Chinese Journal of Mycology

Study on the synergistic antifungal activity of glyceryl monostearate and caspofungin in vitro

QIU Lijuan, CHAO Wen, SHI Anzhe, YAN Lan, LYU Quanzhen, JIANG Yuanying

2021, 16(3): 145-149,165.

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Objective In order to improve the antifungal effect of caspofungin, we screened the synergistic effects of many compounds with caspofungin in vitro. Methods The minimum inhibitory concentration (MIC) and synergistic index (FICI) of glyceryl monostearate (GMS), caspofungin (CAS) and fluconazole (FCZ) against Candida were measured by a microdilution method. In addition, the minimum concentration of glyceryl monostearate and caspofungin used alone or in combination to inhibit the hyphae formation of Candida albicans was investigated in the RPMI 1640 and Spider medium. Results The combination of glyceryl monostearate and caspofungin showed synergistic antifungal effect on pathogenic Candida, and the synergistic index was less than 0.5. When combined with glyceryl monostearate, the concentration of caspofungin inhibiting the formation of hyphae decreased significantly. Conclusion Glyceryl monostearate could enhance the antifungal effect of caspofungin in vitro.

Clinical analysis of 4 cases of disseminated fusariosis with hematological malignancies treated by hematopoietic stem cell transplantation and literature review

CHENG Haoyu, LI Tingting, ZHANG Shuqin, GU Jiangying, XUE Song, ZHANG Weijie, WANG Wenjing, FEI Xinhong, YIN Yuming, WANG Jingbo

2021, 16(3): 150-154.

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Objective To improve the understanding of fusariosis, especially disseminated fusariosis, in patients with hematopoietic stem cell transplantation, so as to achieve early diagnosis and timely treatment, and improve the prognosis. Methods To retrospectively analyze the diagnosis, treatment and prognosis of 4 cases of hematopoietic stem cell transplant patients with disseminated fusariosis treated in our hospital, from April 2015 to September 2020. Results All the 4 patients were confirmed cases that occurred before hematopoietic stem cell implantation or neutrophilic phase, and received amphotericin B liposome combined with voriconazole. Disseminated fusariosis was controlled in 3 patients, and one patient died after treatment. Conclusion Disseminated fusariosis after hematopoietic stem cell transplantation had poor prognosis and high mortality. Effective antifungal therapy and rapid immune reconstruction in early stage were effective means to improve the survival.

A preliminary study on the virulence of Aspergillus lentulus isolated from a patient with COPD on the Galleria mellonella model

XIE Yun, ZHANG Lijuan, PALIDAE·Abliz

2021, 16(3): 155-160.

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Objective Establish an animal model of Aspergillus lentulus (A. lentulus or A.L) infection, and use the animal model to explore the virulence of A. lentulus. Methods One hundred and twenty-five Galleria mellonella were randomly divided into five groups, with Aspergillus lentulus clinical strain and Aspergillus lentulus standard strain as the experimental group, Aspergillus fumigatus and Candida albicans as the control group, and PBS as the blank control group. The experimental group and the control group were made into 10⁶ CFU/mL spore suspension, respectively, and infected with each group of Galleria mellonella. The survival of Galleria mellonella within 72 hours was recorded and the survival curve was made. The intestinal tissues of Galleria mellonella were extracted 24 hours later. The intestinal tissue damage was observed by HE staining. The fungal load in the intestinal tract of the Galleria mellonella and the positive rate of fungal reverse culture were determined by tissue homogenization. The fungal morphology of the intestinal culture was observed by fungal fluorescence staining. Results There was a statistical difference between the survival numbers of Galleria mellonellas of A. lentulus clinical strain and A. lentulus standard strain and A. fumigatus group and C. albicans group (P<0.05); The results showed that the intestinal wall structure of the clinical strain of A. lentulus and the standard strain of A. lentulus was roughly normal, with a small amount of hyphae, spores and inflammatory cell infiltration in local edema. The intestinal structure of the control group was seriously damaged, with hyphae, spores and a large number of inflammatory cell infiltrations; There was a statistical difference in the intestinal fungal load and the positive rate of fungal reverse culture in each group of different fungal species infected Galleria mellonellas (P<0.05); According to the fluorescence microscope observation of the fungus, the clinical strain and standard strain of A. lentulus had more hyphae and fewer spores, while the C. albicans, and A. fumigatus group had more spores. Conclusion Compared with A.fumigatus and C. albicans, the A. lentulus strain has weaker virulence and intestinal damage to larvaes and has a lower lethality rate.

Distribution of Malassezia species on the face of patients with atopic dermatitis of head and neck

LIN Jie, YANG Lianjuan, YANG Mingzhen

2021, 16(3): 161-165.

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Objective To investigate the distribution of Malassezia in patients with head and neck atopic dermatitis(AD) and its relationship with severity. Methods From September to December, 2020, 45 AD patients and 50 healthy volunteers were recruited. Scale samples were taken from the lesion and non-lesion areas on the face both of patients and volunteers with sterile cotton swabs, and the number of copies of 7 species of Malassezia were detected by quantitative real-time PCR. The species distribution and number were analyzed by using cross-sectional analysis. Results For head and neck AD patients,the Malassezia restricta and Malassezia globosa in the facial lesions were 3.13 times (P<0.05) and 6.69 times (P<0.05) of the healthy volunteers, respectively. Both of them were correlated with the severity of AD (P<0.05). Conclusion Malassezia restricta and Malassezia globosa of lesion areas on the face were more in head and neck AD patients than that in healthy people, and their levels were correlated with the severity of the disease.

Distribution and epidemic trend of Candida isolates from patients with oral candidiasis

SONG Yang, HE Jing, HE Chun

2021, 16(3): 166-169,181.

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Objective To analyze the distribution and epidemic trend of Candida isolates from oral candidiasis patients in our hospital in recent five years retrospectively. Methods A total of 27,162 saliva culture samples collected from the Mucosal Department of Peking University Hospital of Stomatology between 2015 and 2019 were retrospectively analyzed. All the results were entered into the Excel form and analyzed in groups according to different species distribution, funged quantities, sexes and ages. Results Among all the Candida strains isolated from oral candidiasis patients from 2015 to 2019, Candida albicans accounted for the highest proportion, while the positive proportion of Candida tropicalis and other Candida increased year by year. In the samples infected by C. albicans, C. tropical and C. glabrata, the number of colonies was mainly ≥200 CFU/mL. However, the number of colonies in samples infected with C. kruseii and other Candida species is mainly ≤30 CFU/mL or ≥200 CFU/mL. In all study populations, the positive rate of infection in female patients was significantly higher than that in male patients (P<0.05), and the positive rate of oral infection generally increased with age and increased significantly after the 41~50 age group. Conclusion Although Candida albicans was still the main pathogen of oral Candida infection, the positive rate of Candida tropicalis and other Candida had been increasing year by year in recent years. The analysis of the distribution and epidemic trend of oral candidiasis might be useful for clinical medication strategy.

A 3 days dose-escalation method for the administration of amphotericin B for childhood acute leukemia with invasive fungal disease

LIU Yingting, CAO Lizhi, WANG Dan, YANG Minghua

2021, 16(3): 170-175.

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Objective To evaluate the efficacy and safety of 3-day rapid dose escalation treatment of amphotericin B(AmB) in childhood acute leukemia(AL) patients with invasive fungal disease(IFD). Methods Data on 108 AL patients with IFD during March 2009 to December 2018 were collected. Those assigned to standard group (n=50) received standard treatment for 5 days. New Group (n=58) received rapid dose-escalation for 3 days, The rate of adverse events and overall success rate in 4 weeks after initiation of AmB therapy were documented and retrospectively analyzed. Results We found the overall success rate was differed significantly between patients with proven and probable fungal infections in two group and the incidence of adverse events was similar between all patients (54.5% vs. 80.5%,P=0.021). Conclusions The 3-day schedule for drug administration of AMB presented a more effective, with less toxicity than the standard approach to treatmentfor childhood acute leukemia patients with IFD. There is nosignificant difference in the rate of AES between the 3-day escalation strategy and the 6-day escalation strategy. So we concluded that three-day dose escalation was better than standard treatment.

In vitro susceptibility of berberine combined with antifungal agents against Talaromyces marneffei

ZHANG Xinyu, PAN Kaisu, LUO Hong, ZHENG Dongyan, ZHENG Yanqin, CAO Cunwei, LIANG Gang

2021, 16(3): 176-181.

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Objective To investigate the effect of berberine alone or in combination with conventional antifungal drugs on Talaromyces marneffei yeast. Methods Twenty-one isolates of T. marneffei were assayed. Drug interactions were assessed with the chequerboard technique using the CLSI microdilution method (M27-A3) with minor modifications. The fractional inhibitory concentration index (FICI) was used to classify drug interactions. Time-kill curves were used to confirm the synergistic interaction. Results Berberine/voriconazole and berberine/amphotericin B combination showed the highest percentage of synergic interaction (71.4%); followed by berberine/itraconazole (66.67%), berberine/fluconazole (47.62%), berberine/caspofungin (52.38%), respectively. Time-kill curves confirmed the synergistic interaction, no antagonistic or indifferent action was observed. Conclusions In vitro berberine could enhances the efficacy of antifungal agents against the yeast form of T. marneffei. The MIC value can be greatly reduced when combined with conventional antifungal drugs. The results indicated berberine might have a potential role in combination with antifungal agents in freating patients infected with T. marneffei.

A case report: sporotrichosis following herpes zoster facialis

GAO Ruijia, LYU Sha, SUN Jinpeng, HU Xin, LI Fuqiu

2021, 16(3): 182-183,187.

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The patient was a 54-year-old woman. She had diffuse erythema, papules, and nodules on the right cheek for 4 months. Dermatological examination: diffuse erythema on the right cheek, multiple rice-to-bean large papules and nodules on the surface. Fungal culture was positive and identified as Sporothrix globosa. The patient was diagnosed as sporotrichosis. Treatment: itraconazole 0.1 g twice daily orally was given, and the skin lesions were significantly improved after 1 month of treatment than before.

A case of Chromoblastomycosis caused by Fonsecaea monophora in Hainan fisherman

NIU Mu, LIAO Wanqing, WU Weiwei, ZHENG Wenai

2021, 16(3): 184-187.

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Here we report a case of chromoblastomycosis caused by Fonsecaea momophora. A 80-year-old man was admitted to the hospital with a more than eleven years’s history of plaque on the right hand. Direct microscopic examination and fungal culture, histopathologic examination, ribosomal internal transcribed spacer (ITS) sequence analysis were performed. The thick-walled, brown sclerotic bodies were observed by direct microscopic examination and histopathological examination. Fungal culture yielded black brown villiform colonies and rhinocladiella type and cladosporium type conidia were observed in the slide culture. The isolate was identified as Fonsecaea momophora according to the ITS sequencing. The patient was prescribled itraconazole(200 mg/d) combined with terbinafine (250 mg/d) for 4 months.The lesions improved greatly and the patient was now under followed-up.

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