Table of Content

28 December 2011, Volume 6 Issue 6

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A model of translational medical mycology—-A case of facial tinea incognito identified by direct DNA extraction from scales and cured by anti-fungal cream under the guidance of drug susceptibility test in vitro

KANG Dao-xian, RAN Yu-ping, YIN Bin, DAI Ya-ling

2011, 6(6):  324-327. 

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Objective To report a case of facial tinea incognito due to Arthroderma vanbreuseghemii,identified by direct DNA extraction from the scales,and compared with that from the isolated colony.The isolated colony was tested in vitro for drug susceptibility.Methods The scales scraped from the affected area were prepared for PCR and fungal culture.DNA was extracted directly from the scale and amplified using the universal fungal primers ITS1/4,the sequences of amplification products were blasted in GenBank.After the pathogen was isolated,the drug susceptibility test was performed using the commercialized anti-fungal creams.Results The case was finally diagnosed as facial tinea incognito due to A.vanbreuseghemii,the teleomorph of Trichophyton interdigitale.The patient was cured after 5 weeks oral terbinafine(250 mg/d) and topical application of antifungal cream containing 1%naftifine-0.25%ketoconazole after 5 weeks.Conclusions PCR-based molecular biological validation of DNA from scales with the ability of rapid identification for pathogenic fungus and using anti-fungal cream directly for in vitro susceptibility test could be a good guidance for direct treatment and monitor during the therapy.This individual diagnosis and treatment program is a successful model of translational medical mycology from bedside to bench and from bench to bedside.

Re-identification,standard CSP typing and in vitro susceptibility of Aspergillus fumigatus complex

GAO Lu-juan, YU Jin, LI Ruo-yu

2011, 6(6):  328-331,336. 

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Objective To investigate the strain distribution of Aspergillus fumigatus complex,the CSP genotypes and in vitro susceptibility of classic A.fumigatus strains.Methods One hundred and sixty-two strains of A.fumigatus complex isolated from 125 patients were re-identified as Aspergillus section Fumigati via macro-and micro-morphological characteristics,and classical A.fumigatus via maximum grow temperature.Atypical strains were identified based on internal transcribed spacer of the rDNA gene(rDNA ITS) sequencing.Classic A.fumigatus was typed by CSP gene sequencing and subsequently analyzed with the international nomenclature.In vitro antifungal susceptibility to itraconazole(ITC),amphotericin B(AMB),voriconazole(VRC) and caspofungin(CAS) were determined by broth microdilution susceptibility test.Results All strains were identified as classic A.fumigatus complex with 16 genotypes.Type t04A,t03 and t01 were most common in our study.MICs of ITC were ≥4 μg/mL in 13 strains isolated from 4 patients(3.2%),two strains of which have MICs against AMB and VRC at 4 μg/mL and 16 μg/mL,respectively.The highest MEC against CAS was 4 μg/mL in 1 strain.Conclusions No newly proposed A.fumigatus associated specie was found.All clinical isolates of classic A.fumigatus in clinical were divided into 16 CSP genotypes,five of which had not been reported previously.Genotype distribution was similar with literature.ITC resistance rate was 3.2%in classical A.fumigatus in China.Resistances to AMB,VRC and CAS exist in some isolates.

Therapeutic efficacy of itraconazole against Aspergillus fumigatuskeratitis

WU Ran, CHENG Bo, JIA Min

2011, 6(6):  332-336. 

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Objective To compare the antifungal activity of itraconazole against Aspergillus fumigatus with fluconazole in vitro and to evaluate the therapeutic efficacy of itraconazole against Aspergillus fumigatus keratitis in mice.Methods Mice model of Aspergillus fumigatus keratitis was set up by intrastromal injection and confirmed by microscopy and fungal culture.Minimal inhibitory concentration(MIC) and minimal fungicidal concentration(MFC) of itraconazole and fluconazole to Aspergillus fumigatus were determined by agar dilution method.Mice with Aspergillus fumigatus keratitis were treated by itraconazole.Clinical assessment,inflammatory evaluation and colony-forming unit(CFU) counting were recorded by the end of the treatment.Results The MICs and MFCs of itraconzole and fluconazole to Aspergillus fumigatus were 6.25 μg/mL and 12.5 μg/mL,500 μg/mL and 1 000 μg/mL,respectively.Compared with control group,mice treated by itraconazole showed significant improvement in clinical assessment,inflammatory evaluation and CFU counting(P<0.05).Conclusions Itraconzole is superior to fluconazole in the treatment of Aspergillus fumigatus keratitis in vitro.

TLR2 expression in rats with Candida albicans infection in lung

LIN Li, WANG Li, ZHOU Yang-yang, CHEN Yao-hua, MENG Xin-li, KANG Jian

2011, 6(6):  337-340. 

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Objective To explore the expression of TLR2 in rats with Candida albicans infection in lung.Method Rats model of Candida albicans infection in lung was set up and changes in pathology were observed.TLR2 expression in the tissues at different timepoints were also observed by immunohis to chemical method.Results The expression of TLR2 in the lung of Candida albicans infected rats was significaltly higher than that in healthy rats.Conclusions Over expression of TLR2 in Candida albicans infected rats may related to inflammatory reaction.

Inhibitory effects of Tribulus terrestris steroid saponin TTS-12 on building biofilm of Cryptococcus neoformans

LI Xiu-li, TIAN Yuan, SHI Yu-ling, GU Jun-ying, LIU Zhi-yu, LI Xiao-jian, GAO Fei

2011, 6(6):  341-343. 

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Objective To investigate the influence of TTS-12,a steroid saponin from Tribulus terrestris,on building biofilm of Cryptococcus neoformans,and to explore the possible mechanism.Methods The inhibitory effects of biofilm formation of Cryptococcus neoformans by TTS-12 was observed by microscopy and assessed by MTT method.The expression of PMT4 mRNA was measured by real-time RT-PCR with different concentrations of TTS-12.Results Compared with control group,TTS-12 treatment showed inhibitory effects on the formation process,making the biofilm more loosened.The growth kinetics and PMT4 mRNA level in TTS-12-treated group were dose-dependently lower than those in the control group(P<0.01).Conclusions TTS-12 may has inhibitory effect on formation of Cryptococcus biofilm by PMT4 gene.

Superficial fungal infection and allergic dermatitis

LIU Fang, SANG Hong, HU Wen-xing, KONG Qing-tao, WANG Xue-lian, WANG Gao-feng, ZHANG Min, DENG De-quan, XIE Qi-mei

2011, 6(6):  344-349. 

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Objective To investigate superficial fungal infection in the etiology of allergic dermatitis by comparing the sensitivities of fungal allergens and unfungal allergens among allergic dermatitis patients with or without tinea,and the identification of pathogens.Methods Totally 353 patients with chronic urticaria,eczema or atopic dermatitis were divided into two groups classified by direct microscopic examination: the group with superficial fungal infection(n=173) and the contral group without superficial fungal infection(n=180).Skin prick tests were performed in all subjects,but fungal culture were administered only in the patients with superficial fungal infection.Results Positive rates to Trichophyton,Specific Penicillium,Curvularia lunata and Aspergillus fumigatus in experiment group were higher than those in control group(P<0.05).Positive rate to Trichophyton in experiment group was higher than that in control group(P<0.001).There were no statistically significant differences among other fungal allergens and unfungal allergens(P>0.05).T.rubrum(52.86%),T.mentagrophytes(14.18%),Epidermophyton floccosum(5.22%) and Candida(6.72%) were cultured in 134 cases of skin allergic diseases with superficial fungal infection.The positive rates were not statistically significant between Trichophyton and dermatophytes(P>0.05).Conclusions Patients with chronic urticaria or eczema who present immediate hypersensitivity to Trichophyton always have dermatophyte infection.Superficial fungal infections seem to be an important factort in the subjects with chronic urticaria or eczema.

A case of corneal ulcer caused by Fusarium solani infection

YUAN Nai-fen, SUN Yan-hua, HAO Hong-yi, ZHANG Meng, LIN Yuan-zhu

2011, 6(6):  355-357. 

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A case of corneal ulcer caused by Fusarium solani was reported.A 40-year-old male carpenter complained of redness,aching,weeping and vision impairment in the left eye for 10 days.After debridment of the cornea and systematic and topical antifungal therapy,the patient’s condition was significantly improved.The pathogen was identified as Fusarium solani.Early diagnosis based on mycology and opportune treatment are crucial for prognosis of fungal keratitis.

One case of hyalohyphomycosis in the foot due to Fusarium solani

GUO Yun, ZHOU Xiao-Hong, FAN Ying-jun, ZHANG Pei-lian, LI Wen-hua

2011, 6(6):  358-360. 

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One patient was diagnosed as hyalohyphomycosis by history,medical examnation,pathology and fungal culture.The pathogen was finally identified as Fusarium solani.The patient showed significant improvement after 3-month treatment with itraconazole and part-leision resection.

A case of primary cutaneous mucormycosis caused by Rhizomucor variabilis

ZHOU Cun-jian, WANG Li, XU Yan, ZHONG Bai-yu, HAO Fei

2011, 6(6):  361-362. 

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A 65-year-old man with diffused swelling plaques in the face for half a year was reported.Characteristic broad,non-septate hyphae were found in the lesion by histopathology.The isolate was identified as Rhizomucor variabilis by fungal culture,PCR and sequence analysis.The patient was diagnosied as primary cutaneous mucormycosis and improved after systemic amphotericin B for 12 days,with total dosage of 1 050 mg.

Clinical observation of compound ciclopirox olamin spray in the treatment of superficial mycosis

YANG Qing-qi, ZHAO Guang, LIU Wen, NA Ai-hua, CHENG Yu

2011, 6(6):  363-366. 

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Objective To investigate the efficacy of compound ciclopirox olamin spray in the treatment of superficial mycosis.Method Compound ciclopirox olamin spray was applied in stage Ⅰonce daily for 4 weeks.In stage Ⅱ,double-blind,randomized controlled trial was conducted.Compound ciclopiroxolamin spray and compound ciclopirox olamin with triamcinolone acetonide spray were applied in the group A and B respectively for 4 weeks(once daily).Results The total effective rate in groupⅠwas 80%by the end of the treatment.The total effective rates in group Ⅱ A and group Ⅱ B were 75%versus 82.35%,94.74%versus 100%at week 2 and week 4,respectively.The efficacy of compound ciclopirox olamin spray in the treatment of superficial mycosis was similar to that of compound ciclopirox olamin with triamcinolone acetonide spray(P>0.05).Conclusions Compound ciclopirox olamin spray is effective and safe in the treatment of superficial mycosis,with obvious pruritus relieving and fewer local irritation.

Special stains in fungal histopathology

MA Tian, SONG Yue-xing, ZOU Xian-biao

2011, 6(6):  367-369. 

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Histological evaluation is quick and easy for pathogen identification and diagnosis in fungal infections.Some common special stains and application will be discussed in this paper.

Progression on the research of two-component signal transduction system in fungus and its inhibitors

XU Xi-guang, ZHANG Zi-ping, CHENG Bo

2011, 6(6):  370-372380. 

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Two-component signal transduction system,which plays an important role in cell metabolism,virulence and pathogenicity,has been found in most lower eukaryotes,prokaryotes and some plants,yet not in human cells.Well-understanding of the mechanism may be helpful for inhibitor designing,which has antifungal effect without damage to host cell.Recent literatures about two-component signal transduction system in fungi and potential inhibitors are reviewed.