Mycopathologia et mycologia applicata

Otomycosis is common throughout the world but barely studied in Spain. Our objective was to determine the microbiological and epidemiological characteristics of this pathology in Cadiz (Spain) between 2005 and 2010. Samples from patients with suspicion of otomycosis underwent a direct microscopic examination and culture on different media for fungi and bacteria. Mycological cultures were incubated at 30°C for at least seven days. Identification of fungi was based on colonial morphology and microscopic examination of fungal structure. From a total of 2,633 samples, microbial growth was present in 1,375 (52.2%) and fungal isolation in 390 (28.4%). We identified 228 yeasts and 184 filamentous fungi (13.4% of positive cultures and 47.2% of otomycosis), associated with yeasts in 22 cases (5.6%). The most frequent species were Aspergillus flavus (42.4%), A. niger (35.9%), A. fumigatus (12.5%), A. candidus (7.1%), A. terreus (1.6%), and Paecilomyces variotii (0.5%). Infection was predominant in men (54.9%) and patients beyond 55 years old (46.8%). The most common clinical symptoms were itching (98.9%), otalgia (59.3%), and hypoacusis (56.0%). Fall season reported the lowest number of cases (20.1%). Incidence of otomycosis and fungi producing otomycosis vary within the distinct geographical areas. In Cadiz, this infection is endemic due to warm temperatures, high humidity, sea bathing, and wind, which contributes to disseminate the conidia. Despite Aspergillus niger has been reported as the main causative agent, A. flavus is predominant in Cadiz. Although infection is usually detected in warm months, we observed a homogeneous occurrence of otomycosis in almost all the seasons.

Invasive fungal infections are a major cause of morbidity and mortality among renal transplant recipients. The aim of this study was to investigate the frequency and risk factors for fungal infections in renal transplant recipients. We retrospectively evaluated all kidney transplant recipients at our center from December 1988 to June 2010 for the epidemiology, spectrum, risk factors, and mortality of invasive fungal infections. In 32 patients (10.30 %), at least one fungal infection developed after the transplantation. The most common pathogens causing fungal infections in our patients were Candida spp. and Aspergillus spp. The independent risk factors associated with invasive fungal infection episodes were antibiotic treatment within the last 3 months (OR 15.88, 95 % CI 3.90–64.73, p < 0.001), cytomegalovirus infection (OR 18.54, 95 % CI 9.01–38.17, p < 0.001), and the presence of diabetes mellitus (OR 6.01, 95 % CI 2.95–12.25, p < 0.001). Mortality was significantly higher among patients with fungal infections than among other patients (53.10 and 17.80 %, respectively; p < 0.001). It is difficult to diagnose and treat fungal infections early, and it can be useful to determine independent risk factors in order to identify and treat high-risk patients.

An inhibitor of Aspergillus flavus has been isolated from peanuts and identified as 5,7-dimethoxyisoflavone. Authentic 5,7-dimethoxyisoflavone, synthesized from benzyl-2-hydroxy-4,6 dimethoxyphenyl (3), and the isolated compound display identical ultraviolet spectra in methanol, in methanol+sodium methoxide, and in methanol+AlCl3; similar behavior in solvent extraction, column chromatography, TLC, and fungal inhibition.

Scanning electron microscopy of oogonia of Phytophthora spp. showed that the oogonial wall was smooth in P. cactorum, P. citricola, P. heveae, and P. palmivora; finely granular in P. megasperma and P. megasperma var. sojae; and coarsely granular in P. parasitica. Transmission electron microscopy demonstrated that the oogonial wall in Phytophthora was composed of three layers with the middle layer being the least or the most electron dense. A coat of amorphous material was found on the entire outer surface of the oogonial wall. Elemental analysis of oogonia by means of a SEM electron probe microanalyzer revealed similar emission spectra among Phytophthora spp. with a characteristic peak for calcium.

We developed a single-tube real-time polymerase chain reaction (PCR) assay with multiple hybridization probes for detecting Candida albicans, C. tropicalis, C. glabrata, and C. parapsilosis. Primers were designed to amplify 18S rRNA gene of the genus Candida, and DNA probes were designed to hybridize two areas of the amplicons. The amplification curves and specific melting peaks of the probes hybridized with PCR product were used for definite species identifications. The reaction specificity was 100 % when evaluating the assay using DNA samples from 21 isolates of fungal and bacterial species. The assay was further evaluated in 129 fungal blood culture broth samples which were culture positive for fungus. Of the 129 samples, 119 were positively identified as: C. albicans (39), C. tropicalis (30), C. parapsilosis (23), C. glabrata (20), Candida spp. (5), and two samples containing mixed C. glabrata/C. albicans and C. glabrata/C. tropicalis. The five Candida spp. were identified by sequencing analysis as C. krusei, C. dubliniensis, C. aquaetextoris, and two isolates of C. athensensis. Of the ten samples which showed negative PCR results, six were Cryptococcus neoformans, and the others were Trichosporon sp., Rhodotorula sp., Fusarium sp., and Penicillium marneffei. Our findings show that the assay was highly effective in identifying the four medically important Candida species. The results can be available within 3 h after positivity of a blood culture broth sample.

Results of a preliminary study of the degree of susceptibility of two inbred mouse strains (C 57 B1/6 and DBA2) and the F1 progeny (BDF1) of these lines are reported. The possible significance of our findings are discussed in respect to the published accounts of the influence of the age, physiological response mechanisms, and immunological defense mechanisms of the suscept host and the age and strain of the fungus and the size of the inoculum. The possibility of theTrichophyton mentagrophytes carriers being animals that had the disease several times in the past, resulting in immunity or a high degree of resistance, is suggested. The results of this study have indicated several technical refinements which will be incorporated into subsequent experiments.

Aerobiological studies to evaluate allergenic fungal spores in the atmosphere of Riyadh were conducted. Burkard personal volumetric sampler were operated as volumetric ‘viable’ spore traps at two different sites (Al-Batha, a more developed area in the south and Al-Ulia, a less developed area in the north) in Riyadh. Twice a week samplings were carried out over a period of 12 month. The seasonal fluctuations of the most frequent fungi were plotted as ‘major’ components. The dominant species at the two sites were members of the genera Alternaria, Aspergillus, Cladosporium, Penicillium and Ulocladium. Drechslera, Fusarium, Rhizopus and Stachybotrytis species were minor components or sporadic. Seasonal variations of the total colonies were significantly (p < 0.05) different. They showed higher concentrations in the winter season and the lowest in summer. The Al-Batha site was always higher in spore concentrations than the Al-Ulia site. The results provide valuable information for the diagnosis and prophylaxis of allergic diseases due to airborne fungi.

The efficacy of the combination of anidulafungin (AFG) at 1 mg/kg plus voriconazole (VRC) at 25 mg/kg was evaluated in a murine model of disseminated infection by Aspergillus flavus using three isolates previously tested in vitro. All the combinations showed indifferent in vitro interaction with the exception of one, which showed synergy. In general, the combined treatment prolonged the survival and reduced the fungal load in comparison with AFG alone, and only in a few cases, it improved the results of the VRC monotherapy. The combination of the two drugs and VRC alone reduced the galactomannan levels in serum in comparison with the control group.