Freshwater Fungal Infections

Diagnosis and Management of Severe Water-Related Skin and Soft Tissue Sepsis: A Summative Review of the Literature

BACKGROUND

Skin and soft tissue infections (SSTIs) are common presentations in the emergency department. However, this is less common after contact with contaminated saltwater or freshwater. This review presents the diagnosis and management of water-related soft tissue sepsis in this vulnerable and difficult-to-treat subgroup of necrotizing soft tissue sepsis.

METHODS

A summative literature overview is presented regarding bacterial and fungal SSTI after contact with contaminated water, with practical diagnostic and management aspects.

RESULTS

The literature indicates that these wounds and infections remain difficult to treat. An approach using appropriate diagnostic tools with both medical and surgical management strategies is provided.

CONCLUSIONS

SSTIs due to water contamination of wounds involve unusual organisms with unusual resistance patterns, and require a nuanced and directed diagnostic approach with an adaptation of the usual antibiotic or antifungal selection to achieve a successful cure, along with aggressive debridement and wound care.

Green Synthesis of Silver Nanoparticles Using Acacia ehrenbergiana Plant Cortex Extract for Efficient Removal of Rhodamine B Cationic Dye from Wastewater and the Evaluation of Antimicrobial Activity

Silver nanoparticles (Ag-NPs) exhibit vast potential in numerous applications, such as wastewater treatment and catalysis. In this study, we report the green synthesis of Ag-NPs using Acacia ehrenbergiana plant cortex extract to reduce cationic Rhodamine B (RhB) dye and for antibacterial and antifungal applications. The green synthesis of Ag-NPs involves three main phases: activation, growth, and termination. The shape and morphologies of the prepared Ag-NPs were studied through different analytical techniques. The results confirmed the successful preparation of Ag-NPs with a particle size distribution ranging from 1 to 40 nm. The Ag-NPs were used as a heterogeneous catalyst to reduce RhB dye from aqueous solutions in the presence of sodium borohydride (NaBH₄). The results showed that 96% of catalytic reduction can be accomplished within 32 min using 20 μL of 0.05% Ag-NPs aqueous suspension in 100 μL of 1 mM RhB solution, 2 mL of deionized water, and 1 mL of 10 mM NaBH₄ solution. The results followed a zero-order chemical kinetic (R² = 0.98) with reaction rate constant k as 0.059 mol L^-1 s^-1. Furthermore, the Ag-NPs were used as antibacterial and antifungal agents against 16 Gram-positive and Gram-negative bacteria as well as 1 fungus. The green synthesis of Ag-NPs is environmentally friendly and inexpensive, as well as yields highly stabilized nanoparticles by phytochemicals. The substantial results of catalytic reductions and antimicrobial activity reflect the novelty of the prepared Ag-NPs. These nanoparticles entrench the dye and effectively remove the microorganisms from polluted water.

Porphyrins developed for photoinactivation of microbes in wastewater

Photodynamic antimicrobial chemotherapy (PACT) is extensively studied as a strategic method to inactivate pathogenic microbes in wastewater for addressing the limitations associated with chlorination, ozonation, and ultraviolet irradiation as disinfection methods, which generally promote the development of resistant genes and harmful by-products such as trihalomethanes. PACT is dependent on photons, oxygen, and a photosensitizer to induce cytotoxic effects on various microbes by generating reactive oxygen species. Photosensitizers such as porphyrins have demonstrated significant microbial inactivation through PACT, hence now explored for wastewater phototreatment. This review aims to evaluate the efficacy of porphyrins and porphyrin-conjugates as photosensitizers for wastewater photoinactivation. Concerns relating to the application of photosensitizers in water treatment are also evaluated. This includes recovery and reuse of the photosensitizer when immobilized on solid supports.

Antifungal agents, yeast abundance and diversity in surface water: Potential risks to water users

South African surface waters are subject to various forms of pollution. Recent findings in aquatic systems suggest an association exists between yeast diversity, chemical pollutants and land coverage, which are important water quality determinants. Yeast abundance and diversity, as well as antifungal agents in two river systems in South Africa, were investigated and related to the existing land coverage. Yeast abundance and diversity were determined from environmental DNA by quantitative polymerase chain reaction and next-generation sequencing, respectively, of the 26S ribosomal ribonucleic acid (rRNA) gene. Antifungal agents were qualitatively and/or quantitatively detected by ultra-high-pressure liquid chromatography-mass spectrometry. Analyses of 2 031 714 high-quality 26S rRNA sequences yielded 5554 amplicon sequence variants (ASVs)/species. ASV richness and Shannon-Wiener index of diversity reflected the southward flow of the river with higher values observed downstream compared to the upstream. Fluconazole concentrations were quantifiable in only two samples; 178 and 271 ng L^-1. Taxonomically, at least 20 yeast species were detected, including the dominant Candida tropicalis, Cryptococcus spp. as well as the lesser dominant Bensingtonia bomiensis, Fereydounia khargensis, Hericium erinaceus, Kondoa changbaiensi, Pseudozyma spp. and Sphacelotheca pamparum. The two dominant species are known opportunistic pathogens which had antifungal resistant traits in previous studies from the same rivers and therefore is a public health threat. The present study provides further evidence that yeasts should be included as part of water quality parameters, especially in developing countries where much of the population are economically disadvantaged, and also immunocompromised due to age and disease.

The occurrence of potentially pathogenic filamentous fungi in recreational surface water as a public health risk

Microfungi occurring in surface water may represent an important health risk. Recreational water reservoirs are a potential reservoir of pathogenic fungi. The aim of the study was to assess the diversity of mycobiota in selected artificial bathing reservoirs with regard to its biosafety for the human population. The studies were conducted during the summer of 2016 in three research seasons (June (I), July and August (II), and September (III)), taking into account the various periods of recreational activities. Filamentous fungi were isolated from water samples collected at five different ponds utilized for recreation. From 162 water samples, 149 fungal taxa of filamentous fungi were identified: 140 were classified to species level and only nine to genus level. Aspergillus fumigatus was the dominant species. The highest species richness (S) was noted in June, with 93 fungal taxa (Menhinick's index from 2.65 to 4.49). Additionally, in season I, the highest diversity of fungal species was revealed (Simpson's diversity index from 0.83 to 0.99). The average number of CFU/1 mL sample ranged between 0.4 and 4.6 depending on the time of sampling and ponds. Of all the isolated species, 128 were clinically relevant (11 from RG-2 and 117 from RG-1), highlighting the need to introduce seasonal mycological monitoring of such reservoirs.

Exposure to Aspergillus in Home and Healthcare Facilities' Water Environments: Focus on Biofilms

Aspergillus conida are ubiquitous in the environment, including freshwater, water for bathing, and in drinking water. Vulnerable patients and those suffering from allergic diseases are susceptible to aspergillosis. Avoidance of Aspergillus is of paramount importance. Potential outbreaks of aspergillosis in hospital facilities have been described where the water supply has been implicated. Little is known regarding the risk of exposure to Aspergillus in water. How does Aspergillus survive in water? This review explores the biofilm state of Aspergillus growth based on recent literature and suggests that biofilms are responsible for the persistence of Aspergillus in domestic and healthcare facilities' water supplies.