Table of Content

28 June 2022, Volume 17 Issue 3

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Antifungal activity of Bacillus velezensis Y6 peptide against Candida albicans

YANG Cheng, QIAO Yunlong, LI Rongyu, XIONG Yanjing, TANG Xingli

2022, 17(3):  183-187,194. 

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Objective To study the inhibitory activity of Bacillus velezensis Y6 metabolite against C. albicans and its mechanism. Methods The inhibitory activity of Bacillus velezensis Y6 fermentation supernatant against C. albicans was studied by plate combined with Oxford cup. The minimum inhibitory concentration (MIC) was determined by gradient dilution method. The active components of the metabolites were screened by TLC. At the same time, the changes in the amount of intracellular macromolecules released and the intake of fluorescent dye PI before and after the treatment of antimicrobial peptides were compared to investigate the effect of antimicrobial peptides on membrane permeability. Results Bacillus velezensis Y6 metabolite could effectively inhibit the growth of C.albicans. When the test concentration was 10 mg·mL^-1, the inhibition zone diameter reached (38.2±0.5) mm, and the MIC concentration was 0.625 mg·mL^-1. Two antimicrobial components were found in the metabolites of Y6 by TLC. The main active component appears purple when encountering ninhydrin,so it may be peptide. The release of intracellular macromolecules and the intake of PI in C. albicans treated with antimicrobial peptides were significantly higher than those in the control group, indicating that the antimicrobial peptides of strain Y6 had a certain damage effect on the integrity of the membrane of C. albicans. Conclusion Bacillus velezensis Y6 produces peptide antifungal substances, which can damage the cell membrane of C.albicans, resulting in obvious antimicrobial activity.

In vitro antifungal susceptibility profiles of Cryptococcus neoformans and Cryptococcus gattii clinical isolates of in Guangxi, Southern China

ZHENG Dongyan, CAO Cunwei, LI Xiuying, ZHENG Yanqing, PAN Kaisu, LIAO Wangqing

2022, 17(3):  188-194. 

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Objective To analyze the clinical characteristics, pathogenic strain identification and in vitro antifungal susceptibility of Cryptococcus neoformans and Cryptococcus gattii in Guangxi. Methods One hundred and three Cryptococcus strains were isolated from 86 patients with confirmed cryptococcosis (14 were HIV-positive and 72 were HIV-negative) and their clinical characteristics were analyzed. 92 strains were identified as Cryptococcus neoformans grubii variant and 11 strains were identified as Cryptococcus gattii using MALDI-TOF MS and ITS region sequencing molecular identification methods. The strains were tested for in vitro antifungal susceptibility to the commonly used antifungal drugs including fluconazole, amphotericin B, 5-fluorocytosine, itraconazole, voriconazole, posaconazole, and esaconazole referring to the CLSI M27-A4 method. Results There were 59 males and 27 females aged 21-84 years in 86 patients, 55 of them had no underlying disease. Referring to the interpretation criteria in CLSI and EUCAST, all strains were sensitive to most antifungal drugs. The minimum inhibitory concentrations of antifungal drugs against Cryptococcus neoformans var. grubii ranged from 0.05-4 μg/mL for fluconazole, 0.25-1 μg/mL for amphotericin B; 0.0625-2 μg/mL for 5-fluorocytosine, 0.0625-0.25 μg/mL for itraconazole, 0.0078-0.25 μg/mL for voriconazole, 0.0313-0.5 μg/mL for posaconazole, and 0.0020-0.125 μg/mL for estaconazole. The minimum inhibitory concentrations of antifungal drugs against Cryptococcus gattii ranged from 1-16 μg/mL for fluconazole, 0.125-1 μg/mL for 5-fluorocytosine, 0.25-1 μg/mL for amphotericin B, 0.0625-0.25 μg/mL for itraconazole, 0.0156-0.125μg/mL for voriconazole, 0.0156-0.25 μg/mL for posaconazole,and 0.0078-0.125 μg/mL for esaconazole. Conclusion MALDI-TOF MS is a rapid and reliable method for the identification of Cryptococcus. Cryptococci isolated in Guangxi are sensitive to clinical antifungal drugs, and the antifungal sensitivity test helps to detect drug-resistant strains at an early stage, which is important for the effective treatment of cryptococcosis.

Report of 24 cases of kerion in children

WANG Jing, YIN Ruirui, ZHANG Furong, CHEN Ping, YANG Guoling

2022, 17(3):  195-199. 

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Objective To analyze the clinical characteristics of 24 kerion children cases. Methods The basic information, clinical manifestations,infective pathway,therapies and following-up of patients were retrospectively analyzed. Results All the cases can be divided into two types:single abscess type for 19 cases and multiple folliculitis type for 5 cases. Keeping pets (mainly cats,dogs and rabbits) in 16 cases, tinea pedis of families in 7 cases, a traumatic history in one case were been found. All cases were cured by oral terbinafine and low-dose glucocorticosteroid、antimycotic drugs within 6-8 weeks without adverse reactions. But five cases remained permanent atrophic scar. Conclusion Fungal fluorescence staining can improve the positive diagnostic rate of kerion. Terbinafine is safe and effective, easy to use, and can be used as the first-line drug for children's kerion.

Drug use evaluation of caspofungin based on weighted TOPSIS method

HUANG Lei, ZHANG Yaming, YIN Cunlin, MIAO Yang, QI Wang, WANG Aming

2022, 17(3):  200-204,230. 

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Objective Establish the detailed rules for the evaluation of rational drug use of caspofungin to promote the rational use in clinical practice. Methods A retrospective study was conducted to screen and archive the medical records of caspofungin in the First People's Hospital of Yancheng from 2021.1-2021.12, and the weighted approximation ideal solution ranking method was used for review. Results A total of 93 qualified cases were screened, including 23 reasonable cases (Ci≥0.8), accounting for 24.73%; 51 basically reasonable cases (0.8>Ci ≥ 0.6), accounting for 54.84%; 19 unreasonable cases (Ci<0.6), accounting for 20.43%. Conclusion The evaluation of the use of caspofungin by weighted approximation is feasible. The evaluation results show that there are still problems in the use of caspofungin in this hospital, and the rectification should be strengthened.

Risk factors for superficial mycoses in military academy cadets

TANG Renjie, WANG Ruina, WANG Xu, WANG Yang, LI Zhiyong, LIU Jiacun, WU Lin, ZHANG Dazhi, YAN Lan

2022, 17(3):  205-212. 

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Objectives To explore the influencing factors of superficial mycoses in cadets of a military academy. Methods Cadets were screened with a physical and microscopic examination. A questionnaire survey was carried out during the examination. The cadets who were suffering from or had a history of superficial fungal infections completed the questionnaire on site. Chi-square tests and binary logistic regression were used to analyze the risk factors of superficial mycoses. Results A total of 1733 valid questionnaires were retrieved. The overall prevalence of superficial mycoses was 10.73%(n=186) in cadets after enrolment. Tinea pedis accounted for the highest proportion (79.03%). Univariate analyses showed that the prevalence of superficial mycoses was correlated with age, the length of military service, family history of fungal diseases, whether suffering from superficial mycoses before enrolment. There were significant differences in the prevalence of superficial mycoses varied with the lifestyle factors, which were whether exchanging beddings with others, the habit of washing hands before and after meals, the frequency of changing socks, and the quality of sleep. The incidence of superficial mycoses was also correlated with the military training factors, which were whether having any other physical injuries due to training before the skin illness, whether excessive sweating frequently, the number of training shoes, and the amount of sweating during exercise. A multivariate analysis demonstrated that the length of military service, family history of fungal diseases, whether suffering from the superficial mycoses before enrolment and whether excessive sweating frequently were risk factors of superficial mycoses. Nevertheless, the frequency of changing socks and the quality of sleep were found to be protective against superficial fungal infections. A binary logistic regression model was established to predict the probability of superficial mycoses in cadets. Conclusions The incidence of superficial fungal infections was high in military cadets. It is of great significance to understand the influencing factors for popularizing knowledge of disease prevention and formulating scientific and effective treatment measures.

The effects of microevolution on Trichosporon assahii infection

PENG Zhuoying, LIAO Yong, BA Gen, YANG Xin, ZHANG Qianyu, YANG Rongya

2022, 17(3):  213-219. 

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Objective To study the effects of microevolution on T. asahii infecting host and the immune response of the body. Methods Use the evolutional strain (TEVO) and original strain (TO) to infect the Balb/c mice, and comparing the differences of fungal relative load and MPO in the tissues、β-glucan in the serum and T cell differentiation in spleens. Results TEVO stains were almost spores, and TO stains were mycelia in morphology. The fungal relative load, MPO and β-glucan concentration of the TEVO group were significantly lower than those of the TO group. The CD4⁺T cells and CD8⁺T cells in the spleens of the TEVO group were more than that in the TO group. Conclusion The ability of the evolutional strain infecting host and the host defense to the evolutional strain in the early stage of infection were all lower than those of original strain, which may be closely related to the phenotype change of the evolutional strain.

Subcutaneous phaeohyphomycosis caused by Microsphaeropsis arundinis：a case report and review of the literatures

YANG Hong, GAO Zhiqin, LIU Siyu, TAN Jingwen, XU Hong, CHEN Jian, YANG Lianjuan

2022, 17(3):  220-224. 

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A 80-year-old male farmer presented with invasive erythema on the right forearm for more than 1 year. He had 10-year history of Diabetes Mellitus. Dermatological examination revealed diffuse, invasive erythema on the right forearm, with warty hyperplasia, covered with black scab, skin damage area 5 cm×10 cm. Direct microscopic examination of the scurf and lesional tissue both showed branched hyphae.Culture showed grew dark gray, velvety colonies with grey-white edge on SDA. Microscopic morphology showed septate, irregularly shaped hyphae with oval, ellipsoidal conidia. Histopathological examination of the lesional tissue revealed Periodic-acid-Schiff (PAS)-positive spore-1ike structures. Sequencing analysis of the internal transcribed spacer (ITS) region revealed 100% consistence between the clinical isolate and reference strain of Microsphaeropsis arundinis. The patient was diagnosed with subcutaneous phaeohyphomycosis caused by M.arundinis. The patient was given itraconazole 400 mg daily orally. Five months later, the skin 1esions was noted to be improved. The patient was still under treatment and observation. The clinical characteristics of phaeohyphomycosis induced by M. arundinis were discussed by reviewing the literatures on infection caused by M. arundinis from 2000 to 2021.

A case of cutaneous chromoblastomycosis caused by Fonsecaea monophora

LIU Ruizhen, CHEN Jing, XU Ming, LU Wanding

2022, 17(3):  225-226. 

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A 63-year-old male presented with a nodule on the left wrist for half a month. Physical examination showed hyperkeratotic plaques and nodule on the left wrist. Histopathological examination revealed a number of brown and roundish thick-walled sclerotic bodies in dermis and multinucleated giant cells. PAS staining was positive. Fungus culture test observed dark-brown to dark fungi which was confirmed as Fonsecaea monophora by sequencing. The patient was treated with oral itraconazole, but finally died of complications of silicosis.

Effect of terbinafine hydrochloride cream combined with 3% boric acid alcohol ear drops on fungal otitis externa

DU Yucong, LIU Huanhai

2022, 17(3):  227-230. 

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Objective To explore the clinical efficacy of THC combined with 3% baa ear drops in the treatment of mycosis. Methods A total of 144 patients with external auditory canal mycosis treated in our hospital were enrolled. The patients were randomly divided into group A and group B. Group A was treated with 3% BAA and THC, and group B was treated with BAA alone. The therapeutic effects and fungal culture results of the two groups were compared and analyzed. Results The cure rate and clinical efficacy score of group A were significantly higher than those of group B (P<0.05); The improvement of pruritus, otorrhea and tinnitus in group A was more obvious than that in group B (P<0.05); Aspergillus and Candida accounted for 57.7% and 22.5% in the positive fungal culture, and they were highly sensitive to terbinafine. Conclusion THC combined with 3% baa ear drops is an effective method for the treatment of fungal otitis externa.