bluuebunny/crossref_metadata_2025_split huggingface dataset:
P309 Clonal outbreak of Trichophyton tonsurans causing tinea capitis among wrestlers in Beijing, China
Authors: Wang Qiqi , Li Ruoyu , Chen Wei , Wan Zhe , Liu Wei 
Published: September 2022

Abstract

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

Objectives
Trichophyton tonsurans, an anthropophilic dermatophyte, mostly causes tinea capitis and tinea corporis and is often associated with outbreaks among athletes involved in combat sports, such as wrestlers and judo athletes. Here, we report an outbreak of tinea capitis caused by Trichophyton tonsurans among five juvenile athletes aged ten to fourteen in a wrestling team in Beijing, China.

Methods
A total of 5 wrestlers aged 10-14 years presented with alopecia, erythema, scales, and pustule on the scalp (Fig. 1a). Scrapings from the lesions were performed by direct microscopic examination using 10% potassium hydroxide (KOH) with calcofluor white and fungal culture. The fungal pathogens were identified by morphology and sequencing of the internal transcribed spacer (ITS) regions. Multilocus genotyping analysis was performed by sequencing of the five gene loci including the ITS and non-transcribed spacer (NTS) of the ribosomal RNA (rRNA) locus, alkalineprotease-1 (ALP1), metalloprotease-5 (MEP5), carboxypeptidases Y (CarbY), which show intraspecies diversity and can be applied to epidemiological investigations and determining the route of infection transmission. Antifungal susceptibility of terbinafine (TBF), itraconazole (ITC), fluconazole (FLC), ketoconazole (KTC), and amphotericin B (AMB) against the causative fungal isolates was determined by broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) M38-A3 document.

Results
The five patients were diagnosed with tinea capitis because of the scalp lesions, spores, and hyphae observed by direct microscopic examination (Fig. 1b), and positive fungal culture. The causative isolates were all identified as T. tonsurans by macroscopic and microscopic characteristics (Fig. 2) and sequencing of ITS regions. The sequences of ITS, NTS, ALP1, MEP5, and CarbY were identical among the five isolates, revealing a single genotype. The abovementioned sequences have been deposited to Genbank. The minimum inhibitory concentrations (MICs) of TBF, ITC, FLC, KTC, and AMB against five T. tonsurans isolates were 0.015 μg/ml, 0.015 μg/ml, 8 μg/ml, 0.06 μg/ml, and 0.5 μg/ml, respectively.

Conclusion
We report an outbreak of tinea capitis caused by T. tonsurans among wrestlers in Beijing, China. Multilocus genotyping analysis revealed that all isolates consisted of a single genotype, suggesting the outbreak may be caused by a single strain of T. tonsurans. The isolates were all susceptible to the common antifungal drugs treating tinea capitis.
P325 Trend of cryptococcal meningitis in patients attending a teaching hospital in north-east india — a single center study
Authors: Acharjee Aindrilla , Ngangom Lilavati , Presanambika R Hari , Ningthoujam Priyolakshmi , Khuraijam Ranjana 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objective
To determine the changing trend of Cryptococcal meningitis in patients attending Regional Institute of Medical Sciences Hospital, Imphal.

Methods
A total of 142 cerebrospinal fluid (CSF) samples collected from patients with suspected meningitis from January 2013 to January 2022 were analyzed in the department of Microbiology, Regional Institute of Medical Sciences, Imphal. The samples were subjected to India ink preparation (IIP), Gram stain, Cryptococcal antigen (CrAg) testing, fungal culture in Sabouraud Dextrose agar (SDA) medium, and Bird Seed Agar.

Results
Out of 142 CSF samples received, direct examination by IIP revealed Cryptococcus in 28 cases (19.7%) whereas, capsular polysaccharide antigen testing using lateral flow immunochromatography kit (CRYPTO-PS) detected a total of 40 cases (28.2%). Culture showed growth of fungus in 22 samples and all were from CrAg positive samples. Maximum number of cases were detected in the year 2019 followed by 2018. Immunosuppression (AIDS) was an important underlying factor. Recurrence was seen in three patients and two cases who were on Cycloserine succumbed while undergoing treatment.

Conclusion
Cryptococcosis continues to be a serious fungal infection among AIDS patients in spite of HAART. High index of clinical suspicion and microbiological examination is necessary to improve clinical outcomes. Whenever immunosuppressive drugs are administered in HIV patients treated earlier for cryptococcosis, monitoring the patient for likely recurrence is to be borne in mind to improve the overall clinical outcome. CrAg testing is an additional armamentarium for the diagnosis of cryptococcosis in the absence of culture positivity.
P344 Automatic detection of pneumocystis jirovecii in microscope images: adeep learning-based approach
Authors: Vera Erick Reyes , Botero-Valencia Juan , Giraldo-Escobar William , Arango Karen , Berrio Indira , Preciado Tonny Naranjo 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objective
Pneumocystis jirovecii Pneumonia is one of the diseases that most affect immunocompromised patients today, and under certain circumstances, it can be fatal. One of the most widely used techniques in diagnostic laboratories for the detection of its etiological agent is optical microscopy. However, some of the disadvantages of this technique are its low sensitivity, low accuracy, and high dependence on an expert to make the diagnosis. Then, this work aims to develop a computational tool based on a deep learning approach to automatically detect the presence of P. jirovecii Pneumonia fungus from optical images, and to increase the accuracy of this conventional technique.

Methods
The study involved 29 randomized patients, from whom respiratory samples (bronchial lavage, and bronchoalveolar lavage) were collected. Methenamine silver staining was then used to prepare the samples. Subsequently, the slides of the analyzed patients were observed using the Leica DM500 microscope using a Leica ICC50 HD camera, and the optical images were taken in at least four random positions on the specimen holder. Thus, an image dataset of 29 different patients was created to detect whether a patient is positive or negative for P. jirovecii Pneumonia. Finally, a deep learning approach based on convolutional neuronal networks (CNN) was proposed and evaluated to improve the accuracy of the microscopy technique. The proposed CNN method incorporates global and local features for pixel-wise segmentation.

Results
First, the dataset image was processed and segmented using the connected components methodology. Likewise, the segmented images were labeled with the help of an expert to train the algorithm. To validate the response of the proposed deep learning approach the obtained results were compared with the obtained conventional image classification techniques like co-occurrence matrix and K-NN. The obtained results reveal that the proposed methodology allows to increase in the accuracy in the P. jirovecii Pneumonia identification up to 98%, while the co-occurrence matrix and K-NN only achieve accuracies of 89% and 85% respectively.

Conclusion
It is possible to demonstrate that techniques based on digital image processing are a useful tool to support the processes of analysis and diagnosis of samples in medical patients with P. jirovecii Pneumonia. In addition, the obtained results demonstrate that methods based on deep learning allow us to develop more precise and accurate analysis methodologies for the analysis of patient samples with P. jirovecii Pneumonia. Our model can be improved by adding new layers, but this would introduce even more hyperparameters that should be adjusted. We intend to extend our model architecture in other areas of medical imaging with the usage of deep learning and computer vision techniques.
P348 tRNA modifications in Candida virulence
Authors: Böttcher Bettina , Leidel Sebastian , Brunke Sascha 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM
Candida albicans is a normal commensal of the gastrointestinal tract, but also an important opportunistic pathogen that can cause life-threatening infections. An important pathogenicity factor of C. albicans is its ability to form hyphae, which are associated with the expression of many different virulence factors. The regulation of hypha formation has been analyzed extensively on the transcriptional and also post-translational level in the past.

Candida albicans has a closely related sister species, C. dubliniensis, which has a lower propensity to form hyphae and only very rarely causes more than superficial infections. We investigated the differences in the genetic setup of these two species and found a gene whose Saccharomyces cerevisiae homolog is involved in tRNA modifications.

We here show that this gene, Hma1, acts as a tRNA-threonyl carbamoyl adenosine dehydratase in C. albicans, and that its activity differs between C. albicans and C. dubliniensis. A deletion mutant shows specific defects in hyphae formation, invasion of host cells, and in virulence in C. albicans. Furthermore, we find that the loss of this tRNA-modifying enzyme leads to changes in ribosome occupancy at 37°C, the temperature encountered in the host.

With these data we link tRNA modifications to host-induced processes of one of the most important fungal pathogens of humans. We thereby add another layer of regulation, between transcription and post-translational modifications, to the virulence program of Candida yeasts.
P355 Pitfalls in medical mycology in India
Authors: Gugnani Harish 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Background information
There is increasing awareness of fungal infections in India. Many diagnostic medical mycology laboratories are now operating in different parts of the country. It is considered worthwhile to mention several pitfalls committed in the diagnosis of mycotic infections in India.

Methods
Literature on fungal infections in India was accessed through different search engines. Publications suggestive of inaccurate reporting were thoroughly read to pinpoint the pitfalls in diagnosis. For checking the accuracy of mycological illustrations, some of the publications were requested from the corresponding authors.

Results
Several accessed publications of Indian authors reported the unbelievably frequent occurrence of anthropophilic and zoophilic dermatophytes in soil. A few articles incorporating incorrect diagnoses of systemic infections have also been published in highly reputed journals. For instance, the article ‘Pathogenic Fungi in Soils of Jabalpur, India’ in Mycoses 1990; 33 (3): 116-125 reports 38% incidence of Microsporum (anthropophilic and zoophilic species) in 35 soils examined. Another publication in the August 2009 issue of the same journal mentions frequent isolation of Trichophyton verrucosum, Microsporum audouinii, and M. canis from Jaipur soils. Authors from several Botany departments in Indian Universities have erroneously reported a high frequency of these dermatophytes and T. rubrum from soils and also on Histoplasma capsulatum from some soils. No illustrations were provided for these fungi including H. capsulatum, nor was in vitro conversion of H. capsulatum to yeast form mentioned. There are also reports of erroneous diagnoses of systemic mycoses. In a paper in IJD 2015; 54:451-455, the authors from Kottayam, Kerala reported on African histoplasmosis as the first indigenous case from India. The diagnosis is doubtful as histopathology was not suggestive and the image of the blood agar culture of the fungus at 37°C showed septate cells resembling arthroconidia rather than yeast cells of Histoplasma. Another publication from a premier medical institute in North India [Intestinal Res 2019;17(1):149-152] reported a series of six cases of intestinal histoplasmosis the histopathological illustration was not at all suggestive of Histoplasma and there was no mention of attempting mycological culture.

Conclusion
Lack of knowledge and training of workers from departments of botany and biological sciences in Indian universities has led to the misidentification of human pathogenic fungi The inaccurate diagnosis of mycotic infections has resulted generally from misidentification of the causative fungi and lack of collaboration between histopathologists and medical mycologists. The need for continued training of medical mycologists and for collaboration between the pathologists and medical mycologists is emphasized to avoid erroneous diagnoses.
P363 Mycoflora diversity in stored water from selected households in nairobi
Authors: Mashedi Olga , Kimani Bridgit , Waithera Leah , Okoth Shiela 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Introduction
Water is a very vital natural resource for all life on earth as it is used widely. Water plays an important role in the world economy, the uses can be categorized into; commercial use where it is used in hostels, restaurants, offices, and other commercial activities. Fungi are ubiquitous in nature; they produce spores that are small-sized, able to stay airborne for a long duration, and transported over long distances during air dispersal. These are major sources of allergens and airway irritants that are detrimental to health. Biofilms in water distribution systems and storage containers provide favorable habitat for microorganisms as they accumulate better in solid-liquid interfaces that enable them to be embedded in the gelatinous matrix of extracellular polymers excreted by the microorganisms leading to resistance of microbes from environmental stresses. Fungi hydrophobicity and adaptability have enabled them to assemble and colonize different surfaces in domestic settings. The potential health effects caused by fungi in treated water are still not well highlighted and thus the need to carry out this study to investigate the mycoflora isolated from stored water.

Methods
This was a cross-sectional study conducted from 2019-2021, whereby 120 water samples were collected from stored containers in households in Nairobi county Kenya. The fungal strains were plated onto Sabouraud's dextrose agar (SDA), Potato Dextrose Agar, and Czapecks Agar media with chloramphenicol (0.05 mg/mL) (Oxoid, U.K.). The plates were incubated for 7 days at 25°C. Fungal identification was done by direct microscopy and morphological features.

Results
A total of 101 fungal species were isolated from water samples. Yeasts 48 (47.5%), Rhodotorula 34 (33.6%) accounted for the unicellular fungi. Among Filamentous mycoflora, the most common isolated fungi were Aspergillus species 13(12.8%), followed by Fusarium spp 4 (3.9%) with Mucor and |Rhizopus species accounting for 1 (0.9%) respectively. Yeasts species were the most common species isolated from water species and Aspergillus species were more frequently isolated from filamentous fungi.

Conclusion
Yeasts species were the most common species isolated from water species and the roles they play in biofilm needs to be further investigated.
P374 Fungal coinfection in patients with SARS-CoV-2: Atertiary care hospital study
Authors: Saini Vikas , Rai Gargi , Singh Praveen , Das Shukla , Singh Narendra Pal 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Background
There is a high risk of developing fungal co-infections in patients infected with SARS-CoV-2, few studies have been conducted on the incidence and risk of these secondary infections. The incidence of Candida infection due to different Candida species is increasing in COVID patients.

Methods
This retrospective study comprised a total of 23 patients with upper respiratory infection investigated in the Department of Microbiology of University College of Medical Sciences (UCMS) and Guru Teg Bahadur Hospital (GTBH), Delhi from April 2021 to June 2021. Identification was done using DNA sequencing.

Results
Of the 23 cases, identification by DNA sequencing, C. albicans was present in 34.78%, C. tropicalis in 30.43%, Pichia kudriavzevii in 26.08%, C. parapsilosis in 4.3%%, and C. auris in 4.3%.

Conclusion
C. albicans is the leading pathogen in our patients, along with the rise in the incidence of P. kudriavzevii which is usually an environmental contaminant. Regular surveillance and infection control practices are future ventures to reduce the burden of infection.
P382 Scalp fungal microbiome and sebum composition in males with and without androgenetic alopecia
Authors: Sugita Takashi , Suzuki Kazuhiro , Cho Otomi 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objects
Lipophilic Malassezia species are abundant in the scalp microbiome; we investigated the scalp microbiome and sebum composition of patients with androgenic alopecia (AGA) and aimed to identify factors accelerating AGA progression.

Materials and Methods
Scalp scale samples (swabs) were collected from 55 male Japanese patients with AGA and 63 healthy individuals. Fungal rRNA genes were amplified by PCR and the amplicons were sequenced on the MiSeq platform. The extent of fungal colonization was determined by qPCR. We used gas chromatography/mass spectrometry to measure the sebum levels of free fatty acids, diglycerides, triglycerides, squalene, free cholesterol, cholesterol esters, and wax.

Results and Discussion
Malassezia restricta predominated in all AGA (64.7%) and non-AGA age groups (44.6%). qPCR revealed that Malassezia colonization was more extensive in the AGA than non-AGA group, regardless of age; the Malassezia level was significantly higher in ADA subjects aged 50–59 than 30-49 years. The TG level was significantly higher in the AGA than non-AGA group (P &lt;.05), but the free fatty acid, squalene, and free cholesterol levels were significantly lower (all P &lt;.05).

Conclusion
Thus, the scalp fungal microbiome and sebum composition may influence AGA development.
P408 Evaluation of fungal serum biomarkers in the diagnosis and for monitoring patients with post tuberculosis chronic pulmonary aspergillosis
Authors: Singh Shreya , Singh Inderpaul , Agarwal Ritesh , Kaur Harsimran , Chakrabarti Arunaloke , Rudramurthy Shivaprakash 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Objectives
The evaluation of serum β-D-glucan, galactomannan, and Aspergillus fumigatus specific IgG in the diagnosis and clinical management of patients with chronic pulmonary aspergillosis.

Methods
Consecutive patients with a past history of pulmonary tuberculosis (PTB) with clinical suspicion of chronic pulmonary aspergillosis (CPA) attending the outpatient services of PGIMER, Chandigarh were included from August 2019 to August 2021, and CPA was defined as described by Denning et al. including both radiological and mycological evidence. Age and sex-matched post-PTB individuals selected from a population attending the chest clinic were enrolled as controls. Serum samples were obtained from all participants and testing for serum β-D-glucan (Fungitell, CapeCod), galactomannan (Platelia, BioRad) and Aspergillus fumigatus specific IgG (ImmunoCAP, Phadia) was performed as per manufacturer's instructions.

Results
A total of 105 post-TB patients with CPA and 11 controls were enrolled. Aspergillus fumigatus (n = 8) was the most commonly isolated species, followed by A. flavus (n = 4), and A. niger (n = 2). The mean A. fumigatus specific IgG levels, serum galactomannan index and BDG levels were higher among CPA cases vs. controls at 101.4 mgA/l vs. 11.8 mgA/l, P-value: .0001; 0.73 vs. 0.35, P-value: .3134; and 133.7 pg/ml vs. 32.37 pg/ml, P-value: .012, respectively (Figs. 1a, b, c). The serum BDG had an area under curve 0.834 ± 0.044 (95% CI: 0.748-0.920) on the ROC curve with a sensitivity of 57.1% and specificity of 100% at the kit cut-off of 80 pg/ml (Fig. 2a). Comparison between CPA patients with multiple (n = 38) versus single lobe (n = 67) involvement showed comparable A. fumigatus specific IgG levels (112.3 vs. 93.8; P-value: .133 respectively) while galactomannan index and BDG levels were higher in cases with multiple vs. single lobe involvement (0.94 vs. 0.57, P-value: .117), and (174.3 vs. 105.3, P-value: .0071), respectively (Fig. 1d, e, f). There was a significant association of BDG value with the severity of dyspnea (P-value: .002) and a trend of higher A. fumigatus specific IgG was also seen to correlate with the severity of dyspnea (Fig. 2b and 2c).

Conclusion
BDG assay can serve as an adjunct in the diagnosis of patients with CPA. An association of higher levels of BDG with multiple lobe involvement and severe dyspnea could be due to more extensive tissue damage associated with a greater release of antigen in circulation during progressive disease. More studies with a larger number of control samples, preferably with multi-center coordination can further improve our understanding of this test's applicability in routine practice.
P427 The value of nasal and oral clinical examination in febrile neutropenic patients for initiating anti-fungal therapy as a preemptive method
Authors: Sarvestani Hasti Kamali , Salehi Mohammadreza , Fard Elahe Samiee , Pourahmad Ramtin , Khansari Mahmoud 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM

Background
Invasive fungal infections (IFIs) are complications that lead to mortality and morbidity in hematologic malignancies. The time of starting anti-fungal therapy is vital. Preemptive anti-fungal therapy has appeared recently as a new policy for the management of IFIs based on noninvasive ways in neutropenic patients.

Methods
We enrolled leukemia patients with neutropenia after chemotherapy in Imam Khomeini Hospital Complex, Tehran, Iran. Patients who entered the neutropenic phase were divided into two categories (empirical and preemptive) for receiving anti-fungal agents. The patients were clinically examined in the preemptive group every day to find IFIs. As soon as clinical evidence of IFIs was observed, antifungal was prescribed. The empirical group patients received antifungals based on the ward protocol. Based on the data in each group, the diagnostic and therapeutic results of cases are followed-up for 3 months. To compare percentages between the two groups, the Chi-squared test was used. And to compare two means between the two groups, the independent t-test was used. All the statistical analyses were done in the Statistical Package for the Social Sciences (SPSS) version 24 software (IBM Corporation, Armonk, New York, USA).

Results
We assessed 132 leukemic patients with inclusion and exclusion criteria. Eventually, 80 patients were enrolled. The mean age was 35.52 years. Demographic data and distribution of leukemia type show no significant differences between the two groups. Despite a higher percentage of IFIs discovered in the preemptive group than the empirical group (25 vs. 18.75%, respectively), but data show no significant differences. The average days of IFIs diagnosis since the beginning of neutropenia in the empirical group were 9.5 days while in the preemptive group, the average days were 5.4 days (P &lt;.05). Totally, there were 15 patients with a proven IFI in each group (40% in the empirical group and 60% in the preemptive group). Results significantly show an increase in surgical sinus debridement in the empirical groups (83.3%) vs. the preemptive groups (55.5%), (P &lt;.05). The mortality rate differed significantly among the two groups; it was 7.5% in the preemptive group and 25% in the empirical group (P &lt;.05).

Conclusion
Daily oral and nasal cavities examination to find the symptoms of IFIs and then start preemptive antifungal agents may be able to lead to accurate diagnosis, earlier treatment, and decreasing sinus surgery debridement in leukemia patients with neutropenia.