1
|
Niu C, Song X, Hao J, Zhao M, Yuan Y, Liu J, Yue T. Identification of Burkholderia gladioli pv. cocovenenans in Black Fungus and Efficient Recognition of Bongkrekic Acid and Toxoflavin Producing Phenotype by Back Propagation Neural Network. Foods 2024; 13:351. [PMID: 38275718 PMCID: PMC10815087 DOI: 10.3390/foods13020351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Burkholderia gladioli pv. cocovenenans is a serious safety issue in black fungus due to the deadly toxin, bongkrekic acid. This has triggered the demand for an efficient toxigenic phenotype recognition method. The objective of this study is to develop an efficient method for the recognition of toxin-producing B. gladioli strains. The potential of multilocus sequence typing and a back propagation neural network for the recognition of toxigenic B. cocovenenans was explored for the first time. The virulent strains were isolated from a black fungus cultivation environment in Qinba Mountain area, Shaanxi, China. A comprehensive evaluation of toxigenic capability of 26 isolates were conducted using Ultra Performance Liquid Chromatography for determination of bongkrekic acid and toxoflavin production in different culturing conditions and foods. The isolates produced bongkrekic acid in the range of 0.05-6.24 mg/L in black fungus and a highly toxin-producing strain generated 201.86 mg/L bongkrekic acid and 45.26 mg/L toxoflavin in co-cultivation with Rhizopus oryzae on PDA medium. Multilocus sequence typing phylogeny (MLST) analysis showed that housekeeping gene sequences have a certain relationship with a strain toxigenic phenotype. We developed a well-trained, back-propagation neutral network for prediction of toxigenic phenotype in B. gladioli based on MLST sequences with an accuracy of 100% in the training set and an accuracy of 86.7% in external test set strains. The BP neutral network offers a highly efficient approach to predict toxigenic phenotype of strains and contributes to hazard detection and safety surveillance.
Collapse
Affiliation(s)
- Chen Niu
- College of Food Science and Technology, Northwest University, Xi’an 710069, China; (C.N.); (X.S.); (J.H.); (Y.Y.)
| | - Xiying Song
- College of Food Science and Technology, Northwest University, Xi’an 710069, China; (C.N.); (X.S.); (J.H.); (Y.Y.)
| | - Jin Hao
- College of Food Science and Technology, Northwest University, Xi’an 710069, China; (C.N.); (X.S.); (J.H.); (Y.Y.)
| | - Mincheng Zhao
- The 20th Research Institute of CETC, Xi’an 710068, China
| | - Yahong Yuan
- College of Food Science and Technology, Northwest University, Xi’an 710069, China; (C.N.); (X.S.); (J.H.); (Y.Y.)
| | - Jingyan Liu
- College of Food Science and Technology, Northwest University, Xi’an 710069, China; (C.N.); (X.S.); (J.H.); (Y.Y.)
| | - Tianli Yue
- College of Food Science and Technology, Northwest University, Xi’an 710069, China; (C.N.); (X.S.); (J.H.); (Y.Y.)
| |
Collapse
|
2
|
Zhao L, Zhao Y, Zhao L, Liu G. Preparation of an N-S dual-doped black fungus porous carbon matrix and its application in high-performance Li-S batteries. Front Chem 2023; 11:1288013. [PMID: 38179239 PMCID: PMC10765507 DOI: 10.3389/fchem.2023.1288013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
A nitrogen-sulfur dual-doped black fungus porous carbon (NS-FPC) matrix was prepared with natural black fungus as the carbon source and cysteine as the nitrogen-sulfur source. A black fungus-based solution was obtained by hydrothermal treatment. After further carbonization activation and combination with sulfur processing, the NS-FPC/S positive electrode materials were prepared. The uniform recombination of biomass carbon provides an efficient conductive framework for sulfur. The porous structure is conducive to the transport of electrolytes. Heteroatom doping can provide a more active site. The structure and composition analyses of the materials were carried out using X-ray diffraction (XRD). The electronic binding energy and bonding state were analyzed by X-ray photoelectron spectroscopy (XPS). The morphology was observed by scanning electron microscopy and transmission electron microscopy. The specific surface area and pore size distribution were analyzed using an N2 adsorption-desorption experiment. Sulfur loading was determined through thermogravimetric analysis. The electrochemical performance of NS-FPC/S in Li-S batteries was systematically investigated. The result shows that the NS-FPC/S electrode maintains more than 1,000 mAh g-1 reversible capacity after 100 cycles at 0.2 C current density, with a capacity retention of 85%. The cycle and rate performance are both considerably superior to those of traditional activated carbon materials.
Collapse
Affiliation(s)
- Liping Zhao
- Institute of Chemical and Industrial Bioengineering, Jilin Engineering Normal University, Changchun, China
- School-Enterprise Joint Technology Innovation Laboratory of Novel Molecular Functional Materials of Jilin Province, Changchun, China
| | - Ye Zhao
- FAW Tooling Die Manufacturing Co., Ltd., Changchun, China
| | - Lihe Zhao
- Daqing Oilfield Design Institute Co., Ltd., Daqing, China
| | - Gang Liu
- Institute of Chemical and Industrial Bioengineering, Jilin Engineering Normal University, Changchun, China
- School-Enterprise Joint Technology Innovation Laboratory of Novel Molecular Functional Materials of Jilin Province, Changchun, China
| |
Collapse
|
3
|
Ambiha R, Gopal R, Siva Subramanian N, Patel Bansi G, Patel Dhenu G, Patel Dharmik B, Patel Disha V, Patel Heli A, Patel Janu N. Knowledge on mucormycosis among nursing Indian students in the state of Gujarat. Bioinformation 2023; 19:1003-1006. [PMID: 37969661 PMCID: PMC10640785 DOI: 10.6026/973206300191003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/17/2023] Open
Abstract
The disorder known as angio-invasive mucormycosis is characterized by tissue necrosis and infarction. The Mucorales order of saprophytic fungi is responsible for its development. It is unclear how widespread mucormycosis is in India due to a lack of population-based investigations. Diabetes mellitus is the risk factor that occurs the most frequently, followed by solid organ transplant and hematological cancer. The present study has been carried out to assess the knowledge regarding mucormycosis among nursing students from Nootan College of Nursing, Visnagar, Gujarat. For this we have selected 100 students by using the probability sampling technique. Structured questions were used to assess the knowledge of nursing students regarding mucormycosis. The Score was categorized as poor, average and good. The results show that 45(45%) of the nursing students having poor knowledge, 35(35%) of them were having average knowledge, 20(20%) of them were having good knowledge. There is an association between gender, program and their level of knowledge. Most of the students having poor knowledge regarding mucormycosis and we need to create awareness regarding mucormycosis to Nursing students.
Collapse
Affiliation(s)
- R Ambiha
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat-384315, India
| | - R Gopal
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat-384315, India
| | - N Siva Subramanian
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat-384315, India
| | | | - Grishbhai Patel Dhenu
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat-384315, India
| | | | - Vikrambhai Patel Disha
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat-384315, India
| | - Alpeshkumar Patel Heli
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat-384315, India
| | - Nareshbhai Patel Janu
- Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat-384315, India
| |
Collapse
|
4
|
Raina D, Rohilla R, Patwal S, Pandita A. The Second COVID-19 Wave Is a Tsunami With Aftershocks: Mucormycosis Ire as Seen in a Tertiary Care Hospital in Uttarakhand, India. Cureus 2023; 15:e47358. [PMID: 38021725 PMCID: PMC10657149 DOI: 10.7759/cureus.47358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND During the spread of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) or the coronavirus disease 2019 (COVID-19) pandemic in recent times, an upsurge of invasive fungal infections (IFIs) such as mucormycosis was witnessed by many countries like India. This COVID-19-associated mucormycosis (CAM) has presented as a menace to the already creaking health infrastructure. Clinical manifestations, risk factors, and end clinical outcomes varied for every other region/country. The aim of this study is to delineate and analyze plausible clinical and epidemiological factors and associated predictors of CAM in suspected patients presenting to a tertiary care hospital in Uttarakhand, India, during the second wave of COVID-19 in India. MATERIAL AND METHODS A total of 200 cases of suspected post‑COVID-19 mucormycosis were enrolled. Data were collected taking into account parameters such as hospitalization and ICU admissions during the episode of COVID-19 infection, steroid/antibiotics/oxygen requirement, and comorbidities such as diabetes mellitus, hypertension, or any chronic illness and outcome. RESULTS Participants diagnosed with CAM using KOH examination and fungal culture were analyzed in the study (n=46). The median age of patients included was 48, 73.9% were males, and 26% were females. The major predisposing factor was found to be diabetes mellitus type 2. Our work suggests that the mean duration between COVID-19 episodes and CAM was 11.86 days with a significant statistical association. Oxygen requirement and imprudent use of steroids/antibiotics were also allied with mucormycosis. CONCLUSION The burden of such IFIs is expected to be unveiled in tropical countries during pandemics such as COVID-19, which lead to immunosuppression in masses post-treatment. Comorbidities such as diabetes, chronic kidney disease, and hypertension add to the risk of acquiring other infectious disease. Such times require competent healthcare professionals such as diagnosticians, physicians, and surgeons who are skilled to manage such IFIs timely.
Collapse
Affiliation(s)
- Dimple Raina
- Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, IND
| | - Ranjana Rohilla
- Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, IND
| | - Shiwang Patwal
- Microbiology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, IND
| | - Ajay Pandita
- Community Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, IND
| |
Collapse
|
5
|
Prakash S, Kumar A. Mucormycosis threats: A systemic review. J Basic Microbiol 2023; 63:119-127. [PMID: 36333107 DOI: 10.1002/jobm.202200334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/28/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Abstract
During the catastrophic wave of Coronavirus disease 2019, health agencies started to report an infrequent but lethal mucormycosis or black fungal infection. Primarily, it causes sinusitis by affecting nasal, oral, lung, brain, ocular, and other body tissues. It becomes more fatal, especially in diabetic, cancer, and immune-compromised patients. Before 2020, the prevalence of mucormycosis was very rare but it has rapidly emerged globally from late 2020 to mid-2021. Recently, the mucormycosis got worse and epidemic with more than 30,000 cases reported across India. The etiology of infection can be diagnosed by molecular, serological, microscopic, and clinical methods. However, early diagnosis of this ailment is still a challenging task due to no standalone diagnostic tool available along with clinical manifestations of the ailment resembling other fungal diseases. The treatment of mucormycosis is also challenging and frequently requires long-term treatment. Amphotericin B was found to be an effective antifungal for preventing mucormycosis but it failed if infection disseminated to necrotizing tissues or adjacent organs. Removal of infected tissue/organ by surgery is an alternative treatment to control mucormycosis. In addition, reversal of underlying predisposing conditions based on therapy is also in practice for its prevention. This review highlights different aspects of mucormycosis such as pathogenesis, diagnosis, treatment, and their challenges and so on. We also emphasized the epidemiological shift during the recent outbreak and its influence on the different regions of India.
Collapse
Affiliation(s)
- Shaurya Prakash
- Department of Biochemistry, Central University of Haryana, Haryana, India
| | - Antresh Kumar
- Department of Biochemistry, Central University of Haryana, Haryana, India
| |
Collapse
|
6
|
Rais N, Ahmad R, Ved A, Parveen K, Bari DG, Prakash O. Diabetic Ketoacidosis (DKA), a Leading Risk Factor for Mucormycosis ( Black Fungus), during the Era of Coronavirus Disease-2019 (COVID-19): An Overview. Curr Diabetes Rev 2023; 19:33-45. [PMID: 35293299 DOI: 10.2174/1573399818666220315162424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/06/2022] [Accepted: 01/31/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Diabetes mellitus (DM) and steroid medication, coincided with coronavirus disease 2019 (COVID-19), results in a weakened immune system, allowing some commonly found pathogens to become more harmful. Mucormycosis (black fungus) is a type of opportunistic infection caused by fungi belonging to the Mucorales family. DM is the most prominent risk factor for mucormycosis. Excessive blood sugar and decreased insulin levels lead to diabetic ketoacidosis (DKA), a devastating complication of DM that can be fatal if left untreated. METHODS Diabetic ketoacidosis is more common in type 1 diabetic patients, although it can also be fall in type 2 diabetic patients. DKA occurs when the body lacks enough insulin to allow blood sugar to enter the cells and is used for energy. Instead, the liver breaks down fat for fuel-producing chemicals known as ketones. RESULTS When too many ketones are created too quickly, they can reach dangerously high levels in the body. Mucormycosis is a rare but serious infectious disease that requires medication or surgical removal. CONCLUSION The confluence of diabetes and COVID-19 makes managing mucormycosis a serious and dead issue. Although the effectiveness of prophylactic antifungal therapy has yet to be demonstrated, hyperglycemia control appears to be the most important step in managing mucormycosis in DKA patients.
Collapse
Affiliation(s)
- Nadeem Rais
- Department of Pharmacy, Bhagwant University, Ajmer, Rajasthan-305004, India
- Department of Pharmacy, Vivek College of Technical Education, Bijnor, Uttar Pradesh-246701, India
| | - Rizwan Ahmad
- Department of Pharmacy, Vivek College of Technical Education, Bijnor, Uttar Pradesh-246701, India
| | - Akash Ved
- Goel Institute of Pharmaceutical Sciences, Lucknow, Uttar Pradesh-226028, India
| | - Kehkashan Parveen
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, Uttar Pradesh-202002, India
| | - Darakhshan Gazala Bari
- Department of Pharmacy, Vivek College of Technical Education, Bijnor, Uttar Pradesh-246701, India
| | - Om Prakash
- Goel Institute of Pharmacy and Sciences, Lucknow, Uttar Pradesh-226028, India
| |
Collapse
|
7
|
Arjmand P, Bahrami M, Mohammadie ZE, Taherynejad M, Khorasani NY, Mehrad‐Majd H, Roshanzamir I, Bakhshaee M. Mucormycosis in pre-COVID-19 and COVID-19 era: A study of prevalence, risk factors and clinical features. Laryngoscope Investig Otolaryngol 2022; 7:LIO2899. [PMID: 36249085 PMCID: PMC9539365 DOI: 10.1002/lio2.899] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 12/15/2022] Open
Abstract
Objective Mucormycosis is a rare yet devastating fungal disease with a frequently fatal outcome. The purpose of this study was to compare the prevalence of mucormycosis, evaluate its risk factors, and assess the patients' outcomes in pre-COVID-19 and COVID-19 era. Methods In this retrospective observational study, clinical data of 158 patients with confirmed histopathological diagnosis of mucormycosis were collected from the medical records departments of Imam Reza and Ghaem hospitals, Mashhad, Iran during 2018-2021. The collected data were risk factors associated with mucormycosis including age, gender, underlying diseases, details of corticosteroid administration, and complications such as blindness and mortality. Results Of 158 studied patients, 48 patients were diagnosed in the pre-pandemic period whereas 110 cases were admitted during the pandemic era. COVID-19 associated mucormycosis (CAM) was observed in 58.1% of the pandemic cases. In the pre-pandemic period, cancer (89.5% vs. 39%, p < .001) was significantly more prevalent while during the pandemic era, the prevalence of diabetes mellitus (16.7% vs. 51%, p < .001) was remarkably higher. Moreover, the mortality rate of mucormycosis was considerably reduced after the pandemic (64.6%-45.4%), especially in CAM patients (35.9%). Conclusion The COVID-19 pandemic has led to an increased prevalence of mucormycosis, due to the convergence of interlinked risk factors such as diabetes mellitus, corticosteroid therapy, and COVID-19. Therefore, clinicians must be aware of the probable occurrence of mucormycosis in the first or second week of COVID-19 infection in vulnerable patients and use the steroids cautiously. Level of evidence 4 Laryngoscope Investigative Otolaryngology, 2022.
Collapse
Affiliation(s)
- Parisa Arjmand
- Department of Otorhinolaryngology, Ghaem HospitalMashhad University of Medical SciencesMashhadIran
| | - Milad Bahrami
- Department of Laboratory Sciences, Faculty of Paramedical SciencesMashhad University of Medical SciencesMashhadIran
| | | | | | | | - Hassan Mehrad‐Majd
- Cancer Molecular Pathology Research CenterMashhad University of Medical SciencesMashhadIran
| | - Imaneh Roshanzamir
- Sinus and Surgical Endoscopic Research Center, Department of OtorhinolaryngologyMashhad University of Medical SciencesMashhadIran
| | - Mehdi Bakhshaee
- Sinus and Surgical Endoscopic Research Center, Department of OtorhinolaryngologyMashhad University of Medical SciencesMashhadIran
| |
Collapse
|
8
|
Jain V, Aggarwal A, Shrimali T, Vishwakarma K, Paul D, Kombade SP, Sharma V, Soni K, Choudhary B, Goyal A, Chugh A, Tiwari S, Sharma DK, Agarwal A, Misra S. Hit or Miss: The Dilemma of Specimen Selection for Microbiological Diagnosis of Rhino-Orbital-Cerebral- COVID-Associated Mucormycosis (ROCM-CAM). Infect Disord Drug Targets 2022; 23:e160822207524. [PMID: 35975857 DOI: 10.2174/1871526522666220816110905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 03/23/2022] [Accepted: 04/12/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND We diagnosed various cases of rhino-orbital-cerebral- COVID-associated Mucormycosis (ROCM-CAM) during India's second wave of COVID-19. This helped formulate novel suggestions for improving laboratory output, applicable anywhere in the world. METHODS To diagnose ROCM-CAM by microbiological methods, we used direct microscopy and conventional culture on various clinical samples within the shortest turn-around time. DESIGN Prospective single-center observational study. PARTICIPANTS Patients with ROCM-CAM. RESULTS Of 113 suspected cases of ROCM-CAM during May 2021, direct microscopy and culture could confirm the disease in 87.61% and 44.25% of patients, respectively. The highest pathogen isolation was seen from maxillary bone fragments, FESS-guided biopsy from pterygopalatine fossae, nasal turbinates and nasal mucosal biopsy. Direct microscopy could diagnose the disease in almost 40% of patients within 24 hours and 60% within two days. Conventional cultures yielded Rhizopus spp. (86%) as the commonest fungal pathogen followed by Mucor spp. (12%) within 7 days. Deep tissue biopsies are more useful for rapid diagnosis than superficial specimens. Routine fungal cultures can supplement case detection and help prognosticate survivors. CONCLUSION The management of ROCM is a surgical emergency. The diagnosis of the condition must therefore be prompt and precise. Despite ongoing antifungal therapy, nasal mucosal tissue, FESSguided, and intra-operative tissue biopsies showed the pathogen's highest diagnostic yield. The diagnostic index improved further when multiple (4-5) high-quality specimens were collected. Nasal swabs and crusts, among the most commonly requested specimens worldwide, were found to have an overall low diagnostic potential.
Collapse
Affiliation(s)
- Vidhi Jain
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Alisha Aggarwal
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Twishi Shrimali
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Kirti Vishwakarma
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Debaleena Paul
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Sarika Prabhakar Kombade
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Vidhu Sharma
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Kapil Soni
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Bikram Choudhary
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Amit Goyal
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Ankita Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Sarbesh Tiwari
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Deepak Kumar Sharma
- Department of General Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Ashwini Agarwal
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, Rajasthan-342005, India
| |
Collapse
|
9
|
Chandley P, Subba P, Rohatgi S. COVID-19-Associated Mucormycosis: A Matter of Concern Amid the SARS-CoV-2 Pandemic. Vaccines (Basel) 2022; 10:1266. [PMID: 36016154 DOI: 10.3390/vaccines10081266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 12/16/2022] Open
Abstract
Mucormycosis is an invasive fungal infection caused by fungi belonging to order Mucorales. Recently, with the increase in COVID-19 infections, mucormycosis infections have become a matter of concern globally, because of the high morbidity and mortality rates associated with them. Due to the association of mucormycosis with COVID-19 disease, it has been termed COVID-19-associated mucormycosis (CAM). In the present review, we focus on mucormycosis incidence, pathophysiology, risk factors, immune dysfunction, interactions of Mucorales with endothelial cells, and the possible role of iron in Mucorales growth. We review the limitations associated with current diagnostic procedures and the requirement for more specific, cost-effective, convenient, and sensitive assays, such as PCR-based assays and monoclonal antibody-based assays for the effective diagnosis of mucormycosis. We discuss the current treatment options involving antifungal drug therapies, adjunctive therapy, surgical treatment, and their limitations. We also review the importance of nutraceuticals-based therapy for the prevention as well as treatment of mucormycosis. Our review also highlights the need to explore the potential of novel immunotherapeutics, which include antibody-based therapy, cytokine-based therapy, and combination/synergistic antifungal therapy, as treatment options for mucormycosis. In summary, this review provides a complete overview of COVID-19-associated mucormycosis, addressing the current research gaps and future developments required in the field.
Collapse
|
10
|
Rashdan HRM, Abdelrahman MT, Shehadi IA, El-Tanany SS, Hemdan BA. Novel Thiadiazole-Based Molecules as Promising Inhibitors of Black Fungi and Pathogenic Bacteria: In Vitro Antimicrobial Evaluation and Molecular Docking Studies. Molecules 2022; 27. [PMID: 35684551 DOI: 10.3390/molecules27113613] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/29/2022] [Accepted: 06/02/2022] [Indexed: 02/01/2023] Open
Abstract
Novel 1,3,4-thiadiazole derivatives were synthesized through the reaction of methyl 2-(4-hydroxy-3-methoxybenzylidene) hydrazine-1-carbodithioate and the appropriate hydrazonoyl halides in the presence of a few drops of diisopropylethylamine. The chemical structure of the newly fabricated compounds was inferred from their microanalytical and spectral data. With the increase in microbial diseases, fungi remain a devastating threat to human health because of the resistance of microorganisms to antifungal drugs. COVID-19-associated pulmonary aspergillosis (CAPA) and COVID-19-associated mucormycosis (CAM) have higher mortality rates in many populations. The present study aimed to find new antifungal agents using the disc diffusion method, and minimal inhibitory concentration (MIC) values were estimated by the microdilution assay. An in vitro experiment of six synthesized chemical compounds exhibited antifungal activity against Rhizopus oryzae; compounds with an imidazole moiety, such as the compound 7, were documented to have energetic antibacterial, antifungal properties. As a result of these findings, this research suggests that the synthesized compounds could be an excellent choice for controlling black fungus diseases. Furthermore, a molecular docking study was achieved on the synthesized compounds, of which compounds 2, 6, and 7 showed the best interactions with the selected protein targets.
Collapse
|
11
|
Jayagayathri R, Mohanty P, Yadalla D, Bakthavatchalam J, Rangarajan V, Maneksha V, Tanwar M, Venkatesh R, Jayashree S. Knowledge, attitude, and practice toward mucormycosis among patients presenting to six tertiary eye care hospitals in South India - A multicentric online questionnaire-based survey. Indian J Ophthalmol 2022; 70:2158-2162. [PMID: 35648003 PMCID: PMC9359275 DOI: 10.4103/ijo.ijo_103_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: To study the awareness on mucormycosis among outpatients who visited six tertiary eye care hospitals at Madurai, Pondicherry, Coimbatore, Tirunelveli, Chennai, and Tirupati. Methods: This was a telephone-based survey conducted using questionnaires consisting of 38 questions in five sections from July 5 to 25, 2021. Patients visiting the eye hospitals for an examination were contacted over their phones and responses were directly entered onto the Google forms platform. Results: A total of 4573 participants were included in the study. Among all participants, a cumulative 83% of participants had some knowledge of mucormycosis. More than 80% of them reported that their prime source of information was through mass communication like television or radio. Around 34.8% of the respondents were aware that it can occur after treatment for coronavirus disease 2019 (COVID-19) infection, only half of them (54.3%) knew that systemic steroids were the main risk factor. The knowledge scores were higher for participants who were diabetics (n = 1235) or had been affected by COVID-19 earlier (n = 456) or whose friends had mucormycosis earlier (n = 312). Knowledge, attitude, and practice (KAP) scores of nonprofessional health-care workers (n = 103) were much better compared to patients. Conclusion: Such KAP studies give us an idea of the impact of the measures taken for educating the public. In this study, a cumulative 83% of participants had some knowledge of mucormycosis and 86% knew that this was an emergency. More than 50% of the participants were not aware that diabetes is a risk factor for mucormycosis.
Collapse
Affiliation(s)
| | - Preeti Mohanty
- Department of Orbit and Oculoplasty, Aravind Eye Hospital, Tirupati, Andhra Pradesh, India
| | - Dayakar Yadalla
- Department of Orbit and Oculoplasty, Aravind Eye Hospital, Pondicherry, India
| | | | - Viji Rangarajan
- Department of Orbit and Oculoplasty, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
| | - Velu Maneksha
- Department of Orbit and Oculoplasty, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - Meghana Tanwar
- Department of Orbit and Oculoplasty, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Rengaraj Venkatesh
- Chief Medical Officer, Department of Glaucoma, Aravind Eye Hospital, Pondicherry, India
| | | |
Collapse
|
12
|
Gupta U, Paliwal D, Rawat S. Mucromycosis in India: Pathophysiology and Perspectives on Treatment and Management. Infect Disord Drug Targets 2022:IDDT-EPUB-123194. [PMID: 35532252 DOI: 10.2174/1871526522666220509064659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/01/2021] [Accepted: 12/16/2021] [Indexed: 11/22/2022]
Abstract
Mucormycosis, also known as "black fungus," is a potentially fatal disorder that causes blurred or double vision, chest pain, and breathing problems. The introduction of novel risk factors and causative agents, as well as the problems with controlling the disease, are all significant problems with mucormycosis in India. It is most common among COVID-19 patients. Mucormycosis is an invasive fungal disease that primarily affects immunosuppressant patients, mainly caused by mold fungi of the genus mucor, rhizopus, rhizomucor, and absidia, which are in the zygomycetes class and the mucorales order. The most common risk factor is diabetes mellitus, followed by haematological malignancy and solid-organ transplantation. Reversal of underlying predisposing factors, surgical debridement of infected tissues, and proper antifungal therapy are all required for the treatment of mucormycosis. In this review, the epidemiology, pathogenesis, and symptoms of black fungus and its association with covid-19, treatment and diagnosis are discussed.
Collapse
Affiliation(s)
- Utsav Gupta
- Department of Pharmacy, School of Medical & Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Deepika Paliwal
- Department of Pharmacy, School of Medical & Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Samridhi Rawat
- Department of Pharmacy, School of Medical & Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| |
Collapse
|
13
|
Imtiaz Khan N, Mahmud T, Nazrul Islam M. COVID-19 and black fungus: Analysis of the public perceptions through machine learning. Eng Rep 2022; 4:e12475. [PMID: 34901767 PMCID: PMC8646461 DOI: 10.1002/eng2.12475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/19/2021] [Accepted: 10/17/2021] [Indexed: 05/05/2023]
Abstract
While COVID-19 is ravaging the lives of millions of people across the globe, a second pandemic "black fungus" has surfaced robbing people of their lives especially people who are recovering from coronavirus. Thus, the objective of this article is to analyze public perceptions through sentiment analysis regarding black fungus during the COVID-19 pandemic. To attain the objective, first, a support vector machine (SVM) model, with an average AUC of 82.75%, was developed to classify user sentiments in terms of anger, fear, joy, and sad. Next, this SVM model was used to predict the class labels of the public tweets (n = 6477) related to COVID-19 and black fungus. As outcome, this article found public perceptions towards black fungus during COVID-19 pandemic belong mostly to sad (n= 2370, 36.59%), followed by joy (n = 2095, 32.34%), fear (n = 1914, 29.55%) and anger (n = 98, 1.51%). This article also found that public perceptions are varied to some critical concerns like education, lockdown, hospital, oxygen, quarantine, and vaccine. For example, people mostly exhibited fear in social media about education, hospital, vaccine while some people expressed joy about education, hospital, vaccine, and oxygen. Again, it was found that mass people have an ignorance tendency to lockdown, COVID-19 restrictions, and prescribed hygiene rules although the coronavirus and black fungus infection rates broke the previous infection records.
Collapse
Affiliation(s)
- Nafiz Imtiaz Khan
- Department of Computer Science and EngineeringMilitary Institute of Science and Technology (MIST)DhakaBangladesh
| | - Tahasin Mahmud
- Department of Computer Science and EngineeringMilitary Institute of Science and Technology (MIST)DhakaBangladesh
| | - Muhammad Nazrul Islam
- Department of Computer Science and EngineeringMilitary Institute of Science and Technology (MIST)DhakaBangladesh
| |
Collapse
|
14
|
Dogra S, Arora A, Aggarwal A, Passi G, Sharma A, Singh G, Barnwal RP. Mucormycosis Amid COVID-19 Crisis: Pathogenesis, Diagnosis, and Novel Treatment Strategies to Combat the Spread. Front Microbiol 2022; 12:794176. [PMID: 35058909 PMCID: PMC8763841 DOI: 10.3389/fmicb.2021.794176] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/30/2021] [Indexed: 01/01/2023] Open
Abstract
The havoc unleashed by COVID-19 pandemic has paved way for secondary ominous fungal infections like Mucormycosis. It is caused by a class of opportunistic pathogens from the order Mucorales. Fatality rates due to this contagious infection are extremely high. Numerous clinical manifestations result in damage to multiple organs subject to the patient's underlying condition. Lack of a proper detection method and reliable treatment has made the management of this infection troublesome. Several reports studying the behavior pattern of Mucorales inside the host by modulation of its defense mechanisms have helped in understanding the pathogenesis of this angio-invasive infection. Many recent advances in diagnosis and treatment of this fungal infection have not been much beneficial. Therefore, there is a need to foster more viable strategies. This article summarizes current and imminent approaches that could aid effective management of these secondary infections in these times of global pandemic. It is foreseen that the development of newer antifungal drugs, antimicrobial peptides, and nanotechnology-based approaches for drug delivery would help combat this infection and curb its spread.
Collapse
Affiliation(s)
- Shreya Dogra
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Akanksha Arora
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Aashni Aggarwal
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Gautam Passi
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Akanksha Sharma
- Department of Biophysics, Panjab University, Chandigarh, India
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Gurpal Singh
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Ravi P. Barnwal
- Department of Biophysics, Panjab University, Chandigarh, India
| |
Collapse
|
15
|
Zirpe K, Pote P, Deshmukh A, Gurav SK, Tiwari AM, Suryawanshi P. A Retrospective Analysis of Risk Factors of COVID-19 Associated Mucormycosis and Mortality Predictors: A Single-Center Study. Cureus 2021; 13:e18718. [PMID: 34790473 PMCID: PMC8584128 DOI: 10.7759/cureus.18718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2021] [Indexed: 12/15/2022] Open
Abstract
Background Mucormycosis has been identified with increasing frequency in patients with coronavirus disease 2019 (COVID-19). Aims We aimed to determine the in-hospital outcome of patients with COVID-19 associated mucormycosis (CAM). Materials and methods This was a single-center, retrospective, observational study. We included patients diagnosed with CAM from a tertiary care hospital in Pune, India. Clinical, laboratory, and in-hospital outcomes were noted. We analyzed factors associated with in-hospital mortality. Results Between February 2021 and June 2021, we identified 84 patients of CAM. The mean age was 49.3 ± 12.1 years. Of the included patients, 64.3% had diabetes mellitus, and 83.3% had received steroids. Mucormycosis was diagnosed after a median of 11 days from the COVID-19 diagnosis. Orbital and central nervous system (CNS) involvement was seen in 29.8% and 23.8% of patients, respectively. During a mean hospital stay of 12.5 ± 8.5 days, 15.5% of patients died. Compared to survivors, the presence of chronic kidney disease (CKD) (p<0.0001), orbital involvement (p=0.039), use of tocilizumab (p<0.0001), and development of renal dysfunction during hospitalization (p<0.0001) were seen in a significantly higher proportion of nonsurvivors. The proportion of patients with diabetes, those receiving steroids, and mean glycosylated hemoglobin (HbA1c) levels did not differ significantly in survivors and nonsurvivors. Conclusion In-hospital mortality in CAM is relatively lower in our institution. CKD, orbital involvement, use of tocilizumab, and renal dysfunction during hospital stay were found to be strong predictors of mortality.
Collapse
Affiliation(s)
- Kapil Zirpe
- Neuro Trauma Intensive Care Unit, Ruby Hall Clinic, Pune, IND
| | - Prajakta Pote
- Neuro Trauma Intensive Care Unit, Ruby Hall Clinic, Pune, IND
| | | | - Sushma K Gurav
- Neuro Trauma Intensive Care Unit, Ruby Hall Clinic, Pune, IND
| | - Anand M Tiwari
- Neuro Trauma Intensive Care Unit, Ruby Hall Clinic, Pune, IND
| | | |
Collapse
|
16
|
Sharma R, Shrivastava S, Kumar Singh S, Kumar A, Saxena S, Kumar Singh R. Deep-AFPpred: identifying novel antifungal peptides using pretrained embeddings from seq2vec with 1DCNN-BiLSTM. Brief Bioinform 2021; 23:6404058. [PMID: 34670278 DOI: 10.1093/bib/bbab422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 01/04/2023] Open
Abstract
Fungal infections or mycosis cause a wide range of diseases in humans and animals. The incidences of community acquired; nosocomial fungal infections have increased dramatically after the emergence of COVID-19 pandemic. The increase in number of patients with immunodeficiency / immunosuppression related diseases, resistance to existing antifungal compounds and availability of limited therapeutic options has triggered the search for alternative antifungal molecules. In this direction, antifungal peptides (AFPs) have received a lot of interest as an alternative to currently available antifungal drugs. Although the AFPs are produced by diverse population of living organisms, identifying effective AFPs from natural sources is time-consuming and expensive. Therefore, there is a need to develop a robust in silico model capable of identifying novel AFPs in protein sequences. In this paper, we propose Deep-AFPpred, a deep learning classifier that can identify AFPs in protein sequences. We developed Deep-AFPpred using the concept of transfer learning with 1DCNN-BiLSTM deep learning algorithm. The findings reveal that Deep-AFPpred beats other state-of-the-art AFP classifiers by a wide margin and achieved approximately 96% and 94% precision on validation and test data, respectively. Based on the proposed approach, an online prediction server is created and made publicly available at https://afppred.anvil.app/. Using this server, one can identify novel AFPs in protein sequences and the results are provided as a report that includes predicted peptides, their physicochemical properties and motifs. By utilizing this model, we identified AFPs in different proteins, which can be chemically synthesized in lab and experimentally validated for their antifungal activity.
Collapse
Affiliation(s)
- Ritesh Sharma
- Department of Computer Science and Engineering, Indian Institute of Technology (BHU), Varanasi, 221005, Uttar Pradesh, India
| | - Sameer Shrivastava
- Division of Veterinary Biotechnology, ICAR-Indian Veterinary Research Institute, Izatnagar, 243122, Uttar Pradesh, India
| | - Sanjay Kumar Singh
- Department of Computer Science and Engineering, Indian Institute of Technology (BHU), Varanasi, 221005, Uttar Pradesh, India
| | - Abhinav Kumar
- Department of Computer Science and Engineering, Indian Institute of Technology (BHU), Varanasi, 221005, Uttar Pradesh, India
| | - Sonal Saxena
- Division of Veterinary Biotechnology, ICAR-Indian Veterinary Research Institute, Izatnagar, 243122, Uttar Pradesh, India
| | - Raj Kumar Singh
- Former Director & Vice Chancellor, ICAR-Indian Veterinary Research Institute, Izatnagar, 243122, Uttar Pradesh, India
| |
Collapse
|
17
|
Khanna M, Challa S, Kabeil AS, Inyang B, Gondal FJ, Abah GA, Minnal Dhandapani M, Manne M, Mohammed L. Risk of Mucormycosis in Diabetes Mellitus: A Systematic Review. Cureus 2021; 13:e18827. [PMID: 34804684 PMCID: PMC8592794 DOI: 10.7759/cureus.18827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/16/2021] [Indexed: 01/04/2023] Open
Abstract
Hyperglycemia or diabetes mellitus (DM) is a disorder of the endocrine system. In this condition, the body is insulin-deficient or resistant to insulin. Due to insulin deficiency or resistance, the body is unable to process sugar. The worldwide prevalence of diabetes mellitus is rising substantially. Hyperglycemia makes the immune system weak, which increases the risk of infection in a diabetic patient. Fungal infection is more common in DM. Mucormycosis is a rare fungal infection in a healthy individual, but in DM, it can cause severe complications and even be fatal if not treated adequately and timely. In our literature review, a total of 19 published articles from the PubMed database and Google Scholar were included. We combed the PubMed database and Google Scholar by using various inclusion and exclusion criteria. The result of the review study shows the increased risk of mucormycosis in a diabetic patient.
Collapse
Affiliation(s)
- Manish Khanna
- Internal Medicine/Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sabitha Challa
- Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ahmed S Kabeil
- Pathology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Bithaiah Inyang
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Faisal J Gondal
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Godwin A Abah
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, Federal Teaching Hospital Gombe, Gombe, NGA
| | - Mahesh Minnal Dhandapani
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Manasa Manne
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Lubna Mohammed
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
18
|
Soni S, Namdeo Pudake R, Jain U, Chauhan N. A systematic review on SARS-CoV-2-associated fungal coinfections. J Med Virol 2021; 94:99-109. [PMID: 34570905 PMCID: PMC8661750 DOI: 10.1002/jmv.27358] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/16/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023]
Abstract
A severe pandemic of Coronavirus Disease (COVID‐19) has been sweeping the globe since 2019, and this time, it did not stop, with frequent mutations transforming into virulent strains, for instance, B.1.1.7, B.1.351, and B.1.427. In recent months, a fungal infection, mucormycosis has emerged with more fatal responses and significantly increased mortality rate. To measure the severity and potential alternative approaches against black fungus coinfection in COVID‐19 patients, PubMed, Google Scholar, World Health Organization (WHO) newsletters, and other online resources, based on the cases reported and retrospective observational analysis were searched from the years 2015–2021. The studies reporting mucormycosis with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) coinfection and/or demonstrating potential risk factors, such as a history of diabetes mellitus or suppressed immune system were included, and reports published in non‐English language were excluded. More than 20 case reports and observational studies on black fungus coinfection in COVID‐19 patients were eligible for inclusion. The results indicated that diabetes mellitus, hyperglycemic, and immunocompromised COVID‐19 patients with mucormycosis were at a higher risk. We found that it was prudent to assess the potential risk factors and severity of invasive mycosis via standardized diagnostic and clinical settings. Large‐scale studies need to be conducted to identify early biomarkers and optimization of diagnostic methods has to be established per population and geographical variation. This will not only help clinicians around the world to detect the coinfection in time but also will prepare them for future outbreaks of other potential pandemics. Observational studies and case reports of Post‐COVID black fungus co‐infection highlighted in review. Along with risk factors, radiological interventions of black fungus co‐infection in COVID‐19 patients and challenges for accurate diagnosis were elaborated. The review discusses interconnection between fungus and SARS‐CoV‐2 co‐infection of mechanism to identify potential biomarkers. Our conclusion will contribute to motivate researchers to design follow‐up plans for black fungus infection in COVID‐19.
Collapse
Affiliation(s)
- Shringika Soni
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| | - Ramesh Namdeo Pudake
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| | - Utkarsh Jain
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| | - Nidhi Chauhan
- Amity Institute of Nanotechnology (AINT), Amity University Uttar Pradesh (AUUP), Noida, India
| |
Collapse
|
19
|
Yasmin F, Najeeb H, Naeem A, Dapke K, Phadke R, Asghar MS, Shah SMI, De Berardis D, Ullah I. COVID-19 Associated Mucormycosis: A Systematic Review from Diagnostic Challenges to Management. Diseases 2021; 9:65. [PMID: 34698143 PMCID: PMC8544552 DOI: 10.3390/diseases9040065] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) outbreak has caused significant destruction, claiming over three million lives worldwide. Post SARS-COV-2 invasion, immunosuppression with hyperglycemia and elevated ferritin levels along with steroidal treatment creates a perfect storm for opportunistic infections. There is increasing evidence of mucormycosis co-infection in COVID-19 patients, during or post-treatment. A worse prognosis, a late diagnosis, and limited guidelines of screening and management of COVID-19 associated mucormycosis have made healthcare professionals fear an epidemic alongside a pandemic. This review geographically reports cases of COVID-19 associated mucormycosis (CAM), evaluates characteristics, clinical manifestations, and outcomes of mucormycosis in COVID-19 active or recovered patients. It further describes preventive strategies and recommendations for optimal management therapy that can be adopted worldwide to curtail an impending threat to the healthcare system.
Collapse
Affiliation(s)
- Farah Yasmin
- Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan; (F.Y.); (A.N.)
| | - Hala Najeeb
- Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan; (F.Y.); (A.N.)
| | - Aisha Naeem
- Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan; (F.Y.); (A.N.)
| | - Kartik Dapke
- Indira Gandhi Government Medical College, Nagpur 440018, India; (K.D.); (R.P.)
| | - Rachana Phadke
- Indira Gandhi Government Medical College, Nagpur 440018, India; (K.D.); (R.P.)
| | | | | | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital “G. Mazzini”, ASL 4, 64100 Teramo, Italy;
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar 25000, Pakistan;
| |
Collapse
|
20
|
Nambiar M, Varma SR, Jaber M, Sreelatha SV, Thomas B, Nair AS. Mycotic infections - mucormycosis and oral candidiasis associated with Covid-19: a significant and challenging association. J Oral Microbiol 2021; 13:1967699. [PMID: 34527182 PMCID: PMC8436966 DOI: 10.1080/20002297.2021.1967699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction Bacterial and fungal secondary infections following COVID-19 disease are widely being reported and are an area that should receive careful attention. Mucormycosis is a fatal fungal condition affecting immunocompromised patients caused by a group of mold mucoromycetes. Candida albicans (C. albicans) is an oral commensal present in almost 40–65% of healthy oral cavities in adults. Several cases of mucormycosis and oral candidiasis have been reported lately in COVID-19 patients, and it may elevate the associated risks of morbidity and mortality. Materials and Methods Articles were taken from a period of 2020 to April 2021 using search sources such as Cochrane, PubMed, Fungiscope and Mycobank using keywords mucormycosis, Black fungus, oral candidiasis, white fungus, COVID-19, Sars-Cov-2. Discussion The development of oral mucocutaneous lesions, such as mucormycosis and candidiasis in COVID-19 patients could be due to inhaling spores resulting in pulmonary and/or sinus congestion and prolonged mechanical ventilation in the ICU settings and the long-term use of broad-spectrum antibiotics respectively. The onset of candidiasis after the emergence of COVID-19 clinical signs and symptoms varied considerably and is reported within 1–30 days in most of the cases reported in the literature. Biofilms present on the denture surfaces are predisposing factors to oral candidiasis. We aim to summarize the limited data available regarding diagnosis, clinical presentation, and therapeutic approaches for the management of Mucormycosis and oral candidiasis in COVID-19 patients. Conclusion Careful monitoring of oral lesions should be instituted through interdisciplinary telemedicine and teleconsultation to aid in primary diagnosis, thereby avoiding personal attendance during the pandemic. Dental practitioners should be included among the interdisciplinary teams for exhaustive intraoral examination and reduce the risk of morbidity and mortality.
Collapse
Affiliation(s)
- Manjusha Nambiar
- Department of Periodontics, College of Dentistry, Sri Rajiv Gandhi, College of Dental Sciences and Hospital, Benguluru, India
| | - Sudhir Rama Varma
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE.,Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, UAE
| | - Mohamed Jaber
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Ajman University, Ajman, UAE
| | - S V Sreelatha
- Department of Oral Pathology, College of Dentistry, Ab Shetty Institute of Dental Sciences- (Nitte to Be Deemed University), Manguluru, India
| | - Biju Thomas
- Department of Periodontics, College of Dentistry, Ab Shetty Institute of Dental Sciences- (Nitte to Be Deemed University), Manguluru, India
| | - Arathi S Nair
- Department of Conservative Dentistry & Endodontics, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Benguluru, India
| |
Collapse
|
21
|
Divakar PK. Fungal Taxa Responsible for Mucormycosis/" Black Fungus" among COVID-19 Patients in India. J Fungi (Basel) 2021; 7:641. [PMID: 34436180 DOI: 10.3390/jof7080641] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023] Open
Abstract
Mucormycosis is caused by fungi belonging to the order Mucorales. The term “Black Fungus” has been widely applied to human pathogenic Mucorales in India. They mainly infect the sinuses and brain, lungs, stomach and intestines, and skin. While this has been considered a rare disease, thousands of cases have been reported during the second wave of COVID-19 in India, between the months of April and June 2021. Hitherto, more than 45,374 cases and over 4300 deaths have been reported among COVID-19 patients across India from April 2021 to July 21, 2021. Though the mortality rate is estimated to be 50%, it could be above 90% if left untreated. In India, Rhizopus arrhizus has been related to be the most common species to cause human mucormycosis, followed by Apophysomyces variabilis, Rhizopus microsporus, and R. homothallicus. Accurate sample identification of human pathogenic Mucorales species is challenging especially due to the frequent lack of diagnostic morphological features. Traditionally, the culture-based approach has been extensively used to isolate and characterize human pathogenic Mucorales. However, this may not be an appropriate approach to objectively isolate and characterize all species, as the germination and growth of fungal spores are highly dependent on culture media and environmental conditions. Therefore, a robust approach to the accurate and rapid identification of human pathogenic Mucorales species is a prerequisite. The metagenomic approach comprehensively sequences and analyzes all genetic material in a complex biological sample and, consequently, this could be an appropriate approach to objectively characterize human pathogenic Mucorales taxa without the need for in vitro culture. The precise identification of the species will not only be useful for the correct diagnosis of this disease, but also for the development of antifungal drugs specific for each species. Accurate and rapid species identification is desperately needed to save lives in the mucormycosis outbreak among COVID-19 patients in India and neighboring countries.
Collapse
|
22
|
Gupta G, S R, Singh Y, Thangavelu L, Singh SK, Dureja H, Chellappan DK, Dua K. Emerging cases of mucormycosis under COVID-19 pandemic in India: Misuse of antibiotics. Drug Dev Res 2021; 82:880-882. [PMID: 34323298 PMCID: PMC8426670 DOI: 10.1002/ddr.21862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/27/2021] [Accepted: 07/19/2021] [Indexed: 02/01/2023]
Abstract
COVID‐19's second wave had a significant impact on India, on May 7, 2021, the largest daily recorded case count was a little more than 4 million, and it has since fallen. Although the number of new cases reported has dropped, during the third week of May 2021, India accounted for about 45% of new cases identified globally and around 34% of deaths. As India maintains its present level of stability, a new urgent threat has emerged in the form of coronavirus‐associated mucormycosis. Mucormycosis, an acute and deadly fungal infection caused by Mucorales‐related fungal species, is a fungal emergency with a particularly aggressive propensity for contiguous spread, associated with a poor prognosis if not properly and immediately identified, and treated. Mucormycosis, sometimes referred to as the “black fungus,” has increased more rapidly in India during the second wave of COVID‐19 than during the first wave, with at least 14,872 cases as of May 28, 2021. Uncontrolled diabetic mellitus (DM) and other immunosuppressive diseases such as neutropenia and corticosteroid treatment have traditionally been identified as risk factors for mucormycosis. Therefore, the use of glucocorticoids or high doses of glucocorticoids in mild COVID‐19 cases (without hypoxemia) should be avoided. In addition, drugs that target the immune pathway, such as tocilizumab, are not recommended without clear benefits.
Collapse
Affiliation(s)
- Gaurav Gupta
- School of Pharmacy, Suresh Gyan Vihar University, Jaipur, India
| | - Roshan S
- Deccan School of Pharmacy, Osmania University, Hyderabad, India
| | - Yogendra Singh
- Department of Pharmacology, Maharishi Arvind College of Pharmacy, Ambabari Circle, Jaipur, India
| | - Lakshmi Thangavelu
- Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical Sciences, Saveetha University, Chennai, India
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Harish Dureja
- Faculty of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak, India
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| |
Collapse
|
23
|
Nelwan EJ, Tunjungputri RN, Wardani RS, Wahyuningsih R. Black Fungus Complicated with COVID-19 in a Man with Underlying Non-Hodgkin's Lymphoma. Acta Med Indones 2021; 53:349-351. [PMID: 34611076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
COVID-19 is a disease reported to suppress cellular immunity. This may lead to the development of opportunistic infections, among others black fungus, or mucormycosis. On the other hand, pre-existing defect in immunity may render patients susceptible to both mucormycosis and COVID-19. Mucormycosis is a relatively rare fungal infection with rapid progression unless diagnosed promptly and treated adequately, and urgent surgical and medical intervention is lifesaving. The manifestation of mucormycosis largely depends on the presence of exposure to the pathogen and the existing risk factor of the host. As black fungus is locally invasive, the majority of cases will involve tissue damage with local destruction and contiguous spread to nearby structure. We here with present a case of black fungus complicated with COVID-19 in a man with underlying non-Hodgkin's lymphoma.
Collapse
Affiliation(s)
- Erni J Nelwan
- 1. Division of Tropical and Infectious Disease. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | | | | | | |
Collapse
|
24
|
Rocha ICN, Hasan MM, Goyal S, Patel T, Jain S, Ghosh A, Cedeño TDD. COVID-19 and mucormycosis syndemic: double health threat to a collapsing healthcare system in India. Trop Med Int Health 2021; 26:1016-1018. [PMID: 34117677 PMCID: PMC8447294 DOI: 10.1111/tmi.13641] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In addition to the overwhelming and uncontrollable second wave of COVID‐19 in India, the country is also dealing with an outbreak of mucormycosis, a deadly fungal infection, which is affecting thousands of COVID‐19 patients. With the increasing number of cases of mucormycosis and a fatality rate of 50%, many Indian states and union territories have declared an epidemic of black fungus due to its unprecedented emergence, which has adversely affected the already debilitated health system of the country. The advent of the new fungal epidemic in the country is due to the overdosage, panic and injudicious use of corticosteroids among COVID‐19 patients, as well as their pre‐existing medical history of diabetes, given that India is the diabetes capital of the world. Thus, there is an urgent need to address this public health concern by having nationwide surveillance, diagnostic and management system of the disease, along with public awareness and education to combat the syndemic of COVID‐19 and mucormycosis in the country.
Collapse
Affiliation(s)
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Samarth Goyal
- Department of Medicine, Kasturba Medical College, Manipal, India
| | - Tapan Patel
- Department of Surgery, Baroda Medical College, Vadodara, India
| | - Shubhika Jain
- Department of Medicine, Kasturba Medical College, Manipal, India
| | - Asmita Ghosh
- Department of Biotechnology, Heritage Institute of Technology, Kolkata, India
| | | |
Collapse
|