bluuebunny/crossref_metadata_2025_split huggingface dataset:
P028 To Study the Susceptibility of Caspofungin in Azole Resistant Candidemia of High-Risk Neonates of Nicu by E-STRIP (MIC) Method andTime to Think for Preventive Measures
Authors: Amritha Anugula , Vagarali Manjula 
Published: September 2022

Abstract

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

Background
The rise in azole-resistant candidemia among bloodstream infections of critically ill neonates had made treatment choices difficult for neonate ICU clinicians. There is gross evidence of an epidemiological shift to non-albicans Candida. Newer class of antifungal drugs especially Echinocandins (caspofungin) came into real-time practice in azole-resistant Candida causing sepsis.

Objective
1) To study the azole-resistance in the Candida isolates from the blood sample.
2) To develop preventive strategies and protocols.

Material and Methods
A total of 222 blood samples collected from NICU from the high-risk neonates with suspected sepsis, who were admitted in the study period and were processed and were evaluated as per the Standard Mycological techniques followed by antifungal susceptibility done according to CLSI guidelines (M44-A2 and M60).

Results
Of 222 blood samples 58 (26.12%) were pure isolates of Candida, of which 17 (29.31%) were C. albicans and 41 (70.68%) were non-albicans Candida. In which C. glabrata (30/41), C. tropicalis (4/41), C. parapsiliosis (6/41), C. krusei (1/41). Maximum resistance was found against fluconazole 39/58 (67.24%) by disc diffusion method. These isolates are maintained and checked for caspofungin and fluconazole susceptibility by the e-strip method in under process (results will be disclosed later).

Conclusion
This study concludes that fluconazole resistance is on the rise. A newer class of drugs Echinocandins have come to the rescue. Strict infection control strategies, appropriate preventive, and therapeutic measures such as prophylactic antifungal use, and a restrictive policy of antibiotic use should be implemented by the health care workers and officials in NICU. Care should be taken for emerging multi-drug resistant species like C. auris.
P046 Local adaptation to antifungal compounds in the model organism Neurospora crassa
Authors: Gonçalves A. Pedro 
Published: September 2022

Abstract

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

The domestication of Neurospora crassa has been a major driver of the fields in fungal molecular and cell biology. Not only this filamentous species enjoys modest nutritional requirements and grows swiftly in the laboratory, but also its genome is considerably well annotated, and a near-complete deletion strain collection is available for functional analyses. Furthermore, decades of research with N. crassa have been accompanied by the accrual of wild isolates from different points of the globe, which are an invaluable tool to study local adaptation. Using a panel of antifungal compounds, we found that drug resistance is naturally heterogeneous in wild populations of N. crassa, and chromosomal mapping of the causal loci is underway to unveil the genetic basis of the observed natural diversity. Furthermore, we are interested in the regulatory role played by two Zn2Cys6 transcription factors, CZT-1, and TAH-3, during fungal responses to various drugs. In summary, despite it being non-pathogenic, N. crassa presents many advantages as a model to study antifungal drug resistance. Since the paucity of valid molecular targets in the fungal cell has been hindering the discovery of new antifungal drugs, we consider that the identification and functional characterization of new genes and pathways involved in drug resistance may inform the adoption of new therapeutic schemes.
P049 Candidemia: Isolate profiling and antifungal susceptibility testing experience from Jodhpur, Western India
Authors: Jain Vidhi , Nare Tejashree , Vishwakarma Kirti , Kundu Aditya , Radhkrishnan Anjuna , Tak Vibhor , Kumar Deepak , Sharma Ankur , Kothari Nikhil 
Published: September 2022

Abstract

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

Objectives
The study was undertaken over a 9-month study period at a tertiary care and super specialty hospital situated in Jodhpur, Western Rajasthan, India, with the following objectives:

Methods
Automated blood culture bottles (BD BACTEC 960) that flagged positive were taken up for gram staining. Those bottles which showed gram-positive budding yeast with or without pseudohyphae were selected as the study isolates for candidemia. All such bottles were subcultures on Sabouraud's dextrose agar and incubates aerobically at 37°C for 2-5 days. Creamy, pasty, off-white colonies of Candida were further taken up for identification by germ tube testing, CHROM agar, and VITEK-MS.
Antifungal susceptibility testing was performed for all isolates by VITEK 2 against fluconazole, caspofungin, voriconazole, micafungin, flucytosine, and amphotericin B.

Results
During the study period May 1, 2021-January 31, 2022, the microbiology laboratory received a total of 10 841 automated blood culture bottles, of which, overall, 1051 flagged positive. Budding yeasts were seen in 92 bottles.
The prevalence of candidemia was found to be 1.49%. Budding yeasts made up 8.75% of all positive blood cultures.
Conventional and automated identification methods showed the non-albicans Candida made up the majority (85.87%) of isolates. Candida tropicalis (43.47%) was the most common species overall, followed by C. parapsilosis (17.37%), C. albicans (14.13%), C. guilliermondi (5.43%), C. glabrata (5.43%), and C. auris (4.34%). Two isolates each of C. kruzei, C. utilis, C. rugosa, and Trichosporon spp. were also obtained.
The antifungal susceptibility testing results for the commonest species C. tropicalis showed susceptibility of 90% against caspofungin and micafungin, 82% against fluconazole and voriconazole, 45% for flucytosine, and 47.5% against amphotericin B. C. albicans showed 100% susceptibility to fluconazole, and caspofungin, while C. parapsilosis showed a lower susceptibility percentage against all drugs in the panel. The two strains of C. auris were solely susceptible to caspofungin.
Demography of the patients showed a male preponderance (M:F ratio was 2:1). The mean age of patients was 44 years.

Conclusion
The prevalence of candidemia in Jodhpur, Western India was found to be 1.45%, a figure much less than that reported from most other tertiary care centers of the country. The commonest isolate was C. tropicalis (43.47%), same as that reported from most Indian studies. Our isolates were largely (&gt;90%) susceptible to the drug of choice caspofungin, including the multidrug-resistant C. auris strains. The study findings reflect a low prevalence of candidemia, indicating adequate antibiotic and antifungal stewardship practices at Jodhpur.
P050 Candida auris and non- auris candidemia in adult patients in a tertiary care set-up, New Delhi, India
Authors: Jangra Priyanka , Capoor Malini , Sachdeva Harish , Tripathi BK , Gupta DK 
Published: September 2022

Abstract

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

Objectives
The aim of this study was to determine the species distribution, compare Candida auris and non-C. auris candidemia risk factors and antifungal susceptibility pattern of candidemia cases in adult patients at a tertiary care hospital, New Delhi, India.

Materials and Methods
Candida species identification was performed by phenotypic methods, VITEK (Biomerieux, France), and DNA sequencing (PGIMER, Chandigarh). The antifungal susceptibility was performed by broth microdilution method as per CLSI M27-A4 guidelines 2017.

Results
Out of 1274 blood samples, 70 samples (5.5%) yielded the growth of Candida species. There was a predominance of NAC spp. over C. albicans in candidemia patients. C. auris (12.85%, 9/70) and non-auris candidemia (87.14%, 61/70) was isolated in this study. In non-auris candidemia, C. tropicalis (28.57%, 20/70) was the predominant Candida species followed by C. parapsilosis (22.85%, 16/70), C. glabrata (14.28%, 10/70). Rare species among NAC spp. included C. mesorugosa, C. lusitaniae, C. krusei and C. haemulonii were isolated. The most common predisposing factor for C. auris and non-auris candidemia was urinary catheter (72.85%, 51/70) followed by an increased period of hospitalization (42.85%, 30/70), diabetes mellitus (21.5%, 15/70), etc. The significantly associated risk factor associated with C. auris was diabetes mellitus (P = .02). The overall resistance was 22.57% to all antifungal drugs. The multidrug resistance (MDR) was noted in 5.71% of isolates.

Conclusions
Early identification of risk factors, Candida speciation, and timely management are crucial for the outcome of candidemia cases. Non-albicans species were predominant over C. albicans depicting the change in the epidemiology and emergence of MDR Candida spp. like C. auris, C. glabrata, C. mesorugosa, C. lusitaniae, and Pichia kudriavzevii (C. kruseii). This warrants routine antifungal susceptibility testing (AFST) and close monitoring. The knowledge of local epidemiological profiles of Candida spp., accurate species identification, and their antifungal susceptibility is crucial for overall patient management.
P070 Antimicrobial peptides from the Coleoptera family Scarabaeidae against Candida and Cryptococcus pathogenic yeasts.
Authors: Toro Lily J. , Rodriguez Melissa , Gómez Beatriz L. , Firacative Carolina , Andreu David , Valle Javier , Santiago Bruno Rivas , Tellez German A. , Henao Diana C. , Castaño Jhon C. , Muñoz Julian E. 
Published: September 2022

Abstract

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

Objectives
Host defense peptides (HDP) are produced by a diversity of beetles. The aims of this work were (1) to find new promising peptides from the Coleoptera family Scarabaeidae with potential biomedical applications, (2) to modify physicochemical and structural characteristics of one of the most promissory peptides in order to improve its antimicrobial properties, and (3) to evaluate the in vitro activity of the HDPs against reference strains of pathogenic Candida and Cryptococcus yeasts.

Materials and Methods
From the Scarabaeidae family transcriptome, 14 promising HDPs were identified. Subsequently, we designed 19 new sequences from Act8 peptide modifying the net charge, hydrophobic angle, and the general composition of amino acids, among other properties, in order to improve the HDPs antifungal activity. The in vitro antifungal susceptibility of the 33 HDPs against C. albicans SC5314, C. krusei, ATCC 6558, C. parapsilosis ATCC 22019, C. glabrata ATCC 2001, C. tropicalis ATCC 750, C. neoformans H99, and C. gattii H0058-I-2029 isolates were evaluated by broth microdilution, with a concentration ranging from 0.19 to 50 μg/ml.

Results
All 14 peptides identified showed in vitro activity against C. krusei, C. parapsilosis, and C. glabrata. One peptide showed in vitro activity against C. albicans, 6 against C. tropicalis, 11 against C. neoformans and 13 against C. gattii. As well the 19 modified peptides showed in vitro activity against C. krusei, C. parapsilosis, C. tropicalis, C. neoformans, and C. gattii. A total of 15 modified peptides showed in vitro activity against C. albicans, and 3 against C. glabrata. MIC ranges per species and per peptide are shown in Table 1.

Conclusions
The HDPs herein analyzed showed a significant in vitro antifungal activity against six Candida and two Cryptococcus pathogenic species. Our findings encourage further work with in vivo experimental models in order to better understand the action mechanisms of these antimicrobial peptides. HDPs from different species are becoming a promising therapeutic alternative in the control of fungal infections.
P081 Azole-resistant Aspergillus fumigatus among NIH hospitalized patients with underlying primary immunodeficiencies
Authors: Seyedmousavi Amir , Youn Jung-Ho , Khil Pavel , Shahegh Sherin , Kwon-Chung K.J. , Zelazny Adrian , Lionakis M 
Published: September 2022

Abstract

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

Objectives
Aspergillus fumigatus causes a variety of diseases in humans. The drugs recommended for treatment of Aspergillus diseases are the mold-active azole antifungals. However, a wide range of mutations in A. fumigatus confers azole resistance, which commonly involves modifications in the cyp51Agene, the target for azole antifungal drugs.

Methods
We investigated 255 clinical A. fumigatus isolates obtained from patients hospitalized at National Institutes of Health Clinical Center, Bethesda, Maryland, USA. The species-level identification of each isolate was evaluated by colony morphology, microscopic characteristics, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF), and PCR-sequencing of the β-tubulin gene. We also studied sequence-based analysis of the Cyp51A gene for the azole-resistant isolates.
The azole antifungal susceptibility profile of each isolate was initially evaluated using 4-well triazole screen plates (Microbiology Associates LLC, Rockville, MD, USA) containing itraconazole (4 μg/ml), voriconazole (2 μg/ml), posaconazole (0.5 μg/ml), and growth control. The full array of antifungal susceptibility was confirmed using microbroth dilution method according to Clinical and Laboratory Standards Institute CLSI M38-A3 guidelines.

Results
Of 255 A. fumigatus isolates, 12 grew on the wells containing azoles, indicating an azole-resistant phenotype. The results were read and recorded after 24 and 48 h of incubation at 35-37°C. Majority of our isolates had visible growth at 24 h. Sequence analysis of the CYP51A gene indicated the presence of M220K mutation in all 12 isolates and no mutations in the other isolates.
The fact that the azole resistance was found in A. fumigatus isolated from patients with previous azole exposure, underscores the possibility that prevalence of azole-resistance might be underestimated in various patient populations because in-vitro susceptibility testing of A. fumigatus is not routinely performed.

Conclusion
In conclusion, prevalence of azole resistance in clinical A. fumigatus isolates obtained from NIH patients underlying primary immunodeficiencies was 4.7%; all the resistant isolates exhibited azole-resistance mutation in Cyp51A gene.
Our finding adds to the growing list of regions where acquired resistance in A. fumigatus of is documented. Our results also indicate that 4-well triazole screen plates are a reliable tool for azole-resistance screening and the selection of isolates that require a full panel of antifungal susceptibility testing.
P100 Potent inhibition of dermatophyte fungi by Australian native jarrah honey
Authors: Fernandes Kenya , Guttentag Annabel , Susantio Daniel , Carter Dee 
Published: September 2022

Abstract

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

Objectives
Honey has been used as a remedy for multiple ailments, and the antibacterial activity of many different floral honeys has been extensively explored. The capacity of honey to inhibit fungi is much less well understood. Here we investigate the inhibition of dermatophyte species by native Australian jarrah honey.

Methods
Jarrah honey was sourced from beekeepers and commercial suppliers. Artificial honey, made from glucose (22.9%), fructose (20.7%), and sucrose (1.6%), was used to control for osmolarity. Hydrogen peroxide production by honey was assessed using horseradish peroxidase (HRP)/ο-dianisidine colorimetric test. Dermatophytes included Microsporum canis, M. nanum, Nannizzia gypsea, Trichophyton interdigitale, T. rubrum, and T. tonsurans. Minimum inhibitory concentrations (MICs) and minimum fungicidal concentrations (MFCs) for honey were assessed using CLSI methods. Fluorescent and scanning electron microscopy were used to visualize the effect of honey on fungal conidia and hyphae.

Results
Jarrah honey inhibited all of the dermatophyte species with MICs ranging from 1.5-3.5% w/v, and MFCs from 2-5% w/v. No antifungal activity was seen with the artificial honey indicating this was not due to osmolarity. Microscopy revealed honey treatment prevented the germination of conidia and caused hyphae to bulge and collapse. While the inhibitory action of jarrah honey was greatly reduced by the addition of catalase suggesting hydrogen peroxide production was responsible for inhibition and killing, microscopy revealed hyphae were still damaged suggesting there are agents within honey that augment antifungal activity. REDOX fluorophores failed to detect internal oxidative stress within hyphae, indicating that damage likely occurs on the hyphal surface.

Conclusion
Jarrah honey is a non-toxic agent that may have utility in the treatment of superficial fungal infections caused by dermatophyte fungal species.
P159 The impact of COVID-19 pandemic on invasive Candida auris infections in Kuwait
Authors: Al-Wathiqi Faten , Alabdallah Alaa , Alobaid Khaled 
Published: September 2022

Abstract

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

Objectives
To evaluate the impact of the coronavirus disease (COVID-19) pandemic on the incidence of Candida auris invasive infections at a national level.

Methods
This is a laboratory-based, three years-period retrospective study. The demographic and mycological data were obtained from the mycology reference laboratory (MRL) active surveillance system. The number of C. auris blood isolates was retrieved for the following years: 2019, 2020, and 2021. C. auris blood isolates from all hospitals were sent to the MRL as part of patient care. Species-level identification was confirmed by chromogenic media, VITEK 2 yeast identification system, and/or MALDI-TOF MS (VITEK MS). Antifungal susceptibility was performed using Etest according to manufacturer instructions. The following antifungal agents were tested: amphotericin B, fluconazole, voriconazole, and caspofungin. If the strain was resistant or intermediate to caspofungin, other echinocandins (micafungin or anidulafungin) were tested for confirmation. Since there were no established clinical breakpoints for C. auris, tentative minimum inhibitory concentrations were used based on experts’ opinions. Incidence rates of COVID-19 during the years 2020 and 2021 (COVID-19) were obtained from the World Health Organization website. All data were numerically coded and labelled for each variable using Microsoft Excel (Version 16.57, 2021), then analyzed by SAS 9.4 (SAS Institute., USA). P-value &lt;.05 was considered statistically significant.

Results
A total of 307 samples isolated from invasive infections were reported with C. auris in this study (50 in 2019, 102 in 2020, and 155 in 2021). The number of patients reported with C. auris invasive infection increased significantly (P &lt;.05) from 50 in 2019 (pre-COVID-19) to 155 in 2021 (post-COVID-19). This was associated with the waves of the COVID-19 pandemic in Kuwait. Of 307 C. auris isolates tested, all were resistant to fluconazole. Resistance to amphotericin B and caspofungin was 29/307 (9%) and 3/285 (1%) respectively.

Conclusion
Patients infected with COVID-19 are at considerable risk of invasive candidiasis especially critically ill patients staying in ICU. The significant increase in C. auris invasive infections as seen during this pandemic clearly demonstrates the great ability of this opportunistic pathogen to cause secondary lethal infections among COVID-19 patients. In addition, the spread of C. auris among patients in care facilities results in outbreaks, which further compromises the health care services and threatens patient safety. Therefore, a greater understanding of its epidemiology and awareness among healthcare staff about its identification methods, antifungal resistance profile and infection control measures are essential to improve outcomes and prevent further hospital transmission.
P198 Persistent Fungemia with Candida auris in a patient with enterocutaneous fistula
Authors: Gohel Swati 
Published: September 2022

Abstract

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

Objective
Candida auris (C. auris) is a major emerging threat to the healthcare sector in view of the difficulty in early identification by standard methods, multidrug resistance, and ease of spread in healthcare settings. Here, we report a case of persistent C. auris fungemia (&gt;2 months) in a patient with enterocutaneous fistula.

Methods
A 57-year-old man without any comorbidities underwent surgery for diverticular perforation which was complicated by intra-abdominal abscesses, anastomotic leak, and multidrug-resistant bacteremia requiring higher antibiotics, total parenteral nutrition, and prolonged ICU stay. Patient was admitted to our center with sepsis and blood culture grew C. auris. Patient was managed with injection of caspofungin (in the absence of sensitivity breakpoints). Patient continued to grow C. auris in the blood so flucytosine was added as a part of combination antifungal therapy. On dual antifungal therapy for 28 days there was a transient clearance of fungemia. Work up for endocarditis, intrabdominal collection, and endophthalmitis were negative. But Patient was continued on total parenteral nutrition via central line in view of enterocutaneous fistula. Patient developed a recurrence of fungemia after 4 days of stopping antifungal treatment. Patient was started on injection of mycafugin and voriconazole (in view of on treatment resistance to flucytosine), on which cultures turned sterile and patient improved. Plan was made to give total 6 weeks of parenteral combination antifungal therapy.

Results
C. auris management complexities stem from multiple factors. The above case emphasizes the urgent need for C. auris specific minimum inhibitory concentration breakpoints and standard guidelines for treatment. Currently, treatment is based on the Center for Disease Control's proposed breakpoints (extrapolated from other Candida spp.). Upfront combination antifungal treatment might be the answer till further studies.

Conclusion
Management of invasive C. auris infection presents a major therapeutic challenge to clinicians and a major threat to healthcare sector even after timely identification.