decision makers should be made aware of this risk.
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Affiliation(s)
- Anlin Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Zhengtu Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guansheng Su
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ya Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Yuzhuo Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Jinkai Liang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Xiaoxue Cheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,Nanshan School of Guangzhou Medical University, Guangzhou, China
| | - Xidong Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yongming Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,*Correspondence: Feng Ye ;
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Wang T, Cao Y, Zhang H, Wang Z, Man CH, Yang Y, Chen L, Xu S, Yan X, Zheng Q, Wang YP. COVID-19 metabolism: Mechanisms and therapeutic targets. MedComm (Beijing) 2022; 3:e157. [PMID: 35958432 PMCID: PMC9363584 DOI: 10.1002/mco2.157] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 01/18/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) dysregulates antiviral signaling, immune response, and cell metabolism in human body. Viral genome and proteins hijack host metabolic network to support viral biogenesis and propagation. However, the regulatory mechanism of SARS‐CoV‐2‐induced metabolic dysfunction has not been elucidated until recently. Multiomic studies of coronavirus disease 2019 (COVID‐19) revealed an intensive interaction between host metabolic regulators and viral proteins. SARS‐CoV‐2 deregulated cellular metabolism in blood, intestine, liver, pancreas, fat, and immune cells. Host metabolism supported almost every stage of viral lifecycle. Strikingly, viral proteins were found to interact with metabolic enzymes in different cellular compartments. Biochemical and genetic assays also identified key regulatory nodes and metabolic dependencies of viral replication. Of note, cholesterol metabolism, lipid metabolism, and glucose metabolism are broadly involved in viral lifecycle. Here, we summarized the current understanding of the hallmarks of COVID‐19 metabolism. SARS‐CoV‐2 infection remodels host cell metabolism, which in turn modulates viral biogenesis and replication. Remodeling of host metabolism creates metabolic vulnerability of SARS‐CoV‐2 replication, which could be explored to uncover new therapeutic targets. The efficacy of metabolic inhibitors against COVID‐19 is under investigation in several clinical trials. Ultimately, the knowledge of SARS‐CoV‐2‐induced metabolic reprogramming would accelerate drug repurposing or screening to combat the COVID‐19 pandemic.
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Affiliation(s)
- Tianshi Wang
- Shanghai Key Laboratory for Tumor Microenvironment and Inflammation Department of Biochemistry and Molecular Cell Biology Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Ying Cao
- State Key Laboratory of Oncogenes and Related Genes Shanghai Cancer Institute Renji Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Haiyan Zhang
- Bai Jia Obstetrics and Gynecology Hospital Shanghai China
| | - Zihao Wang
- Fudan University Shanghai Cancer Center Key Laboratory of Breast Cancer in Shanghai Shanghai Key Laboratory of Radiation Oncology Cancer Institute and The Shanghai Key Laboratory of Medical Epigenetics Institutes of Biomedical Sciences Shanghai Medical College Fudan University Shanghai China.,Department of Oncology Shanghai Medical College Fudan University Shanghai China.,The International Co-laboratory of Medical Epigenetics and Metabolism Ministry of Science and Technology Shanghai China
| | - Cheuk Him Man
- Division of Hematology Department of Medicine University of Hong Kong Pokfulam Hong Kong, China
| | - Yunfan Yang
- Department of Cell Biology School of Basic Medical Sciences Cheeloo College of Medicine Shandong University Jinan China
| | - Lingchao Chen
- Department of Neurosurgery Huashan Hospital Shanghai Medical College Fudan University National Center for Neurological Disorders Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration Neurosurgical Institute of Fudan University Shanghai Clinical Medical Center of Neurosurgery Shanghai China
| | - Shuangnian Xu
- Department of Hematology Southwest Hospital Army Medical University Chongqing China
| | - Xiaojing Yan
- Department of Hematology The First Affiliated Hospital of China Medical University Shenyang China
| | - Quan Zheng
- Center for Single-Cell Omics School of Public Health Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Yi-Ping Wang
- Fudan University Shanghai Cancer Center Key Laboratory of Breast Cancer in Shanghai Shanghai Key Laboratory of Radiation Oncology Cancer Institute and The Shanghai Key Laboratory of Medical Epigenetics Institutes of Biomedical Sciences Shanghai Medical College Fudan University Shanghai China.,Department of Oncology Shanghai Medical College Fudan University Shanghai China.,The International Co-laboratory of Medical Epigenetics and Metabolism Ministry of Science and Technology Shanghai China
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The Menace of Candida auris Epidemic Amidst the COVID-19 Pandemic: A Systematic Review. Diseases 2022; 10:diseases10030058. [PMID: 36135214 PMCID: PMC9497911 DOI: 10.3390/diseases10030058] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/13/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the causative agent for the Coronavirus Disease 2019 (COVID-19) pandemic, has sparked a medical emergency worldwide. With the rise in COVID-19 infections and an eventual increase in hospitalized critically ill patients, a trend of bacterial, fungal, and viral superinfection has been noted. One important agent of co-infection identified is Candida auris. Due to its multidrug-resistant nature and easy transmissibility, C. auris is difficult to manage in COVID-positive patients. Patients with comorbidities, immunosuppressive states, intubated and on ventilators are more likely to contract the fungal infection. Therefore, it is essential to the first screen, diagnose, and isolate patients with C. auris infection and manage and treat them while preventing the spread of the disease. Failure to recognize and prevent its spread may lead to an eventual epidemic or even a pandemic during the current COVID-pandemic, which the exhausted healthcare system can most definitely not handle. This systematic review investigates the prevalence of C. auris, its pathophysiology, diagnosis, prevention, and treatment during the COVID-19 pandemic.
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Tracing, Tracking and Treating COVID-19 Associated Rhino-Orbito Cerebral Mucormycosis (ROCM). Indian J Otolaryngol Head Neck Surg 2022; 74:3304-3312. [PMID: 35999950 PMCID: PMC9387887 DOI: 10.1007/s12070-022-03134-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 07/10/2022] [Indexed: 01/08/2023] Open
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Celis Camargo AM, Jay Romero JA, Pizarro Nieto GA, Reyes Lobo A, Comincini Cantillo E. COVID-19 y rinosinusitis invasiva aguda secundaria a mucormicosis: a propósito de 2 casos en Colombia. REPERTORIO DE MEDICINA Y CIRUGÍA 2022. [DOI: 10.31260/repertmedcir.01217372.1359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introducción: la mucormicosis es una infección micótica poco frecuente, también conocida como zigomicosis o phycomycosis, de baja prevalencia, pero con alta mortalidad, por lo regular ocasionada por estados de inmunosupresión como los que ocurren después de infecciones por COVID-19, teniendo esta asociación patológica una alta tasa de mortalidad y secuelas en la salud de los que la padecen. Presentación de los casos: son dos casos de mucormicosis rinocerebral asociados con COVID-19 y se describen el manejo y los desenlaces.
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Antifungal therapy in the management of fungal secondary infections in COVID-19 patients: A systematic review and meta-analysis. PLoS One 2022; 17:e0271795. [PMID: 35901069 PMCID: PMC9333218 DOI: 10.1371/journal.pone.0271795] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives The prevalence of fungal secondary infections among COVID-19 patients and efficacy of antifungal therapy used in such patients is still unknown. Hence, we conducted this study to find the prevalence of fungal secondary infections among COVID-19 patients and patient outcomes in terms of recovery or all-cause mortality following antifungal therapy (AFT) in such patients. Methods We performed a comprehensive literature search in PubMed®, Scopus®, Web of Sciences™, The Cochrane Library, ClinicalTrial.gov, MedRxiv.org, bioRxiv.org, and Google scholar to identify the literature that used antifungal therapy for the management fungal secondary infections in COVID-19 patients. We included case reports, case series, prospective & retrospective studies, and clinical trials. Mantel Haenszel random-effect model was used for estimating pooled risk ratio for required outcomes. Results A total of 33 case reports, 3 case series, and 21 cohort studies were selected for final data extraction and analysis. The prevalence of fungal secondary infections among COVID-19 patients was 28.2%. Azoles were the most commonly (65.1%) prescribed AFT. Study shows that high survival frequency among patients using AFT, received combination AFT and AFT used for >28 days. The meta-analysis showed, no significant difference in all-cause mortality between patients who received AFT and without AFT (p = 0.17), between types of AFT (p = 0.85) and the duration of AFT (p = 0.67). Conclusion The prevalence of fungal secondary infections among COVID-19 patients was 28.2%. The survival frequency was high among patients who used AFT for fungal secondary infections, received combination AFT and AFT used for >28 days. However, meta-analysis results found that all-cause mortality in COVID-19 patients with fungal secondary infections is not significantly associated with type and duration of AFT, mostly due to presence of confounding factors such as small number of events, delay in diagnosis of fungal secondary infections, presence of other co-infections and multiple comorbidities.
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Seyedjavadi SS, Bagheri P, Nasiri MJ, Razzaghi-Abyaneh M, Goudarzi M. Fungal Infection in Co-infected Patients With COVID-19: An Overview of Case Reports/Case Series and Systematic Review. Front Microbiol 2022; 13:888452. [PMID: 35875562 PMCID: PMC9298665 DOI: 10.3389/fmicb.2022.888452] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/03/2022] [Indexed: 01/08/2023] Open
Abstract
Fungal co-infections are frequent in patients with coronavirus disease 2019 (COVID-19) and can affect patient outcomes and hamper therapeutic efforts. Nonetheless, few studies have investigated fungal co-infections in this population. This study was performed to assess the rate of fungal co-infection in patients with COVID-19 as a systematic review. EMBASE, MEDLINE, and Web of Science were searched considering broad-based search criteria associated with COVID-19 and fungal co-infection. We included case reports and case series studies, published in the English language from January 1, 2020 to November 30, 2021, that reported clinical features, diagnosis, and outcomes of fungal co-infection in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Totally, 54 case reports and 17 case series were identified, and 181 patients (132 men, 47 women, and 2 not mentioned) co-infected with COVID-19 and fungal infection enrolled. The frequency of fungal co-infection among patients with COVID-19 was 49.7, 23.2, 19.8, 6.6, and 0.5% in Asia, America, Europe, Africa, and Australia, respectively. Diabetes (59.6%) and hypertension (35.9%) were found as the most considered comorbidities in COVID-19 patients with fungal infections. These patients mainly suffered from fever (40.8%), cough (30.3%), and dyspnea (23.7%). The most frequent findings in the laboratory results of patients and increase in C-reactive protein (CRP) (33.1%) and ferritin (18.2%), and lymphopenia (16%) were reported. The most common etiological agents of fungal infections were Aspergillus spp., Mucor spp., Rhizopus spp., and Candida spp. reported in study patients. The mortality rate was 54.6%, and the rate of discharged patients was 45.3%. Remdesivir and voriconazole were the most commonly used antiviral and antifungal agents for the treatment of patients. The global prevalence of COVID-19-related deaths is 6.6%. Our results showed that 54.6% of COVID-19 patients with fungal co-infections died. Thus, this study indicated that fungal co-infection and COVID-19 could increase mortality. Targeted policies should be considered to address this raised risk in the current pandemic. In addition, fungal infections are sometimes diagnosed late in patients with COVID-19, and the severity of the disease worsens, especially in patients with underlying conditions. Therefore, patients with fungal infections should be screened regularly during the COVID-19 pandemic to prevent the spread of the COVID-19 patients with fungal co-infection.
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Affiliation(s)
| | - Parmida Bagheri
- Department of Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
| | - Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Goudarzi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Miryala SK, Anbarasu A, Ramaiah S. Organ-specific host differential gene expression analysis in systemic candidiasis: A systems biology approach. Microb Pathog 2022; 169:105677. [PMID: 35839997 PMCID: PMC9283004 DOI: 10.1016/j.micpath.2022.105677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 12/19/2022]
Abstract
Patients admitted to the hospital with coronavirus disease (COVID-19) are at risk for acquiring mycotic infections in particular Candidemia. Candida albicans (C. albicans) constitutes an important component of the human mycobiome and the most common cause of invasive fungal infections. Invasive yeast infections are gaining interest among the scientific community as a consequence of complications associated with severe COVID-19 infections. Early identification and surveillance for Candida infections is critical for decreasing the COVID-19 mortality. Our current study attempted to understand the molecular-level interactions between the human genes in different organs during systematic candidiasis. Our research findings have shed light on the molecular events that occur during Candidiasis in organs such as the kidney, liver, and spleen. The differentially expressed genes (up and down-regulated) in each organ will aid in designing organ-specific therapeutic protocols for systemic candidiasis. We observed organ-specific immune responses such as the development of the acute phase response in the liver; TGF-pathway and genes involved in lymphocyte activation, and leukocyte proliferation in the kidney. We have also observed that in the kidney, filament production, up-regulation of iron acquisition mechanisms, and metabolic adaptability are aided by the late initiation of innate defense mechanisms, which is likely related to the low number of resident immune cells and the sluggish recruitment of new effector cells. Our findings point to major pathways that play essential roles in specific organs during systemic candidiasis. The hub genes discovered in the study can be used to develop novel drugs for clinical management of Candidiasis.
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Affiliation(s)
- Sravan Kumar Miryala
- Medical and Biological Computing Laboratory, School of Biosciences and Technology Vellore Institute of Technology (VIT), Vellore, 632014, Tamil Nadu, India
| | - Anand Anbarasu
- Medical and Biological Computing Laboratory, School of Biosciences and Technology Vellore Institute of Technology (VIT), Vellore, 632014, Tamil Nadu, India
| | - Sudha Ramaiah
- Medical and Biological Computing Laboratory, School of Biosciences and Technology Vellore Institute of Technology (VIT), Vellore, 632014, Tamil Nadu, India.
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Nazari T, Sadeghi F, Izadi A, Sameni S, Mahmoudi S. COVID-19-associated fungal infections in Iran: A systematic review. PLoS One 2022; 17:e0271333. [PMID: 35816494 PMCID: PMC9273100 DOI: 10.1371/journal.pone.0271333] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/29/2022] [Indexed: 12/17/2022] Open
Abstract
Objectives
This systematic review aims to summarize the mycological and clinical features of COVID-19-associated fungal infections (CAFIs) in Iran.
Methods
PubMed, Web of Science, Scopus, Cochrane Library, SID, Magiran, IranDoc, and Google Scholar were searched for Persian and English articles published from January 1, 2020, to November 5, 2021, using a systematic search strategy. Studies on Iranian patients suffering from CAFIs were included in the review.
Results
Twenty-two studies comprising 169 patients were retrieved. Reported CAFIs included candidiasis (85, 50.30%), mucormycosis (35, 20.71%), aspergillosis (29, 17.16%), fusariosis (6, 3.55%), three cases caused by rare pathogens (Rhodotorula mucilaginosa, Diaporthe foeniculina, and Sarocladium kiliense) and 11 (6.51%) uncharacterized mold infections. The most common underlying diseases were diabetes (67/168, 39.88%), cardiovascular diseases (55/168, 32.74%), and hypertension (43/168, 25.59%). The use of antibiotics (111/124, 89.52%), corticosteroids (93/132, 70.44%), and mechanical ventilation (66, 51.16%) were the most common predisposing factors. Totally, 72 (50.35%) of 143 patients with CAFIs died (data were not available for 26 patients).
Conclusion
Fungal infections are evident to be a complication of COVID-19 in Iran; thus, clinicians should consider them as a differential diagnosis, especially in patients with comorbidities and previous antibiotic or corticosteroid use.
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Affiliation(s)
- Tina Nazari
- Department of Medical Geriatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadeghi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Izadi
- Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Setayesh Sameni
- Department of Medical Sciences, Shahrood Branch, Islamic Azad University, Shahrood, Iran
| | - Shahram Mahmoudi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- * E-mail: ,
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Avkan-Oğuz V, Çelİk M, Eren-Kutsoylu OÖ, Nazli A, Uğur YL, Taylan A, Ergan B, Irmak Ç, Duğral E, Özkütük AA. Fungal colonization and infections in patients with COVID-19 in intensive care units: A real-life experience at a tertiary-care hospital. Respir Med Res 2022; 82:100937. [PMID: 35792466 PMCID: PMC9249560 DOI: 10.1016/j.resmer.2022.100937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE To evaluate the management of patients with COVID-19 in the intensive care units (ICUs) with fungal infection/colonization and to highlight diagnostic problems in these patients. METHODS We included all patients with a COVID-19 diagnosis who were aged ≥18 years and followed in the ICU for the first 8 months. Patient data were obtained from medical records. We compared the risk factors, laboratory data, and outcomes of patients with fungal infection/colonization. RESULTS A total of 118 patients (81 men and 37 women) were included. The mean age was 70.3 ± 14.8 (35-94) years. Of the patients, 79 (66.9%) patients were ≥65 years old. Fungal infection/colonization was detected in 39 (33.1%) patients. Fungi were isolated from 34 (28.8%) patients. Ten fungal species were isolated from 51 samples (the most common being Candida albicans). Three patients (2.5%) had proven candidemia. We observed two (1.7%) possible cases of COVID-19-associated pulmonary aspergillosis (CAPA). Eighteen patients (15.3%) underwent antifungal therapy. The risk of fungal infection/colonization increased as the duration of invasive mechanical ventilation increased. The fatality rate was 61.9% and increased with age and the use of mechanical ventilation. The fatality rate was 4.2-times-higher and the use of mechanical ventilation was 35.9-times-higher in the patients aged ≥65 years than in the patients aged <65 years. No relationship was found between fungal colonization/infection, antifungal treatment, and the fatality rate. CONCLUSION During the pandemic, approximately one-third of the patients in ICUs exhibited fungal infection/colonization. Candida albicans was the most common species of fungal infection as in the pre-pandemic area. Because of the cross-contamination risk, we performed diagnostic bronchoscopy and control thorax computed tomography during the ICU stay, and our patients mainly received empirical antifungal therapy.
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Affiliation(s)
- Vildan Avkan-Oğuz
- Dokuz Eylul University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Turkey.
| | - Muammer Çelİk
- Dokuz Eylul University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Oya Özlem Eren-Kutsoylu
- Dokuz Eylul University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Arzu Nazli
- Dokuz Eylul University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Yasin Levent Uğur
- Dokuz Eylul University Faculty of Medicine, Department of Anesthesiology and Reanimation, Turkey
| | - Abdullah Taylan
- Dokuz Eylul University Faculty of Medicine, Department of Radiology, Turkey
| | - Begüm Ergan
- Dokuz Eylul University Faculty of Medicine, Department of Pulmonary Diseases, Turkey
| | - Çağlar Irmak
- Dokuz Eylul University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Esra Duğral
- Dokuz Eylul University Faculty of Medicine, Health Sciences Institute / Deputy Chief Physician, Turkey
| | - A Aydan Özkütük
- Dokuz Eylul University Faculty of Medicine, Department of Medical Microbiology, Turkey
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Schier C, Foerster (née Reiter) J, Heupel M, Dörner P, Klaas M, Schröder W, Rink L, Slusarenko AJ, Gruhlke MCH. Allicin as a Volatile or Nebulisable Antimycotic for the Treatment of Pulmonary Mycoses: In Vitro Studies Using a Lung Flow Test Rig. Int J Mol Sci 2022; 23:ijms23126607. [PMID: 35743050 PMCID: PMC9224539 DOI: 10.3390/ijms23126607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/29/2022] Open
Abstract
Fungal infections of the lung are an increasing problem worldwide and the search for novel therapeutic agents is a current challenge due to emerging resistance to current antimycotics. The volatile defence substance allicin is formed naturally by freshly injured garlic plants and exhibits broad antimicrobial potency. Chemically synthesised allicin was active against selected fungi upon direct contact and via the gas phase at comparable concentrations to the pharmaceutically used antimycotic amphotericin B. We investigated the suppression of fungal growth by allicin vapour and aerosols in vitro in a test rig at air flow conditions mimicking the human lung. The effect of allicin via the gas phase was enhanced by ethanol. Our results suggest that allicin is a potential candidate for development for use in antifungal therapy for lung and upper respiratory tract infections.
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Affiliation(s)
- Christina Schier
- Department of Plant Physiology, RWTH Aachen University, 52074 Aachen, Germany; (A.J.S.); (M.C.H.G.)
- Correspondence:
| | | | - Monika Heupel
- Landwirtschaftskammer Rheinland, 50765 Köln-Auweiler, Germany;
| | - Philipp Dörner
- Chair of Fluid Mechanics and Institute of Aerodynamics, RWTH Aachen University, 52062 Aachen, Germany; (P.D.); (M.K.); (W.S.)
| | - Michael Klaas
- Chair of Fluid Mechanics and Institute of Aerodynamics, RWTH Aachen University, 52062 Aachen, Germany; (P.D.); (M.K.); (W.S.)
| | - Wolfgang Schröder
- Chair of Fluid Mechanics and Institute of Aerodynamics, RWTH Aachen University, 52062 Aachen, Germany; (P.D.); (M.K.); (W.S.)
| | - Lothar Rink
- Institute of Immunology, RWTH Aachen University Hospital, 52074 Aachen, Germany;
| | - Alan J. Slusarenko
- Department of Plant Physiology, RWTH Aachen University, 52074 Aachen, Germany; (A.J.S.); (M.C.H.G.)
- GENAWIF e.V.—Society for Natural Compound and Active Ingredient Research, 52070 Aachen, Germany;
| | - Martin C. H. Gruhlke
- Department of Plant Physiology, RWTH Aachen University, 52074 Aachen, Germany; (A.J.S.); (M.C.H.G.)
- GENAWIF e.V.—Society for Natural Compound and Active Ingredient Research, 52070 Aachen, Germany;
- Institute of Applied Microbiology—iAMB, Aachener Biology and Biotechnology—ABBt, RWTH Aachen University, 52074 Aachen, Germany
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Ali K, Salih SAM. Resurgence of mucormycosis during COVID-19 pandemic. ORAL AND MAXILLOFACIAL SURGERY CASES 2022; 8:100262. [PMID: 35634238 PMCID: PMC9126614 DOI: 10.1016/j.omsc.2022.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/20/2022] [Accepted: 05/16/2022] [Indexed: 01/27/2023] Open
Abstract
Objective To explore the literature on corona-associated mucormycosis and explain its relevance to dentists and oral surgeons. Methods A literature search was carried out to identify reported cases on corona-associated mucormycosis since the start of COVID-19 pandemic. Results A review of literature identified 265 published papers on CAM between March 2020 and September 2021. Careful screening of abstracts and full texts revealed 29 studies reporting case series of CAM and, 27 case reports on CAM. Conclusions A multitude of factors may be responsible for the alarming rise in the incidence of corona-associated mycosis including reduced access to routine medical services during the pandemic, injudicious use of antibiotics, steroids and nutritional supplements. Risk factors contributing to corona-associated mucormycosis need to be recognized. Dentists and oral surgeons can contribute to early recognition of corona-associated mucormycosis involving the maxilla, and palate. Prioritizing research focus on optimal management of mucormycosis may reduce the morbidity and mortality associated with this debilitating infection.
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Marena GD, Ramos MADS, Carvalho GC, Junior JAP, Resende FA, Corrêa I, Ono GYB, Sousa Araujo VH, Camargo BAF, Bauab TM, Chorilli M. Natural product‐based nanomedicine applied to fungal infection treatment: A review of the last 4 years. Phytother Res 2022; 36:2710-2745. [DOI: 10.1002/ptr.7460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/25/2022] [Accepted: 03/26/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Gabriel Davi Marena
- Department of Drugs and Medicines, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
- Department of Biological Sciences, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
| | - Matheus Aparecido dos Santos Ramos
- Department of Drugs and Medicines, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
- Department of Biological Sciences, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
| | - Gabriela Corrêa Carvalho
- Department of Drugs and Medicines, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
| | | | | | - Ione Corrêa
- Department of Biological Sciences, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
| | - Gabriela Yuki Bressanim Ono
- Department of Biological Sciences, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
| | - Victor Hugo Sousa Araujo
- Department of Drugs and Medicines, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
| | - Bruna Almeida Furquim Camargo
- Department of Drugs and Medicines, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
| | - Tais Maria Bauab
- Department of Biological Sciences and Health University of Araraquara (UNIARA) Araraquara Brazil
| | - Marlus Chorilli
- Department of Drugs and Medicines, School of Pharmaceutical Sciences São Paulo State University (UNESP) Araraquara Brazil
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Baten N, Wajed S, Talukder A, Masum MHU, Rahman MM. Coinfection of fungi with SARS-CoV-2 is a detrimental health risk for COVID-19 patients. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2022; 11:64. [PMID: 35529527 PMCID: PMC9066134 DOI: 10.1186/s43088-022-00245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
Background Notable fungal coinfections with SARS-CoV-2 in COVID-19 patients have been reported worldwide in an alarming way. Mucor spp. and Rhizopus spp. were commonly known as black fungi, whereas Aspergillus spp. and Candida spp. were designated as white fungi implicated in those infections. In this review, we focused on the global outbreaks of fungal coinfection with SARS-CoV-2, the role of the human immune system, and a detailed understanding of those fungi to delineate the contribution of such coinfections in deteriorating the health conditions of COVID-19 patients based on current knowledge. Main body Impaired CD4 + T cell response due to SARS-CoV-2 infection creates an opportunity for fungi to take over the host cells and, consequently, cause severe fungal coinfections, including candidiasis and candidemia, mucormycosis, invasive pulmonary aspergillosis (IPA), and COVID-19-associated pulmonary aspergillosis (CAPA). Among them, mucormycosis and CAPA have been reported with a mortality rate of 66% in India and 60% in Colombia. Moreover, IPA has been reported in Belgium, Netherlands, France, and Germany with a morbidity rate of 20.6%, 19.6%, 33.3%, and 26%, respectively. Several antifungal drugs have been applied to combat fungal coinfection in COVID-19 patients, including Voriconazole, Isavuconazole, and Echinocandins. Conclusion SARS-CoV-2 deteriorates the immune system so that several fungi could take that opportunity and cause life-threatening health situations. To reduce the mortality and morbidity of fungal coinfections, it needs immunity boosting, proper hygiene and sanitation, and appropriate medication based on the diagnosis.
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Cruzado Vega LL, Santos García A. SARS-CoV-2 and Aspergillus pneumonia in kidney transplantation: More frequent than we think? Nefrologia 2022; 42:359-360. [PMID: 36210623 PMCID: PMC9459420 DOI: 10.1016/j.nefroe.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 06/16/2023] Open
Affiliation(s)
| | - Alba Santos García
- Sección de Nefrología, Hospital General Universitario de Elche, Elche, Spain
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Madrigal-Aguilar DA, Gonzalez-Silva A, Rosales-Acosta B, Bautista-Crescencio C, Ortiz-Álvarez J, Escalante CH, Sánchez-Navarrete J, Hernández-Rodríguez C, Chamorro-Cevallos G, Tamariz J, Villa-Tanaca L. Antifungal Activity of Fibrate-Based Compounds and Substituted Pyrroles That Inhibit the Enzyme 3-Hydroxy-methyl-glutaryl-CoA Reductase of Candida glabrata (CgHMGR), Thus Decreasing Yeast Viability and Ergosterol Synthesis. Microbiol Spectr 2022; 10:e0164221. [PMID: 35377226 PMCID: PMC9045318 DOI: 10.1128/spectrum.01642-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/04/2022] [Indexed: 12/24/2022] Open
Abstract
Due to the emergence of multidrug-resistant strains of yeasts belonging to the Candida genus, there is an urgent need to discover antifungal agents directed at alternative molecular targets. The aim of the current study was to evaluate the capacity of three different series of synthetic compounds to inhibit the Candida glabrata enzyme denominated 3-hydroxy-methyl-glutaryl-CoA reductase and thus affect ergosterol synthesis and yeast viability. Compounds 1c (α-asarone-related) and 5b (with a pyrrolic core) were selected as the best antifungal candidates among over 20 synthetic compounds studied. Both inhibited the growth of fluconazole-resistant and fluconazole-susceptible C. glabrata strains. A yeast growth rescue experiment based on the addition of exogenous ergosterol showed that the compounds act by inhibiting the mevalonate synthesis pathway. A greater recovery of yeast growth occurred for the C. glabrata 43 fluconazole-resistant (versus fluconazole-susceptible) strain and after treatment with 1c (versus 5b). Given that the compounds decreased the concentration of ergosterol in the yeast strains, they probably target ergosterol synthesis. According to the docking analysis, the inhibitory effect of 1c and 5b could possibly be mediated by their interaction with the amino acid residues of the catalytic site of the enzyme. Since 1c displayed higher binding energy than α-asarone and 5b, it is the best candidate for further research, which should include structural modifications to increase its specificity and potency. The derivatives could then be examined with in vivo animal models using a therapeutic dose. IMPORTANCE Within the context of the COVID-19 pandemic, there is currently an epidemiological alert in health care services due to outbreaks of Candida auris, Candida glabrata, and other fungal species multiresistant to conventional antifungals. Therefore, it is important to propose alternative molecular targets, as well as new antifungals. The three series of synthetic compounds herein designed and synthesized are inhibitors of ergosterol synthesis in yeasts. Of the more than 20 compounds studied, two were selected as the best antifungal candidates. These compounds were able to inhibit the growth and synthesis of ergosterol in C. glabrata strains, whether susceptible or resistant to fluconazole. The rational design of antifungal compounds derived from clinical drugs (statins, fibrates, etc.) has many advantages. Future studies are needed to modify the structure of the two present test compounds to obtain safer and less toxic antifungals. Moreover, it is important to carry out a more in-depth mechanistic approach.
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Affiliation(s)
- Damián A. Madrigal-Aguilar
- Departamento de Química Orgánica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Adilene Gonzalez-Silva
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Blanca Rosales-Acosta
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Celia Bautista-Crescencio
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Jossué Ortiz-Álvarez
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Carlos H. Escalante
- Departamento de Química Orgánica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | | | - César Hernández-Rodríguez
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Germán Chamorro-Cevallos
- Departamento de Farmacia, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Joaquín Tamariz
- Departamento de Química Orgánica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Lourdes Villa-Tanaca
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
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