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Zhang Y, Gu K, Du W, Xu A. Risk factors and prediction model for mortality in HIV/Talaromyces marneffei co-infection: A retrospective cohort study. Heliyon 2024; 10:e32560. [PMID: 38961941 PMCID: PMC11219485 DOI: 10.1016/j.heliyon.2024.e32560] [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: 03/25/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
Background This study aimed to identify the risk factors associated with mortality among patients co-infected with human immunodeficiency virus (HIV) and Talaromyces marneffei (TM) in China, and develop a risk prediction model. Methods In this retrospective cohort analysis conducted from 2013 to 2024, comprehensive clinical data from 160 patients were analyzed using a logistic regression model to identify mortality predictors and construct a predictive model. An additional 36 patients constituted the validation cohort, which was specifically designed to evaluate the predictive value of the model. Model performance was assessed using the area under the curve (AUC). Results The overall mortality rate for hospitalized patients with HIV/TM co-infection was 17.35 %. The median age was 35.0 years, and 89.30 % were male. Additionally, 89.80 % of the patients reported fever and 87.76 % presented with lymphadenopathy. Key independent risk factors associated with mortality included age (odds ratio (OR): 1.103, 95 % confidence interval (CI) = 1.033-1.178, P = 0.003), procalcitonin (PCT) levels (OR: 1.270, 95 % CI = 1.052-1.534, P = 0.013), and urea to albumin ratio (UAR) (OR: 1.491, 95 % CI = 1.175-1.892, P < 0.001). Advanced age, elevated PCT levels, and increased UAR were identified as independent risk factors of mortality. Furthermore, the mortality prediction probability combining age, PCT, and UAR exhibited a high predictive value in patients with HIV/TM co-infection. Additionally, the AUC showed a good discrimination ability in the validation group (AUC, 0.898). Conclusions Advanced age, elevated PCT levels, and increased UAR significantly determine mortality in patients with HIV/TM co-infection. These findings underscore the potential of using laboratory parameters as predictive indicators of mortality, facilitating the early identification of HIV/TM co-infection cases in clinical practice.
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Affiliation(s)
- Yan Zhang
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, 310023, Zhejiang, China
| | - Kailong Gu
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, 310023, Zhejiang, China
| | - Wei Du
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, 310023, Zhejiang, China
| | - Aifang Xu
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, 310023, Zhejiang, China
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2
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Nong Y, Wang F, Shuai F, Chen S. Morphology, Development, and Pigment Production of Talaromyces marneffei are Diversely Modulated Under Physiologically Relevant Growth Conditions. Curr Microbiol 2024; 81:119. [PMID: 38526674 DOI: 10.1007/s00284-024-03623-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/22/2024] [Indexed: 03/27/2024]
Abstract
Talaromyces marneffei is an opportunistic pathogenic fungus that mainly affects HIV-positive individuals endemic to Southeast Asia and China. Increasing efforts have been made in the pathogenic mechanism and host interactions understanding of this pathogen in the last two decades; however, there are still no conclusions on how T. marneffei was transmitted from the donor bamboo rats to humans. A perception that the failure of fungus isolation from soil was attributed to the low salt tolerance of T. marneffei. Therefore, the effect of environmental fluctuations in fungal growth and development is fundamental for the characterization of its origin and fungal biology understanding. Herein, we characterized high osmolarity, pH, metal ions, nutrients, and oxidative stress have versatile effects on T. marneffei hyphal or yeast growth, conidia generation, and pigment production. Among these, high pH, low glucose amounts, and the inorganic nitrogen ammonium tartrate stimulated the red pigment production, whereas high osmolarity, high pH, and the inorganic nitrogen sodium nitrate could significantly accelerate the conidia generation. Specifically, zinc starvation repressed conidia generation and prevented the wrinkled yeast colony formation, indicating the function of zinc regulators in pathogenicity regulation. Since conidia are recognized as the infectious propagules, the effects characterization of different environmental factors in T. marneffei morphology in this work will not only expand the growth and pathogenic biology understanding of the fungus but also provide more clues for the T. marneffei infection transmission origin investigation.
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Affiliation(s)
- Yuan Nong
- Guangxi University of Chinese Medicine, Nanning, 530200, Guangxi, China
| | - Fang Wang
- Intensive Care Unit, Shenzhen Key Laboratory of Microbiology in Genomic Modification & Editing and Application, Shenzhen University Medical School, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, 518035, Shenzhen, China.
| | - Feifei Shuai
- Intensive Care Unit, Shenzhen Key Laboratory of Microbiology in Genomic Modification & Editing and Application, Shenzhen University Medical School, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, 518035, Shenzhen, China
| | - Shi Chen
- Guangxi University of Chinese Medicine, Nanning, 530200, Guangxi, China.
- Intensive Care Unit, Shenzhen Key Laboratory of Microbiology in Genomic Modification & Editing and Application, Shenzhen University Medical School, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, 518035, Shenzhen, China.
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3
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Zheng D, Liang T, Wu W, Al-Odaini N, Pan K, Huang L, Huang G, Tang L, Li X, He S, Jian H, Wei N, Wei LJ, Pan Y, Tang P, Meng C, Qin J, Wan Z, Chen X, Cao C. The Epidemiology of Tinea Capitis in Guangxi Province, China. Mycopathologia 2023; 188:489-496. [PMID: 37356056 DOI: 10.1007/s11046-023-00762-w] [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: 09/23/2022] [Accepted: 06/06/2023] [Indexed: 06/27/2023]
Abstract
The aim of this study was to analyze the epidemiological characteristics and pathogen spectrum of tinea capitis in Guangxi, southern China. A multicenter prospective descriptive study was conducted in 8 hospitals across Guangxi. From January 2019 to July 2022, one hundred seventy-one (171) patients diagnosed with tinea capitis were included. Demographic data, risk factors, and fungal data were collected. If necessary, species were further identified by morphological or molecular sequencing in the central laboratory. Of the 171 cases of tinea capitis, 74.3% occurred in patients aged 2-8 years. Children with tinea capitis were mainly boys (59.6%) and were more likely than adults to have a history of animal contact (44.2% vs. 33.3%) and zoophilic dermatophyte infection (76.9% vs. 46.7%, P = 0.008). The adults were mainly female (53%) and were more likely than children to have a history of infection with anthropophilic organisms (53.3% vs. 18.9%). The causative agents of tinea capitis in Guangxi were diverse, and the most common pathogen was Microsporum canis (M. cani, n = 98, 62%), followed by Trichophyton mentagrophytes (T. mentagrophytes n = 18, 11.4%) and Trichophyton tonsurans (T. tonsurans n = 12, 7.6%). In addition, tinea capitis caused by Nannizzia incurvata (N. incurvata) and Trichophyton verrucosum (T. verrucosum) was detected in the study. Notably, the proportion of patients with kerion in the study was 41.5% (n = 71), and most of those patients were children (n = 68), especially neglected children living in the rural mountainous areas of Guangxi, where they were unable to receive timely diagnosis and appropriate treatment. In conclusion, the causative agents of tinea capitis in Guangxi, South China, are diverse, and the incidence of kerion is high, indicating that diagnosis and treatment modalities in the region remain grossly inadequate. Clinicians and policy-makers should collaborate to adopt public health strategies to control the disease.
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Affiliation(s)
- Dongyan Zheng
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Tianwei Liang
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Weixuan Wu
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Najwa Al-Odaini
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Kaisu Pan
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lan Huang
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Guomei Huang
- The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, People's Republic of China
| | - Lulu Tang
- The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, People's Republic of China
| | - Xinlei Li
- Department of Mycology, Yulin Hospital of Dermatology, Yulin, 537000, People's Republic of China
| | - Shao He
- Department of Mycology, Yulin Hospital of Dermatology, Yulin, 537000, People's Republic of China
| | - Huahui Jian
- Baise City People's Hospital, Baise, 533000, Guangxi, People's Republic of China
| | - Nibo Wei
- Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, Guangxi, People's Republic of China
| | - Li Juan Wei
- Nanning Second People's Hospital, Nanning, 530031, Guangxi, People's Republic of China
| | - Yanbin Pan
- Nanning Second People's Hospital, Nanning, 530031, Guangxi, People's Republic of China
| | - Ping Tang
- Nanning Second People's Hospital, Nanning, 530031, Guangxi, People's Republic of China
| | - Caifeng Meng
- Liuzhou Maternity and Children Healthcare Hospital, Louzhou, 545000, Guangxi, People's Republic of China
| | - Jinglin Qin
- Guangxi Zhuang Autonomous Region People's Hospital, Nanning, 530021, Guangxi, People's Republic of China
| | - Zhe Wan
- Department of Dermatology and Venereology, The First Hospital and Research Center for Medical Mycology, Peking University, Beijing, 100034, People's Republic of China
| | - Xiaoqing Chen
- Department of Dermatology and Venereology, The First Hospital and Research Center for Medical Mycology, Peking University, Beijing, 100034, People's Republic of China
| | - Cunwei Cao
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
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Matos AC, Jota Baptista C, Oliveira PA, Soares AS, Figueira L, Matos M, Coelho AC. First morphological and molecular isolation of Talaromyces marneffei in beech marten (Martes foina) in Portugal. Res Vet Sci 2023; 162:104945. [PMID: 37421825 DOI: 10.1016/j.rvsc.2023.104945] [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: 11/21/2022] [Revised: 03/02/2023] [Accepted: 07/01/2023] [Indexed: 07/10/2023]
Abstract
Talaromyces marneffei is a zoonotic fungus that mostly infects immunocompromised individuals. For the first time, this fungus was isolated in an adult beech marten (Martes foina) hit by a car, found dead in Penamacor, Portugal. During the necropsy, different samples (skin, fur, lymph nodes, lung, spleen, kidneys, and brain) were collected and processed for microbiology (including mycology) and molecular biology. T. marneffei was identified through its mycological characteristics and confirmed by PCR in hair samples. No other lesions or alterations were reported, except a concomitant presence of M. avium subsp. paratuberculosis in lung, kidney and brain samples. To the authors' knowledge, this is the first description of this fungus beech marten, as well as the first case of co-infection with M. avium subsp. paratuberculosis in wildlife fauna. These results suggest a sylvatic life-cycle of T. marneffei, involving beech martens, in Portugal.
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Affiliation(s)
- Ana Cristina Matos
- CERNAS, Research Center for Natural Resources, Environment and Society, Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal; QRural- Quality of Life in the Rural World- Research Unit, Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal
| | - Catarina Jota Baptista
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal; Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Inov4Agro - Institute for Innovation, Capacity Building and Sustainability of Agri-food Production, UTAD, Vila Real, Portugal; IBIOMED - Instituto de Biomedicina de la Universidad de León, León, Spain; Faculty of Veterinary Medicine, Lusófona University of Humanities and Technologies (FMV-ULHT), Lisbon; Portugal.
| | - Paula A Oliveira
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal; Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Inov4Agro - Institute for Innovation, Capacity Building and Sustainability of Agri-food Production, UTAD, Vila Real, Portugal
| | - Ana Sofia Soares
- CECAV - Animal and Veterinary Research Centre, Vila Real, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal
| | - Luís Figueira
- QRural- Quality of Life in the Rural World- Research Unit, Polytechnic Institute of Castelo Branco, 6000-084 Castelo Branco, Portugal
| | - Manuela Matos
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Inov4Agro - Institute for Innovation, Capacity Building and Sustainability of Agri-food Production, UTAD, Vila Real, Portugal; Department of Genetics and Biotechnology, UTAD, 5000-801, Vila Real, Portugal
| | - Ana Cláudia Coelho
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5000-801 Vila Real, Portugal; CECAV - Animal and Veterinary Research Centre, Vila Real, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal
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5
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Sun A, Gou X, Zhu Y, Lv H, Ge Y. Identification of Talaromyces marneffei Infection in an HIV-Negative Patient by ITS Sequencing. Infect Drug Resist 2023; 16:5275-5282. [PMID: 37601563 PMCID: PMC10438431 DOI: 10.2147/idr.s418174] [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: 05/08/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023] Open
Abstract
Disseminated ankle mycosis is a life-threatening systemic infection caused by the emerging opportunistic and lethal fungal pathogen Talaromyces marneffei which is more common in HIV-positive patients. However, an increasing number of infections are occurring in HIV-negative patients. Here, we report a case of Talaromyces marneffei infection in HIV-negative patient. A 50s HIV-negative male patient with fever, cough, bloody sputum expectoration, pulmonary sarcoidosis and body rashes was hospitalized at Zhejiang Provincial People's Hospital. CT scanning showed pulmonary multiple nodules with apical bronchial occlusion, patchy infiltration and pathological biopsy demonstrated bronchiolitis obliterans with organized pneumonia and chronic active inflammation of lung tissue with infiltration of numerous lymphocytes, plasma cells, phagocytes and neutrophils. Laboratory tests revealed significantly increased white blood cells count 18.3 ×109/L, neutrophil count 15.34 ×109/L, monocyte count 0.66 ×109/L, platelet count 517 ×109/L, C-reactive protein 116 mg/L, erythrocyte sedimentation rate 112mm/h. The β-D-glucan test was negative (33.06 pg/mL) while fungal culture of broncho alveolar lavage fluid revealed colonies with temperature-dependent dimorphic growth character and Talaromyces marneffei was confirmed by ITS sequencing of the colonies. The patient exhibited radiological improvement and clinical recuperation after intravenously guttae of voriconazole. Talaromycosis in immunocompetent and HIV-negative individuals is relatively rare and is characterized by an insidious onset, various clinical manifestations, and is clinically challenging. Fungal culture and ITS sequencing are warranted for diagnosis Talaromyces marneffei infection. This is the first report on identification of Talaromyces marneffei infection in an HIV-negative patient with skin involvement by ITS sequencing in Zhejiang.
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Affiliation(s)
- Aihua Sun
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People’s Republic of China
- School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, 310059, People’s Republic of China
| | - Xiaoyu Gou
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People’s Republic of China
- School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, 310059, People’s Republic of China
| | - Yongze Zhu
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People’s Republic of China
| | - Huoyang Lv
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People’s Republic of China
| | - Yumei Ge
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, 310014, People’s Republic of China
- School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, 310059, People’s Republic of China
- Key Laboratory of Biomarkers and in vitro Diagnosis Translation of Zhejiang Province, Hangzhou, Zhejiang, 310053, People’s Republic of China
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6
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Wang F, Han R, Chen S. An Overlooked and Underrated Endemic Mycosis-Talaromycosis and the Pathogenic Fungus Talaromyces marneffei. Clin Microbiol Rev 2023; 36:e0005122. [PMID: 36648228 PMCID: PMC10035316 DOI: 10.1128/cmr.00051-22] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Talaromycosis is an invasive mycosis endemic in tropical and subtropical Asia and is caused by the pathogenic fungus Talaromyces marneffei. Approximately 17,300 cases of T. marneffei infection are diagnosed annually, and the reported mortality rate is extremely high (~1/3). Despite the devastating impact of talaromycosis on immunocompromised individuals, particularly HIV-positive persons, and the increase in reported occurrences in HIV-uninfected persons, diagnostic and therapeutic approaches for talaromycosis have received far too little attention worldwide. In 2021, scientists living in countries where talaromycosis is endemic raised a global demand for it to be recognized as a neglected tropical disease. Therefore, T. marneffei and the infectious disease induced by this fungus must be treated with concern. T. marneffei is a thermally dimorphic saprophytic fungus with a complicated mycological growth process that may produce various cell types in its life cycle, including conidia, hyphae, and yeast, all of which are associated with its pathogenicity. However, understanding of the pathogenic mechanism of T. marneffei has been limited until recently. To achieve a holistic view of T. marneffei and talaromycosis, the current knowledge about talaromycosis and research breakthroughs regarding T. marneffei growth biology are discussed in this review, along with the interaction of the fungus with environmental stimuli and the host immune response to fungal infection. Importantly, the future research directions required for understanding this serious infection and its causative pathogenic fungus are also emphasized to identify solutions that will alleviate the suffering of susceptible individuals worldwide.
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Affiliation(s)
- Fang Wang
- Intensive Care Unit, Biomedical Research Center, Shenzhen Institute of Translational Medicine, Health Science Center, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
| | - RunHua Han
- Department of Chemistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shi Chen
- Intensive Care Unit, Biomedical Research Center, Shenzhen Institute of Translational Medicine, Health Science Center, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
- Department of Burn and Plastic Surgery, Biomedical Research Center, Shenzhen Institute of Translational Medicine, Health Science Center, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital, Shenzhen, China
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7
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Harika P, Asthana B, Vashisht R, Yadav N, Hazra N, Manrai M, Menon AS. Disseminated talaromycosis: Truly uncommon or uncommonly recognized? Med J Armed Forces India 2023. [DOI: 10.1016/j.mjafi.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Khoo SC, Goh MS, Alias A, Luang-In V, Chin KW, Ling Michelle TH, Sonne C, Ma NL. Application of antimicrobial, potential hazard and mitigation plans. ENVIRONMENTAL RESEARCH 2022; 215:114218. [PMID: 36049514 PMCID: PMC9422339 DOI: 10.1016/j.envres.2022.114218] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/06/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
The tremendous rise in the consumption of antimicrobial products had aroused global concerns, especially in the midst of pandemic COVID-19. Antimicrobial resistance has been accelerated by widespread usage of antimicrobial products in response to the COVID-19 pandemic. Furthermore, the widespread use of antimicrobial products releases biohazardous substances into the environment, endangering the ecology and ecosystem. Therefore, several strategies or measurements are needed to tackle this problem. In this review, types of antimicrobial available, emerging nanotechnology in antimicrobial production and their advanced application have been discussed. The problem of antimicrobial resistance (AMR) due to antibiotic-resistant bacteria (ARB)and antimicrobial resistance genes (AMG) had become the biggest threat to public health. To deal with this problem, an in-depth discussion of the challenges faced in antimicrobial mitigations and potential alternatives was reviewed.
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Affiliation(s)
- Shing Ching Khoo
- Henan Province Engineering Research Centre for Biomass Value-added Products, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China; BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Meng Shien Goh
- Henan Province Engineering Research Centre for Biomass Value-added Products, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China; BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Amirah Alias
- Eco-Innovation Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Vijitra Luang-In
- Natural Antioxidant Innovation Research Unit, Department of Biotechnology, Faculty of Technology, Mahasarakham University, Khamriang, Kantarawichai, Maha Sarakham, 44150, Thailand
| | - Kah Wei Chin
- BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Tiong Hui Ling Michelle
- BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia
| | - Christian Sonne
- Henan Province Engineering Research Centre for Biomass Value-added Products, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China; Aarhus University, Department of Bioscience, Arctic Research Centre (ARC), Frederiksborgvej 399, PO Box 358, DK-4000, Roskilde, Denmark.
| | - Nyuk Ling Ma
- Henan Province Engineering Research Centre for Biomass Value-added Products, School of Forestry, Henan Agricultural University, Zhengzhou, 450002, China; BIOSES Research Interest Group, Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030, Kuala Nerus, Terengganu, Malaysia.
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9
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Peng L, Shi YB, Zheng L, Hu LQ, Weng XB. Clinical features of patients with talaromycosis marneffei and microbiological characteristics of the causative strains. J Clin Lab Anal 2022; 36:e24737. [PMID: 36268985 DOI: 10.1002/jcla.24737] [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: 07/21/2022] [Revised: 10/02/2022] [Accepted: 10/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Talaromyces marneffei (T. marneffei) is a temperature-dependent dimorphic fungus that is mainly prevalent in Southeast Asia and South China and often causes disseminated life-threatening infections. This study aimed to investigate the clinical features and improve the early diagnosis of talaromycosis marneffei in nonendemic areas. METHODS We retrospectively analyzed the medical records of six cases of T. marneffei infection. We describe the clinical manifestations, laboratory tests, and imaging manifestations of the six patients. RESULTS Talaromyces marneffei infection was confirmed by sputum culture, blood culture, tissue biopsy, and metagenomic next-generation sequencing (mNGS). In this study, there were five disseminated-type patients and two HIV patients. One patient died within 24 h, and the others demonstrated considerable improvement after definitive diagnosis. CONCLUSIONS Due to the lack of significant clinical presentations of talaromycosis marneffei, many cases may be easily misdiagnosed in nonendemic areas. It is particularly important to analyze the imaging manifestations and laboratory findings of infected patients. With the rapid development of molecular biology, mNGS may be a rapid and effective diagnostic method.
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Affiliation(s)
- Lei Peng
- School of Medicine, Ningbo University, Ningbo, China
| | - Yu-Bo Shi
- Department of Medical Laboratory, Ningbo First Hospital, Ningbo, China
| | - Lin Zheng
- Department of Medical Laboratory, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | - Li-Qing Hu
- Department of Medical Laboratory, Ningbo First Hospital, Ningbo, China
| | - Xing-Bei Weng
- School of Medicine, Ningbo University, Ningbo, China.,Department of Medical Laboratory, Ningbo First Hospital, Ningbo, China
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10
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Shen LX, Yang D, Chen RF, Liu DH. Talaromyces marneffei Influences Macrophage Polarization and Sterilization Ability via the Arginine Metabolism Pathway in Vitro. Am J Trop Med Hyg 2022; 107:tpmd210568. [PMID: 35895344 PMCID: PMC9490654 DOI: 10.4269/ajtmh.21-0568] [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: 05/22/2021] [Accepted: 05/07/2022] [Indexed: 11/26/2022] Open
Abstract
The opportunistic fungal pathogen Talaromyces marneffei, which is endemic across a narrow band of tropical Southeast Asia and southern China, is an intracellular pathogen that causes systemic and lethal infection through the mononuclear phagocyte system. The mechanisms by which T. marneffei successfully replicates and escapes the immune system remain unclear. To investigate the role of arginine metabolism in the escape of T. marneffei from killer macrophages, we assessed inducible nitric oxide synthase (iNOS) and arginase expression, nitric oxide (NO) production, arginase and phagocytic activity, and the killing of T. marneffei in a coculture system. Our results indicate that T. marneffei induced macrophage polarization toward the M2 phenotype and regulated the arginine metabolism pathway by prolonging infection, thereby reducing antimicrobial activity and promoting fungal survival. Moreover, inhibiting T. marneffei-induced macrophage arginase activity with Nω-hydroxy-nor-arginine restored NO synthesis and strengthened fungal killing. These findings indicate that T. marneffei affects macrophage polarization and inhibits macrophage antimicrobial function via the arginine metabolism pathway.
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Affiliation(s)
- Lin-xia Shen
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
- Department of Dermatology and Venereology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Di Yang
- Department of Dermatology, The Third Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Ri-feng Chen
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Dong-hua Liu
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
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11
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Important Mycoses of Wildlife: Emphasis on Etiology, Epidemiology, Diagnosis, and Pathology—A Review: PART 1. Animals (Basel) 2022; 12:ani12151874. [PMID: 35892524 PMCID: PMC9331704 DOI: 10.3390/ani12151874] [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: 06/17/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary The number of wild animals is steadily declining globally, so the early diagnosis and proper treatment of emerging diseases are vital. Fungal diseases are commonly encountered in practice and have a high zoonotic potential. This article describes aspergillosis, candidiasis, histoplasmosis, cryptococcosis, and penicilliosis, and is only the first part of a detailed review. The laboratory methods (fungal isolation, gross pathology, histopathology, histochemistry, cytology, immunohistochemistry, radiography, CT, PCR, or ELISA) used in the diagnosis and the clinical details that provide a complete view of the mycoses are presented. Abstract In the past few years, there has been a spurred tripling in the figures of fungal diseases leading to one of the most alarming rates of extinction ever reported in wild species. Some of these fungal diseases are capable of virulent infections and are now considered emerging diseases due to the extremely high number of cases diagnosed with fungal infections in the last few decades. Most of these mycotic diseases in wildlife are zoonotic, and with the emergence and re-emergence of viral and bacterial zoonotic diseases originating from wildlife, which are causing devastating effects on the human population, it is important to pay attention to these wildlife-borne mycotic diseases with zoonotic capabilities. Several diagnostic techniques such as fungal isolation, gross pathology, histopathology, histochemistry, cytology, immunohistochemistry, radiography, CT, and molecular methods such as PCR or ELISA have been invaluable in the diagnosis of wildlife mycoses. The most important data used in the diagnosis of these wildlife mycoses with a zoonotic potential have been re-emphasized. This will have implications for forestalling future epidemics of these potential zoonotic mycotic diseases originating from wildlife. In conclusion, this review will highlight the etiology, epidemiology, diagnosis, pathogenesis, pathogenicity, pathology, and hematological/serum biochemical findings of five important mycoses found in wild animals.
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12
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Wang Y, Deng K. Environmental Risk Factors for Talaromycosis Hospitalizations of HIV-Infected Patients in Guangzhou, China: Case Crossover Study. Front Med (Lausanne) 2021; 8:731188. [PMID: 34881254 PMCID: PMC8645774 DOI: 10.3389/fmed.2021.731188] [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: 06/26/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Talaromycosis is a fatal opportunistic infection prevalent in human immunodeficiency virus (HIV)-infected patients, previous studies suggest environmental humidity is associated with monthly talaromycosis hospitalizations of HIV-infected patients, but the acute risk factor remains uncertain. In this study, we evaluated the associations between talaromycosis hospitalizations of HIV-infected patients (n = 919) and environmental factors including meteorological variables and air pollutants at the event day (assumed "lag 0" since the exact infection date is hard to ascertain) and 1-7 days prior to event day (lag 1-lag 7) in conditional logistics regression models based on a case crossover design. We found that an interquartile range (IQR) increase in temperature at lag 0-lag 7 (odds ratio [OR] [95% CI] ranged from 1.748 [1.345-2.273] to 2.184 [1.672-2.854]), and an IQR increase in humidity at lag 0 (OR [95% CI] = 1.192 [1.052-1.350]), and lag 1 (OR [95% CI] = 1.199 [1.056-1.361]) were significantly associated with talaromycosis hospitalizations of HIV-infected patients. Besides, temperature was also a common predictor for talaromycosis in patients with co-infections including candidiasis (n = 386), Pneumocystis pneumonia (n = 183), pulmonary tuberculosis (n = 141), and chronic hepatitis (n = 158), while humidity was a specific risk factor for talaromycosis in patients with candidiasis, and an air pollutant, SO2, was a specific risk factor for talaromycosis in patients with Pneumocystis pneumonia. In an age stratified evaluation (cutoff = 50 years old), temperature was the only variable positively associated with talaromycosis in both younger and older patients. These findings broaden our understanding of the epidemiology and pathogenesis of talaromycosis in HIV-infected patients.
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Affiliation(s)
- Yaping Wang
- Infectious Diseases Institute, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Kai Deng
- Infectious Diseases Institute, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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13
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Islam MM, Farag E, Mahmoudi A, Hassan MM, Mostafavi E, Enan KA, Al-Romaihi H, Atta M, El Hussein ARM, Mkhize-Kwitshana Z. Rodent-Related Zoonotic Pathogens at the Human-Animal-Environment Interface in Qatar: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115928. [PMID: 34073025 PMCID: PMC8198466 DOI: 10.3390/ijerph18115928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/06/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022]
Abstract
Rodents are one of the most diversified terrestrial mammals, and they perform several beneficial activities in nature. These animals are also important as carriers of many pathogens with public health importance. The current systematic review was conducted to formulate a true depiction of rodent-related zoonoses in Qatar. Following systematic searches on PubMed, Scopus, Science Direct, and Web of Science and a screening process, a total of 94 published articles were selected and studied. The studied articles reported 23 rodent-related zoonotic pathogens that include nine bacterial, eleven parasitic, and three viral pathogens, from which the frequently reported pathogens were Mycobacterium tuberculosis (32 reports), Escherichia coli (23), and Salmonella spp. (16). The possible pathway of entry of the rodent-borne pathogens can be the land port, seaports, and airport of Qatar through carrier humans and animals, contaminated food, and agricultural products. The pathogens can be conserved internally by rodents, pets, and livestock; by agricultural production systems; and by food marketing chains. The overall estimated pooled prevalence of the pathogens among the human population was 4.27% (95%CI: 4.03–4.51%; p < 0.001) with significant heterogeneity (I2 = 99.50%). The top three highest prevalent pathogens were M.tuberculosis (30.90%; 22.75–39.04%; p < 0.001; I2 = 99.70%) followed by Toxoplasma gondii (21.93%; 6.23–37.61%; p < 0.001; I2 = 99.30%) and hepatitis E virus (18.29%; 11.72–24.86%; p < 0.001; I2 = 96.70%). However, there is a knowledge gap about the listed pathogens regarding the occurrence, transmission pathways, and rodent role in transmission dynamics at the human–animal–environment interface in Qatar. Further studies are required to explore the role of rodents in spreading zoonotic pathogens through the One Health framework, consisting of zoologists, ecologists, microbiologists, entomologists, veterinarians, and public health experts in this country.
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Affiliation(s)
- Md Mazharul Islam
- Department of Animal Resources, Ministry of Municipality and Environment, Doha P.O. Box 35081, Qatar; (K.A.E.), (M.A.)
- School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu Natal, Durban 4000, South Africa
- Correspondence: or (M.M.I.); (E.F.); Tel.: +974-660-64382 (M.M.I.); +974-440-70396 (E.F.)
| | - Elmoubashar Farag
- Ministry of Public Health, Doha P.O. Box 42, Qatar;
- Correspondence: or (M.M.I.); (E.F.); Tel.: +974-660-64382 (M.M.I.); +974-440-70396 (E.F.)
| | - Ahmad Mahmoudi
- Department of Biology, Faculty of Science, Urmia University, Urmia 5756151818, Iran;
| | - Mohammad Mahmudul Hassan
- Faculty of Veterinary Medicine, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh;
| | - Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran 1316943551, Iran;
- National Reference Laboratory for Plague, Tularemia and Q Fever, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Hamadan 6556153145, Iran
| | - Khalid A. Enan
- Department of Animal Resources, Ministry of Municipality and Environment, Doha P.O. Box 35081, Qatar; (K.A.E.), (M.A.)
- Department of Virology, Central Laboratory, The Ministry of Higher Education and Scientific Research, Khartum 7099, Sudan;
| | | | - Muzzamil Atta
- Department of Animal Resources, Ministry of Municipality and Environment, Doha P.O. Box 35081, Qatar; (K.A.E.), (M.A.)
- College of Animal Production, Bahri University, Khartoum 11111, Sudan
| | - Abdel Rahim M. El Hussein
- Department of Virology, Central Laboratory, The Ministry of Higher Education and Scientific Research, Khartum 7099, Sudan;
| | - Zilungile Mkhize-Kwitshana
- School of Life Sciences, College of Agriculture, Engineering & Science, University of KwaZulu Natal, Durban 4000, South Africa;
- South African Medical Research Council, Cape Town 7505, South Africa
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14
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Zhou Y, Liu Y, Wen Y. Gastrointestinal manifestations of Talaromyces marneffei infection in an HIV-infected patient rapidly verified by metagenomic next-generation sequencing: a case report. BMC Infect Dis 2021; 21:376. [PMID: 33882850 PMCID: PMC8059157 DOI: 10.1186/s12879-021-06063-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 04/09/2021] [Indexed: 12/20/2022] Open
Abstract
Background The manifestation of Talaromyces marneffei infection in some HIV-infected patients may be atypical. Cases with gastrointestinal involvement have rarely been reported. It is hard to make a diagnosis when patients are lacking the characteristic rash and positive blood culture. Case presentation Here, we described a patient living with HIV who complained of fever and abdominal pain, and was rapidly diagnosed with Talaromyces marneffei infection by metagenomic next-generation sequencing (mNGS) using formalin-fixation and paraffin-embedded (FFPE) samples of omentum majus tissue. We also reviewed reported related cases. Conclusions Talaromyces marneffei is an unusual cause of clinical presentations involving obvious abdominal pain and lower gastrointestinal bleeding, but can be included in the differential diagnosis. As an important diagnostic tool, the significance of mNGS using FFPE samples of lesions provides a more targeted diagnosis.
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Affiliation(s)
- Ying Zhou
- Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Yongfeng Liu
- BGI PathoGenesis Pharmaceutical Technology, BGI-Shenzhen, Shenzhen, Guangdong Province, China
| | - Ying Wen
- Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, China.
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15
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Liu D, Chen R. Characteristic CD86 stain for organisms in cutaneous lesions of Talaromyces marneffei infection. J Am Acad Dermatol 2021; 86:1144-1145. [PMID: 33892011 DOI: 10.1016/j.jaad.2021.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/18/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Donghua Liu
- Department of Dermatology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
| | - Rifeng Chen
- Department of Dermatology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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16
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Wang M, Zhang Z, Yan J, Shi J, Liu S, Wan H. The Presence of Secondary Evans Syndrome in AIDS Patients with Talaromyces marneffei Infection. Infect Drug Resist 2021; 14:1265-1271. [PMID: 33824596 PMCID: PMC8018431 DOI: 10.2147/idr.s300082] [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: 01/08/2021] [Accepted: 03/04/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Talaromyces marneffei (T.M) is a common opportunistic fungus in human immunodeficiency virus (HIV) infection individual. Secondary Evans syndrome in AIDS patients with Talaromyces marneffei infection has not been reported before. Here, we described cases related to this comorbidity. Methods AIDS patients diagnosed with Talaromyces marneffei infection from 2016 to 2020 at Xixi Hospital of Hangzhou were included in this retrospective study. Results Total 76 AIDS patients with T.M infection were enrolled. The most common symptoms were fever and cough (70/76; 55/76, respectively). 53/76 (69.74%) patients got positive results of direct antiglobulin test. 14/76 AIDS-T.M patients combined with secondary Hemophagocytic lymphohistiocytosis (HLH). Five patients were diagnosed with AIDS-T.M associated Evans syndrome. There were severe inflammatory reaction, liver dysfunction, coagulation dysfunction and immunodeficiency status in AIDS-T.M patients with secondary Evans syndrome. All patients received antifungal therapy and three patients received corticosteroids for Evans syndrome treatment. One patient died due to sepsis. Conclusion AIDS-T.M patients with secondary Evans syndrome is extremely rare and we need to be alert to the occurrence of secondary Evans syndrome in AIDS-T.M patients. Clinicians should timely start effective antifungal treatments with suspicious T.M infection in AIDS patients.
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Affiliation(s)
- Mengyan Wang
- Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, Hangzhou, 310023, People's Republic of China
| | - Zhongdong Zhang
- Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, Hangzhou, 310023, People's Republic of China
| | - Jun Yan
- Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, Hangzhou, 310023, People's Republic of China
| | - Jinchuan Shi
- Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, Hangzhou, 310023, People's Republic of China
| | - Shourong Liu
- Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, Hangzhou, 310023, People's Republic of China
| | - Hu Wan
- Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Sixth People's Hospital, Hangzhou, 310023, People's Republic of China
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17
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Guo J, Ning XQ, Ding JY, Zheng YQ, Shi NN, Wu FY, Lin YK, Shih HP, Ting HT, Liang G, Lu XC, Kong JL, Wang K, Lu YB, Fu YJ, Hu R, Li TM, Pan KS, Li XY, Huang CY, Lo YF, Chang IYF, Yeh CF, Tu KH, Tsai YH, Ku CL, Cao CW. Anti-IFN-γ autoantibodies underlie disseminated Talaromyces marneffei infections. J Exp Med 2021; 217:152070. [PMID: 32880631 PMCID: PMC7953730 DOI: 10.1084/jem.20190502] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/22/2020] [Accepted: 08/06/2020] [Indexed: 12/16/2022] Open
Abstract
Talaromyces marneffei causes life-threatening opportunistic infections, mainly in Southeast Asia and South China. T. marneffei mainly infects patients with human immunodeficiency virus (HIV) but also infects individuals without known immunosuppression. Here we investigated the involvement of anti-IFN-γ autoantibodies in severe T. marneffei infections in HIV-negative patients. We enrolled 58 HIV-negative adults with severe T. marneffei infections who were otherwise healthy. We found a high prevalence of neutralizing anti-IFN-γ autoantibodies (94.8%) in this cohort. The presence of anti-IFN-γ autoantibodies was strongly associated with HLA-DRB1*16:02 and -DQB1*05:02 alleles in these patients. We demonstrated that adult-onset acquired immunodeficiency due to autoantibodies against IFN-γ is the major cause of severe T. marneffei infections in HIV-negative patients in regions where this fungus is endemic. The high prevalence of anti-IFN-γ autoantibody-associated HLA class II DRB1*16:02 and DQB1*05:02 alleles may account for severe T. marneffei infections in Southeast Asia. Our findings clarify the pathogenesis of T. marneffei infection and pave the way for developing novel treatments.
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Affiliation(s)
- Jing Guo
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xin-Qiang Ning
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Jing-Ya Ding
- Laboratory of Human Immunology and Infectious Disease, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Yan-Qing Zheng
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.,Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Na-Na Shi
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Feng-Yao Wu
- Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - You-Kun Lin
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Han-Po Shih
- Laboratory of Human Immunology and Infectious Disease, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - He-Ting Ting
- Laboratory of Human Immunology and Infectious Disease, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Gang Liang
- School of Preclinical Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiang-Chan Lu
- Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Jin-Ling Kong
- Department of Respiratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ke Wang
- School of Preclinical Medicine, Guangxi Medical University, Nanning, Guangxi, China
| | - Yi-Bo Lu
- Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Yu-Jiao Fu
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Rong Hu
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Tian-Min Li
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Kai-Su Pan
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiu-Ying Li
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chun-Yang Huang
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.,Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yu-Fang Lo
- Laboratory of Human Immunology and Infectious Disease, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Ian Yi-Feng Chang
- Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Fu Yeh
- Laboratory of Human Immunology and Infectious Disease, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.,Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kun-Hua Tu
- Laboratory of Human Immunology and Infectious Disease, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.,Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Huan Tsai
- Laboratory of Host-Microbe Interactions and Cell Dynamics, Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Lung Ku
- Laboratory of Human Immunology and Infectious Disease, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.,Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Cun-Wei Cao
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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18
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Chen M, Xu N, Xu J. Cryptococcus Neoformans Meningitis Cases Among China's HIV-Infected Population may have been Severely Under-Reported. Mycopathologia 2020; 185:971-974. [PMID: 32989582 PMCID: PMC7521573 DOI: 10.1007/s11046-020-00491-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/18/2020] [Indexed: 11/28/2022]
Abstract
Cryptococcal meningitis (CM) is the leading fungal infection of the central nervous system. Globally, most CM cases have been reported from patients with compromised immunities, especially those infected with HIV. However, reports from China have shown that most CM infections were from HIV-negative, immunocompetent hosts. Here, we reviewed the published reports and found those studies were almost exclusively based on patients from hospitals associated with Chinese universities but not from specialized infectious diseases hospitals where most Chinese HIV-infected patients have been treated. Thus, we believe CM cases among China’s HIV-infected population may have been severely under-reported. Analyses of CM cases in specialized infectious diseases hospitals are needed to identify the true epidemiological pattern of CM in China.
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Affiliation(s)
- Min Chen
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Nan Xu
- Department of Dermatology, Shanghai East Hospital, Tongji University, 150 Jimuo Road, Shanghai, 200120, China.
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, Canada.
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19
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Huang C, Tsui CKM, Chen M, Pan K, Li X, Wang L, Chen M, Zheng Y, Zheng D, Chen X, Jiang L, Wei L, Liao W, Cao C. Emerging Cryptococcus gattii species complex infections in Guangxi, southern China. PLoS Negl Trop Dis 2020; 14:e0008493. [PMID: 32845884 PMCID: PMC7449396 DOI: 10.1371/journal.pntd.0008493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/17/2020] [Indexed: 12/20/2022] Open
Abstract
The emergence and spread of cryptococcosis caused by the Cryptococcus gattii species complex has become a major public concern worldwide. C. deuterogattii (VGIIa) outbreaks in the Pacific Northwest region demonstrate the expansion of this fungal infection to temperate climate regions. However, infections due to the C. gattii species complex in China have rarely been reported. In this study, we studied eleven clinical strains of the C. gattii species complex isolated from Guangxi, southern China. The genetic identity and variability of these isolates were analyzed via multi-locus sequence typing (MLST), and the phylogenetic relationships among these isolates and global isolates were evaluated. The mating type, physiological features and antifungal susceptibilities of these isolates were also characterized. Among the eleven isolates, six belonged to C. deuterogattii, while five belonged to C. gattii sensu stricto. The C. deuterogattii strains from Guangxi, southern China were genetically variable and clustered with different clinical isolates from Brazil. All strains were MATα, and three C. deuterogattii isolates (GX0104, GX0105 and GX0147) were able to undergo sexual reproduction. Moreover, most strains had capsule and were capable of melanin production when compared to the outbreak strain from Canada. Most isolates were susceptible to antifungal drugs; yet one of eleven immunocompetent patients died of cryptococcal meningitis caused by C. deuterogattii (GX0147). Our study indicated that the highly pathogenic C. deuterogattii may be emerging in southern China, and effective nationwide surveillance of C. gattii species complex infection is necessary. Cryptococcosis is a fatal systemic fungal disease caused by Cryptococcus neoformans/gattii species complexes. As a former member of the C. neoformans, C. gattii had been easily neglected before being elevated to species level. Human C. gattii species complex infection was previously confined to the tropical and subtropical regions worldwide. However, in 1999, an outbreak of C. gattii species complex occurred on Vancouver Island in Canada then expanded to the Pacific Northwest in the USA, causing over 200 infections. The highly virulent, highly pathogenic and more resistant to antifungal drugs of this species have become a therapeutic problem. To initiate a better understanding of the infection characteristics and pathogenicity of C. gattii species complex in Guangxi, southern China, the current study aimed to characterize the C. gattii species complex isolates genetically and phenotypically. The ISHAM consensus MLST scheme was utilized to investigate the genetic structure of C. gattii species complex and to correlate their geographic origin, clinical source, virulence factors and antifungal susceptibility. The authors expect that this work can support surveillance and encourage more research and public health initiatives to prevent and control the cryptococcosis cause by C. gattii species complex.
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Affiliation(s)
- Chunyang Huang
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Clement K. M. Tsui
- Department of Pathology, Sidra Medicine, Qatar
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine–Qatar, Doha, Qatar
- Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Min Chen
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
| | - Kaisu Pan
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Xiuying Li
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Linqi Wang
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, P. R. China
| | - Meini Chen
- Clinical Medicine (8-year program), XiangYa School of Medicine, Central South University, Changsha, P. R. China
| | - Yanqing Zheng
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Dongyan Zheng
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Xingchun Chen
- The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, P. R. China
| | - Li Jiang
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Lili Wei
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Wanqing Liao
- Shanghai Key Laboratory of Molecular Medical Mycology, Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, P. R. China
- * E-mail: (WL); (CC)
| | - Cunwei Cao
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
- * E-mail: (WL); (CC)
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Vergidis P, Rao A, Moore CB, Rautemaa-Richardson R, Sweeney LC, Morton M, Johnson EM, Borman AM, Richardson MD, Augustine T. Talaromycosis in a renal transplant recipient returning from South China. Transpl Infect Dis 2020; 23:e13447. [PMID: 32794335 DOI: 10.1111/tid.13447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/11/2020] [Accepted: 07/25/2020] [Indexed: 01/22/2023]
Abstract
Talaromycosis is a fungal infection endemic in Southeast Asia. We report a case of a renal transplant recipient who developed infection after a trip to South China. She presented with constitutional symptoms and was found to have an FDG-avid lung mass. Histopathology demonstrated small yeast cells and culture grew Talaromyces marneffei. The patient was treated with 2 weeks of liposomal amphotericin B followed by itraconazole. The dose of tacrolimus was significantly reduced because of the interaction with itraconazole. Mycophenolate mofetil was discontinued. After 12 months of treatment, the mass had completely resolved. Talaromycosis has mainly been reported in patients with AIDS and is uncommon among solid organ transplant recipients. The immune response against T. marneffei infection is mediated predominantly by T cells and macrophages. The diagnosis may not be suspected outside of endemic areas. We propose a therapeutic approach in transplant patients by extrapolating the evidence from the HIV literature and following practices applied to other endemic mycoses.
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Affiliation(s)
- Paschalis Vergidis
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA
| | - Anirudh Rao
- Department of Renal Medicine and Transplant Nephrology, Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK
| | - Caroline B Moore
- Mycology Reference Centre Manchester, ECMM Excellence Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Riina Rautemaa-Richardson
- Mycology Reference Centre Manchester, ECMM Excellence Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Department of Infectious Diseases, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Louise C Sweeney
- Department of Microbiology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Muir Morton
- Department of Renal Medicine and Transplant Nephrology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Elizabeth M Johnson
- Public Health England UK National Mycology Reference Laboratory, Science Quarter, Southmead Hospital, Bristol, UK.,Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Andrew M Borman
- Public Health England UK National Mycology Reference Laboratory, Science Quarter, Southmead Hospital, Bristol, UK.,Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Malcolm D Richardson
- Mycology Reference Centre Manchester, ECMM Excellence Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Titus Augustine
- Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK
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Pan M, Huang J, Qiu Y, Zeng W, Li Z, Tang S, Wei X, Zhang J. Assessment of Talaromyces Marneffei Infection of the Intestine in Three Patients and a Systematic Review of Case Reports. Open Forum Infect Dis 2020; 7:ofaa128. [PMID: 32523970 PMCID: PMC7264840 DOI: 10.1093/ofid/ofaa128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/09/2020] [Indexed: 12/22/2022] Open
Abstract
Background Hematogenous dissemination of Talaromyces marneffei can result in multiorgan involvement (skin, lung, and reticuloendothelial system involvement); however, few studies have reported intestinal T marneffei infections. We investigated clinical features, management, and patient outcomes concerning Talaromyces-related intestinal infections. Methods Patients with Talaromycosis between August 2012 and April 2019 at The First Affiliated Hospital of Guangxi Medical University, China, were retrospectively analyzed. Patients presenting with intestinal Talaromycosis and endoscopy-confirmed diagnoses were investigated. We also undertook a systematic review of the relevant English and Chinese literature. Results Of 175 patients diagnosed with Talaromycosis, 33 presented with gastrointestinal symptoms, and 31 underwent stool cultures, 1 of which tested positive. Three patients had gastrointestinal symptoms and negative stool cultures, and endoscopic tissue biopsy confirmed a pathological diagnosis. A systematic review of 14 reports on human Talaromycosis identified an additional 16 patients. Fever, weight loss, and anemia were the most common symptoms, along with abdominal pain, diarrhea, and bloody stools. Abdominal computed tomography showed intestinal wall edema and thickening and/or abdominal lymphadenopathy. Endoscopy showed erosion, hyperemia, edema, and multiple intestinal mucosal ulcers. Of the 19 patients, 16 received antifungal therapy, 14 of whom recovered and 2 died. Three patients received no therapy and died. Conclusions Gastrointestinal disseminated Talaromycosis is not rare and can affect the stomach, duodenum, and colon, and may involve the entire digestive tract. Colon is the most common site. Endoscopy is needed for patients presenting with gastrointestinal symptoms in T marneffei-infected endemic areas. Systemic application of effective antifungal therapy can improve the prognosis.
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Affiliation(s)
- Mianluan Pan
- Department of Respiratory and Critical Care Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China.,Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jie Huang
- Department of Tuberculosis, Fourth People Hospital of Nanning City, Nanning, Guangxi, China
| | - Ye Qiu
- Department of Comprehensive Internal Medicine, The Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Wen Zeng
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhangcheng Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shudan Tang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xuan Wei
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jianquan Zhang
- Department of Respiratory and Critical Care Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China.,Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Li F, Zhang Z, Hu S, Zhao W, Zhao J, Kváč M, Guo Y, Li N, Feng Y, Xiao L. Common occurrence of divergent Cryptosporidium species and Cryptosporidium parvum subtypes in farmed bamboo rats (Rhizomys sinensis). Parasit Vectors 2020; 13:149. [PMID: 32204732 PMCID: PMC7092434 DOI: 10.1186/s13071-020-04021-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 03/16/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Bamboo rats are widely farmed in southern China for meat, but their potential in transmitting pathogens to humans and other farm animals remains unclear. METHODS To understand the transmission of Cryptosporidium spp. in these animals, 709 fecal samples were collected in this study from Chinese bamboo rats (Rhizomys sinensis) on nine farms in Jiangxi, Guangxi and Hainan provinces, China. They were analyzed for Cryptosporidium spp. using PCR and sequence analyses of the small subunit rRNA gene. Cryptosporidium parvum, C. parvum-like and C. ubiquitum-like genotypes identified were subtyped by sequence analysis of the 60 kDa glycoprotein (gp60) gene. RESULTS Altogether, Cryptosporidium spp. were detected in 209 (29.5%) samples. The detection rate in samples from animals under two months of age (70.0%,105/150) was significantly higher than in samples from animals above 2 months (18.6%, 104/559; χ2 = 150.27, df = 1, P < 0.0001). Four Cryptosporidium species/genotypes were identified: C. parvum (n = 78); C. occultus (n = 1); a new genotype that is genetically related to C. ubiquitum (n = 85); and another new genotype that is genetically related to C. parvum (n = 44). Among them, C. parvum (27,610 ± 71,911 oocysts/gram of feces) and the C. parvum-like genotype (38,679 ± 82,811 oocysts/gram of feces) had higher oocyst shedding intensity than the C. ubiquitum-like genotype (2470 ± 7017 oocysts/gram of feces) and the C. occultus (1012 oocysts/gram of feces). The C. parvum identified belonged to three subtypes in two rare subtype families, including IIpA9 (n = 43), IIpA6 (n = 6) and IIoA15G1 (n = 9), while the C. parvum-like and C. ubiquitum-like genotypes generated very divergent gp60 sequences. CONCLUSIONS Results of the present study suggest that bamboo rats on the study farms were infected with diverse Cryptosporidium species and divergent C. parvum subtypes, which probably had originated from their native habitats. As similar C. parvum subtypes have been recently detected in humans and farmed macaques, attentions should be paid to the potential role of these new farm animals in the transmission of zoonotic pathogens.
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Affiliation(s)
- Falei Li
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, Guangdong, China.,Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, 510642, Guangdong, China
| | - Zhenjie Zhang
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, Guangdong, China
| | - Suhui Hu
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, Guangdong, China
| | - Wentao Zhao
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, Guangdong, China
| | - Jianguo Zhao
- Key Laboratory of Tropical Biological Resources of Ministry of Education, School of Life and Pharmaceutical Sciences, Hainan University, Haikou, 570228, Hainan, China
| | - Martin Kváč
- Institute of Parasitology, Biology Centre of the Czech Academy of Sciences, 370 05, Ceske Budejovice, Czech Republic
| | - Yaqiong Guo
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, Guangdong, China
| | - Na Li
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, Guangdong, China
| | - Yaoyu Feng
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, Guangdong, China. .,Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, 510642, Guangdong, China.
| | - Lihua Xiao
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642, Guangdong, China. .,Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, 510642, Guangdong, China.
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23
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Andrianopoulos A. Laboratory Maintenance and Growth of Talaromyces marneffei. ACTA ACUST UNITED AC 2020; 56:e97. [PMID: 32040264 DOI: 10.1002/cpmc.97] [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: 11/07/2022]
Abstract
Talaromyces marneffei is an important opportunistic human pathogen endemic to Southeast Asia. It is one of a number of pathogenic fungi that exhibits thermally controlled dimorphism. At 25°C, T. marneffei grows in a multicellular, filamentous hyphal form that can differentiate to produce dormant spores called conidia. These conidia are the likely infectious agent. At 37°C, T. marneffei grows as a uninucleate yeast that divides by fission. The yeast cells are the pathogenic form of this fungus. The protocols described here explain how to grow T. marneffei in the two vegetative growth forms in vitro, grow yeast cells inside mammalian macrophages, produce conidial stocks, and store strains both short and long term. © 2020 by John Wiley & Sons, Inc. Basic Protocol 1: Growth of the vegetative hyphal form on solid medium Alternate Protocol 1: Growth of the vegetative hyphal form in liquid suspension Basic Protocol 2: Growth of the vegetative yeast form on solid medium Alternate Protocol 2: Growth of the vegetative yeast form in liquid suspension Basic Protocol 3: Growth for production of dormant conidia Support Protocol: Preparation of Miracloth filter tubes Basic Protocol 4: Growth of Talaromyces marneffei in mammalian macrophages Basic Protocol 5: Storage of Talaromyces marneffei strains Alternate Protocol 3: Lyophilization of Talaromyces marneffei strains.
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Affiliation(s)
- Alex Andrianopoulos
- Genetics, Genomics and Systems Biology, School of BioSciences, The University of Melbourne, Victoria, Australia
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24
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Le T, Thanh NT, Thwaites GE. Talaromycosis (Penicilliosis). HUNTER'S TROPICAL MEDICINE AND EMERGING INFECTIOUS DISEASES 2020:682-685. [DOI: https:/doi.org/10.1016/b978-0-323-55512-8.00090-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
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Talaromycosis (Penicilliosis) Due to Talaromyces (Penicillium) marneffei: Insights into the Clinical Trends of a Major Fungal Disease 60 Years After the Discovery of the Pathogen. Mycopathologia 2019; 184:709-720. [DOI: 10.1007/s11046-019-00410-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pongpech N, Rotjanapan P. Absence of cutaneous involvement in disseminated Talaromyces marneffei infection in an AIDS patient: a case report and literature review. Infect Drug Resist 2019; 12:1493-1499. [PMID: 31239726 PMCID: PMC6556212 DOI: 10.2147/idr.s207819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/17/2019] [Indexed: 12/24/2022] Open
Abstract
Background Talaromyces marneffei (T. marneffei) is an important opportunistic pathogen found in human immunodeficiency virus-positive individuals in Southeast Asia, Southern China, and Northeastern India. Patients with disseminated talaromycosis commonly develop multi-organ involvement including the skin. In this report, we describe the clinical presentation, investigation, management, and clinical outcome of an acquired immune deficiency syndrome (AIDS) patient with newly diagnosed disseminated talaromycosis without skin involvement. Case presentation A 27-year-old male with AIDS presented with acute onset of abdominal pain for 4 days and fever for 2 days. He had been diagnosed with AIDS, pneumocystis pneumonia, and presumptive smear-negative pulmonary tuberculosis 2 months previously. His initial CD4 count was 91 cells/mm3. After a 3-week course of trimethoprim/sulfamethoxazole and anti-tuberculosis treatment, anti-retroviral therapy was initiated. Physical examination revealed left upper quadrant tenderness but no abnormal skin lesions. On this visit, his CD4 count rose to 272 cells/mm3 (19%). Computed tomography of the abdomen showed evidence of a small hypodense lesion with a thin enhancing rim at the spleen and extensive intra-abdominal lymphadenopathy. Empirical amphotericin B deoxycholate was administered in response to positive serum galactomannan, although this was switched to intravenous liposomal amphotericin B 1 week later because of acute kidney injury. Blood and bone marrow cultures for fungus grew T. marneffei on days 9 and 12, respectively. After 21 days of treatment, oral itraconazole replaced intravenous therapy. The patient was discharged home after 29 days in the hospital and continued to improve clinically at a follow-up visit as an outpatient. Conclusion Talaromycosis is a fairly common opportunistic infection among AIDS patients in Thailand, despite a rise in CD4 count which may reflect a change in immune status. To a lesser extent, a systemic disease without skin involvement can be expected in real clinical practice.
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Affiliation(s)
- Nisha Pongpech
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Porpon Rotjanapan
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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27
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Affiliation(s)
| | - Daniel O. Oluwayelu
- Department of Veterinary Microbiology, University of Ibadan, Ibadan, Nigeria
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28
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Brown AJ, Gow NA, Warris A, Brown GD. Memory in Fungal Pathogens Promotes Immune Evasion, Colonisation, and Infection. Trends Microbiol 2019; 27:219-230. [DOI: 10.1016/j.tim.2018.11.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/19/2018] [Accepted: 11/01/2018] [Indexed: 12/20/2022]
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Ma X, Wang Y, Zhang HJ, Wu HX, Zhao GH. First report of Giardia duodenalis infection in bamboo rats. Parasit Vectors 2018; 11:520. [PMID: 30236164 PMCID: PMC6149208 DOI: 10.1186/s13071-018-3111-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 09/11/2018] [Indexed: 12/31/2022] Open
Abstract
Background The zoonotic parasite, Giardia duodenalis (syns. G. lamblia and G. intestinalis), has been widely reported in humans and animals, including rodents. The bamboo rat, a rodent species belonged to the subfamily Rhizomyinae, is farmed in China because of its medicinal and edible values. However, no information of G. duodenalis infection was available in bamboo rats prior to the present study. Here, the prevalence and genetic diversity of G. duodenalis in bamboo rats from Hunan Province of China were investigated. Results Of 480 faecal samples collected from six farms located in four cities (Wugang, Chenzhou, Huaihua and Jishou) of Hunan Province, 52 (10.8%) were positive for G. duodenalis infection by using a nested PCR approach targeting the beta giardin (bg) gene. Significant differences (P < 0.01) in prevalence were found among different age groups and geographical localities, and among different farms in Wugang city. Sequence analysis revealed existence of the zoonotic assemblage B and genetic diversity of G. duodenalis in these animals. Multilocus genotyping analysis also indicated broad genetic diversity of assemblage B isolates in these bamboo rats. Conclusions This is the first report of the infection and genetic variations of G. duodenalis in bamboo rats. These findings will provide basic data for implementing effective strategies to control giardiasis in bamboo rats. Electronic supplementary material The online version of this article (10.1186/s13071-018-3111-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xun Ma
- College of Veterinary Medicine, Northwest A&F University, 22 Xinong Road, Yangling, 712100, People's Republic of China
| | - Yi Wang
- College of Veterinary Medicine, Northwest A&F University, 22 Xinong Road, Yangling, 712100, People's Republic of China
| | - Hui-Jun Zhang
- College of Veterinary Medicine, Northwest A&F University, 22 Xinong Road, Yangling, 712100, People's Republic of China
| | - Hao-Xian Wu
- College of Veterinary Medicine, Northwest A&F University, 22 Xinong Road, Yangling, 712100, People's Republic of China
| | - Guang-Hui Zhao
- College of Veterinary Medicine, Northwest A&F University, 22 Xinong Road, Yangling, 712100, People's Republic of China.
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Isolation of Talaromyces marneffei from the Skin of an Egyptian Mongoose ( Herpestes ichneumon) in Portugal. J Wildl Dis 2018; 55:238-241. [PMID: 29953315 DOI: 10.7589/2017-02-037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report a case of Talaromyces marneffei skin infection in an Egyptian mongoose ( Herpestes ichneumon) in Portugal. The isolated fungus was identified through its mycologic characteristics, morphology, and PCR amplification.
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Lei HL, Li LH, Chen WS, Song WN, He Y, Hu FY, Chen XJ, Cai WP, Tang XP. Susceptibility profile of echinocandins, azoles and amphotericin B against yeast phase of Talaromyces marneffei isolated from HIV-infected patients in Guangdong, China. Eur J Clin Microbiol Infect Dis 2018. [PMID: 29536323 DOI: 10.1007/s10096-018-3222-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Talaromyces marneffei (T. marneffei) can cause talaromycosis, a fatal systemic mycosis, in patients with AIDS. With the increasing number of talaromycosis cases in Guangdong, China, we aimed to investigate the susceptibility of 189 T. marneffei clinical strains to eight antifungal agents, including three echinocandins (anidulafungin, micafungin, and caspofungin), four azoles (posaconazole, itraconazole, voriconazole, and fluconazole), and amphotericin B, with determining minimal inhibition concentrations (MIC) by Sensititre YeastOne™ YO10 assay in the yeast phase. The MICs of anidulafungin, micafungin, caspofungin, posaconazole, itraconazole, voriconazole, fluconazole, and amphotericin B were 2 to > 8 μg/ml, >8 μg/ml, 2 to > 8 μg/ml, ≤ 0.008 to 0.06 μg/ml, ≤ 0.015 to 0.03 μg/ml, ≤ 0.008 to 0.06 μg/ml, 1 to 32 μg/ml, and ≤ 0.12 to 1 μg/ml, respectively. The MICs of all echinocandins were very high, while the MICs of posaconazole, itraconazole, and voriconazole, as well as amphotericin B were comparatively low. Notably, fluconazole was found to have a higher MIC than other azoles, and exhibited particularly weak activity against some isolates with MICs over 8 μg/ml. Our data in vitro support the use of amphotericin B, itraconazole, voriconazole, and posaconazole in management of talaromycosis and suggest potential resistance to fluconazole.
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Affiliation(s)
- H-L Lei
- Research Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People's Republic of China
| | - L-H Li
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People's Republic of China
| | - W-S Chen
- Department of Clinical Laboratory, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People's Republic of China
| | - W-N Song
- Department of Clinical Laboratory, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People's Republic of China
| | - Y He
- Department of Medical Ultrasonics, Guangzhou First People's Hospital, Guangzhou, Guangdong Province, 510060, People's Republic of China
| | - F-Y Hu
- Research Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People's Republic of China
| | - X-J Chen
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People's Republic of China
| | - W-P Cai
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People's Republic of China
| | - X-P Tang
- Research Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, 510060, People's Republic of China.
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33
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Epidemiology of fungal infections in China. Front Med 2018; 12:58-75. [DOI: 10.1007/s11684-017-0601-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 10/23/2017] [Indexed: 01/19/2023]
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Investigating Clinical Issues by Genotyping of Medically Important Fungi: Why and How? Clin Microbiol Rev 2017; 30:671-707. [PMID: 28490578 DOI: 10.1128/cmr.00043-16] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Genotyping studies of medically important fungi have addressed elucidation of outbreaks, nosocomial transmissions, infection routes, and genotype-phenotype correlations, of which secondary resistance has been most intensively investigated. Two methods have emerged because of their high discriminatory power and reproducibility: multilocus sequence typing (MLST) and microsatellite length polymorphism (MLP) using short tandem repeat (STR) markers. MLST relies on single-nucleotide polymorphisms within the coding regions of housekeeping genes. STR polymorphisms are based on the number of repeats of short DNA fragments, mostly outside coding regions, and thus are expected to be more polymorphic and more rapidly evolving than MLST markers. There is no consensus on a universal typing system. Either one or both of these approaches are now available for Candida spp., Aspergillus spp., Fusarium spp., Scedosporium spp., Cryptococcus neoformans, Pneumocystis jirovecii, and endemic mycoses. The choice of the method and the number of loci to be tested depend on the clinical question being addressed. Next-generation sequencing is becoming the most appropriate method for fungi with no MLP or MLST typing available. Whatever the molecular tool used, collection of clinical data (e.g., time of hospitalization and sharing of similar rooms) is mandatory for investigating outbreaks and nosocomial transmission.
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Chen J, Zhang R, Shen Y, Liu L, Qi T, Wang Z, Song W, Tang Y, Lu H. Clinical Characteristics and Prognosis of Penicilliosis Among Human Immunodeficiency Virus-Infected Patients in Eastern China. Am J Trop Med Hyg 2017; 96:1350-1354. [PMID: 28719279 DOI: 10.4269/ajtmh.16-0521] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AbstractTalaromyces marneffei infection is increasingly observed in people living with human immunodeficiency virus (HIV) in eastern China, a nonendemic area. This study aimed to draw the clinician's attention to this disease by presenting the clinical characteristics and prognosis of penicilliosis among HIV-infected patients from this region. We retrospectively analyzed HIV-infected patients with culture-proven T. marneffei infection admitted during January 1, 2014-December 31, 2015, at the Shanghai Public Health Clinical Center. A total of 48 patients with confirmed HIV infection and penicilliosis were enrolled, which accounted for a mean of 3.2% (95% confidence interval: 2.4-4.2%) of yearly HIV infection admissions among patients from eastern China. Symptoms included fever, cough, and gastrointestinal complaints, whereas the most common sign was skin lesions. Anemia occurred in 87.5% (42/48) of the patients. The overall mortality rate was 16.7%. Low CD4 T-cell count and hemoglobin level were correlated with mortality. Based on these results, we concluded that penicilliosis should be considered in HIV-infected patients from eastern China who present with fever, cutaneous lesions, and anemia. The clinical characters and the prognosis of patients with penicilliosis are similar to those in endemic areas. More attention should be paid to penicilliosis patients with low CD4 T-cell count and/or low hemoglobin level.
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Affiliation(s)
- Jun Chen
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Renfang Zhang
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yinzhong Shen
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Li Liu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Tangkai Qi
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zhenyan Wang
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Wei Song
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yang Tang
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Limper AH, Adenis A, Le T, Harrison TS. Fungal infections in HIV/AIDS. THE LANCET. INFECTIOUS DISEASES 2017; 17:e334-e343. [PMID: 28774701 DOI: 10.1016/s1473-3099(17)30303-1] [Citation(s) in RCA: 264] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 01/25/2023]
Abstract
Fungi are major contributors to the opportunistic infections that affect patients with HIV/AIDS. Systemic infections are mainly with Pneumocystis jirovecii (pneumocystosis), Cryptococcus neoformans (cryptococcosis), Histoplasma capsulatum (histoplasmosis), and Talaromyces (Penicillium) marneffei (talaromycosis). The incidence of systemic fungal infections has decreased in people with HIV in high-income countries because of the widespread availability of antiretroviral drugs and early testing for HIV. However, in many areas with high HIV prevalence, patients present to care with advanced HIV infection and with a low CD4 cell count or re-present with persistent low CD4 cell counts because of poor adherence, resistance to antiretroviral drugs, or both. Affordable, rapid point-of-care diagnostic tests (as have been developed for cryptococcosis) are urgently needed for pneumocystosis, talaromycosis, and histoplasmosis. Additionally, antifungal drugs, including amphotericin B, liposomal amphotericin B, and flucytosine, need to be much more widely available. Such measures, together with continued international efforts in education and training in the management of fungal disease, have the potential to improve patient outcomes substantially.
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Affiliation(s)
| | - Antoine Adenis
- Inserm CIC 1424, Centre d'Investigation Clinique Antilles Guyane, Centre Hospitalier de Cayenne, Cayenne, France; Equipe EA 3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, Cayenne, France
| | - Thuy Le
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Hawaii Centre for AIDS, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Thomas S Harrison
- Institute of Infection and Immunity, St George's, University of London, London, UK.
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Headley SA, Pretto-Giordano LG, Lima SC, Suhett WG, Pereira AHT, Freitas LA, Suphoronski SA, Oliveira TES, Alfieri AF, Pereira EC, Vilas-Boas LA, Alfieri AA. Pneumonia due to Talaromyces marneffei in a Dog from Southern Brazil with Concomitant Canine Distemper Virus Infection. J Comp Pathol 2017; 157:61-66. [PMID: 28735673 DOI: 10.1016/j.jcpa.2017.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 05/26/2017] [Accepted: 06/02/2017] [Indexed: 02/06/2023]
Abstract
The pathological and molecular findings associated with Talaromyces marneffei-induced pneumonia with concomitant infection by canine distemper virus (CDV) are described in a dog. The principal pathological alteration occurred in the lungs. Histopathology confirmed multifocal granulomatous pneumonia associated with numerous intralesional and intracellular septate fission cells consistent with T. marneffei. A molecular assay designed to amplify a partial fragment of the 18S rRNA gene of T. marneffei provided positive results from two fungal cultures derived from the lung. Sequencing and phylogenetic analyses confirmed the results of polymerase chain reaction (PCR). Furthermore, antigens of the CDV N protein were identified within the bronchial epithelium by immunohistochemistry and a PCR assay amplified the CDV N gene from hepatic and pulmonary fragments. Collectively, the pathological and molecular techniques confirmed a diagnosis of T. marneffei-induced pneumonia with concomitant infection by CDV. These findings represent the first description of pulmonary penicilliosis in the dog and extend the geographical niche of this emerging infectious pathogen. In this case, infection by CDV may have induced immunosuppression, which facilitated the development of pulmonary penicilliosis.
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Affiliation(s)
- S A Headley
- Laboratory of Animal Pathology, Universidade Estadual de Londrina, Paraná, Brazil.
| | | | - S C Lima
- Laboratory of Genetics and Bacterial Taxonomy, Department of General Biology, Universidade Estadual de Londrina, Paraná, Brazil
| | - W G Suhett
- Small Animal Internal Medicine, Department of Veterinary Clinics, Universidade Estadual de Londrina, Paraná, Brazil
| | - A H T Pereira
- Laboratory of Animal Pathology, Universidade Estadual de Londrina, Paraná, Brazil
| | - L A Freitas
- Laboratory of Molecular Biology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Paraná, Brazil
| | - S A Suphoronski
- Laboratory of Mycology, Universidade Estadual de Londrina, Paraná, Brazil
| | - T E S Oliveira
- Laboratory of Animal Pathology, Universidade Estadual de Londrina, Paraná, Brazil
| | - A F Alfieri
- Laboratory of Molecular Biology, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Paraná, Brazil
| | - E C Pereira
- Laboratory of Mycology, Universidade Estadual de Londrina, Paraná, Brazil
| | - L A Vilas-Boas
- Laboratory of Genetics and Bacterial Taxonomy, Department of General Biology, Universidade Estadual de Londrina, Paraná, Brazil
| | - A A Alfieri
- Multi-User Animal Health Laboratory, Molecular Biology Unit, Department of Veterinary Preventive Medicine, Universidade Estadual de Londrina, Paraná, Brazil
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Lee PP, Lau YL. Cellular and Molecular Defects Underlying Invasive Fungal Infections-Revelations from Endemic Mycoses. Front Immunol 2017; 8:735. [PMID: 28702025 PMCID: PMC5487386 DOI: 10.3389/fimmu.2017.00735] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/09/2017] [Indexed: 01/29/2023] Open
Abstract
The global burden of fungal diseases has been increasing, as a result of the expanding number of susceptible individuals including people living with human immunodeficiency virus (HIV), hematopoietic stem cell or organ transplant recipients, patients with malignancies or immunological conditions receiving immunosuppressive treatment, premature neonates, and the elderly. Opportunistic fungal pathogens such as Aspergillus, Candida, Cryptococcus, Rhizopus, and Pneumocystis jiroveci are distributed worldwide and constitute the majority of invasive fungal infections (IFIs). Dimorphic fungi such as Histoplasma capsulatum, Coccidioides spp., Paracoccidioides spp., Blastomyces dermatiditis, Sporothrix schenckii, Talaromyces (Penicillium) marneffei, and Emmonsia spp. are geographically restricted to their respective habitats and cause endemic mycoses. Disseminated histoplasmosis, coccidioidomycosis, and T. marneffei infection are recognized as acquired immunodeficiency syndrome (AIDS)-defining conditions, while the rest also cause high rate of morbidities and mortalities in patients with HIV infection and other immunocompromised conditions. In the past decade, a growing number of monogenic immunodeficiency disorders causing increased susceptibility to fungal infections have been discovered. In particular, defects of the IL-12/IFN-γ pathway and T-helper 17-mediated response are associated with increased susceptibility to endemic mycoses. In this review, we put together the various forms of endemic mycoses on the map and take a journey around the world to examine how cellular and molecular defects of the immune system predispose to invasive endemic fungal infections, including primary immunodeficiencies, individuals with autoantibodies against interferon-γ, and those receiving biologic response modifiers. Though rare, these conditions provide importance insights to host defense mechanisms against endemic fungi, which can only be appreciated in unique climatic and geographical regions.
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Affiliation(s)
- Pamela P Lee
- LKS Faculty of Medicine, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Yu-Lung Lau
- LKS Faculty of Medicine, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.,Shenzhen Primary Immunodeficiencies Diagnostic and Therapeutic Laboratory, The University of Hong Kong-Shenzhen Hospital (HKU-SZH), Shenzhen, China
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Fungal Dimorphism and Virulence: Molecular Mechanisms for Temperature Adaptation, Immune Evasion, and In Vivo Survival. Mediators Inflamm 2017. [PMID: 28626345 PMCID: PMC5463121 DOI: 10.1155/2017/8491383] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The thermally dimorphic fungi are a unique group of fungi within the Ascomycota phylum that respond to shifts in temperature by converting between hyphae (22–25°C) and yeast (37°C). This morphologic switch, known as the phase transition, defines the biology and lifestyle of these fungi. The conversion to yeast within healthy and immunocompromised mammalian hosts is essential for virulence. In the yeast phase, the thermally dimorphic fungi upregulate genes involved with subverting host immune defenses. This review highlights the molecular mechanisms governing the phase transition and recent advances in how the phase transition promotes infection.
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Xiong XF, Fan LL, Kang M, Wei J, Cheng DY. Disseminated histoplasmosis: a rare clinical phenotype with difficult diagnosis. Respirol Case Rep 2017; 5:e00220. [PMID: 28250930 PMCID: PMC5326786 DOI: 10.1002/rcr2.220] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/14/2017] [Accepted: 01/24/2017] [Indexed: 02/05/2023] Open
Abstract
We describe a rare and interesting case of a 37‐year‐old man who presented with an intermittent fever, progressive cytopenia, and hepatosplenomegaly. Histopathological examination of a bone marrow smear revealed haemophagocytes and intracellular yeast‐like Histoplasma capsulatum (H. capsulatum); thus, we prolonged the blood culture duration to detect fungi, and H. capsulatum was detected in the peripheral blood. After the diagnosis of disseminated histoplasmosis, the patient was successfully treated with amphotericin B and symptomatic therapy. This is the first case in southwest China for which H. capsulatum was cultivated in peripheral blood, illustrating that the duration of specimen culture should be lengthened if a specific pathogen infection is suspected. Moreover, this case enriches our understanding of clinical manifestations of disseminated histoplasmosis.
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Affiliation(s)
- Xiao-Feng Xiong
- Department of Respiratory and Critical Care Medicine West China Hospital of Sichuan University Chengdu Sichuan China
| | - Li-Li Fan
- Department of Respiratory and Critical Care Medicine West China Hospital of Sichuan University Chengdu Sichuan China
| | - Mei Kang
- Department of Clinical Laboratory Medicine West China Hospital of Sichuan University Chengdu Sichuan China
| | - Jia Wei
- Department of Respiratory Medicine The Second People's Hospital Chengdu Sichuan China
| | - De-Yun Cheng
- Department of Respiratory and Critical Care Medicine West China Hospital of Sichuan University Chengdu Sichuan China
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Zhang Z, Tao F, Li Y, Xiao Y, Zhang Z, Liu J. Disseminated Penicillium marneffei infection recurrence in a non-acquired immune deficiency syndrome patient: A case report. Mol Clin Oncol 2016; 5:829-831. [PMID: 28105364 DOI: 10.3892/mco.2016.1038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 07/07/2016] [Indexed: 11/06/2022] Open
Abstract
Penicillium marneffei is a rare deep tissue fungal infection causing an endemic in Southeast Asia. This infection causes penicilliosis disease and is more common in patients who are immunocompromised. To date, no cases of P. marneffei infection relapse following treatment have been reported. A 36-year-old patient attended our hospital as a result of intermittent fever, cough, shortness of breath and multiple soft lesions located on the face, arms, neck and trunk. The medical radiological examination of the lung revealed multiple patchy exudative shadows, thick-walled hollow inner part of the visible lesions, bilateral pleural and pericardial effusion. Assessing the skull and right collarbone, bilateral thoracic ribs and a plurality revealed numeorus lesions with reduced bone destruction and revealed that the patient was positive for P. marneffei infection. After 6 months of antifungal therapy, pulmonary symptoms and the surface lesions of the patient rapidly disappearance and the physical condition markedly improved. The patient did not attend a follow-up and stopped antifungal treatment. In February 2016, the patient presented with left breast and subcutaneous soft tissue mass of the head and neck. Fungal culture results revealed that the patient was again positive for P. marneffei infection. The present case suggested that clinical doctors and patients must pay more attention to regular treatment of the disseminated P. marneffei. It also highlighted the requirement for awareness of penicilliosis in non-acquired immune deficiency syndrome patients, who are not immunocompromised, who are living in or traveling to P. marneffei-endemic areas.
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Affiliation(s)
- Zhixue Zhang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410000, P.R. China
| | - Fangxu Tao
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410000, P.R. China
| | - Yining Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410000, P.R. China
| | - Yudong Xiao
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410000, P.R. China
| | - Zhishu Zhang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410000, P.R. China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410000, P.R. China
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Abstract
ABSTRACT
Filamentous mycoses are often associated with significant morbidity and mortality. Prompt diagnosis and aggressive treatment are essential for good clinical outcomes in immunocompromised patients. The host immune response plays an essential role in determining the course of exposure to potential fungal pathogens. Depending on the effectiveness of immune response and the burden of organism exposure, fungi can either be cleared or infection can occur and progress to a potentially fatal invasive disease. Nonspecific cellular immunity (i.e., neutrophils, natural killer [NK] cells, and macrophages) combined with T-cell responses are the main immunologic mechanisms of protection. The most common potential mold pathogens include certain hyaline hyphomycetes, endemic fungi, the
Mucorales
, and some dematiaceous fungi. Laboratory diagnostics aimed at detecting and differentiating these organisms are crucial to helping clinicians make informed decisions about treatment. The purpose of this chapter is to provide an overview of the medically important fungal pathogens, as well as to discuss the patient characteristics, antifungal-therapy considerations, and laboratory tests used in current clinical practice for the immunocompromised host.
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Weerasinghe H, Payne M, Beard S, Andrianopoulos A. Organism-wide studies into pathogenicity and morphogenesis in Talaromyces marneffei. Future Microbiol 2016; 11:511-26. [PMID: 27073980 DOI: 10.2217/fmb.16.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Organism-wide approaches examining the genetic mechanisms controlling growth and proliferation have proven to be a powerful tool in the study of pathogenic fungi. For many fungal pathogens techniques to study transcription and protein expression are particularly useful, and offer insights into infection processes by these species. Here we discuss the use of approaches such as differential display, suppression subtractive hybridization, microarray, RNA-seq, proteomics, genetic manipulation and infection models for the AIDS-defining pathogen Talaromyces marneffei. Together these methods have broadened our understanding of the biological processes, and genes that underlie them, which are involved in switching between the saprophytic and pathogenic states of T. marneffei, the maintenance of these two specialized cell types and its ability to cause disease.
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Affiliation(s)
- Harshini Weerasinghe
- Genetics, Genomics & Development, School of BioSciences, University of Melbourne, Victoria 3010, Australia
| | - Michael Payne
- Genetics, Genomics & Development, School of BioSciences, University of Melbourne, Victoria 3010, Australia
| | - Sally Beard
- Genetics, Genomics & Development, School of BioSciences, University of Melbourne, Victoria 3010, Australia
| | - Alex Andrianopoulos
- Genetics, Genomics & Development, School of BioSciences, University of Melbourne, Victoria 3010, Australia
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44
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Chen R, Ji G, Wang L, Ren H, Xi L. Activation of ERK1/2 and TNF-α production are regulated by calcium/calmodulin signaling pathway during Penicillium marneffei infection within human macrophages. Microb Pathog 2016; 93:95-9. [PMID: 26828872 DOI: 10.1016/j.micpath.2016.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/16/2016] [Accepted: 01/28/2016] [Indexed: 11/25/2022]
Abstract
Previous study have shown that Penicillium marneffei (P. marneffei)-induced TNF-α production via an extracellular signal-regulated kinase (ERK) mitogen-activated protein kinase-dependent mechanism is an important host defence mechanism against P. marneffei in human macrophages. Therefore, we explore signaling pathway that regulates TNF-α secretion and activation of ERK1/2 by intracellular signaling mechanisms during P. marneffei infection. We found that ERK1/2 activation was dependent on the calcium/calmodulin/calmodulin kinase Ⅱ pathway in P. marneffei-infected human macrophages. In contrast, P. marneffei-induced p38 MAPK activation was negatively regulated by calcium/calmodulin/calmodulin kinase Ⅱ signaling pathway. Furthermore, TNF-α production in P. marneffei-infected human macrophages was also dependent on Ca(2+)/calmodulin/calmodulin kinase Ⅱ pathway. These data suggest that Ca(2+)/calmodulin/calmodulin kinase Ⅱ pathway plays vital regulatory roles in macrophage activation and subsequent cytokine production during P. marneffei infection.
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Affiliation(s)
- Renqiong Chen
- Department of Dermatology, Lianyungang First People's Hospital, Lianyungang, 222002, China; Department of Dermatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Guangquan Ji
- Department of Dermatology, Lianyungang First People's Hospital, Lianyungang, 222002, China
| | - Ling Wang
- Department of Dermatology, Changshu First People's Hospital, Changshu, 215500, China
| | - Hong Ren
- Department of Dermatology, Lianyungang First People's Hospital, Lianyungang, 222002, China
| | - Liyan Xi
- Department of Dermatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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Panapruksachat S, Iwatani S, Oura T, Vanittanakom N, Chindamporn A, Niimi K, Niimi M, Lamping E, Cannon RD, Kajiwara S. Identification and functional characterization of Penicillium marneffei pleiotropic drug resistance transporters ABC1 and ABC2. Med Mycol 2016; 54:478-91. [PMID: 26782644 DOI: 10.1093/mmy/myv117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 12/18/2015] [Indexed: 11/14/2022] Open
Abstract
Penicilliosis caused by the dimorphic fungus Penicillium marneffei is an endemic, AIDS-defining illness and, after tuberculosis and cryptococcosis, the third most common opportunistic infection of AIDS patients in tropical Southeast Asia. Untreated, patients have poor prognosis; however, primary amphotericin B treatment followed by prolonged itraconazole prophylaxis is effective. To identify ATP-binding cassette (ABC) transporters that may play a role in potential multidrug resistance of P. marneffei, we identified and classified all 46 P. marneffei ABC transporters from the genome sequence. PmABC1 and PmABC2 were most similar to the archetype Candida albicans multidrug efflux pump gene CDR1. P. marneffei Abc1p (PmAbc1p) was functionally expressed in Saccharomyces cerevisiae, although at rather low levels, and correctly localized to the plasma membrane, causing cells to be fourfold to eightfold more resistant to azoles and many other xenobiotics than untransformed cells. P. marneffei Abc2p (PmAbc2p) was expressed at similarly low levels, but it had no efflux activity and did not properly localize to the plasma membrane. Interestingly, PmAbc1p mislocalized and lost its transport activity when cells were shifted to 37 °C. We conclude that expression of PmAbc1p in S. cerevisiae confers resistance to several xenobiotics indicating that PmAbc1p may be a multidrug efflux pump.
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Affiliation(s)
| | - Shun Iwatani
- Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Japan
| | - Takahiro Oura
- Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Japan
| | | | | | - Kyoko Niimi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand
| | - Masakazu Niimi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand
| | - Erwin Lamping
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand
| | - Richard D Cannon
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, New Zealand
| | - Susumu Kajiwara
- Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Japan
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Zheng J, Gui X, Cao Q, Yang R, Yan Y, Deng L, Lio J. A Clinical Study of Acquired Immunodeficiency Syndrome Associated Penicillium Marneffei Infection from a Non-Endemic Area in China. PLoS One 2015; 10:e0130376. [PMID: 26083736 PMCID: PMC4471200 DOI: 10.1371/journal.pone.0130376] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 05/20/2015] [Indexed: 11/25/2022] Open
Abstract
Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of penicilliosis among the patients with acquired immunodeficiency syndrome (AIDS) in non-endemic areas of China, and then to discuss its incubation period and the diagnostic performance of serum galactomannan test for penicilliosis. Methods Medical records and travel histories of penicilliosis patients in Zhongnan hospital from January 2006 to December 2013, and the interval from when the patients left the endemic area to the onset of the disease was analyzed. Serum galactomannan levels of penicilliosis patients and AIDS patients with fever were measured by the Platelia Aspergillus Enzyme Immunoassay Kit. Results A total of 47 AIDS-associated penicilliosis were confirmed by fungal culture, which accounted for 4.8% of 981 AIDS-related admissions. The sensitivity and specificity of serum galactomannan test for penicilliosis were 95.8% (23/24) and 90.9% (30/33), respectively, (cutoff index = 1.0). Two independent predictors for early mortality (death within 12 weeks) of the patients (21.3%, 10/47) were a delayed diagnosis and no treatment with antifungal therapy. Among 14 patients who became ill after leaving endemic areas, ten patients presented with the onset symptoms within 12 months (from 11 days to 360 days). We found a patient living with asymptomatic P. marneffei fungemia who had not received any antifungal therapy until 18 months’ follow up. Conclusions The co-infection of P. marneffei and HIV was not uncommon in the non-endemic areas of penicilliosis in China. There exists a latent form of infection for P. marneffei. The incubation period of penicilliosis may be quite different from one patient to another. In AIDS patients, the serum galactomannan test has utility for the diagnosis of penicilliosis. When patients with penicilliosis/AIDS were diagnosed early and treated with standardized antifungal therapy and combined antiretroviral therapy, their prognosis improved.
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Affiliation(s)
- Jinding Zheng
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xien Gui
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- * E-mail:
| | - Qian Cao
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Rongrong Yang
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yajun Yan
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Liping Deng
- Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jonathan Lio
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
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47
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Chen R, Ji G, Ma T, Huang X, Ren H, Xi L. Role of intracellular free calcium in killing Penicillium marneffei within human macrophages. Microb Pathog 2015; 83-84:29-34. [PMID: 25959526 DOI: 10.1016/j.micpath.2015.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 05/04/2015] [Accepted: 05/06/2015] [Indexed: 12/01/2022]
Abstract
Increases in cytosolic Ca(2+) concentration ([Ca(2+)]c) promote phagocyte antimicrobial responses. Here, we investigated macrophages stimulated by Penicillium marneffei (P. marneffei). [Ca(2+)]c was determined in macrophages loaded with the fluorescent calcium probe Fura 2/AM as they were stimulated by P. marneffei. We found that P. marneffei induced an increase in [Ca(2+)]c in human macrophages. Further, increased [Ca(2+)]c with the ionophore A23187 promoted phagosomal acidification and maturation and reduced intracellular replication of P. marneffei in P. marneffei-infected human macrophages, whereas decreased [Ca(2+)]c with the chelation MAPTAM decreased TNF-α production, inhibited phagosomal acidification and maturation and increased intracellular replication of P. marneffei. These data indicate that Ca(2+) signaling may play an important role in controlling the replication of P. marneffei within macrophages.
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Affiliation(s)
- Renqiong Chen
- Department of Dermatology, Lianyungang First People's Hospital, Lianyungang 222002, China
| | - Guangquan Ji
- Department of Dermatology, Lianyungang First People's Hospital, Lianyungang 222002, China
| | - Tuan Ma
- Department of Dermatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiaowen Huang
- Department of Dermatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hong Ren
- Department of Dermatology, Lianyungang First People's Hospital, Lianyungang 222002, China
| | - Liyan Xi
- Department of Dermatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
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48
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Xia XJ, Shen H, Xu AE. Cutaneous Penicillium marneffei infection in a patient with idiopathic CD4(+) lymphocytopenia. J Dermatol 2015; 42:812-4. [PMID: 25912013 DOI: 10.1111/1346-8138.12899] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/09/2015] [Indexed: 11/29/2022]
Abstract
We describe a case of cutaneous Penicillium marneffei infection in a non-HIV-infected male patient with idiopathic CD4(+) T lymphocytopenia (ICL). The cutaneous lesions were cured after the treatment of itraconazole combined with interleukin-2.
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Affiliation(s)
- Xiu-Jiao Xia
- Department of Dermatology, Third Hospital of Hangzhou, Hangzhou, China
| | - Hong Shen
- Department of Dermatology, Third Hospital of Hangzhou, Hangzhou, China
| | - Ai-e Xu
- Department of Dermatology, Third Hospital of Hangzhou, Hangzhou, China
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49
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Treatment of Disseminated Talaromyces marneffei with Tracheal Infection: Two Case Reports. Mycopathologia 2015; 180:245-9. [PMID: 25863952 DOI: 10.1007/s11046-015-9891-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 04/06/2015] [Indexed: 10/23/2022]
Abstract
Talaromyces marneffei infection involving the trachea presents as diffuse irregular nodules that grow on the tracheal lumen and/or rarely present as concurrent severe eosinophilia. Herein, we report two patients without HIV infection whose main tracheal and/or principal bronchi were involved by T. marneffei infection, which manifested as diffuse proliferative nodules. In case 1, the infection primarily affected the main trachea, resulting in structural cartilage damage, tracheal stenosis, and tracheal absence. In case 2, there were diffuse proliferative nodules in the trachea and bronchi with marked eosinophilia. The final diagnosis was made based on a positive culture from bronchiolar lavage fluid, skin, and tracheal polyps. Case 1 was administered antifungal treatment combined with surgery, but relapse occurred during a 3-month follow-up period. Case 2 was treated by intravenous liposomal amphotericin B combined with atomized inhaled liposomal amphotericin B, and he later showed improvement; there was no relapse during the 12-month period of antifungal treatment. Importantly, atomized inhaled amphotericin B antifungal treatment for T. marneffei infection has never been previously reported.
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Huang X, He G, Lu S, Liang Y, Xi L. Role of Rhizomys pruinosus as a natural animal host of Penicillium marneffei in Guangdong, China. Microb Biotechnol 2015; 8:659-64. [PMID: 25824250 PMCID: PMC4476820 DOI: 10.1111/1751-7915.12275] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/11/2015] [Indexed: 11/29/2022] Open
Abstract
Penicillium marneffei, a dimorphic fungus that can cause penicilliosis marneffei, is endemic in Southeast Asia. The only known hosts of P. marneffei are humans and bamboo rats. The aim of our study was to explore the distribution of P. marneffei in bamboo rats, their associated environment and non-rat-associated environments. Totally, 270 samples were collected in Guangdong province of China in 2012; the prevalence of P. marneffei was much higher in samples collected from surrounding areas of burrows (8.2%) than in the samples obtained from non-rat-associated sites (2%) or artificial farms of bamboo rats (0%). There was no difference in P. marneffei isolated rate from different areas of Guangdong province. The infection is prevalent in all rats, and this fungus could be frequently seen in the rats' lungs. This study confirms that bamboo rat is the ecological niche of P. marneffei and hypothesizes that bamboo rats become infected by inhaling aerosolized conidia originating from environmental sources, rather than by the fecal-oral route or transplacental crossing. According to the result of no detection of P. marneffei in the artificial farm, the activity of bamboo rats might be more relevant to the distribution and dissemination of P. marneffei in natural environment.
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Affiliation(s)
- Xiaowen Huang
- Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes, Research Center of Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guohua He
- Department of Dermatology and Venereology, The Second People's Hospital of Liwan District, Guangzhou, China
| | - Sha Lu
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuheng Liang
- Guangdong Provincial Center for Disease Control and Prevention, Institute of Pathogenic Microbiology, Guangzhou, China
| | - Liyan Xi
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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