bluuebunny/crossref_metadata_2025_split huggingface dataset:
P097 Epidemiology of dermatophytes related infections in Kuwait: a retrospective study
Authors: Al-Aryan Anoud , Al-Sabah Humoud Yousef , Al Obaid Khaled A. 
Published: September 2022

Abstract

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

Introduction and Objective
Dermatophytes are a common cause of cutaneous infections that affect a large number of healthy individuals throughout their lives. Although such infections are classically benign, they have a negative impact on patient’s physical and psychological health. We aim to explore the epidemiology of dermatophytes infections at a national level.

Methods
The study was conducted retrospectively. Demographic and microbiological data were obtained from laboratory information system in the Mycology Reference Laboratory in the year 2021. Dermatophytes were either isolated from clinical samples in mycology reference laboratory or sent from other laboratories for species identification. The clinical samples were divided into two parts. The first half was examined microscopically, and the second half was inoculated on Sabouraud agar media with and without cycloheximide and then incubated at 30°C for at least 2 weeks. Dermatophytes were identified by colonial morphology and microscopic characteristics.

Results
During the year 2021, 60 dermatophytes were found. The male to female ratio was 2:1. A total of 60% of patients were children. Half of the cases were isolated from hair specimens and the second half were from the skin. Only one dermatophyte was isolated from nail cultures. Regarding dermatophytes distribution, Microsporum species were the commonest and involved mostly M. canis (26). Other less common species included two M. audouinii and two M. praecox. A total of seven other Microsporum species were not identified to species level. On the other hand, 23 Trichophyton species were found including 5 T. tonsurans, 4 T. interdigitale, 3 T. rubrum, 1 T. simii, and 1 T. erinacei. A total of 9 other Trichophyton species were not identified to species level.

Conclusions
Higher rates of infection were seen in males compared to females. Phenotypic identification has failed in identifying a significant number of isolates. As in other types of molds, the phenotypic examination may also result in inaccurate identification, especially among uncommon and evolving species. Hence, molecular testing is essential for accurate identification and better understanding of the epidemiology of dermatophytes-related infections. The following species were reported for the first time in Kuwait, namely: T. erinaceid, T. simii, and M. praecox.
P098 Human protothecosis: Acase report in Northeastern Brazil
Authors: De Maria Azevedo Conceicao , Santos Daniel Wagner , Diniz Yankee Costa Magalhaes Yankee Costa Magalhaes , Simões-Neto Eudes Alves Simões Neto , Mendes Rafael Bezerra Rafael Bezerra , Diniz Francy Dazia Menezes Ferreira , Silva Raimunda Ribeiro , Conceição Patrícia Cristina Ribeiro , de Oliveira Melo Bruna , Marques Sirlei Garcia , Bonfim Maria Rosa Quaresma 
Published: September 2022

Abstract

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

Introduction
Protothecosis is an emergent disease caused by members of the genus Prototheca. Most such infections probably occurred by traumática inoculation into subcutaneous tissues.

Objectives
It is to report a case of human cutaneous protothecosis identified in the state of Maranhão, northeast Brazil. Case report: 75-year-old patient, Merchant, from the municipality of São Luís Island, Northeastern Brazil. He sought care referring to an erythematous and painful lesion on the left arm that started 6 months before the treatment. On examination, he presented an infiltrative, hyperemic lesion with burning pain throughout the upper limb (Fig. 1). The patient reported that a week before the onset of the condition, he suffered trauma on the arm, with a laceration in the skin, while cleaning a sewage system with clay pipes. During the healing process, he noticed a hyperemic, slightly pruritic lesion measuring 2 cm which did not improve. He sought medical assistance at the dermatological service, who suspected dermatophytosis, initiating treatment with terbinafine (250 mg, once a day), evolving with worsening of the lesion. A lesion biopsy was indicated, to histopathological examination, which showed circular, moniliform structures, diagnosed as protothecosis (Fig. 2). Treatment with itraconazole (200 mg/day) was started, with no therapeutic response and the lesion spread throughout the patient's left upper limb. Submitted to a new investigation with biopsy for direct research and culture for fungi, being identified Prototheca Wicherhamii, by Maldi-Tof®, with sensitivity to itraconazole and ampfotericin B. PCR amplification of the genetic material obtained in the clinical isolate was performed with purification of its product, and sequencing showed genetic similarity of 97,46% with Prototheca Wickerhamii. The sequence obtained was deposited in Genbank under number MZ409514. In the absence of therapeutic response to itraconazole (400 mg/day), and significant worsening of the lesion, with presentation of a secondary infection caused by Staphylococcus haemoliticus, treatment with Clindamycin (900 mg/day for 10 days) and Liposomal Amphotericin B (4 mg/kg/day for 45 days) were performed. After suspension of Liposomal Amphotericin B, the lesions recurred in 15 days, and voriconazole (200 mg 12/12 h) was prescribed for 6 months, with complete regression of the lesions. Currently, he is free of injuries, having been followed up every 6 months.

Conclusion
Rare disease caused by chlorophyllous algae may be surprising due to the severity and lack of response to antifungals that show sensitivity in vitro.
P111 A case of nail discoloration due to topical treatment of onychomycosis with luliconazole 5% nail solution
Authors: Sato Tomotaka , Fukada Norihito , Kinjo Akihiko , Hatta Mariko , Akimoto Ryota , Kobayashi Hisashi , Fukuzumi Satoshi 
Published: September 2022

Abstract

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM
We use efinaconazole 10% topical solution and luliconazole 5% nail solution for topical treatment of onychomycosis in Japan. We show a case of onychomycosis treated with nail debridement and topical luliconazole 5% nail solution to the nail and topical luliconazole 1% cream to the foot.

A woman in her seventies with chronic urticaria had a nail spike color change on her left big toe (Fig. 1).

We opened the spike lesions with a plastic nipper and KOH direct microscopic examination showed dermatophytoma. We treated with topical luliconazole cream on the toes and soles of the foot and 5% solution on the nail. Because of the summer season, she walked outside in sandals without socks during treatment and noticed the nail yellow color change (Fig. 2). We advised the patient to protect from sun light and not to walk outside without socks. Due to the report from the production company, the reason for nail color change to yellowish is photodegradation of luliconazole. After 1 year since first visit, the fungal infection of the big toe disappeared by our topical treatment. The nail yellow color change also disappeared. We recommended avoiding sunlight exposure on the treated nail during topical treatment of luliconazole 5% nail solution.
P122 Myeloid-derived suppressor cells as a potential biomarker and therapeutic target in rhino-orbital mucormycosis patients
Authors: Singh Praveen , Das Shukla , Rai Gargi , Ansari Mohammad Ahmad , Gupta Neelima , Sharma Sonal 
Published: September 2022

Abstract

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

Background
Mucormycosis is a deadly fungal infection that emerges in patients affected with COVID-19. All fungal illnesses are caused by dysregulated adaptive immunity, but Myeloid-derived suppressor cells (MDSC) have added a new dimension to the chronic inflammatory response.

Objective
We attempted to enumerate the MDSC immune response in rhino-orbital mucormycosis patients before and after treatment and compared the data with healthy control.

Methods
A total of 3 ml of blood samples were taken in an EDTA vial from 20 patients with mucormycosis and 20 age-matched healthy control. A second blood sample was collected to examine the immune system post three months of treatment. Mycological identification was performed on nasal crust retrieved after surgery using KOH/culture. The expression of the MDSC marker was analyzed by immunostaining with the antibodies against CD14, HLA-DR, CD11b, CD33, CD66 (Biolegend). Fluorescence profiles were recorded by Flow Cytometer (BD FACSAria™ III) and analyzed by Flow Jo software (BD Biosciences). The percentage of positive cells is used to express the results. The GraphPad Prism (version 8, GraphPad software, LaJolla, CA, USA) was used to analyze the data. All of the results were considered significant when P &lt;.05.

Results
All of the patients tested positive for Rhizopus arrhizus, which was confirmed by the culture. The percentages of Monocytic-MDSC (mMDSC: CD14 + HLA-DR-/low) cells were significantly high in patients compared to healthy control. In post-3-month treatment, the percentages of mMDSC were found significantly low and comparable with healthy control. Granulocytic MDSC (gMDSC: HLA-DR-/low CD33 + CD11b + CD66+) cell population was higher in patients compared with healthy control and patients with post-3-month treatment.

Conclusion
MDSC regulates T cells and other immune cells with a different mode of action. The findings in this study imminently indicate the mechanism of immune dysregulation involving MDSC pathways in mucormycosis and provide evidence that restoration of immune balance causes reduction of MDSC cells may be considered a therapeutic option for long-term benefit.
P146 Penicillium-like mo ld: caught red-handed, but remained unidentified
Authors: Rege Sujata , Soman Rajeev , Chavan Dipali , Dadke Mahendra 
Published: September 2022

Abstract

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

Objective
This case highlights the presence of a self-limited respiratory mycosis in an immunocompetent host and need for fungal sequencing in diagnosis of such rare cases.

Methods and Results
Ms X, a 25-year-old, apparently healthy software engineer, had an overnight journey in an air-conditioned bus from Hyderabad to Pune. The next day, she developed throat irritation followed 3 days later by fever and cough without dyspnea nor wheezing. Her chest X-ray was found to be normal at the time. Three days later she was admitted to our hospital, wherein X-ray chest and CT chest showed bilateral randomly scattered nodular shadows (Fig. 1). She was referred to ID as a case of suspected tuberculosis, but her presenting symptom being sore throat, the acuteness of symptoms, presence of nodular lung shadows which were absent on the X-ray chest done just 3 days earlier were against the diagnosis of TB. Inhalational fungal or viral pneumonitis were hence considered.
Transbronchial biopsy showed an intense alveolar inflammatory exudate, but GMS staining did not reveal any fungal hyphae. BAL Galactomannan, Xpert MTB/RIF were negative. Both BAL and CT guided lung nodule biopsy samples grew a mold. Red pigment formation in culture and its morphological appearance on LPCB mount (Fig. 2) led to a diagnosis of Penicillium species infection. MALDI TOF MS, which had only a few Penicillium spp in its 2018 database, failed to identify the organism, leading us to believe that it could be a different Penicillium species.
Since the patient was showing clinical improvement, a self-limited infection was thought of and therapy was withheld with cautious follow-up. The patient was completely asymptomatic after 10 days and CT chest done 20 days later showed complete resolution of the nodules.
We believe that this illness was due to inhalation of spores from the air-conditioning vent, eliciting a brisk inflammatory response in the alveoli. The organism grew from BAL and CT guided biopsy from viable spores, but it failed to germinate into hyphae in the human host and hence was not seen on histopathology and did not produce galactomannan which is only released from the tips of growing hyphae.

Conclusion
Fungi are often isolated from poorly maintained air conditioning vents. In this case, the Penicillium like organism failed to produce progressive disease in the immunocompetent host. If the same organism could be cultured from the AC vent, showed genetic relatedness with the clinical isolate; the source, transmission, and disease linkage could have been established in this case.
P149 Short tandem repeat genotyping of South American Candida tropicalis isolates
Authors: Spruijtenburg Bram , Baqueiro Cynthea C.S.Z. , de Almeida Jr. João Nóbrega , Colombo Arnaldo L. , de Groot Theun , Meis Jacques F. 
Published: September 2022

Abstract

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

Candida tropicalis is a clinically relevant yeast that causes candidemia in humans with a high mortality rate. The yeast primarily infects immunocompromised patients and causes outbreaks in health care facilities. A short tandem repeat (STR) typing scheme for C. tropicalis was applied to a collection of 217 clinical and environmental isolates from South America, predominantly from Brazil, and included nine fluconazole-resistant isolates. Application of the STR typing resulted in the identification of 153 genotypes. Typing demonstrated 11 clusters containing more than two isolates. In one cluster of six, we found three fluconazole-resistant isolates, while there were another five closely related fluconazole-resistant isolates. ERG11 mutation screening was performed on all 9 resistant isolates. The closely related resistant isolates all contained Y132F in combination with the novel Y257H/N mutation. The remaining resistant isolate did not exhibit mutations in ERG11 suggesting a different resistance mechanism. Altogether, we applied a novel STR genotyping for C. tropicalis and showed several in-hospital clusters suggesting cross-transmission.
P154 Fungal spore count in a tertiary care hospital in Mumbai, India
Authors: Naik Aparna , Rodrigues Camilla , Basu Shaoli , Agarwal Umang , Sunavala Ayesha , Prasad Ravindra , Shetty Anjali 
Published: September 2022

Abstract

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

Objectives
Fungal spores are ubiquitously present in the environment. Appropriate temperature and humidity can lead to fungal growth. It is of concern in a hospital environment. Diabetic and immunosuppressed persons are more vulnerable to such infections. The fairly humid and slightly warm climate of Mumbai is ideal for fungal growth. According to an article released in March 2021, the total fungal count in Mumbai was 16.2 CFUs. Here is a brief gist of how fungal spores were controlled within a tertiary hospital in Mumbai, India which is located near sea by simple but effective methods.

Methods
Air sampling of the Operation Theatre (OT), Central Sterile Supply Department (CSSD), Bone marrow transplant (BMT) areas is done on weekly basis in the hospital and for areas such as ICU (Intensive Care Unit), Oncology (ONCO) Ward, Cardiac Catheterization (Cath) lab and Digital subtraction angiography (DSA) lab monthly air sampling is done to check for bacterial and fungal load. Two types of air samplers are used: Heico air sampler from HiMedia and Dyanamicro air sampler. OT, BMT, CSSD have HEPA (high efficiency particulate air) filters installed for filtration of air. The other areas like ICU, ONCO ward, Cath lab, and DSA lab do not have HEPA filters.

Results
In the last 4 years there were two instances where fungal growth was observed once in BMT and once in ICU. In ICU Aspergillus niger growth was observed and in BMT there was a growth of multiple Aspergillus spp. It took nearly 3-4 months for the eradication of the fungus in BMT and 2 months to clear the fungus from ICU. Due to strict engineering control, we were able to restrict the spread within hospital.
In BMT unit the growth was observed during rainy season when because of heavy rain there was seepage in one wall of the unit and also there was a leakage of sink in the ante-room area. When these repairs were done the fungal growth was not observed afterward.
In ICU thorough cleaning of the Air Handling Unit (AHU) filter leads to resolution of the issue.
Both these episodes were uneventful as no patient had any infection due to these.
Factors that helped in controlling the fungal spores spread are:

Conclusion
Even though the hospital is situated near sea and the outside air has high humidity and high microbial load, effective engineering measures and close monitoring of the areas can help in controlling the spread of fungus within the hospital. Routine periodic checks of the air for fungal spores can also help prevent nosocomial infections.
P156 Oral Candidiasis among inpatients with COVID-19 in the North of Iran
Authors: Ahangarkani Fatemeh , Babamahmoodi Farhang , Rezai Mohammad Sadegh , Mohammadi-Kali Ali , Najafi Narges , Alizadeh-Navaei Reza , Badali Hamid 
Published: September 2022

Abstract

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

Objectives
We aimed to characterize oral candidiasis epidemiology, species distribution, and antifungal susceptibility profiles among COVID-19 patients.

Methods
This observational cross-sectional study enrolled patients ˃18 years old with confirmed oral candidiasis admitted at Razi teaching hospital (a reference infectious disease center in Mazandaran Province). Oral samples from patients with suspected oral candidiasis infection were collected and were confirmed for oral candidiasis by microscopic examination and fungal culture. Fungal isolates were identified using Multiplex polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism. In vitro susceptibility testing for amphotericin B, fluconazole, voriconazole, and micafungin of all identified isolates was performed using broth microdilution according to the Clinical and Laboratory Standards Institute (CLSI) broth microdilution guideline (M27-A3 and M60) standard.

Results
Among 4133 COVID-19 admitted patients during a year in Razi hospital, 120 patients had confirmed oral candidiasis. Totally 172 Candida isolates causing oral candidiasis isolated from these patients were identified. Most patients were infected with a single Candida species; however, it is notable that mixed Candida species caused oral candidiasis in 46 patients. Candida albicans (60.46%) was the most common species. Among non-albicans Candida species, C. glabrata (17.44%) was the most isolates, followed by C. tropicalis (11.62%), C. kefyr (7.55%), and C. krusei (2.9%). Although non-albicans Candida species, including C. glabrata and C. krusei demonstrated high minimum inhibitory concentration (MIC) against azole drugs, in terms of MIC90 values, all tested drugs exhibited superior activity against C. albicans. In terms of MIC Geometric mean, amphotericin B and micafungin were more potent than all comparator drugs.

Conclusions
Our study described the high incidence of oral candidiasis caused by non-albicans Candida species in COVID-19 patients; most of them, including C. glabrata and C. krusei exhibits intrinsic decreased susceptibility to the azole class of antifungals. Further studies should design an appropriate prophylaxis program to prevent oral candidiasis in COVID-19 patients.
P183 Monitoring of candida colonization in the respiratory tract of COVID-19 cases
Authors: Diba Kambiz , Makhdoomi Khadige , Nejadrahim Rahim , Namaki Atefeh 
Published: September 2022

Abstract

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

Objectives
Opportunistic yeasts potentially cause infection or colonization in the lower respiratory tract. Candida albicans is a common agent of yeast infections but other yeasts such as non-albicans Candida are important as resistant fungi to antifungal drugs. The predisposing factors for the overgrowth and invasion by Candida species include corticosteroid therapies, long-time hospitalization, antibiotic therapies, and primary infections by Mycobacterium tuberculosis and viral agents. The screening of Candida colonization in the lower respiratory tract of the cases with a history of COVID-19 was performed in this study at a great training hospital in Northwest of Iran.

Methods
During the pandemic COVID-19, about 445 cases with severe COVID-19 hospitalized and used dexamethasone were investigated for Candida infections and colonization by the laboratory data of Medical Mycology Center, UMS University, Urmia, Iran. Our subjects were sputum, bronco-alveolar and bronchial specimens. Candida elements including pseudo-hypha and blasto-spores microscopically were investigated. Differential cultures and PCR-RFLP were used for the identification of Candida yeasts at the level of species.

Results
Totally, 54 yeast overgrowth was detected in the clinical specimens including Candida albicans 28 (51.8%), non-albicans Candida species 24 (44.4%) and a case of Pneumocystis jirovecci. All of the cases with Candida detections were Covid-19 positive. Moreover, two cases of rhino-cerebral Mucomycosis, two cases of TB, two cases of asthma, and one case of cystic fibrosis were included.

Conclusion
As a conclusion, Fungi especially Candida yeasts be considered as the potential pathogens in cases with a history of severe COVID-19 and corticosteroid therapy during stay at the hospital.