bluuebunny/crossref_metadata_2025_split huggingface dataset:
P483 Invasive fungal infection in hematopoietic stem cell transplant recipient from an Indian oncology setting
Authors: Ghafur Abdul , Das Bikram , Karthik Radhika , Easaw Benjamin M , Raja Ramanan T , Easaw Jose 
Published: September 2022

Abstract

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

Objectives
Invasive fungal infections (IFI) are one of the major causes of morbidity and mortality in post-hematopoietic stem cell transplant (HSCT) recipients. Data from India are limited. The objective was to analyze the incidence, risk factors, and outcomes associated with IFI in our center.

Methods
Adult patients, who underwent marrow/stem cell transplantation between 2014-2018, in an oncology center in India, were included in this retrospective observational study. The revised consensus definition of IFI by the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) in 2008, was considered to define cases. Incidence, risk factors, and outcomes associated with IFI were analyzed.

Results
Out of the 126 patients who underwent HSCT between 2014-2018, 56 (44.4%) had Allo HSCT, 64 (50.8%) had auto HSCT and 6 (4.8%) had haplo-identical HSCT. A total of 83 (63%) were males and 43 (34%) females, 113 (83.9%) Asians, and 13 (10.3%) Africans. Total 111 (88%) patients received myeloablative conditioning and 24 (19%) received total body irradiation. The hematological conditions were acute myeloid leukemia (AML) n = 23 (18.25%), acute lymphoblastic leukemia (ALL) n = 16 (12.69%), chronic myeloid leukemia (CML) n = 4 (3.17%), Hodgkins lymphoma (HL) n = 17 (13.4%), non-Hodgkins lymphoma (NHL) n = 11 (8.73%), Myeloma n = 35 (27.7%), sickle cell disease n = 13 (10.31%), etc. Most patients received fluconazole 78 (61.9%) followed by micafungin 23 (18.25%), posaconazole 20 (15.87%), voriconazole 4 (3.17%), and liposomal amphoterin B 1 (0.79%) as antifungal prophylaxis. The overall rate of IFI (possible cases included) was auto-HSCT n = 5 (7.81%), and Allo-HSCT n = 5 (8.92%). Among auto-HSCT, the IFI was Proven = 0, Probable n = 1 (1.5%), and Possible n = 4 (6.25%), and among Allo-HSCT Proven = 0, Probable n = 2 (3.57%), and Possible n = 3 (5.35%). These cases had IFI lung based on imaging and serological tests. None of the cases had a lung biopsy. There were no incidents of candidemia. No patients in Haplo-HSCT had IFI. The 1-year survival rate among the IFI cases was 8/10 (80%). As the number of patients with IFI was very low, a meaningful comparison of the risk factors, and the impact of prophylactic regimens were difficult.

Conclusions
The overall rate of IFI in HSCT patients in our setting was low compared to global data.
P496 Effect of fluconazole prophylaxis in prevention of local fungal infections in patients of head and neck cancers receiving chemo-radiotherapy
Authors: Lohia Shashwat , Suri Kapil , Capoor Malini 
Published: September 2022

Abstract

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

Objectives
To ascertain, in head and neck cancer patients receiving chemo-radiotherapy, the efficacy of fluconazole prophylaxis in
1. Reducing the incidence of oropharyngeal fungal infections
2. Reducing the incidence of severe i.e., grade 3 and 4 oropharyngeal mucositis

Methods
A total of 66 cases of Stage III or IV squamous cell carcinoma of the oral cavity or oropharynx who were candidates for radical chemo-radiotherapy (CCRT) were randomly assigned between arm A (study arm) and arm B (control arm) using computer-generated algorithms. Both arms received conventionally fractionated radiation (66-70 Gy) with concurrent weekly intravenous cisplatin (40 mg/m2) along with standard measures of oropharyngeal hygiene. In addition, arm A received Tab Fluconazole 100 mg/d administered per oral after lunch from initiation to the completion of radiotherapy, while arm B received Tab Fluconazole 100 mg/d, if fungal infections appeared, for a period of 7-14 days.
Weekly clinical examination for oro-pharyngeal candidiasis was done. Throat swabs for microbiological assessment of fungal colonization were done before treatment (zero week), during second and sixth week of CCRT, and 4 weeks after the completion of CCRT, and if any clinical suspicion of fungal infection was present.

Results
See Figures below.

Conclusion
Tab fluconazole 100 mg prophylaxis in head and neck cancer patients receiving chemo-radiation is
P500 Validation panel for MALDI-TOF identification of fungi
Authors: Stubbe Dirk , Becker Pierre , D'hooge Elizabet , Debergh Hanne , Packeu Ann 
Published: September 2022

Abstract

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM
Sciensano, the Belgian federal scientific institute for public and animal health, houses the BCCM/IHEM Fungi Collection which contains more than 15 000 strains, belonging to over 1 500 different species. The collection is managed according to ISO 9001 standards.

Its purpose is to make fungal strains available for academics, clinicians, industry, and education.

Fungal pathogens are not as often encountered as bacteria in the clinical laboratory. Additionally, laboratories may not have the knowledge or logistics for the long-term preservation of axenic fungal isolates. Without an array of fungal strains with confirmed identity, it is complicated to implement new protocols and equipment when these need to be validated for the identification of fungi.

To short-cut this problem and support laboratories in identifying clinical fungi in routine activities, BCCM/IHEM has developed two validation panels for the identification of fungi via MALDI-TOF mass spectrometry: there is a validation panel with yeasts and a validation panel with filamentous fungi. The selection of strains is based on species that are routinely encountered in a clinical laboratory, and also contains some rarer, but emerging fungal pathogens, like Trichophyton indotineae and Candida auris. The identity and purity of the strains in these panels have been verified according to ISO 17025 accredited protocols. This allows the laboratory to evaluate in a short term the extraction protocol, the MALDI-TOF machine, and the database of reference mass spectra.
S1.3a Genetics andgenomics of Malassezia species
Authors: Laniri Giuseppe 
Published: September 2022

Abstract

S1.3 Malassezia: genetics, genomics, and biology, September 21, 2022, 11:00 AM - 12:30 PM

Malassezia includes yeasts belonging to the subphylum Ustilaginomycotina within the Basidiomycota. Malassezia yeasts are attracting the interest of both basic and applied scientists for their unique biological features, and for their importance in clinical and cosmetic settings. Although Malassezia yeasts are commonly found as commensal on human and animal skin, they are also associated with several skin disorders, such as dandruff/seborrheic dermatitis, atopic eczema, pityriasis versicolor, and folliculitis. More recently, an association of Malassezia with Crohn's disease, pancreatic ductal adenocarcinoma, and psoriasis exacerbation has been reported. To understand the genetic basis of Malassezia commensalism and pathogenicity, the availability of genomic and molecular tools plays a crucial role. Genomics advances in Malassezia reveal karyotype variations and gene turnover events, including genes horizontally transferred from bacteria. Moreover, the increasing availability of transcriptomic data allows us to prioritize studies on novel key genes that potentially characterize the pathophysiology of Malassezia fungi. For gene function studies, protocols for Agrobacterium tumefaciens-mediated transformation were developed and utilized in strategies of random insertional mutagenesis or targeted gene replacement through CRISPR/Cas9. Developed tools can be combined with the use of host-pathogen interaction models, such as the easy-to-use wax moth larvae of Galleria mellonella or the more complex murine skin model, enabling the characterization of both the fungal components that trigger skin damage and inflammation, and the inflammatory and antifungal response of the host to prevent fungal infection through immunological and molecular analyses of experimentally infected tissue.
S1.3c Diversity and hybridization in Malassezia furfur
Authors: Theelen Bart 
Published: September 2022

Abstract

S1.3 Malassezia: genetics, genomics, and biology, September 21, 2022, 11:00 AM - 12:30 PM

The Basidiomycetous yeast Malassezia is the most abundant fungal genus on healthy human skin but may also cause various skin disorders such as seborrheic dermatitis, dandruff, and pityriasis versicolor. In recent years, Malassezia has increasingly been implicated in health and disease beyond the skin: as an underestimated cause of Malassezia bloodstream infections (BSIs) in immunocompromised patients and neonates, associated with Crohn's disease, promoting pancreatic oncogenesis, and exacerbating cystic fibrosis. Malassezia furfur is the number one Malassezia BSI cause and is also implicated in many skin disorders. With these new discoveries of Malassezia’s impact on human health, the need for a better understanding of its evolution and pathobiology also became more pressing. Hybridization has been suggested as a biological mechanism of adaptation to new hosts, and may lead to increased pathogenicity. Many examples of major hybrid yeast pathogens exist, such as Candida albicans, C. orthopsilosis, C. metapsilosis, and multiple examples in the Cryptococcus gattii/Cryptococcus neoformans species complex. Here the multiple hybridization events of the Malassezia furfur species complex will be discussed. Two distinct hybridization events occurred between the same parental lineages, and these parental strains were originally also hybrids. The identification of a pseudobipolar mating system and the analysis of the mating-type loci provide evidence that sexual liaisons of mating compatible cells from these parental lineages led to a diploid/aneuploid state in the hybrid lineages. Sequence similarity percentages suggest that both parental lineages in fact are two different species. The genetic diversity of ca 300 strains belonging to this species complex is evaluated in relationship to host background and phenotype.
S1.5a Epidemiology of myotic keratitis in developing countries
Authors: Thomas Philip Aloysius 
Published: September 2022

Abstract

S1.5 Mycotic keratitis, September 21, 2022, 11:00 AM - 12:30 PM

Mycotic keratitis (corneal infection due to a fungal etiology) is a well-recognized ophthalmological emergency warranting rapid initiation of specific antifungal therapy. However, the magnitude of the problem of mycotic keratitis in the community, especially in the Indian subcontinent and the developing world, is, perhaps, less apparent. A minimal annual incidence estimate of 1051, 787 cases (23.6/100 000 population [popln]) globally has recently been reported, with the highest rates being in Asia (33.9/100 000 popln, an absolute number of 939 895) and Africa (13.5/100 000; 75 196); if all culture-negative cases are assumed to be fungal, especially where the incidence of mycotic keratitis is known to be high, then the annual incidence would be about 1480 916 cases. A fungal etiology has been found to account for a very high proportion (&gt; 45%) of microbial keratitis cases in countries in the Indian subcontinent. Countries where a fungal etiology accounts for &gt;25% of microbial keratitis mostly tend to abut the equator. Interestingly, the proportion of microbial keratitis patients with a proven fungal etiology shows a significant negative correlation with the gross domestic product per capita. Although it is clear that the most common fungal species are Fusarium, Aspergillus, and Candida species, marked regional variations in fungal etiology have been noted. It is important to realize that sensitivity of the culture of ocular fungal pathogens can vary, depending on the pathogen, as well as the competence of the testing laboratory. For some countries, multiple reports over time have been noted, with there being some evidence of an increasing trend in the proportion of all microbial keratitis cases being diagnosed as mycotic keratitis. Even in a single geographical location, cases of mycotic keratitis may be higher than the yearly average at certain times of the year, such as during the harvest or windy seasons, or when there is increased relative humidity. A disturbing statistic to note is that, in 8%-11% of patients with mycotic keratitis, the affected eye needs to be removed, representing an irreversible annual loss of 84 143-115 697 eyes. It is recognized that many people suffering from mycotic keratitis in rural distant communities never present to health care workers due to financial and other constraints. Hence, the actual number of people afflicted by mycotic keratitis, man-days lost due to the disease and during therapy, and reduced quality of life due to persistent disability (corneal scarring) in the Indian subcontinent and developing countries requires further study.
S1.5b The burden of mycotic keratitis in West Africa
Authors: Gugnani Harish 
Published: September 2022

Abstract

S1.5 Mycotic keratitis, September 21, 2022, 11:00 AM - 12:30 PM

Background
Fungal infection of the cornea, known as mycotic keratitis, can cause permanent corneal scarring and perforation resulting in the loss of the eye. This paper reviews the prevalence and epidemiology of mycotic keratitis in different countries in West Africa to estimate its burden.

Methods
An exhaustive search of the literature was made on Google, PubMed, MEDfacts, Cochrane Library, and Web of knowledge using different sets of keywords, viz. mycotic keratitis, ocular fungal infection, West Arica, risk factor, prevention, etc.

Results
A study in Nigeria over a period of 4 years (1974-1977) dealt with 42 confirmed cases of mycotic keratitis with Fusarium solani as the predominant etiological agent (14 cases) followed by Penicillium citrinum (8 cases) and Aspergillus fumigates (5 cases), Candida spp (3 cases). The remaining 12 cases were that of Fusarium moniliforme, Aspergillus spp, Penicillium sp, and Cladosporium spp. The predisposing factors identified were trauma from palm tree leaves, thorns, kernels, or other plant objects, mechanical tools, and frying oil. A 10-year review (2003-2012) of 152 cases of corneal ulcers at the University of Calabar Teaching Hospital, Calabar, Nigeria revealed only 2 (2.9%) cases due to Aspergillus sp, many patients in this study were farmers. Other studies from Nigeria only mentioned the prevalence of keratitis without any mention of fungal etiology. Of the two studies from Ghana, the one conducted in 1999 showed the predominant agents Fusarium spp. (52.3%) and Aspergillus spp. (15.3%), in the other one conducted in 1999-2001, these agents were represented by 42.2% and 17.4% respectively. In another prospective study of suppurative corneal ulcers in 290 cases in Ghana (June 1999-May 2001), the etiological agents identified in culturally proven 77 (85.5%) cases of mycotic keratitis were Fusarium spp-46, A. flavus-9, A. fumigates-7, A. niger-1, A. nidulans-1, and Aspergillus sp-1 A Siera Leonian study of cases of suspected infectious ulcerative keratitis from January 2005 to January 2006) detected 35.6% of mycotic keratitis and 13.7% of mixed fungal and bacterial etiology. A study on the burden of serious fungal infections in Togo mentioned an annual incidence of 951 cases of mycotic keratitis but no details of fungal etiology were mentioned.

Conclusion
Investigators have estimated the annual global incidence of fungal keratitis at over 1 million cases. Reports of cases reported from some countries represent only a tip of the true burden of mycotic keratitis in West Africa. There is a need for comprehensive surveys (involving collaboration between ophthalmologists and microbiologists) of mycotic keratitis in representative communities in collaboration with primary health centers and hospitals in different countries. It should be possible to produce a combined antifungal antibacterial preparation for widespread and immediate prophylactic first-aid use after corneal trauma, especially in rural areas.
S10.5a Fungal respiratory infections in cystic fibrosis patients in the Middle East
Authors: Hedayati Mohammad , Ghazanfari Mona , Ashrafi-Khozani Mahtab , sarae Sabrieh Asadi Shahi , Ghanbari Somayeh , Parsay Shima , Yaalimadad Sanaz , Shirvan Bahador Nikoueian 
Published: September 2022

Abstract

S10.5 Fungal respiratory infections in Cystic Fibrosis, September 24, 2022, 10:30 AM - 12:00 PM
Cystic Fibrosis (CF) is among the most common genetic disorders, which involves multiple organs including the respiratory tract. CF is thought to be an uncommon disease in the Middle East (ME). However, the prevalence is estimated at 1 in 30 000-50 000, while the incidence is estimated at 1 in 2000-5800 live births. Several studies from ME revealed that many children with CF in these populations probably remain undiagnosed due to lack of clinical suspicion and proper diagnostic facilities. According to the experts’ idea, CF may be more common in Iran than expected before.

Chronic colonization of the airways of CF patients and infections due to a wide variety of opportunistic fungal pathogens including Aspergillus, Candida, Scedosporium species, Exophiala dermatitidis, Rasamsonia argillacea complex, and Lomentospora prolificans are currently increasing. On the other hand, the resistance of these opportunistic pathogens to commonly available antifungals challenges therapeutic options and consequently endanger the CF patients’ life.

Dissimilar to bacterial colonization or infections, the epidemiology and pathogenicity of colonization and fungal respiratory infections in CF are less known. According to our recent study, the prevalence rate of respiratory colonization was reported as 73.3%. Among mold isolates, Aspergillus was also the most common genus followed by Scedosporium species. In contrast to the reports from western countries, A. flavus was also identified as the most prevalent species of Aspergillus from ME countries including Iran and India.

In some studies, allergic bronchopulmonary aspergillosis (ABPA) in CF patients from ME was evaluated. In our recent experience from Iran, of 86 patients with CF, 9 (10.5%) cases were met ABPA diagnosis. A. flavus was the most common agent followed by A. fumigatus, A. terreus and A. tubingensis.

A significant resistance of Scedosporium and Aspergillus isolates from CF patients against the main antifungal agents in invasive fungal infections therapy was reported in different studies.

According to these realities, there are a few reports on the Research Topic ‘Fungal Respiratory Infections and Colonization in CF’ from Iran and some other ME countries. Therefore, in this presentation, we are going to highlight our experiences and other published data from Iran and ME in this field including clinical presentations, fungal species involved, diagnosis strategies, and in vitro antifungal susceptibility patterns of fungal isolates from CF patients, and common treatments and prophylactic strategies.
S10.5b Bacterial and fungal coinfections in cystic fibrosis
Authors: Briard Benoit 
Published: September 2022

Abstract

S10.5 Fungal respiratory infections in Cystic Fibrosis, September 24, 2022, 10:30 AM - 12:00 PM
Lung infections due to Aspergillus fumigatus are in constant augmentation in cystic fibrosis (CF) patients. Up to 55% of CF patients show respiratory complications and exacerbated inflammation due to A. fumigatus. Allergic bronchopulmonary aspergillosis is the major complication found in up to 15% of these CF patients. Moreover, up to 60% of CF patients who are already infected chronically by Pseudomonas aeruginosa are also colonized by A. fumigatus. The interactions between A. fumigatus and P. aeruginosa showed a balance between inhibitory and stimulatory effects on fungal growth in mixed A. fumigatus-P. aeruginosa cultures.

Moreover, the interaction between the bacteria and A. fumigatus modulates exposure to fungal patterns and the innate immune response to the pathogens. Indeed, superinfection by A. fumigatus of patients already colonized by P. aeruginosa leads to hyperinflammation. Therefore, studying the interaction between bacteria and fungus in cystic fibrosis is crucial.
S2.5a Magnusiomyces spp.
Authors: Hamprecht Axel 
Published: September 2022

Abstract

S2.5 Rare yeasts, September 21, 2022, 3:00 PM - 4:30 PM

Magnusiomyces clavatus and Magnusiomyces capitatus are emerging yeasts with intrinsic resistance to many commonly used antifungal agents. Identification is difficult, and the determination of susceptibility patterns with commercial and reference methods is equally challenging. For this reason, few data on invasive infections by Magnusiomyces spp. are available. We, therefore, determined the epidemiology and susceptibility of Magnusiomyces isolates from bloodstream infections (BSI) isolated in Germany and Austria from 2001 to 2020. A total of 34 Magnusiomyces BSI were analyzed; isolates were identified by internal transcribed spacer (ITS) sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Antifungal susceptibility was determined by EUCAST broth microdilution and gradient tests. Of the 34 isolates, M. clavatus was more common (n = 24) than M. capitatus (n = 10). BSI by Magnusiomyces spp. were more common in men (62%) and mostly occurred in patients with hemato-oncological malignancies (79%). The highest in vitro antifungal activity against M. clavatus/M. capitatus was observed for voriconazole (MIC50, 0.03/0.125 mg/l), followed by posaconazole (MIC50, 0.125/0.25 mg/l). M. clavatus isolates showed overall lower MICs than M. capitatus. With the exception of amphotericin B, a low essential agreement between gradient test and microdilution was recorded for all antifungals (0%-70%). Both species showed distinct morphologic traits on ChromAgar Orientation medium and Columbia blood agar, which can be used for differentiation if no MALDI-TOF MS or molecular identification is available. In conclusion, most BSI were caused by M. clavatus. The lowest MICs were recorded for voriconazole. Gradient tests demonstrated unacceptably low agreement and should preferably not be used for susceptibility testing of Magnusiomyces spp.
S2.5c Exophiala spp.
Authors: Steinmann Joerg 
Published: September 2022

Abstract

S2.5 Rare yeasts, September 21, 2022, 3:00 PM - 4:30 PM

The black yeast Exophiala dermatitidis is an opportunistic pathogen, causing phaeohyphomycosis in immunosuppressed patients, chromoblastomycosis, and fatal infections of the central nervous system in otherwise healthy Asian patients. In addition, it is also regularly isolated from respiratory samples from cystic fibrosis patients, with rates varying between 1% and 19%. Melanin, as part of the cell wall of black yeasts, is one major factor known to contribute to the pathogenicity of E. dermatitidis and increased resistance against host defense and anti-infective therapeutics. Further virulence factors, e.g., the capability to adhere to surfaces and to form biofilm were reported.