First case of superficial infection due to Naganishia albida (formerly Cryptococcus albidus) in Iran: A review of the literature

Cryptococcus albidus infected pulmonary mycosis with miliary nodules in CT imaging: Two case reports

We presented two cases of Cryptococcus albidus fungemia in men who were identified with millary nodules by chest computed tomography (CT). They present cough and fever, with no other abnormal physical examination. The patients were treated successfully with a week-long course of voriconazole tablets. Accurate microbiological diagnosis of NGS and effective therapy as antifungal treatment of voriconazole tablet are critical for C albidus infection. Total of 18 cases of C albidus infection cases were identified from 2000 years to now, eight of which were invasive C albidus infection, and ten were noninvasive infection. None died cases were reported in noninvasive infection.

Cutaneous Naganishia albida (Cryptococcus albidus) infection: a case report and literature review

Naganishia albida (Cryptococcus albidus) is considered saprophytic fungi, and is rarely reported as a human pathogen. Cutaneous infections caused by non-neoformans cryptococcus are rare. We describe a case of an immunocompetent older male with cutaneous cryptococcosis caused by Naganishia albida following skin trauma, and conduct a literature review in PubMed, Lilacs, and Embase. Only six previous similar reports were found. The seven cases (including ours) were widely distributed geographically (Brazil, the US, the UK, Hungary, South Korea, and Iran), all males, and their ages varied, ranging from 14 to 86 years. Four individuals had underlying skin diseases (Sezary Syndrome, psoriasis, and skin rash without etiology) plus potentially immunosuppressive underlying conditions (diabetes mellitus, kidney transplantation, and the use of etanercept, adalimumab, and methylprednisolone). Cutaneous presentation was polymorphic, with lesions characterized as warts, ulcers, plaques, and even macules. Two patients presented disseminated disease. Serum cryptococcal antigen was negative in six patients, and diagnosis was made by fungal culture in all. There is a lack of data on optimal antifungal treatment and outcomes.

Monitoring of airborne fungi during the second wave of COVID-19 in selected wards of the referral university hospital in southeastern Iran

Microbiological monitoring of the air hospital is essential for prevention and control, due to the possible airborne route of infection transmission, especially in high-risk wards. This study aimed to monitor the airborne fungi during the second wave of the COVID-19 pandemic in selected wards of the biggest university educational hospital in Kerman, southeastern Iran. This study was conducted in 11 different wards, separated into the patient room and nursing station, of the Afzalipour hospital from May to August 2021. Fungal isolates were characterized to the species level by conventional and sequencing methods. Out of 93 obtained fungal colonies, 70 (75.3%) isolates were filamentous and 23 (24.7%) isolates were yeast. Aspergillus species were the predominant fungal isolates among the filamentous colonies (n=19; 27.1%), and Naganishia albida (formerly Cryptococcus albidus) was identified as the most common yeast isolate (n=13/23; 56.8%). The infectious ward was the most contaminated unit (n=19/93), while the least contaminated units were the neonatal intensive care unit (n=3/93), and oncology (n=3/93). The statistical findings displayed that the number of fungal isolates in patients' rooms is significantly higher than in nurses' stations (p-value=0.013). Our study demonstrated the presence of diverse fungal species in all wards of the hospital. Considering the presence of airborne fungi in hospitals and related public health problems is one of the critical issues for health systems management. In this regard, efficient monitoring of airborne fungi might play an influential role in hospital infection control and surveillance, particularly in high-risk hospitalization patients in critical wards.

Environmental Factors Affecting Diversity, Structure, and Temporal Variation of Airborne Fungal Communities in a Research and Teaching Building of Tianjin University, China

Airborne fungi are widely distributed in the environment and may have adverse effects on human health. A 12-month survey on the diversity and concentration of culturable airborne fungi was carried out in a research and teaching building of Tianjin University. Indoor and outdoor environments were analyzed using an HAS-100B air sampler. A total of 667 fungal strains, belonging to 160 species and 73 genera were isolated and identified based on morphological and molecular analysis. The most abundant fungal genera were Alternaria (38.57%), Cladosporium (21.49%), and Aspergillus (5.34%), while the most frequently appearing species was A. alternata (21%), followed by A. tenuissima (12.4%), and C. cladosporioides (9.3%). The concentration of fungi in different environments ranged from 0 to 150 CFU/m3 and was significantly higher outdoor than indoor. Temperature and sampling month were significant factors influencing the whole building fungal community, while relative humidity and wind speed were highly correlated with fungal composition outdoor. Variations in the relative abundance of major airborne fungal taxa at different heights above-ground could lead to different community structures at different floors. Our results may provide valuable information for air quality monitoring and microbial pollution control in university building environments.

Analysis of culturable airborne fungi in outdoor environments in Tianjin, China

Background

Fungal spores dispersed in the atmosphere may become cause of different pathological conditions and allergies for human beings. A number of studies have been performed to analyze the diversity of airborne fungi in different environments worldwide, and in particular in many urban areas in China. We investigated, for the first time, the diversity, concentration and distribution of airborne fungi in Tianjin city. We sampled 8 outdoor environments, using open plate method, during a whole winter season. Isolated fungi were identified by morphological and molecular analysis. Environmental factors which could influence the airborne fungi concentration (temperature, humidity, wind speed, and air pressure) were monitored and analyzed. The effect of different urban site functions (busy areas with high traffic flow and commercial activities vs. green areas) on airborne fungal diversity was also analyzed.

Results

A total of 560 fungal strains, belonging to 110 species and 49 genera of Ascomycota (80 %), Basidiomycota (18 %), and Mucoromycota (2 %) were isolated in this study. The dominant fungal genus was Alternaria (22 %), followed by Cladosporium (18.4 %), Naganishia (14.1 %), Fusarium (5.9 %), Phoma (4.11 %), and Didymella (4.8 %). A fungal concentration ranging from 0 to 3224.13 CFU m^− 3 was recorded during the whole study. Permutational multivariate analysis showed that the month was the most influential factor for airborne fungal community structure, probably because it can be regarded as a proxy of environmental variables, followed by wind speed. The two analyzed environments (busy vs. green) had no detectable effect on the air fungal community, which could be related to the relatively small size of parks in Tianjin and/or to the study season.

Conclusions

Our study shed light on the highly diverse community of airborne fungi characterizing the outdoor environments of Tianjin, and clarified the role that different environmental factors played in shaping the analyzed fungal community. The dominant presence of fungi with potential hazardous effect on human health, such as Alternaria, Cladosporium and Naganishia, deserves further attention. Our results may represent a valuable source of information for air quality monitoring, microbial pollution control, and airborne diseases prevention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12866-021-02205-2.

Evaluation of a rapid immunochromatographic test for the detection of Candida species from oropharyngeal samples

Oropharyngeal candidiasis is the most common opportunistic fungal infectious disease. Culture methods and microscopy are used to detect the presence of Candida species in clinical specimens. We have previously developed an immunochromatographic test (ICT) to enable the simple and rapid diagnosis of candidiasis. In this study, we evaluated the performance of the ICT for the detection of Candida species from pharyngeal swabs and compared the results with those of the culture method. The isolated Candida species were identified using polymerase chain reaction-restriction fragment length polymorphism, and viable cell counts were determined using selective chromogenic agar. The detection rate of C. albicans was 63.3% and 0% among ≤10² and ≥ 10⁶ colony-forming units (CFU)/mL of viable Candida cells from pharyngeal swabs, respectively. The detection rate of nonC. albicans Candida species, especially C. glabrata, increased commensurately from 16.7% at ≤10² CFU/mL to 75.0% at ≥10⁶ CFU/mL. Among the 300 pharyngeal swabs analyzed, 59 cultures detected Candida species at a count of >10³ CFU/mL (53 were ICT-positive). Of the remaining 241 culture-negative specimens, 219 were ICT-negative. The sensitivity, specificity, and accuracy of the ICT were 89.8%, 90.9%, and 90.7%, respectively. Taken together, the ICT evaluated can be made readily available for clinical use in detecting Candida.

Ecology of yeasts associated with kernels of several durum wheat genotypes and their role in co-culture with Saccharomyces cerevisiae during dough leavening

This work was performed to investigate on the yeast ecology of durum wheat to evaluate the interaction between kernel yeasts and the commercial baker's yeast Saccharomyces cerevisiae during dough leavening. Yeast populations were studied in 39 genotypes of durum wheat cultivated in Sicily. The highest level of kernel yeasts was 2.9 Log CFU/g. A total of 413 isolates was collected and subjected to phenotypic and genotypic characterization. Twenty-three yeast species belonging to 11 genera have been identified. Filobasidium oeirense, Sporobolomyces roseus and Aureobasidium pullulans were the species most commonly found in durum wheat kernels. Doughs were co-inoculated with yeasts isolated from wheat kernels and commercial Saccharomyces cerevisiae, in order to evaluate the interactions between yeasts and the leavening performance. Yeast populations of all doughs have been monitored as well as dough volume increase and weight loss (as CO₂) measured after 2 h of fermentation. The doughs whose final volume was higher than control dough (inoculated exclusively with S. cerevisiae) were those inoculated with Naganishia albida, Vishniacozyma dimennae (118 mL each), and Candida parapsilosis (102 mL). The weight losses were variable, depending on the co-culture used with S. cerevisiae and the values were in the range of 0.08-1.00 g CO₂/100 g. The kernel yeasts species C. parapsilosis, N. albida, P. terrestris, R. mucilaginosa and V. dimennae deserves future attention to be co-inoculated with the commercial starter S. cerevisiae in order to improve the sensory characteristics of bread.

Assaying the effect of yeasts on growth of fungi associated with disease

Background

Pathogenic fungi often cause serious infections mainly in immunocompromised persons. The number of infections caused by the non-albicans Candida or other species has significantly increased over the last years. These infections present a major challenge in the health sector because these pathogenic fungi have strong virulence and often show resistance to the commonly used antifungal treatments. To solve the problems caused by the drug resistant pathogenic fungi, it is necessary to find new antifungal agents and their sources. The aim of this study was to give evidence that yeasts can effectively fight against strains which belong to pathogenic fungi and reveal those yeasts which are able to inhibit growth of Kodamaea ohmeri, Pichia kudriavzevii, Naganishia albida or Candida tropicalis. Furthermore, we wanted to determine the effects of certain culturing factors on the growth inhibition.

Results

Our screening revealed that although the strains belonging to pathogenic species were much more tolerant to the yeast-produced bioactive agents than the non-disease-associated yeasts, growth of Kodamaea ohmeri and Candida tropicalis could be inhibited by Metschnikowia andauensis, while Naganishia albida could be controlled by Pichia anomala or Candida tropicalis. Our data proved that the experimental circumstances could have a serious impact on the inhibitory capacity of the yeasts. Appearance of inhibition strongly depended on media, pH and temperature. Our data also shed some light on the fact that Pichia kudriavzevii must have high natural resistance to the yeast-produced agents, while other species, such as Saccharomycopsis crataegensis belonged to the easily inhibitable species.

Conclusions

Our study suggests that yeast-produced bioactive agents could be potential growth inhibitory agents against the disease-associated fungi and yeasts can also contribute to alternative approaches to combat against pathogenic fungi. Our data revealed an important role of the culturing factors in inhibition and pointed to the complex nature of antagonism.

Draft Genome Sequences of Tremellomycetes Strains Isolated from the International Space Station

The draft genome sequences of six eukaryotic microbial strains belonging to the class Tremellomycetes isolated from the International Space Station were assembled. Further characterization of these sequences will aid in the understanding of the influence of microgravity conditions on these organisms’ potential pathogenicity.

The draft genome sequences of six eukaryotic microbial strains belonging to the class Tremellomycetes isolated from the International Space Station were assembled. Further characterization of these sequences will aid in the understanding of the influence of microgravity conditions on these organisms’ potential pathogenicity.

Vultures from different trophic guilds show distinct oral pathogenic yeast signatures and co-occurrence networks

Vultures have evolved adaptive mechanisms to prevent infections associated with their scavenging lifestyle. However, food-borne exposure to antimicrobial pharmaceuticals can promote opportunistic infections with adverse outcomes. Here, we used multivariate and network analyses to increase understanding of the behavior of the yeast communities causing oral mycosis outbreaks recently reported in wild nestling cinereous (Aegypius monachus), griffon (Gyps fulvus) and Egyptian (Neophron percnopterus) vultures (CV, GV and EV, respectively) exposed to antibiotics from livestock farming. Common and unique yeast signatures (of Candida, Debaromyces, Diutina, Meyerozyma, Naganishia, Pichia, Rhodotorula, Trichosporon and Yarrowia species) associated with oral mycoses were identified in the three vulture species. Hierarchical clustering analysis (HCA) and principal component analysis (PCA) highlighted that oral lesions from CV and GV shared similar yeast signatures (of major causative pathogens of opportunistic mycoses, such as Candida albicans, Candida parapsilosis and Candida tropicalis), while EV had a distinct yeast signature (of uncommon pathogenic species, such as Candida dubliniensis, Candida zeylanoides, Pichia fermentans and Rhodotorula spp.). Synergistic interactions between yeast species from distinct fungal phyla were found in lesions from CV and GV, but not in EV. These formed co-occurrence subnetworks with partially or fully connected topology. This study reveals that the composition, assembly and co-occurrence patterns of the yeast communities causing oral mycoses differ between vulture species with distinct feeding habits and scavenging lifestyles. Yeast species widely pathogenic to humans and animals, and yeast co-occurrence relationships, are distinctive hallmarks of oral mycoses in CV and GV. These vulture species are more exposed to antibiotics from intensively medicated livestock carcasses provided in supplementary feeding stations and show higher incidence of thrush-like oral lesions than EV. These findings may be useful for development of new initiatives or changes in the conservation of these avian scavengers affected by anthropogenic activities.

Fatal fungaemia due to Cryptococcus albidus in an elderly diabetic woman presenting with pleural effusion

This is a fatal case of fungaemia due to Cryptococcus albidus in an elderly woman with type 2 diabetes mellitus who presented pleural effusion as the only clinical presentation. Not only infections of the pleura are uncommon presentations of pulmonary cryptococcosis, but these infections due to non-C. neoformans species are extremely rare. This report places C. albidus on the growing number of disseminated mycosis-causing agents in diabetic patients.

Otomycosis Due to the Rare Fungi Talaromyces purpurogenus, Naganishia albida and Filobasidium magnum

Otomycosis is a common finding in otorhinolaryngology clinics and is usually caused by species of Candida and Aspergillus, particularly black aspergilli. Meanwhile, other fungi can give rise to this infection, and the identification of these requires accurate methods. Here, we report three cases of otomycosis due to rare fungal pathogens. All the patients were young females, and manipulation of the ear canal was identified as a common potentially predisposing factor. In direct examination, filamentous fungal elements (in one case) and yeast cells (in two other cases) were seen. Culture was positive in all cases. Based on PCR-sequencing of internal transcribed spacers and β-tubulin (for mold isolate), the isolated fungi were identified as Talaromyces purpurogenus, Naganishia albida and Filobasidium magnum. By susceptibility testing of the isolates to fluconazole, itraconazole, voriconazole and amphotericin B, the lowest minimum inhibitory concentration values were observed for amphotericin B followed by voriconazole. Patients were successfully treated by a combination of antifungals and corticosteroids with no relapse over the next year, except for the case due to F. magnum, in which, despite partial recovery, a course of relapse was reported in the 1-year follow-up call.

Cryptococcus albidus Fungemia in an Immunosuppressed Child: Case Report and Systematic Literature Review

Cryptococcus albidus, synonymous with Naganishia albida, rarely causes opportunistic infection in immunocompromised individuals. Its clinical features, particularly in children, are not well defined. Here, we report a case of C albidus fungemia in an immunosuppressed child; we also present results of a systematic review, for which we searched PubMed, Embase, and Web of Science using the keywords "cryptococcus" and "albidus." Our goal was to describe the spectrum of disease, diagnostic approaches, therapies, and outcomes. We identified 20 cases of invasive infection, only 2 of which involved children, and 7 cases of noninvasive infection. The reports originated in the Americas, Europe, and Asia. Of those with invasive infection, 16 (80%) patients had an underlying chronic disorder or had received immunosuppressive therapy, 8 (40%) had fungemia, and 6 (30%) had a central nervous system infection. The attributable case fatality rate was 40%. C albidus is an opportunistic yeast that can rarely cause life-threatening fungemia and central nervous system infection in individuals of any age, especially those who are immunocompromised.

Molecular epidemiology and antifungal susceptibility profiles of clinical Cryptococcus neoformans/Cryptococcus gattii species complex

Introduction. Limited data regarding the epidemiology and susceptibility profiles of cryptococcosis are available in the Middle East.Aim. Our study aimed to evaluate the molecular diversity, mating types and antifungal susceptibility pattern of Cryptococcus species (n=14) isolated from 320 suspected patients with cryptococcosis.Methodology. The URA5 gene was subjected to restriction fragment length polymorphism and sequence analysis. In addition, in vitro antifungal susceptibility testing was performed by Clinical and Laboratory Standards Institute (CLSI) M27-A4 and M59 guidelines.Results. Overall, 14 (4.4 %) patients were confirmed as cryptococcosis. Based on molecular type, 85.7 and 14.3 % of the isolates were C. neoformans VN I and VN II, respectively. Phylogenetic analysis of URA5 gene sequences revealed clustering of VN I and VN II isolates into two distinct clades with a substantial difference within each molecular type. Voriconazole and 5-fluorocytosine, respectively, had the lowest (0.031 μg ml^-1) and highest (8 µg ml^-1) MICs. The epidemiological cutoff values (ECVs) for amphotericin B, fluconazole, voriconazole and 5-fluorocytosine encompassed ≥97 % of all 14 C. neoformans VN I species. However, according to the CLSI document M59, ECVs for itraconazole (7; 50 % of the isolates) and for posaconazole (1; 7.1 % of the isolate), were one log2 dilution higher than the wild type range. Combinations of amphotericin B with 5-fluorocytosine, amphotericin B with fluconazole and fluconazole with 5-fluorocytosine exhibited synergistic effects against 37, 31 and 12.5 % of the isolates, respectively.Conclusion. Our findings may significantly contribute to the development of management strategies for patients at a higher risk of cryptococcosis, particularly HIV-positive individuals.

Cryptococcus and cryptococcosis in Iran during 1969-2019: A systematic review and meta-analysis

OBJECTIVE

Limited data are available on the epidemiology and etiology of cryptococcal infections in the Middle East. We aimed to conduct the systematic review and meta-analysis to summarize the epidemiological data on prevalence of Cryptococcus species complexes in trees and their surroundings, bird guano and secretions, animals, and highlight the reported episodes of cryptococcosis in Iran.

MATERIALS AND METHODS

Twelve databases, including PubMed, Science Direct, Scopus, Proquest, Google Scholar, Embase, and the ISI Web of Science, as well as the national databases, from January 1969 to October 2019 were searched. Furthermore, gray literature (e.g., thesis, congress abstracts) was evaluated using Iran Doc and www.thesis.

RESEARCH

ac.ir. Search process was accomplished on English or Persian language articles using the following keywords: "Cryptococcus", "Cryptococcosis", "invasive fungal infection", "Humans", "Birds", "Pigeon", "Animals", "Tree", "Eucalyptus", and "Iran", both alone and in combination.

RESULTS

Overall 36 studies were eligible regarding Cryptococcus and cryptococcosis in Iran. The total prevalence rates of Cryptococcus species in the tree was 4.7% (95% CI: 2.3-7.8), and in bird guano was 20.4% (95% CI: 10.7-32.2). Cryptococcosis in animal, and human were 1.7% (95% CI: 0.01-5.1), and 2.8% (95% CI: 0.7v6.1), respectively. The highest prevalence of Cryptococcus in the trees (14.6%), and bird guano (89.4%) in Khorasan, animals (8.9%) in Chaharmahal and Bakhtiari, and human (4.4%) in Mazandaran provinces were reported.

CONCLUSIONS

Given the significant risk of Cryptococcus species for susceptible humans, mainly HIV-infected patients, it seems quite necessary to adopt concrete preventive strategies to pinpoint the environmental habitats of this yeast.