bluuebunny/crossref_metadata_2025_split huggingface dataset:
P439 Biomarker detection for the diagnosis of disseminated histoplasmosis in people living with HIV/ AIDS in Southern Brazil: a year of implementation
Authors: Blan Bianca , Basso Rossana , Poester Vanice , Benelli Jéssica , Sanchotene Karine , Xavier Melissa 
Published: September 2022

Abstract

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

Background
Disseminate histoplasmosis (DH) is an important opportunistic disease in HIV/AIDS patients.

Objective
We aimed to report partial results of the implementation of the Histoplasma urinary biomarker as a routine test for the diagnosis of DH in people living with HIV/AIDS (PLWHA) admitted to a reference hospital in Southern Brazil.

Methods
The study was performed in a tertiary hospital, which is recognized as a regional reference center to 21 cities for the treatment of PLWHA. At this service, since the beginning of 2021, a new protocol for DH investigation was adopted, including the systematic execution of urinary antigen test for histoplasmosis (Histoplasma GM EIA, IMMY®) in PLWHA. We retrospectively evaluated data from all of these patients diagnosed with DH in the last 1 year, between March 2021 and March 2022. The study was approved by our university ethics committee (CEP/FURG; N° 234/2018).

Results
Within the 12 months period, 243 patients from our hospital were investigated by Histoplasma GM EIA through urine samples. A total of 19 were diagnosed with DH through this test, resulting in a prevalence of 7.8%. Interestingly, nine of them were also investigated by antibody detection through immunodiffusion test (IMMY), being all negative in this serology. DH was the AIDS-defining illness in 21% of these patients (4/19), and co-infection with Mycobacterium tuberculosis was detected in 37% (7/19). Half of the patients (11/19) were severe immunosuppressed (CD4 + lymphocytes &lt;100 cells/mm3), 21% (n = 4) had rates between 100 and 200 cells/mm3 and 21% (n = 4) had &gt;200 cells/mm3. The majority of the patients (74%; n = 14) had advanced signs of DH, showing pulmonary impairment, weight loss, fever, neurological, and/or skin lesions and lymphadenopathy, suggesting late diagnosis, 16% (3/19) of the patients had few signs of DH (suggesting precocity), and two patients were diagnosed before the onset of the clinical manifestation, with the strategy of the use of GM Histoplasma EIA as a screening test. Although the antifungal treatment, five of them (35.7%) died.

Conclusion
The systematic use of the test to detect a specific biomarker in urine samples had improved substantially the diagnosis of DH in PLWHA in our hospital (19 cases in one year). In addition, since we could diagnose DH with precocity in five patients, we suggest that in regions where DH is hyperendemic, the GM Histoplasma EIA could be used as a screening test for all AIDS patients, similar to what is preconized to cryptococcal disease. More robust studies are instigated to evaluate this strategy, and its benefits to an early diagnosis, resulting in a better quality of life, better prognosis, and consequently reduction of the mortality rate.
P456 Defungi: direct mycological examination of microscopic fungi images
Authors: Álvarez María Alejandra Vanegas , Sopó Leticia , Sopo Camilo Javier Pineda , Hajati Farshid , Gheisari Soheil 
Published: September 2022

Abstract

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

Objective
To classify five fungi types using two different deep learning approaches and three different convolutional neural network models, VGG16, Inception V3, and ResNet50.

Method
A mycological laboratory in Colombia donated the images used for the development of this research work. They were manually labeled into five classes and curated with subject matter expert assistance. The images were later cropped and modified with automated coding routines to produce the final dataset.

Results
We present experimental results classifying five types of fungi using two different deep learning approaches and three different convolutional neural network models, VGG16, Inception V3, and ResNet50. The first approach benchmarks the classification performance for the models trained from scratch, while the second approach benchmarks the classification performance using pre-trained models based on the ImageNet dataset. Using k-fold cross-validation testing on the 5-class dataset, the best performing model trained from scratch was Inception V3, reporting 73.2% accuracy. Likewise, the best performing model using transfer learning was VGG16, with 85.04% accuracy.

Conclusion
The statistics provided by the two approaches create an initial benchmark to encourage future research work to improve classification performance. Furthermore, the dataset built is published on Kaggle and GitHub to encourage future research.
P463 Toxicological evaluation of Aureobasidum pullulans var. pullulans induced mycotoxicosis in amurine model
Authors: Kumari Ankita , Singh Karuna 
Published: September 2022

Abstract

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

Objectives
The genus Aureobasidium includes 14 species, amongst which Aureobasidium pullulans is the most well-known species. Aureobasidium pullulans, includes two well-documented varieties found in indoor environments and associated with health issues: A. pullulans var. pullulans and A. pullulans var. melanogenum. Aureobasidium pullulans is a mold belonging to the family Dothioraceae. It colonizes nails, hair, and skin in humans. Deleterious immune reactions may occur in humans, like hypersensitivity pneumonitis and allergies. Respiratory allergies may result due to high levels of Aureobasidium in the air. The metabolites of the mold, like mycotoxin, are known to cause toxic-irritant effects. In view of this, the present work evaluates the effects of the toxic secondary metabolites of A. pullulans var. pullulans (CBS 577.93) in a murine model.
In order to maximize the toxicological potential of A. pullulans pullulans (CBS 577.93) for the production of mycotoxins, an understanding of its mode of action in an animal model is necessary. In the present study, we report the mycotoxicological activity of A. pullulans pullulans (CBS 577.93) in experimental mice.

Material and Methods
Mycotoxins isolated from A. pullulans pullulans (CBS 577.93) were used for the experimental induction of mycotoxicosis in Swiss mice (C3HHC strain). The mycotoxin was administered intraperitoneally (IP) and intranasally (IN). To assess the toxic effects of the A. pullulans mycotoxins, eight organs, namely liver, lungs, kidney, spleen, stomach, heart, brain, and testis, were taken into consideration. The hematological, histopathological, and biochemical aspects of A. pullulans-induced mycotoxicosis were investigated.

Results

Conclusion
Thus, from the present study, we concluded that mycotoxins isolated from A. pullulans (CBS 577.93) documented toxicity in all eight organs, with the testis and lungs being the worst affected organs. Even at a very small concentration and short exposure, the mycotoxin caused severe damage to the vital organs. New risk assessment approaches should be considered to investigate the toxicological interactions of A. pullulans mycotoxins in the indoor environment and in animal models.
P480 A novel zincophore locus in Candida auris?
Authors: Chakraborty Tanmoy , Wilson Duncan 
Published: September 2022

Abstract

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM
Candida auris is an emerging multidrug-resistant human fungal pathogen that is spreading rapidly across the world and is associated with hospital-acquired invasive infections with high mortality rates. Whilst previous studies have focused on understanding the basic biology and drug resistance mechanisms of C. auris, nothing is known about the strategies underlying trace metal acquisition. Trace metals like zinc are known to be crucial for numerous biological functions across all kingdoms of life. Thus, in this study, we aimed to characterize the zinc uptake mechanisms of C. auris and determine their role in virulence. We compared the ability of C. auris to grow in zinc-restricted conditions with other pathogenic fungi belonging to the CTG and WGD clade. Regardless of the clade, we found that C. auris has a striking ability to grow under extreme zinc-limiting conditions when compared with other human pathogenic fungi.

Other fungi have been demonstrated to scavenge zinc via a zincophore locus, encoding a secreted zinc-binding protein Pra1 and its cognate receptor, Zrt101. However, in silico analysis of C. auris revealed that this species has undergone a rearrangement of the locus. The canonical zincophore gene PRA1 has translocated to another chromosome and the extracellular zinc-binding domain of the Zrt101 receptor has undergone an inverted duplication generating a novel putative zincophore.

Our qRT-PCR analysis demonstrated that both PRA1 and the novel zincophore genes were upregulated in response to neutral pH and zinc-restriction. Protein supernatant from C. auris strains also showed high zinc binding activity. Furthermore, we have generated mutants lacking the novel zincophore gene in C. auris by CRISPR/Cas9 and found that these deletion mutants exhibited perturbed growth under zinc limitation. Together our observations suggest that C. auris has evolved a unique zinc acquisition strategy from the environment and the host.
P489 Anti-granulocyte-macrophage colony-stimulating factor (Anti-GM-CSF) autoantibodies—the underrecognized cause of Cryptococcosis in non-HIV individuals in Thailand: Case series from a single tertiary care hospital
Authors: Pongdumbun Tuvanont , Treebupachatsakul1 Pornpit , Umrod Pinklow , Tantibhedhyangkul Wiwit , Chayakulkeeree Methee 
Published: September 2022

Abstract

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

Background
Cryptococcosis is an opportunistic fungal infection in immunocompromised patients. Granulocyte-macrophage colony-stimulating factor (GM-CSF) regulates the functions of phagocytes and alveolar macrophages, which are crucial in cryptococcal control. Anti-granulocyte-macrophage colony-stimulating factor (Anti-GM-CSF) autoantibodies have been found to be associated with cryptococcosis in non-HIV individuals but this syndrome has never been described in Thai population.

Methods
We report here the case series of patients hospitalized in a tertiary care hospital in Northern Thailand.

Results
Three apparently immunocompetent patients, 34, 38, and 45 years old, were presented with neurological manifestations. Brain computed tomography scans and lumbar punctures were performed and the results showed evidence of cryptococcal meningoencephalitis. Two of the patients also had pulmonary cryptococcosis. We performed Anti-GM-CSF autoantibody ELISA assays in the patient's sera and all of three serum samples revealed a high titer of anti-GM-CSF autoantibodies. The patients were treated with amphotericin B deoxycholate with or without flucytosine for induction antifungal therapy, followed by fluconazole consolidation treatment. All patients were cured and had favorable outcomes.

Conclusions
Anti-GM-CSF autoantibodies syndrome is underrecognized in Thai patients and is a new entity of immunodeficiency associated with cryptococcal meningoencephalitis and disseminated cryptococcosis in Thai patients.
P501 Aspergillus fumigatus complicates one third of the patients with suspected bronchial asthma or pulmonary tuberculosis: Clinical validation of indigenously developed diagnostic kits
Authors: Kale Kavita , Bharmal Mohammed Husain , Choudhary Hansraj , Chowdhary Anuradha , Chaudhry Anil , Agarwal Ritesh , Shivaprakash M. Rudramurthy , Chakrabarti Arunaloke , Madan Taruna 
Published: September 2022

Abstract

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

Objectives
Aspergillus fumigatus, an opportunistic fungus, causes complications in about 5%-20% of bronchial asthma and about 26% of pulmonary tuberculosis patients. Detection of Aspergillus fumigatus specific IgG and IgE antibodies in the patient serum is an excellent tool to screen for Aspergillus sensitization early on to employ anti-fungal drugs in the clinical management to stall the progression of lung fibrosis.

Methods
Novel indigenous AfuPEPLISA assays were developed for the detection of specific IgG and IgE, based on the 12 amino acid long synthetic peptide epitope of Asp f1, an 18 kDa major allergen/antigen. The novel diagnostic kits were manufactured at a licensed GMP facility under a test license. Independent validation of the kits was pursued at PGIMER and VPCI hospitals in suspected bronchial asthma patients (n = 1307), and the diagnostic efficiency was compared with currently used ImmunoCAP assay.

Results
The diagnostic specificity and sensitivity were found to be 95.7% and 89.8%, respectively, for IgG; and 94.2% and 70%, respectively for IgE AfuPEPLISA, and were not significantly different from ImmunoCAP assay. Screening of the suspected patients of pulmonary tuberculosis (PTB) at RBIPMT Hospital for the presence of A. fumigatus specific IgG and IgE antibodies was pursued using AfuPEPLISA kits. A total of 82 out of 254 suspected PTB patients (32.3%) were seropositive in agreement with the previous reports.
See Figures 1 and 2 below.

Conclusion
The study inferred that indigenously developed AfuPEPLISA kits are an economically viable option to integrate in the clinical management of patients with suspected bronchial asthma or PTB for efficient diagnosis of Aspergillus sensitization.
P7 Banging your head against the (fungal) wall
Authors: Gow Neil A R 
Published: September 2022

Abstract

Plenary session 7, September 23, 2022, 2:00 PM - 3:00 PM

For a fungus, there may be nothing as biologically variable and highly regulated as its cell wall. This makes the wall intellectually and methodologically challenging to study, but worth the effort because they have the potential to reveal novel targets for antifungal drugs and the mechanisms that are important for immune recognition. Differences and adaptations to the cell wall composition can serve to resist chemotherapy and create a moving target for efficient immune recognition. We have used a variety of microscopic, forward, and reverse genetic and immunological tools to generate a new spatially accurate model of the cell wall and to explore how dynamic changes in the wall influence drug efficacy and immune surveillance. We show that the cell has a mechanism to maintain wall robustness within physiological limits. We also have demonstrated that immune-relevant epitopes can be diffuse or clustered, superficial or buried in the cell wall and they changed during batch culture and between yeast, hypha, and other cellular morphologies. We have screened libraries of mutants with immune pattern recognition receptors (PRRs) to define the sub-set of fungal genes that assemble and regulate immune epitopes. This is revealing novel processes that are important for the assembly of the cell wall. These experiments demonstrate that the fungal cell surface is ordered, complex and dynamically changing, requiring immune recognition to mobilize the concerted action of multiple receptors operating singly and in combination. My presentation will focus on work that demonstrates and describes recent advances that have generated a scaler and dynamic model of the cell wall that illuminates mechanisms of immune recognition and cell wall homeostasis.
S1.1d Risk factors associated with oropharyngeal candidiasis in COVID-19 patients: a case control study
Authors: Salehi Mohammadreza , Kiyaei Reyhaneh Sadat , Khodavaisy Sadegh , Khajavirad Nasim , Manshadi Seyed Ali Dehghan , Darazam Ilad Alavi , Seifi Arash 
Published: September 2022

Abstract

S1.1 Controversies in the clinical management of invasive candidiasis in critically ill patients, September 21, 2022, 11:00 AM - 12:30 PM

Objectives
With the emergence and spread of the coronavirus disease-19 (COVID-19) in the world, humans have been faced with the biggest challenge in health care systems in recent decades. The aim of the present study is to identify risk factors associated with oropharyngeal candidiasis (OPC) in COVID-19 patients.

Methods
The total number of confirmed COVID-19 patients was 218 (105 participants as cases who experienced OPC and 113 participants as controls without any evidence of OPC). The questionnaire used in this study consists of demography data, treatment strategy, clinical and laboratory data, and underlying diseases to collect information at the time of clinical OPC and follow them until the end of hospitalization.

Results
Pseudomembranous candidiasis (77/105, 73.3%) was the most prevalent form of OPC in case patients. The majority of cases (58.1%) and control (58.4%) groups were male. Increasing age of COVID-19 patients (P = .03) and length of hospitalization (P = .016) were significantly associated with OPC. Diabetes (P = .003), solid tumor (P = .019), and hypertension (P = .000) were the most common underlying conditions. Use of dentures (P = .003) and poor oral hygiene (P = .000) were related to OPC in case groups. Therapy with chloroquine (P = .012), IVIG (P = .001), diuretics (P = .000), and corticosteroid pulse therapy (P = .000) were significantly associated with the development of OPC in case patients.

Conclusion
It is reasonable to consider that old age, length of hospitalization, poor oral hygiene, corticosteroid usage, diabetes, solid tumor, and hypertension may predispose to the development of OPC in COVID-19 patients.
S4.5a A randomized, double blind phase II proof-of-concept superiority trial of fosravuconazole 200 mg or 300 mg weekly dose versus itraconazole 400 mg daily, all three arms in combination with surgery, in patients with eumycetoma in Sudan—top line results
Authors: Fahal Ahmed Hassan , Bakhiet Sahar Mubarak , Mohamed El Samani Wadaa , Ahmed Eiman Siddig , Bakhiet Osama El Hadi , Yousif Abu Bakar Ahmed , Fahal Lamis Ahmed , Alla Hadel Yassir Atta , Razig A Razig Osman A , Siddig Emmanuel Edwar , Hassan Omnia Babekir , Abdulla Sahar A Rahman , Mohaemd Amir Faroug , Jodda Nagwa Adam , Bahar Mustafa El Nour , Nyaoke Borna A. , Egondi Thaddaeus , Oyieko Peelen , Zijlstra Eduard E. , Strub-Wourgaft Nathalie 
Published: September 2022

Abstract

Objectives
To determine whether, in addition to surgery, fosravuconazole (Fos) monotherapy of either 200 mg or 300 mg weekly was more effective [defined as complete cure at the End of Treatment (EOT; 52-week) visit] than the standard-of-care 12-month regimen of itraconazole (Itra) monotherapy, in patients with small to moderate eumycetoma lesions caused by Madurella mycetomatis.

Methods
This was a single-center (Mycetoma Research Center, Khartoum, Sudan), comparative, randomized, double-blind, parallel-group, active-controlled, clinical superiority trial in participants with eumycetoma requiring surgery. Participants were randomized in a 1:1:1 ratio. In Arm 1 participants took a loading dose of Fos 300 mg on Day 1, Day 2, and Day 3, followed by a weekly dose of 300 mg for a total duration of 12 months. In Arm 2 participants took Fos 200 mg on Day 1, Day 2, and Day 3, followed by a weekly dose of 200 mg for a total duration of 12 months. In Arm 3 participants took Itra 400 mg daily for 12 months. All patients underwent surgery after 6 months of treatment in which the remaining lesion was removed. Mycetoma lesions were between 2 to ≤16 cm in diameter. The age cut-off was ≥15 years. The diagnosis of M. mycetomatis was confirmed by PCR. Safety monitoring included, among other, severe, and serious treatment-related events.

Results
A total of 122 participants were screened and 104 participants were enrolled (34 in Fos 300 mg, 34 in Fos 200 mg weekly, and 36 in Itra 400 mg). Complete cure after 12 months (EOT) of treatment was demonstrated in terms of an absence of eumycetoma mass, sinuses, and discharge; normal ultrasound of the lesion site or normal MRI; and a negative fungal culture from a surgical biopsy if a mycetoma mass was present. The complete cure rate was assessed in the mITT population. Secondary efficacy analyses were performed in the Per Protocol population. In addition, the influence of age, changes in clinical symptoms and signs, size, and duration of the lesion on outcome was examined. Safety was satisfactory and compliance was good.

Conclusion
This is the first randomized controlled trial in eumycetoma, comparing two azoles, fosravuconazole (two dosage regimens) and itraconazole, in combination with surgery. Detailed efficacy and safety results will be communicated and discussed in the oral presentation.
S7.1d Reliability of bedside point-of-care tests for Candida neoformans , M. tuberculosis and S. pneumoniae in adults living with HIV presenting with suspected central nervous system infection (CNS) in low- and middle-income settings: Preliminary results from the DREAMM study
Authors: Leclere Aude Sturny , Beaumont Emma , Cohen Jérémie F. , Kanyama Cecilia , Mfinanga Sayoki , Kouanfack Charles , Lesikari Sokoine , Nyirenda Saulos , Phiri Samuel , Boyer-Chammard Timothée , Molloy Síle , Hosseinipour Mina , Bradley John , Jaffar Shabbar , Harrison Thomas , Lortholary Olivier , Loyse Angela 
Published: September 2022

Abstract

S7.1 Update in management of fungal infection in adult hematology, September 23, 2022, 10:30 AM - 12:00 PM

Background
Bedside point-of-care (POC) testing, with parallel laboratory testing, represents a unique opportunity to improve and speed up the diagnostic workup of people living with HIV with suspected CNS infection in resource-limited settings.

Objectives
To assess the agreement between POC tests for Cryptococcus neoformans, Mycobacterium tuberculosis, and Streptococcus pneumoniae performed at the bedside and in the routine laboratory, in African low- and middle-income countries (LMICs).

Methods
From January 2018 to March 2021, the following POC tests were performed in parallel at the bedside and in the routine laboratory: Cryptococcal antigen lateral flow assay (CrAg LFA, Immy) in blood and cerebrospinal fluid (CSF), tuberculosis lipoarabinomannan (TB-LAM, Alere) in urine, and, where indicated, pneumococcal antigen (Streptococcus pneumoniae (SP), Biosynex) in CSF.
Participants: HIV-infected adults (&gt;18 years old) suspected of CNS infection.
Setting: The prospective multicenter DREAMM project (Driving Reduced AIDS Meningo-Encephalitis Mortality) in five hospital sites in Cameroon, Malawi, and Tanzania.
Primary outcome: Cohen's kappa statistic of agreement between the results of POC tests obtained at the bedside and the routine laboratory.

Results
The study included 356 consecutive participants (mean age 39.5 +/- 10 years; 68.7% ART-experienced; 46.3% male; median CD4 count 75/mm3; abnormal mental status 75%). In total, 148/355 (41.7%) participants had positive bedside CrAg in blood, 140/315 (44.4%) positive bedside CrAg in CSF, 64/339 (18.9%) positive bedside TB-LAM in urine, and 10/175 (5.7%) positive bedside SP in CSF. Kappa statistics evaluating agreement between bedside and laboratory test results were: 0.98 [95% confidence interval (CI) 0.96-1.00; n = 347] for blood CrAg, 0.99 (95%CI, 0.98-1.00; n = 307) for CSF CrAg, 0.92 (95% CI, 0.87-0.98; n = 330) for urinary TB-LAM, and 0.68 (95%CI, 0.40-0.96; n = 34) for CSF SP.

Conclusions
Bedside POC tests for Cryptococcus spp. are highly reliable and can be safely performed in parallel to laboratory testing to expedite targeted treatment in people living with HIV with suspected CNS infection in African LMICs. Other bedside POC tests need further evaluation before large-scale implementation.