bluuebunny/crossref_metadata_2025 huggingface dataset:
Best Practices of Bioinspired Design: Key Themes and Challenges
Authors: Wissa Aimy , Alleyne Marianne , Barley William C , Suarez Andrew V
Published: September 2022

Synopsis

Bioinspired design (BID) is an interdisciplinary research field that can lead to innovations to solve technical problems. There have been many attempts to develop a framework to de-silo engineering and biology and implement processes to enable BID. In January of 2022, we organized a symposium at the 2022 Society of Integrative and Comparative Biology Annual Meeting to bring together educators and practitioners of BID. The symposium aimed to (a) consolidate best practices in teaching bioinspiration, (b) create and sustain effective multidisciplinary teams, (c) summarize best approaches to conduct problem-based or solution-driven fundamental research, and (d) bring BID innovations to market. During the symposium, several themes emerged. Here we highlight three critical themes that need to be addressed for BID to become a truly interdisciplinary strategy that benefits all stakeholders and results in innovation. First, there is a need for a usable methodology that leads to proper abstraction of biological principles for engineering design. Second, the utilization of engineering models to test biological hypotheses is essential for the continued engagement of biologists in BID. Third, there is a necessity of proven team-science strategies that will lead to successful collaborations between engineers and biologists. Accompanying this introduction is a variety of perspectives and research articles highlighting best practices in BID research and product development and guides that can highlight the challenges and facilitate interdisciplinary collaborations in the field of BID.
Normalizing failure: when things go wrong in participatory marine social science fieldwork
Authors: Cvitanovic C , van Putten E I , Tuohy P , Annand-Jones R
Published: September 2022

Failure is a normal and critical part of the scientific process; however, the admittance of failure remains largely stigmatized within the sciences. In this paper, we argue that sharing stories of failure should be normalized, not only for the advancement of knowledge and improvement of research outcomes, but also for the health and well-being of the scientific community. We feel that this is particularly important for early career researchers, as it will help to set more realistic expectations of a career in science and to help reframe failure as a positive force for good. To do so, we draw upon our recent experiences of failure in participatory marine social science fieldwork. We share our personal perspectives of, among other things, how we felt when confronted with failure in the field, and more importantly, the strategies we used to confront, deal with, and overcome those failures. By doing so, we generate a list of practical steps and considerations that marine social science researchers can follow to help them navigate their own failures in the field, should they occur.
Vehicle detection method with low-carbon technology in haze weather based on deep neural network
Authors: Tao Ning , Xiangkun Jia , Xiaodong Duan , Jinmiao Song , Ranran Liang
Published: September 2022

Vehicle detection based on deep learning achieves excellent results in normal environments, but it is still challenging to detect objects in low-quality picture obtained in hazy weather. Existing methods tend to ignore favorable latent information and it is difficult to balance speed and accuracy, etc. Therefore, the existing deep neural network is studied, and the YOLOv3 algorithm is improved based on ResNet. Aiming at the problem of low utilization of shallow features, DensNet is added in the feature extraction stage to reduce feature loss and increase utilization. An attention module is added in the feature extraction and fusion stage to better focus on potential information and improve the detection accuracy in haze weather. In view of the difficulty of vehicle detection in haze weather, focal loss is introduced to give more weights to difficult samples, balance the number of difficult and easy samples and improve detection accuracy. The experimental results show that the recognition accuracy of the improved network for vehicles reaches 75%, which proves the effectiveness of the method.
Inhibition of Phosphodiesterase 2 Ameliorates Post-Traumatic Stress–Induced Alcohol Intake Disorder by Regulating cAMP/cGMP Signaling
Authors: Pan Xiaoyu , Chen Ling , Shan Chunyan , Cai Lisha , Wang Yue , Chen Yue , Gu Ming , Liu Kaiping , Li Pihong , Pan Jianchun
Published: September 2022

Background

Post-traumatic stress disorder (PTSD) is the prevalent psychiatric disorder that induces alcohol use disorders (AUD) such as abnormal alcohol intake and anxiety. However, little is known about whether phosphodiesterase 2 (PDE2)-cAMP/cGMP signaling is involved in PTSD-induced AUD.

Methods

The present study used single-prolonged stress (SPS) to mimic PTSD that induced increases in ethanol intake and preference (2-bottle choice test) and anxiety-like behavior (elevated-plus maze test and novelty suppressed feeding test). PDE2 inhibitor Bay 60-7550 (Bay) was administered to the mice and protein kinase A (PKA) inhibitor H89 and PKG inhibitor KT5823 were micro-injected into dorsolateral striatum (DLS) and central amygdala (CA) of mice to determine whether the effects of Bay on anxiety-like behavior in SPS mice are brain region dependent.

Results

PDE2 inhibitor Bay rescued SPS-induced decreases in open arm entries and open arm time exposure in elevated-plus maze test and reversed increased latency to feed in the novelty suppressed feeding test. Moreover, SPS-induced ethanol use disorder was reversed by Bay as evidenced by decreased ethanol intake and preference without changing total fluid intake in the SPS mice after treatment with Bay. However, Bay did not change the ethanol metabolism or sucrose or quinine intake and preference. The locomotor activity was not affected after treatment with Bay. Interestingly, microinjection of PKA or PKG inhibitor H89 or KT5823 into DLS prevented the effects of Bay on alcohol intake and preference and cAMP-response element binding proteins phosphorylation and brain derived neurotrophic factor expression in DLS but not on the anxiety-like behavior in SPS mice. Microinjection of these inhibitors into CA prevented Bay-induced anxiolytic-like effects and cAMP-response element binding proteins phosphorylation and brain derived neurotrophic factor levels in CA but did not affect ethanol intake in SPS mice, indicating that the effects of Bay on different behaviors are brain region dependent.

Conclusions

These findings support the hypothesis that PDE2-cAMP/cGMP signaling may differentially mediate PTSD-induced AUD and anxiety-like behavior.
Livestock Asset Dynamics Amongst Pastoralists in Northern Kenya
Authors: Mburu Samuel , Kaiser Micha , Sousa-Poza Alfonso
Published: September 2022

Understanding household-level asset dynamics has important implications for designing relevant poverty reduction policies. To advance this understanding, we develop a microeconomic model to analyse the impact of a shock (e.g., a drought) on the behavioural decisions of pastoralists in Northern Kenya. Using household panel data, this study then explores the livestock asset dynamics using both non-parametric and semi-parametric techniques to establish the shape of the asset accumulation path and to determine whether multiple equilibria exist. More specifically, using tropical livestock units as a measure of livestock accumulation over time, we show not only that these assets converge to a single equilibrium but also that forage availability and herd diversity play a major role in such livestock accumulation.
Improved Performance of the Reference Casein Control Group in AOAC Official MethodSM 960.48 (Protein Efficiency Ratio, Rat Bioassay) for Determining the Biological Quality of Protein in Infant Formula
Authors: Hoskin Jeanne M
Published: September 2022

Background

AOAC Official MethodSM960.48 is the official method for ensuring the biological quality of protein in infant formulas after adjusting for differences in N, fat, ash, moisture, crude fiber, fat content, and carbohydrate type.

Objective

To improve the performance of the control diet group.

Method

The control diet in Study 1 was matched to the infant formula test diet. Both control diets in Study 2 used the AOAC mineral mixture; one had added cystine.

Results

In Study 1, deficient growth in control rats led to poor PER results. In Study 2, growth was adequate but cystine addition reduced meaningful differences between casein and infant formula protein.

Conclusions

Sulfate salts in the method’s mineral mixture may substitute in part for the deficient organic sulfur content in casein.

Highlights

The findings confirm the need to follow the AOAC Method 960.48 and FDA recommendations, and to make other changes only if, after evaluation, nonprotein differences could affect growth.
Improving the 3D facies model with the seismic-derived log volumes: a case study from the Asmari Formation in the Hendijan Field, southwest Iran
Authors: Abdolahi Aziz , Chehrazi Ali , Rahimpour-Bonab Hossain , Kadkhodaie Ali , Seyedali Seyedmohsen , Rao Ying
Published: September 2022

The prolific Oligocene-Miocene Asmari Formation is the primary reservoir rock hosting important hydrocarbon resources in Iran and consists of fluvial/deltaic siliciclastic and shallow marine carbonate rocks in the Hendijan Field. Due to the significant facies variability of the formation, the presence and quality of the reservoir pose a significant uncertainty in the characterization of the reservoir. This study compares two facies models, one based on well logs only and the second based on estimated facies volumes as a secondary variable in facies modelling. The petrophysical evaluation with microscopic thin sections and electrofacies analysis were used to classify the facies and determine the reservoir quality. As a result, the Ghar Member was identified as a highly porous interval, while the lower part of the Asmari Formation is characterized by tight facies. A sequential Gaussian simulation (SIS) algorithm was used to build the 3D facies model on the basis of the well logs. Acoustic impedance, shear impedance and density (derived from pre-stack inversion) were used as inputs to an artificial neural network to generate acoustic and density log volumes. Using electrofacies cut-offs, facies volume was constructed and used as a secondary variable to improve the initial facies model. The final facies model was compared with the blind well to check the validity of the prediction and satisfactory results were obtained. Since the values are present in all the cells of the reservoir (the traditional facies model only has values for the well location), the estimated facies volume is an accurate variable in the prediction of the facies model for the Asmari reservoir and for this reason the secondary facies model is more reliable than the primary one.
Seepage visualization and detection of diaphragm wall leakage with electrical potential method: an experimental investigation
Authors: He Junzuo , Liao Shaoming , Liu Menbo , Li Zewen , Zhao Guoqiang , Tu Junfei
Published: September 2022

Attributed to the opacity of soil and rock mass, seepage visualization is a thorny problem in the model test around diaphragm wall leakage, which has played an increasingly significant role in deep excavation engineering recently. Enlightened by the geoelectrical field response method, the electrical potential method was proposed in this study. By means of a model experiment, the applicability of the proposed method was verified and approaches for evaluating the seepage characteristics were discussed. Based on the analyses, several conclusions could be drawn: (i) based on the electrical potential method, a circuit is established by connecting the power supplier, the ground and several monitoring electrodes and voltmeters. When the seepage passes through a certain electrode, the increase of voltage can be observed so that the seepage flow can be visualized. (ii) The effectiveness of the electrical potential method is validated by the excellent agreement between photos of practical seepage flow and the nephograms depicted on the basis of the voltages measured on the electrodes. (iii) The time history curve of the measured voltage is S-shaped and composed of a small ladder rising stage, a sharp increasing stage and a convergence stage. The seepage flow velocity, inhomogeneity and the leakage point location can be evaluated by the time cost between the two major rise beginning points, the time cost for the major rise process and the maximum measured voltage, respectively. The proposed method can provide valuable support to the diaphragm wall leakage model test and other seepage experiments.
Pest Quest: A Game of Strategy, Uncertainty, and Sticky Traps
Authors: Helmberger Maxwell S , Lampasona Timothy P , Lorenz Amanda R , Grieshop Matthew J
Published: September 2022

Educational games are employed to teach a variety of scientific skills and concepts. We evaluated Pest Quest, a co-operative tabletop game designed to teach about Integrated Pest Management. In it, students worked together to protect a farm from insect pests by scouting and making sound treatment decisions. We gave students in an introductory, nonmajors entomology course assessments of their Integrated Pest Management knowledge and attitudes toward agriculture before and after playing a digital port of the game. We also administered a postgame survey to gauge students’ opinions and feelings about the game. Pest Quest proved engaging and accessible, with students enjoying the game and having the impression it helped them learn. However, this conclusion was not captured in our assessments. We provide access to physical and digital versions of Pest Quest and suggestions for more effective implementation in entomology and agriculture classrooms.
On the role of the phyllosphere community in leaf wettability and water shedding
Authors: Drummond Julia S , Rosado Bruno H P
Published: September 2022

We explore the interplay among factors affecting leaf wettability and water shedding by discussing how the phyllosphere directly affects plant wettability.
Distinct chemical resistance-inducing stimuli result in common transcriptional, metabolic, and nematode community signatures in rice root and rhizosphere
Authors: Desmedt Willem , Kudjordjie Enoch Narh , Chavan Satish Namdeo , Desmet Sandrien , Nicolaisen Mogens , Vanholme Bartel , Vestergård Mette , Kyndt Tina
Published: September 2022

Induced resistance (IR), a phenotypic state induced by an exogenous stimulus and characterized by enhanced resistance to future (a)biotic challenge, is an important component of plant immunity. Numerous IR-inducing stimuli have been described in various plant species, but relatively little is known about ‘core’ systemic responses shared by these distinct IR stimuli and the effects of IR on plant-associated microbiota. In this study, rice (Oryza sativa) leaves were treated with four distinct IR stimuli (β-aminobutyric acid, acibenzolar-S-methyl, dehydroascorbic acid, and piperonylic acid) capable of inducing systemic IR against the root-knot nematode Meloidogyne graminicola and evaluated their effect on the root transcriptome and exudome, and root-associated nematode communities. Our results reveal shared transcriptional responses—notably induction of jasmonic acid and phenylpropanoid metabolism—and shared alterations to the exudome that include increased amino acid, benzoate, and fatty acid exudation. In rice plants grown in soil from a rice field, IR stimuli significantly affected the composition of rhizosphere nematode communities 3 d after treatment, but by 14 d after treatment these changes had largely reverted. Notably, IR stimuli did not reduce nematode diversity, which suggests that IR might offer a sustainable option for managing plant-parasitic nematodes.
Comparison of RhD Typing Results by Serology and Molecular Methods
Authors: Gammon Richard R , Conceicao Michelle , Benitez Nancy , Bright Frieda , Counts Kelley , Resto Claribel , Rexer Karl
Published: September 2022

Objective

Molecular testing determines D antigen status when abnormal serologic results are observed. Molecular testing is routinely batched, resulting in longer turnaround time for abnormal D status resolution. During the interim, obstetric patients with questionable/uninterpretable and weak D typing results by serology, per the immunohematology reference laboratory (IRL) policy, will receive RhD negative blood. This study aimed to determine whether serology results achieved a concordance.

Methods

Six hospitals provided samples to the IRL (first IRL) for RhD status by DNA. De-identified samples were sent for serology RhD (second IRL). A concordance of ≥80% was acceptable.

Results

Forty-nine samples were evaluated. Results were concordant (65.3% [32/49]) and discordant (34.7% [17/49]). This is significantly lower than clinically acceptable 80% (z = 2.57, P < .05). The turnaround-time was 3.0 hours for serology and 4.4 days for molecular evaluation.

Conclusion

Due to a low concordance, serology could not be used in place of molecular testing.
Usefulness of Genetic Aberration and Shorter Telomere Length in Myelodysplastic Syndrome: A Pilot Study
Authors: Park Hee Sue , Son Bo Ra , Kwon Jihyun
Published: September 2022

Objective

We aimed to evaluate the clinical usefulness of genetic aberration and shorter telomere length (TL) in individuals with myelodysplastic syndrome (MDS).

Methods

A targeted sequencing panel with 49 genes and TL measurement by quantitative real-time polymerase chain reaction were performed for 46 subjects.

Results

According to the revised International Prognostic Scoring System (IPSS-R) subtypes, the mutation frequency was 33.3%, 57.9%, and 100% in the very low/low, intermediate, and very high/high risk groups, respectively. A shorter telomere was detected in 43.5%. We defined group 1 as IPSS-R-high or -very high risk, group 2 as having 1 or more genetic aberrations, group 3 as having a shorter TL, and group 4 as having a longer TL than the age-matched reference. Group 1 and group 2 showed an adverse prognosis. The TL was not strongly correlated with MDS prognosis. However, it may be related to a poor long-term prognosis.

Conclusion

Genetic variation and shorter TL may be helpful in reclassifying non–high-risk groups.
The Impact of COVID-19 on the Laboratory Professionals’ Clinical Education: a Qualitative Study
Authors: Phillips Heather L , Latchem Shelley R , Crutcher Theresa , Catalano Timothy A , Jator Eleanor K
Published: September 2022

A 48-question survey was developed and disseminated to laboratory professionals. This survey sought the perspective of clinical educators on a variety of topics, including two open-ended questions on the impact COVID-19 had on student clinical rotations and the ensuing policy changes. Of 207 clinical sites that participated in the survey., Some terminated student clinical rotations without offering any other training alternative. Others employed a number of strategies such as shortening the length of clinical rotations, taking fewer students, transitioning to an online learning platform, or delaying training until a future date. Some mandated regular illness checks, symptom checks, and COVID-19 testing when available. Clinical educators expressed concern over the lack of continuity of student clinical training, policy changes related to COVID-19 and student training that were deemed to diminish the quality of the students’ clinical education. With terminated, delayed or shortened clinical rotations at many sites, in combination with staff and supply shortages, clinical educators were concerned about the overall quality of clinical education the students were receiving. In addition to these concerns, the reduction of student graduates during the pandemic decreased the number of applicants for job vacancies exasperating a pre-pandemic problem.
P110 AIRE gene mutation predisposing chronic mucocutaneous Candidiasis in two kids from a Chinese family
Authors: Ma Yubo , Wang Xiaowen , Li Ruoyu
Published: September 2022

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM

 

Objectives

Chronic mucocutaneous candidiasis (CMC) is a group of clinical syndromes characterized by chronic recurrent skin, nails, and mucosal superficial Candida infections. Various gene mutations have been reported to predispose individuals to CMC and its related syndrome. This study aims to study the clinical features and the genetic background underlying two kids of CMC from a Chinese family.

Methods

Clinical and laboratory findings of the two patients were studied, including physical examination, direct microscopic examination, and fungal culture. Genomic DNA of all family members was extracted from peripheral blood leukocytes, and whole-exome sequencing (WES) was performed.

Results

A 2-year-old boy and his sister were admitted to the hospital due to recurrent thrush and thickening of their nails. Direct microscopic examination of their nails and the brother's tongue showed branched pseudohyphae and yeast cells, and Candida albicans was identified through fungal culture. The brother also experienced a progressively impaired vision, which was diagnosed as retinitis pigmentosa, causing no light perception in one eye and light perception up to 0.1 in the other. Their parents belonged to the Hui population (a minority population in China) and had a history of consanguineous marriage. Chronic mucocutaneous candidiasis (CMC) was diagnosed, and oral fluconazole was prescribed. After continuous fluconazole treatment for 6 months, the nails and the tongue became normal. These patients are still under follow-up.

Due to the recurrent Candida infections and history of consanguineous marriage, genetic susceptibility was suspected. When we compared the WES data with all genes reported to be related to CMC, a homozygous mutation in the AIRE gene was noted (C. 769 C >T, p. Arg257Ter) in both patients. The parents were heterozygous carriers of the variant.

Conclusion

In this study, we identified two CMC patients of Chinese harboring AIRE mutations. These patients remind us the importance of genetic analysis in management of CMC, which then help to adjust the time of treatment, as well as to predict and early detect related complications.
P119 Dysregulated IL-23R and CD25 T cells in post -COVID-19 Rhino-Orbital Mucormycosis patients
Authors: Rai Gargi , Das Shukla , Singh Praveen Kumar , Ansari Mohammad Ahmad , Gupta Neelima , Sharma Sonal , Rawat Kanchan
Published: September 2022

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM

 

Objectives

To study the IL-23R (Th17) and CD25+ (Treg) in CD4 + T cell populations in rhino-orbital mucormycosis post-COVID-19 patients and in healthy controls.

Methods

The study included 20 cases of mucormycosis and 20 healthy controls. Nasal crust, collected post-surgery was subjected to KOH/culture for mycological identification. Venous blood sample (3 ml) was collected in EDTA vials from cases and controls and stained with different monoclonal antibodies such as CD3, CD4, CD25, and IL-23R for analyzing the expression of Th17 and Treg cells by flow cytometry. The assays were performed at the time of enrolment of patients and repeat blood samples were taken from each patient for staining 3 months later after treatment prescribed by Otorhinolaryngologists. Statistical analysis was done using SPSS software and the P-value ≤ .05 considered as significant. All the data are expressed as the mean ± SD.

Results

All the cases were found positive by KOH and confirmed for Rhizopus arrhizus by culture.

The flow cytometry analysis showed that the percentage of CD4 + IL-23R+ (Th17) cells was significantly high in patient before treatment compared to healthy controls and found to be lower post 3 months of antifungal treatment. The percentage positivity of CD4 + CD25+ (Tregs) cells was decreased in patients (before treatment) as compared to controls and after treatment groups. The percentage positivity of CD4 + CD25 + cells was significantly increased in patients after treatment.

Conclusion

We observed a noticeable immune imbalance, with elevated CD4 + IL-23R Th17 and diminished CD4 + CD25 + T regulatory cells. The findings imminently indicate the mechanism of immune dysregulation involving Th17 and Treg pathways in mucormycosis and provide evidence that restoration of Th17/Treg may be considered as a therapeutic option for long-term benefit. Recovery of CD4 + CD25 + T cells after treatment indicated a favorable phenotype outcome.
P139 Candida : An important partner in polymicrobial colonization on indwelling medical devices
Authors: Joshi Purvi , Danu Pooja , Gajjar Devarshi
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Indwelling medical devices are of routine use in hospitals for patient care but they lead to the colonization of microbes on their surface making the patient vulnerable to device-related infections (DRI). Biofilms formed due to the growth of microbes are the most common cause of device-related infections.

Objectives

To isolate, identify and study the microbial colonization of indwelling medical devices (urinary catheters and central venous catheters).

To quantify the biofilm formed by the isolates.

Method

In the present study, microflora was isolated from urinary catheters (n = 28) and central venous catheters (n = 25) that were catheterized in ICU patients. Quantification of biofilm was done by Crystal violet assay.

Results

Among 28 urinary catheters, 14 catheters had polymicrobial colonisation (n = 10 mixed bacterial and fungal colonization, n = 3 polybacterial, and n = 1 polyfungal), 10 catheters were observed to have mono-species colonization (n = 6 fungal, n = 4 bacterial), while 4 catheters did not show any colonization. Whereas among 25 central venous catheters, only 3 catheters showed mono-bacterial colonization and 2 catheters showed mono-fungal growth and 20 catheters did not show any colonization. A total of 46 isolates were obtained from all urinary and central venous catheters, out of which Candida spp. was found to be highest in number with n = 13 and 30% of total isolates obtained (the Fig. 1 shows the distribution of microflora obtained). The interesting observation in the study is that Candida spp. is found to have multi-species colonization with bacterial isolates (Pseudomonas aeuroginosa, Klebsiella pneumoniae, Staphylococcus haemolyticus, Enterococcus faecium, and Stenotrophomonas maltophilia) as well as fungal isolates (Trichosporon asahii). Quantification of biofilm formed by these isolates was carried out by crystal violet assay and it was observed that 35.6% isolates formed strong biofilm of which Candida spp. was a major contributor. It was also observed that Candida spp. was always the stronger biofilm forming partner in mixed species biofilms.

Conclusion

It was concluded that majority of colonization on indwelling medical devices are polymicrobial and Candida spp. appears as an important partner in polymicrobial colonization. Among all obtained isolates maximum were strong biofilm forming of which Candida spp. were the major contributors.
P168 Metastatic mo ld infections after COVID-19: the mo ld time -bomb
Authors: Soman Rajeev , Chakraborty Sourabh , Joe Geethu , Purandare Bharat , Panchakshari Shweta , Patwardhan Sampada
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

Objective

COVID-19-positive patients are at risk of invasive mold infection. The portal of entry is presumably the lungs, but infection may disseminate to involve other organs as described in this case series.

Patients and Methods

Patients who presented with de novo mold infection (6 proven and 1 probable) involving kidney, spine, eye, knee joint, subcutaneous tissue within 10-180 days of COVID-19 infection were included in this series (Table 1).

Conclusion

These cases suggest that metastatic infection by molds involving various organs could result from a presumed primary source in the lungs. However, the precise connection between pulmonary and metastatic infection is difficult to establish.

COVID-19 patients should be carefully followed for such metastatic mold infections which need proper diagnosis and management.
P184 Candida auris candidemia in COVID-19 and post-COVID-19 patients in a tertiary care hospital in North India
Authors: Dixit Ajai Kumar , Marak Rungmei S. K. , Bhartiya Chitra , Azim Afzal , Sahu Chinmoy , Tripathi Shikha
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

Introduction

Candida spp. accounts for 70%-80% of invasive bloodstream fungal infections. It is most commonly spread in long-term care facilities, caring for people with severe medical conditions. Patients hospitalized for COVID-19 are at risk for healthcare-associated infections like candidemia. Candida auris is an emerging, multidrug-resistant, healthcare-associated fungal pathogen. Candida auris is currently one of the most common clinical fungal pathogens, causing nosocomial infections. Due to its higher drug-resistance rate, C. auris is more difficult to treat, requires longer hospitalization periods, and results in higher morbidity and mortality than other Candida species.

Aim and Objectives

To analyze the risk factors associated with C. auris candidemia in COVID-19 and post-COVID-19 patients at tertiary care center.

Material and Methods

We prospectively analyzed all positive blood samples which were received in the Microbiology department at SGPGI, Lucknow for a period of 1 year (March 2020-March 2021). Blood samples were inoculated and cultured in BACTEC Bottles (BD) and incubated for 5 days at 37°C. The bottles which flagged positive, a Gram's stain was performed and were sub-cultured on SDA for isolation of yeast colonies. Isolated yeasts were identified by phenotypic method and confirmed by MALDI-TOF MS. Demographics details of the patients were collected and recorded. The significant associated risk factors with C. auris candidemia were analyzed.

Results

A total of 13 000 blood samples were received during the 1-year study period from different departments of the hospital.1.25% (n = 163) of the blood culture samples were positive for candidemia. Out of 163 Candida culture-positive blood samples, 27.61% (n = 45) were C. auris. A total of 64% (n = 29) C. auris candidemia was seen in non-COVID-19 patients, 31.1% (n = 14) in COVID-19 patients, and two patients had a history of post-COVID-19 infection. The associated risk factors included the use of broad-spectrum antibiotics, intravenous catheterization, underlying respiratory illness, mechanical ventilation, use of steroids, and dialysis. A total of 46.6% (n = 21) mortality was seen with C. auris candidemia.

Conclusions

Candida auris candidemia continues to be a threat in hospitalized patients. This study shows prevalence of C. auris candidemia in COVID-19 and post-COVID-19 patients with 47% mortality. Candida auris is continuously reported from different departments in our institute, especially from intensive care units with high morbidity and mortality. An alertness, awareness and infection control practices by the healthcare personnel will help in early diagnosis and appropriate antifungal therapy and control the spread of C. auris.
P189 The effect of COVID-19 and immunosuppressive drugs and diabetes on the spread of mucomycosis
Authors: Esfidani Maryam
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

 

Mucormycosis is a serious but rare opportunistic fungal infection that spreads rapidly, so prompt diagnosis and treatment are essential to prevent high mortality rates and complications. Mucormycosis is caused by the inhalation of filamentous fungi, especially in patients with suppressed immune systems. Mucormycosis affected human populations after COVID-19. According to searches, invasive mucormycosis to COVID-19 has been widely reported from survivors, mild to severe. Of course, it seems that the underlying diseases and most importantly uncontrolled diabetes or immunosuppressive diseases have provided the conditions for the development of black fungus. In addition, over-the-counter administration of steroid drugs to control inflammation of the cornea seems to be another cause of the spread of the disease. Groups of patients were analyzed for the link between the COVID-19 epidemic and the nightmare of mucormycosis. Black fungus usually causes necrosis of the head and neck, including the nose, paranasal sinuses, and facial bones, which can sometimes cause complications. Therefore, the present study emphasizes mucormycosis and its associated conditions, its mechanism in normal individuals with COVID-19, the effective factors and challenges to overcome this black mold infection.
P206 Phenotypic and molecular characterization of emerging Basidiomycete Schizophyllum commune isolated from clinical samples from India
Authors: Gupta Sunita , Kaur Harsimran , Ghosh Anup , Rudramurthy Shivaprakash , Chakrabarti Arunaloke
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

Objective

Schizophyllum commune is an environmental basidiomycete capable of causing human infections. Its identification is difficult as often it produces sterile, cottony white colonies without any conidia formation. S. commune is characterized by clamp connections and hyphal spicules. Though it produces basidiocarps with basidiospores it is difficult to induce in vitro. Molecular techniques are essential to confirm its identification. Here, we present the description of Schizophyllum commune isolates collected at our center over the last 5 years.

Methods

All the isolates used in this study was received from various part of India and accessioned at the National culture collection of pathogenic fungi (NCCPF), Chandigarh India. Isolates were grown on Sabouraud dextrose agar and malt-extract agar (MEA) at 25°C for 5-7 days. Lacto phenol cotton blue mounts were prepared and a microscopic examination was done. For observing basidiocarps, MEA plates were incubated for 6-8 weeks. DNA extraction was done using the phenol-chloroform method and ITS region was amplified using pan-fungal primers followed by Sanger sequencing.

Results

Among total of 22 Schizophyllum commune cultures, 19 were isolated from lower respiratory samples, two from corneal scrapings, and one from the brain. Upon microscopic examination, the major identification feature of this fungi, i.e., clamp connection and spicules were observed only in 8 (36%) isolates. The remaining 14 (64%) were identified up to species level using ITS sequencing. Basidiocarps could be induced only in two isolates.

Conclusion

Although rarely involved in human disease, Schizophyllum commune is being isolated from the clinical specimens. As microscopic identification is difficult and needs expertise, molecular identification is required for early diagnosis and treatment.
P223 First case of Candida auris candidemia in Manipur, Northeast India
Authors: Konjengbam Ojita , Khuraijam Ranjana , Ningthoujam Priyolaxmi , Acharjee Aindrilla , Presanambika Hari , Thingam Binita
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

Objective

Candida auris is known as an emerging ‘superbug’ because of its intrinsic resistance to one or more, sometimes to all available antifungal drugs and spreading globally. It has the ability to cause devastating nosocomial infections. In India, C. auris infection is on the rise with reports from north, south, central and eastern India. Here we present the first case of C. auris fungemia from a tertiary care hospital of Manipur in Northeast India.

Methods

A 15-year-old Muslim girl was referred from a private hospital to Regional Institute of Medical Sciences (RIMS) hospital on November 19, 2021 with a history of burning epigastrium, headache, loss of appetite, shortness of breath, dry cough, fever, and generalized weakness for last 3 days. At the time of admission she was cyanotic. Family gave history of congenital heart disease and frequent visits to hospital. Echocardiogram revealed congenital cyanotic heart disease (Tetralogy of Fallot) showing large perimembranous VSD with bidirectional shunt. A complete hemogram showed neutrophilic leukocytosis with shift to left with band form, absolute monocytosis, and increased RBC count with mild anisocytosis. On November 24, 2021, 5 days after admission, her condition deteriorated and she was shifted to ICU. However, the condition of the patient deteriorated and she died on November 29, 2021 due to acute decompensated heart failure. Follow-up of other patients admitted in the same ward revealed no candidemia in next the few weeks.

Results

A single blood culture sent on November 29, 2021 was incubated in an automated blood culture system, BacT Alert and showed growth of budding yeast cells. Growth in SDA revealed it to be Candida sps. and Gram-stained smear examination revealed presence of budding yeast cells but no pseudohyphae. Germ tube test was negative. On CHROM agar, it produces pale yellow colonies at 24 h which progresses to light purple colonies around the rim at 48 h. Further processing in VITEK 2 (Biomerieux) identified it as C. auris. The isolate was sent to National Culture Collection of Pathogenic Fungi, WHO collaborating center, PGIMER and the isolate was confirmed as Candida auris by MALDI-TOF assay.

Conclusion

Candida auris is spreading irrespective of the level of health care. Blood culture before administration of antibiotics and in febrile sick patients cannot be underestimated. Rapid and accurate identification methods for timely diagnosis and stringent infection control measures with an emphasis on hand hygiene are important to prevent and control C. auris outbreaks.
P233 COVID-19-a ssociated Mucormycosis: an experience of invasive fungal sinusitis from a tertiary care referral center in Northern India
Authors: Marak Rungmei S K , Chaudhary Radhika , Keshri Amit Kumar , Baghel Surendra Singh , Manogaran Ravi Sankar , Dixit Ajai Kumar , Mishra Prabhakar
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

Objectives

The study was aimed to determine the patient demographics, risk factors, which include comorbidities, presenting symptoms and signs, medications used to treat COVID-19, species of Mucorales isolated, and the management outcome of COVID-19-associated mucormycosis.

Methods

It was a 6-month retrospective, propensity score-matched, comparative study conducted at a tertiary care center, involving 124 patients with COVID-19 associated mucormycosis admitted between April and September 2021, who were suffering from or had a history of COVID-19 infection.

Results

Among the 124 patients, 87 were male, and 37 were female. A total of 72.6% of patients received steroids, while 73.4% received antibiotics, and 55.6% received oxygen during COVID-19 management. The most common comorbidities were diabetes mellitus (83.9%) and hypertension (30.6%). A total of 92.2% had mucor, 16.9% had Aspergillus, 12.9% had both, and one patient had hyalohyphomycosis on fungal smear and culture. The comparative study showed the significant role of serum ferritin, glycemic control, steroid use, and duration in COVID-19-associated invasive fungal disease (P <.001). Headache and facial pain (68, 54.8%) were the most common symptoms. The most involved sinonasal site was the maxillary sinus (90, 72.6%). Direct KOH microscopy for fungus was positive in 100% of the cases, 82.2% were Mucorales; 12.9% showed mixed fungal hyphae (mucormycetes and Aspergillus spp.), 4% Aspergillus and hyaline septate non-Aspergillus fungus hyphae were seen in 0.8%. Mucoraceous fungi isolated were R. arrhizus, R. microsporus, R. homothallicus, Rhizomucor pusillus, and Leithemia corymbifera. The overall survival rate at the 3-month follow-up was 79.9%.

Conclusion

COVID-19-related aggressive inflammatory response, uncontrolled glycemic level, and rampant use of steroids are the most important predisposing factors in developing COVID-19-associated invasive fungal sinusitis caused by Mucorales. A high index of suspicion, aggressive surgical and antifungal therapy resulted in the successful outcomes for most of the patients.
P264 Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei
Authors: Rai Madhu , Patel Medical Priyanka , Rodriguez Camilla , Basu Shaoli , Salvi Asmita , Agrawal Umang , Sunavala Ayesha , Soman Rajiv , Shetty Anjali
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

 

Two cases of Rhinocladiella mackenziei have been noted in our institute, the first case in 2015 (post-renal transplant) and the second case in 2021 (post-COVID infection). Both the patients had received immunosuppressants for varying duration. Both the cases presented to the hospital with neurological deficit secondary to brain abscess. On initial assessment, the melanized fungus was noted which was later identified as Rhinocladiella on culture and further confirmed with molecular methods. Both the cases were treated with injection of L AmB, voriconazole and 5FC for a prolonged duration and later discharged when the condition improved. The renal transplant patient was advised lifelong voriconazole since he would continue to be on immunosuppressants. To our knowledge, the second patient diagnosed post-COVID could be the first case report of invasive dematiaceous fungal infection in an apparently immunocompetent individual. Both cases also highlight the challenges in management such as designing an appropriate regimen, deciding the optimum duration of antifungal therapy, and managing the toxicities associated with long-term antifungal use. R. mackenziei is a frequently fatal melanized neurotropic fungus known to carry almost 100% mortality despite the combination of antifungal agents and surgery. Central nervous system infections due to R. mackenziei have been exclusively reported from the Middle East, except for cases recently reported from India.
P267 Candida in the biliary tract: extrapolative PK PD considerations
Authors: Rege Sujata , Soman Rajeev , Chavan Dipali , Hanchanale Pavan
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

Objective

Candida norvegensis is an uncommon Candida species causing infection in immunocompromised hosts. It is intrinsically resistant to Fluconazole, which is commonly the empiric choice for therapy. A strong association with post-liver transplant status, as in this case and near-100% mortality, likely due to inappropriate antifungal therapy and lack of source control has been reported in the literature.

Methods and Results

Mr. AK, a 32-year-old gentleman, 10 months post-liver transplant recipient, had stenting done for biliary stricture. A month later, he developed ESBL E. coli cholangitis and bacteremia for which he was treated with Meropenem. Flaky pus was seen during stent exchange which grew Candida norvegensis on culture with 97% probability of identification (Fig. 1). Suspecting cholangitic abscesses, patient would require at least 3 weeks of antifungals and Meropenem.

Since there is limited data about antifungal susceptibilities of C. norvegensis, MICs were generated on VITEK by using names of other Candida species. Micafungin was found to show an MIC of 0.12 and voriconazole of 0.25. EUCAST breakpoints are only provided for certain species and for others treatment is based on PK/PD considerations. The PK PD indices for efficacy of voriconazole is AUC/MIC of 30 and of Echinocandins is Cmax/MIC of 1R, which prompted extrapolation in this case.

The extrapolative PK PD considerations were as follows (Table 1).

Micafungin dose of 150 mg generates a biliary trough level of 1.9 mcg/mlR, which will lead to Cmax/MIC (1.9/0.12) of 15.83, exceeding the required target Cmax/MIC for cidal therapy of echinocandins which is 1R. Micafungin and Meropenem were administered for 3 weeks and the patient responded well to treatment.

Conclusion

This case highlights the importance of speciation of Candida spp, extrapolating MICs and breakpoints for species where data are not available, early source control and use of PK/PD considerations in choosing the appropriate antifungal agent on a case-by-case basis.
P279 Invasive Trichosporonosis: an emerging blood stream fungal infection in immunocompromised patients
Authors: Mukherjee Dip Narayan , Seal Soumyadeep
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

Trichosporon is a genus of yeast-like fungi. It is perhaps most widely known as the cause of white piedra, a benign superficial mycosis seen in immunocompetent individuals in tropical and subtropical regions. However, the incidence of invasive trichosporonosis has increased in immunocompromised patients, most notably those with hematologic malignancies. Invasive infections due to Trichosporon species are considered rare so far, but during the past two decades, they have emerged as important opportunistic pathogens in immunocompromised individuals.

 

All patients with blood culture positive for Trichosporon species from January 2020 to August 2020 at Woodlands Multispecialty Hospital, Kolkata, India were evaluated. In vitro susceptibility testing was performed using the reference broth micro-dilution method. Clinical co-relation was done with the positive culture report and patient's clinical condition to rule out colonization/contamination.

 

A total of 7 patients were found to have blood culture positive for Trichosporon species among which five were true infections. Various predisposing factors previously reported to be associated with invasive trichosporonosis were also considered in the present study. All the cases were associated with either post radiotherapy/chemotherapy with renal failure requiring dialysis via hemodialysis catheter or use of central venous catheter or chemoport. Underlying malignancy was found in all patients. Susceptibility testing has been performed for 5-FC, amphotericin B, and Azoles. Azoles had good in vitro activity, whereas amphotericin B had higher MIC values. The all-cause mortality rate was 43%.

 

Invasive Trichosporon infection is a rare, life-threatening infection in immunocompromised patients. Our study highlights the association of central venous catheter and hemodialysis catheter with Trichosporon fungemia and its high mortality. Therefore, strict infection control measures while handling these devices are recommended to prevent these infections. Species identification and susceptibility testing are to be attempted for all relevant clinical isolates in view of demonstrable resistance to certain antifungal drugs. Echinocandins are not effective in the treatment of trichosporon infection. Amphotericin B should also be avoided. Azoles, in particular, voriconazole is the drug of choice.
P292 Short tandem repeat genotyping of Indian Candida tropicalis isolates reveals intrahospital cross transmission
Authors: Spruijtenburg Bram , Jain Kusum , Tarai Basidhar , Sachdeva Neelam , Chowdhary Anuradha , de Groot Theun , Meis Jacques
Published: September 2022

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM

 

 

Candida tropicalis is a clinically relevant yeast that causes candidemia in humans with a high mortality rate. The yeast primarily infects immunocompromised patients and causes outbreaks in health care facilities and is the predominant Candida species from clinical specimens in India. Antifungal-resistant isolates have been reported. Here, we applied a novel short tandem repeat (STR) C. tropicalis typing scheme to a collection of 402 clinical and environmental Indian isolates from New Delhi. Multiple large clusters (n = 7) containing more than 2 isolates were detected, and allocated to individual hospitals, except for the largest cluster. This cluster contained 14 isolates from two different hospitals, suggesting cross-transmissions. Two closely related clusters are allocated to the same two hospitals. Altogether, a novel high-resolution STR genotyping for C. tropicalis revealed hitherto unrecognized clusters of hospital transmission.