Chinese Journal of Mycology

Mycoses of implantation

XI Li-yan, CHEN Ren-qiong

2013, 8(2): 65-68.

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Implantation or subcutaneous mycoses are common in tropical and subtropical regions of the world. These infections have multiple features in common, including similar epidemiology, mode of transmission and so on.Some occur in specific endemic areas.And the clinical manifestations of these infections are diverse,the cure is very difficult and often causes deformity and dysfunction if the cure is not timely.So that it affects the patients' life quality.This review aims to the epidemiology of the most clinically significant implantation mycoses,such as sporotrichosis,eumycetoma,chromoblastomycosis,phaeohyphomycosis and zygomycosis.Clinical manifestations, diagnosis, and treatment options are also reviewed.

Construction of knockout strains of MXR1 gene in Candida albicans

TAN Hong-yue, LI Ping, HU Chan, ZHU Hong-mei, GU Jun, WEN Hai

2013, 8(2): 69-73.

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Objective To construct the plasmid for MXR1 disruption, and knockout the MXR1 gene in Candida albicans.Methods Up and down streams of MXR1 gene ORF were amplified and inserted into the p5921 plasmid.MXR1 gene was disrupted according to the Ura-Blaster method. The constructed strains were identified by PCR and Southern-blot methods.Results The knockout plasmid pUC-MXR1-URA3 and MXR1 disruption strains were successfully constructed.Conclusions The MXR1 disruption strains are helpful for the study of the drug-resistance mechanism.

Clinical analysis and genotype identification of pathogenic strains of children’s sporotrichosis in Fuyu county, Jilin Province

LV Sha, LI Fu-qiu, JIN Ju-hua, LIU Xiao-ming

2013, 8(2): 74-77,128.

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Objective To make the clinical analysis of children's Sporothrix schenckii infections and genic identification of partial strains in Fuyu county,Jilin Province. And to understand whether the strains in this area had stronger pathogenicity because of genic differences by comparing the gene sequences of these strains with those of Sporothrix schenckii strains from another county in Jilin Province.Methods To analyze the clinical characteristics, 35 cases of children's sporotrichosis in our clinic from January 1 to Apirl 30,2011 were enrolled. The genic identifications of ribosome-conservative spacer, ITS and NTS of 8 of the strains were performed.Results Comparing with the standard strain, the NTS of five strains which caused Sporothrix schenckii infections in Fuyu coutry have the loss of many bases. Among them, four strains have the non-contiguous loss of 10 bases from exactly the same positions 208 to 232bp; the other one strain have the non-contiguous loss of 21 bases from the position 208 to 249 bp.Conclusions The strains which resulted in the higher incidence of sporotrichosis in Fuyu county might have stronger pathogenicity because of the bases loss in NTS.

A clinical analysis of renal transplant patients with cryptococcal meningitis

YANG Ya-li, DU Lin, WEN Hai, ZHU Fan-yuan, FANG Wei, ZHU Yuan-jie, GU Ju-lin, CHEN Jiang-han, LIAO Wan-qing

2013, 8(2): 78-82.

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Objective To analysis the clinical features of renal transplant patients with cryptococcal meningitis, and the difficulties of the diagnosis and treatment.Methods Four patients with cryptococcal meningitis after renal transplantation were involved in this study.The clinical manifestations,laboratory data,treatment and prognosis were analyzed.Results Four patients,2 male and 2 female, were underwent renal transplantation for the first time.The clinical manifestations included headache and fever.Three patients were confirmed cryptococcal meningitis by CSF culture and means of India ink. All patients were given antifungal treatment of amphotericin B liposome, voriconazole, and 5-flucytosine, while 1 patient was given amphotericin B intrathecal injection. After 2-4 months treatment, the results of cryptococcus smear turned negative, and clinical symptoms disappeared in 4 patients. Now all the 4 patients are still in follow-up, and there are no relapse.Conclusions Renal transplant patients with cryptococcal meningitis presented atypical clinical manifestations, which made it extremely difficult to diagnosis. Early diagnosis,timely treatment,and cooperation between different departments are the key to improve outcomes.

Multiple myeloma complicated with upper gastrointestinal invasive candidiasis：two case reports and literature review

JIN Li-na, DU Juan, YUAN Zhen-gang, ZHANG Chun-yang, FU Wei-jun, HOU Jian

2013, 8(2): 83-86.

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Objective To discuss the clinical features of multiple myeloma who complicated with upper gastrointestinal invasive candidiasis, and improve our knowledge about this disease. Methods We retrospectively analysed two patients with multiple myeloma complicated with upper gastrointestinal invasive candidiasis, and reviewed literature about this disease to understanding it's risk factors, clinical fature, diagnosis, differential diagnosis and therapy. Result Case 1 A woman was diagnosed a κ light chain multiple myeloma for which she successfully underwent allo-bone marrow transplant. 4 months later she developed diarrhea and pain of belly, anti GVHD treatment was inefficiency. By electronic gastroscopy she was diagnosed upper gastrointestinal invasive candidiasis, and was cured by infusing caspofungin. Case 2 A man was diagnosed an IgG λ multiple myeloma for which he unsuccessfully underwent chemotherapy. With progression of the disease, he developmented abdominal distension,belly pain, heart failure, renal failure as well as pulmonary candidiasis. By electronic gastroscopy he was diagnose upper gastrointestinal invasive candidiasis.Treating with itraconazole and caspofungin were futility, and soonly died of multi-organic failure and cadidiasis infection. Conclusion We explored the clinical features of the disease and found it's prone to misdiagnosis. Clinician need enhance the knowledge of the disease, and electronic gastroscopy is essential for diagnosis as well as assessment of treatment effect.

Clinical analysis of 56 cases of candidal balanoposthitis

YANG Lian-juan, GAO Zhi-qin, GONG Wei-ming, YANG Hong, LI Ming, DAI He-jun, WEN Hai

2013, 8(2): 87-89.

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Objective To investigate the clinical and mycological characteristics of candidal balanoposthitis in patients.Methods All the clinical and mycological records from 56 patients with candidal balanoposthitis at our STD clinic were reviewed.The clinical features, precipitating factors, mycological features and treatment experiences were summarized.Result The 56 patients were aged between 18 and 61 years (mean age,34.11?9.92 years), 67.9% (38/56) were aged between 20 and 40 years, 87.5% (49/56) were uncircumcised, 14.29% (8/56) were suffering from diabetes mellitus. 49 strains of Candida species were isolated from 48 patients, 44 (91.84%) were Candida albicans and 5 (8.16%) were Candida parapsilosis. All the patients were treated with sertaconazole cream topical and 5 patients with severe symptoms were combined with itraconazole oral,In the result, 76.79% (43/56) of patients showed a favorable response, followed after one month with clinical and mycological cure.Conclusion Candidal balanoposthitis is prone to the young men and Candida albicans is still the most common pathogen. Sertaconazole topical treatment is effective. Avoiding Sex is helpful to improve cure rates and re-infection.

Clinical analysis 30 cases of tinea corporis caused by Microsporum canis

MA Yue-e, GU Jun-ying, GAO Fei, LIU Zhi-yu, XU Hui, LI Xiu-li

2013, 8(2): 90-92.

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Objective Through clinical analyzing the 30 cases of tinea corporis caused by Microsporum canis to explore the common sources of infection and control scheme.Methods Thirty patients with tinea corporis in our hospital from June 2012 to July were recruited and the pathogenic funguses were identified through fungal culture, the results were analyzed clinically. The patients were cured with bifonazole cream or terbinafine cream.Results All the 30 patients contacted with a cat or dog beforeinfected, and the infection had a short time. The fungal culture results showed that the pathogenic fungus were all Microsporum canis. The patients were all healed after treatment.Conclusion All the 30 patients of tinea corporis caused by Microsporum canis had similar skin lesions' characters, and they recovered after effective treatment by external using anti-fungal ointment.

Bibliometric analysis of literatures on onychomycosis in China

WU Fan, FENG Jiao, KONG Qing-tao, LIU Fang, SANG Hong

2013, 8(2): 93-96.

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Objective To reflect current situation of studies on onychomycosis (OM), so as to provide thinking and evidence for further studies.Methods Quantitative analysis on OM is carried out with bibliometric method, using CNKI and Wanfang Data as resource.Results Altogether 826 literatures are effective, annual literature of OM was increased slowly at the beginning, then achieved peak and now at a stationary phase. Most of them, amounting for 48.18% of total literatures, were from Beijing, Jiangsu, Guangdong, Shanghai and Shandong. The articles, which were published by Chinese Academy of Medical Sciences Institute of Skin Diseases and Peking University First Hospital, added up to 5.57% of total literatures. There were 37 authors who published 3 or more articles as first author, taking 4.48% of all first authors. "Journal of Clinical Dermatology", "Chinese Journal of Dermatology", "The Chinese Journal of Dermatovenereology" and "China Journal of Leprosy and Skin Diseases" were core journals of OM research. The degree of cooperation was 3.01 and the rate of cooperation was 73.24%.There were 423 literatures about clinical effect observation, which was the major research content of OM literatures.Forty-five literatures were supported by research sponsorship, accounting for 5.45% of total literatures.Conclusion OM research in Chain has come to a relatively stable development period, however, there are big gaps between different areas in research ability, more cooperation between researchers and more scientific research funds are still needed. Basic research about pathogenesis may become the new major research direction.

Analysis of the efficacy of photodynamic therapy of condyloma acuminatum with vulvovaginal candidiasis of women infections

ZHANG Yun-jie, YANG Yu-guang, GUO Xiao-juan, ZOU Xian-biao

2013, 8(2): 101-104.

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Objective To evaluate the clinical effect of 5-ALA photodynamic therapy in treating patient of condyloma acuminatum (CA) with vulvovaginal candidiasis infections.Methods The 66 cases in treatment group were treated by photodynamic combined with antifungal therapy, while the 50 cases in control group by frozen combined with antifungal therapy.Results Complete response rate of treatment group was 92.4%, while that of control group was 78.0%. The difference was statistically significant (χ²=4.978, P=0.026); The cure rate of fungal infection of treatment group was 97.0%, while that of control group 86.0%. The difference was statistically significant (χ²=4.783, P=0.029). Patients were followed up for 6 months, the recurrence rate of condyloma of treatment group was 7.5%, the control group 24.0% (χ²=6.136, P=0.013). After 2 months of follow-up, the recurrence rate of fungi infection of treatment group was 4.5%, whlie the control group 16.0% (χ²=4.349, P=0.037).Conclusion 5-ALA photodynamic combined with antifungal is a safe and effective treatment of condyloma acuminatum (CA) with vulvovaginal candidiasis with low recurrence rate.

Observation on therapeutic effect of terbinafine taken orally with different methods in the treatment of toenail onychomycosis

SHEN Yi

2013, 8(2): 105-108.

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Objective The curative effect of terbinafine taken orally with different methods in the treatment of toenail onychomycosis was evaluated.Methods Based on group controlled, group A took oral terbinafine tablet 0.25 g/d for consecutive 12 weeks, group B took oral terbinafine tablet 0.25 g/d for the first 4 weeks, and then alternate-day dosing 0.25 g from the 5th week to the 16th week, recording and analyzing assessment at the 16th week and the 26th week respectively.Results 1 001 cases were validated.Group A got 512 cases which the clinical efficiency was 83.01%, 95.31% respectively; group B got 489 cases which the clinical efficiency was 81.12%, 93.86% respectively.Conclusion Two groups' corresponding period of observation efficiency by the chi-square test was difference with no statistically significant. In reducing dosage for 14 tablets can achieve similar efficacy, with it can improve the compliance of patient. Comparing the result of 26th week with the 16th week, curative effect further improved, it indicated that terbinafine tablet treatment to onychomycosis got significant after-effect.

Research progress of antifungal compound from nature product

YAN Wu-yan, CAO Ying-ying, JIANG Yuan-ying

2013, 8(2): 111-115.

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In recent years,the morbidity and mortality rates of infected patients are still increasing.However, the kind of available antifungal drugs are numbered, and the phenomenon of drug resistance made the current station worse. Develop new kindof antifungal drugs become necessary,finding new high-efficient compound with antifungal activity from nature product has been a hot area of research for several years.Expanding alternative therapeutic agents in the treatment of fungal infection and reducing the occurrence of drug resistance might be achieved by screening new chemical entities with antifungal activities from natural products. In order to clarify their antifungal mechanisms, this paper summarized the antifungal agents which have been reported, based on their different chemical structure and origin. This help to develop high efficient new antifungal precursor structure and find the new antifungal targets.

Advances in research on synergists of antifungal drug

DAI Li, JIANG Yuan-ying, ZHANG Da-zhi

2013, 8(2): 116-119.

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Recently, antifungal resistance showed an increasing trend, especially, the resistance to azole antifungal agents such as fluconazole is the most serious, which attributes to one of the reasons for treatment failure. Increasing dosage of drug or drug combination therapy are common methods to treat drug-resistant fungal. Moreover, it is reported that some plant extracts or small molecules can significantly increase the susceptibility of antifungal drug against resistant isolates. The synergistic effect of two agents is expected to be a new strategy to combat resistant fungal. Herein, we reviewed the advances in research on the sensitizer of antifungal drugs at home and abroad.

Advances in reasearch etiology of tinea unguium

FENG Jiao, ZENG Mei-hua, CHEN Jun, WU Fan, LV Gui-xia, REN Fang, SANG Hong

2013, 8(2): 120-123.

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Onychomycosis is a common infection of the nail plate or nail bed caused by dermatophytes, yeasts, and nondermatophyte molds. Dermatophytes are the major etiologic agents, Tinea unguium describes onychomycosis caused by a dermatophyte species. The dermatophytic fungi include numerous species of fungi which belong to three genera:Trichophyton, Microsporum, and Epidermophyton. With the popularity of the basic medical mycology and improvement of the fungi examination technology, more and more dermatophytic species were isolated from nails. Knowing the exact pathogen is important and has implications in therapy,prognosis and epidemiology. This article will review the pathogenic fungi of Tinea unguium which had been reported in the literature.

An update of antifungals functioning on inhibiting Candida albicans biofilm formation

ZHAO Lan-xue, LI De-dong, WANG Yan, JIANG Yuan-ying

2013, 8(2): 124-128.

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Candida albicans is the most common fungal pathogen which can form biofilm, and the formation of biofilm leads to drug resistance and repeated infections in clinic. Over recent years we have witnessed the discovery of natural products with anti-biofilm activity and the development of combination-therapy against Candida biofilm. The antifungal agents with anti-biofilm activity were discussed in this review.

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