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Shu F, Pruksaphon K, Nosanchuk JD, Thammasit P, Youngchim S. Evaluation of the yeast phase-specific monoclonal antibody 4D1 and Galanthus nivalis agglutinin sandwich ELISA to detect Talaromyces marneffei antigen in human urine. Front Cell Infect Microbiol 2023; 13:1163868. [PMID: 37705932 PMCID: PMC10495985 DOI: 10.3389/fcimb.2023.1163868] [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: 02/11/2023] [Accepted: 08/04/2023] [Indexed: 09/15/2023] Open
Abstract
Talaromyces (Penicillium) marneffei (TM) is an important, but neglected, thermally dimorphic fungus. It is the pathogenic cause of talaromycosis, which is strongly associated with the immunodeficiency state present in individuals with advanced HIV disease. The purpose of this study was to develop a sandwich enzyme-linked immunosorbent assay (sandwich ELISA) for the detection of T. marneffei cytoplasmic yeast antigen (TM CYA) in human urine. Monoclonal antibody (MAb) 4D1 specifically binds to TM CYA. Galanthus nivalis agglutinin (GNA), a mannose -binding lectin, recognizes and binds to mannose residues of TM CYA. For the sandwich ELISA, the microplate was coated with GNA as the capturing molecule for absorbing immune complexes of MAb 4D1-TM CYA. The MAb 4D1-GNA sandwich ELISA did not detect a cross-reaction with other antigens from other fungi or bacteria. Seventy-four urine samples from patients with blood culture -confirmed talaromycosis and 229 urine samples from people without talaromycosis residing in the endemic area were subjected to the MAb 4D1-GNA sandwich ELISA. At an optical density (OD) cutoff value of 0.356, the sensitivity was 89.19% [95% confidence interval (CI): 79.80% -95.22%]; the specificity was 98.69% (95% CI: 96.22% -99.73%). The diagnostic performance of the MAb 4D1-GNA sandwich ELISA was highly consistent with those of blood culture and the Platelia Aspergillus galactomannan (GM) ELISA kit. Collectively, the MAb 4D1-GNA sandwich ELISA is a promising technique for the rapid diagnosis of T. marneffei infection, which would facilitate the early treatment of patients with talaromycosis and it may be used to monitor treatment responses.
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Affiliation(s)
- Fangyi Shu
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Anatomy, Youjiang Medical University for Nationalities, Baise, China
| | - Kritsada Pruksaphon
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Joshua D. Nosanchuk
- Department of Medicine (Infectious Diseases), Albert Einstein College of Medicine, Bronx, NY, United States
| | - Patcharin Thammasit
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirida Youngchim
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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He J, Li JS, Xu HY, Kuang YQ, Li J, Li HB, Li Z, Zhou HL, Wang RR, Li YY. A Reliable Murine Model of Disseminated Infection Induced by Talaromyces Marneffei. Mycopathologia 2021; 187:53-64. [PMID: 34743276 DOI: 10.1007/s11046-021-00596-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022]
Abstract
Talaromycosis (penicilliosis) caused by Talaromyces marneffei is one of the most important opportunistic infection diseases in tropical countries of South and Southeast Asia. Most infections occurred in individuals with human immunodeficiency virus (HIV) and the primarily reason for the increase in the number of the cases is HIV pandemic. The pathogenesis of T. marneffei infection is unclear. There is still no ideal animal model for studying talaromycosis. In this study, we developed a stable, safe and maneuverable murine model that mimics human T. marneffei disseminated infection using T. marneffei yeast intraperitoneal injected to BALB/c nude mice. We successfully observed symptoms similar to those seen in clinical patients in this murine model, including skin lesions, hepatosplenomegaly, pulmonary infection and mesenteric lesions. We further studied the pathological changes of various tissues and organs in the infected animals to help better understand the severity of the infection. This model may provide a good tool for studying disseminated infection induced by T. marneffei.
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Affiliation(s)
- Juan He
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Jia-Sheng Li
- College of Chinese Materia Medica, Yunnan University of Chinese Medicine, 1076 Yuhua Road, Chenggong, Kunming, 650500, Yunnan, China
| | - Hong-Yan Xu
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Yi-Qun Kuang
- NHC Key Laboratory of Drug Addiction Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Medical University, Kunming, 650032, China
| | - Jun Li
- College of Chinese Materia Medica, Yunnan University of Chinese Medicine, 1076 Yuhua Road, Chenggong, Kunming, 650500, Yunnan, China
| | - Hong-Bin Li
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Zhe Li
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Hui-Ling Zhou
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Rui-Rui Wang
- College of Chinese Materia Medica, Yunnan University of Chinese Medicine, 1076 Yuhua Road, Chenggong, Kunming, 650500, Yunnan, China.
| | - Yu-Ye Li
- Department of Dermatology and Venereology, First Affiliated Hospital of Kunming Medical University, 295 Xichang Road, Kunming, 650032, Yunnan, China.
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Li Y, Tang M, Sun S, Hu Q, Deng S. Successful treatment of Talaromyces marneffei infection in a kidney transplant recipient with voriconazole followed by itraconazole for the first time. J Mycol Med 2021; 32:101214. [PMID: 34763148 DOI: 10.1016/j.mycmed.2021.101214] [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: 05/19/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022]
Abstract
Talaromyces (Penicillium) marneffei (T. marneffei) is an important pathogenic thermally dimorphic fungus in Southeast Asia that leads to a life-threatening systemic mycosis in immunodeficient hosts, especially in AIDS patients. With the increasing AIDS epidemic, the number of patients with T. marneffei infections in mainland China has increased rapidly in recent years. The infection can be life-threatening in people with immunodeficiencies, such as HIV, organ transplantations, autoimmune diseases, and malignant tumors. Here, we present a disseminated T. marneffei infection case in a renal transplant recipient successfully treated with voriconazole followed by itraconazole. We describe the patient's clinical progression from onset symptoms to recovery and review the additional 14 published cases with T. marneffei infections in renal transplant recipients. In addition, we discuss the route of infection and treatment strategies of T. marneffei. Our data suggest that patients with kidney transplantations in T. marneffei infection-endemic areas should presume the possibility of infection and initiate appropriate antifungal treatment.
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Affiliation(s)
- Yunfei Li
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Mimi Tang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China; Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Shusen Sun
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China; Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Western New England University, Springfeld, MA 01119, USA
| | - Qin Hu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China; Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Sheng Deng
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China; Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China.
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Ying RS, Le T, Cai WP, Li YR, Luo CB, Cao Y, Wen CY, Wang SG, Ou X, Chen WS, Chen SZ, Guo PL, Chen M, Guo Y, Tang XP, Li LH. Clinical epidemiology and outcome of HIV-associated talaromycosis in Guangdong, China, during 2011-2017. HIV Med 2020; 21:729-738. [PMID: 33369035 PMCID: PMC7978497 DOI: 10.1111/hiv.13024] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Talaromycosis is an invasive mycosis endemic to Southeast Asia. This study aimed to investigate the epidemiology, clinical features and prognostic factors of HIV-associated talaromycosis in Guangdong, China. METHODS We retrospectively evaluated HIV patients hospitalized with histopathology- or culture-confirmed talaromycosis between 2011 and 2017. Factors associated with poor prognosis were identified using logistic regression. RESULTS Overall, 1079 patients with HIV-associated talaromycosis were evaluated. Both the number and prevalence of talaromycosis among HIV admissions increased from 125 and 15.7% in 2011 to 253 and 18.8% in 2017, respectively, reflecting the increase in HIV admissions. Annual admissions peaked during the rainy season between March and August. Common clinical manifestations included fever (85.6%), peripheral lymphadenopathy (72.3%), respiratory symptoms (60.8%), weight loss (49.8%), skin lesions (44.5%) and gastrointestinal symptoms (44.3%). Common laboratory abnormalities were hypoalbuminaemia (98.6%), anaemia (95.6%), elevated aspartate aminotransferase level (AST) (76.9%), elevated alkaline phosphatase level (55.8%) and thrombocytopenia (53.7%). The median CD4 count was 9 cells/μL. Talaromyces marneffei was isolated from blood and bone marrow cultures of 66.6% and 74.5% of patients, respectively. The rate increased to 86.6% when both cultures were performed concurrently. At discharge, 14% of patients showed worsening conditions or died. Leucocytosis, thrombocytopenia, elevated AST, total bilirubin, creatinine and azole monotherapy independently predicted poor prognosis. CONCLUSIONS The incidence of HIV-associated talaromycosis has increased in Guangdong with the high HIV burden in China. Skin lesions were seen in less than half of patients. Induction therapy with azole alone is associated with higher mortality. Findings from this study should help to improve treatment of the disease.
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Affiliation(s)
- R S Ying
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - T Le
- Division of Infectious Diseases and International Health, Duke University School of Medicine, Durham, NC, USA
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - W P Cai
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Y R Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - C B Luo
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Y Cao
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - C Y Wen
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - S G Wang
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - X Ou
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - W S Chen
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - S Z Chen
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - P L Guo
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - M Chen
- Hospital-Acquired Infection Control Department, Bijie Third People's Hospital, Bijie, China
| | - Y Guo
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - X P Tang
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - L H Li
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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