Pneumonia Caused by Lichtheimia Ramosa During the COVID-19 Pandemic in Hubei Province, China：A Case Report and Literature Review

BackgroundMucor infection cannot be ignored in patients with pulmonary shadowing with cavitation .This paper reports a case of mucormycosis during the COVID-19 pandemic in Hubei Province, China. Case PresentationA anesthesiology doctor was initially diagnosed as COVID-19 due to changes in lung imaging. Later Lichtheimia ramose was found by Metagenomic next generation sequencing (mNGS) in the Bronchoalveolar lavage fluid (BALF).After adjusting amphotericin B for anti-infective treatment, the patient's infection lesions were shranked and the symptoms were significantly relieved. ConclusionThe diagnosis of invasive fungal infections is very difficult, mNGS can make an accurate pathogenic diagnosis of invasive fungal diseases for the clinic and provide a basis for clinical treatment.

Pneumonia caused by Lichtheimia ramosa during the COVID-19 pandemic in Hubei Province, China：mNGS assists diagnosis

BackgroundRecently, COVID-19 is still pandemic in worldwide. India has reported multiple cases of COVID-19 combined with mucormycosis(MM)(1). This paper reports a case during the COVID-19 pandemic in Hubei Province, China. Case PresentationA anesthesiology doctor was initially diagnosed as COVID-19 due to changes in lung imaging. Later Lichtheimia ramose was found by Metagenomic next generation sequencing (mNGS) in the Bronchoalveolar lavage fluid (BALF).After adjusting amphotericin B for anti-infective treatment, the patient's infection lesions were shranked and the symptoms were significantly relieved.ConclusionThe diagnosis of invasive fungal infections is very difficult, mNGS can make an accurate pathogenic diagnosis of invasive fungal diseases for the clinic and provide a basis for clinical treatment.

β-Galactosidase-Producing Isolates in Mucoromycota: Screening, Enzyme Production, and Applications for Functional Oligosaccharide Synthesis

β-Galactosidases of Mucoromycota are rarely studied, although this group of filamentous fungi is an excellent source of many industrial enzymes. In this study, 99 isolates from the genera Lichtheimia, Mortierella, Mucor, Rhizomucor, Rhizopus and Umbelopsis, were screened for their β-galactosidase activity using a chromogenic agar approach. Ten isolates from the best producers were selected, and the activity was further investigated in submerged (SmF) and solid-state (SSF) fermentation systems containing lactose and/or wheat bran substrates as enzyme production inducers. Wheat bran proved to be efficient for the enzyme production under both SmF and SSF conditions, giving maximum specific activity yields from 32 to 12,064 U/mg protein and from 783 to 22,720 U/mg protein, respectively. Oligosaccharide synthesis tests revealed the suitability of crude β-galactosidases from Lichtheimia ramosa Szeged Microbiological Collection (SZMC) 11360 and Rhizomucor pusillus SZMC 11025 to catalyze transgalactosylation reactions. In addition, the crude enzyme extracts had transfructosylation activity, resulting in the formation of fructo-oligosaccharide molecules in a sucrose-containing environment. The maximal oligosaccharide concentration varied between 0.0158 and 2.236 g/L depending on the crude enzyme and the initial material. Some oligosaccharide-enriched mixtures supported the growth of probiotics, indicating the potential of the studied enzyme extracts in future prebiotic synthesis processes.

Systemic mucormycosis caused by Lichtheimia ramosa in a pregnant cow

Mucormycosis is a life-threatening fungal disease caused by opportunistic pathogens present in the environment. This report presents a case of a Lichtheimia ramosa infection that manifested as characteristic lesions in various visceral organs of a pregnant cow in Korea. The post-mortem examination revealed the cause of death to be mucormycosis. The fungi isolated from the liver were found to be Lichtheimia spp. Analysis of the fungi using Internal Transcribed Spacer gene sequencing facilitated the identification of Lichtheimia ramosa. To the best of our knowledge, this is the first clinical case of angioinvasive mucormycosis in cattle.

In Vitro Activity of Manogepix (APX001A) and Comparators against Contemporary Molds: MEC Comparison and Preliminary Experience with Colorimetric MIC Determination

ABSTRACT Manogepix (APX001A) is the active moiety of the drug candidate fosmanogepix (APX001), currently in clinical development for the treatment of invasive fungal infections. We compared manogepix EUCAST minimum effective concentrations (MECs) to MICs of five comparators and CLSI MECs and MICs by a colorimetric method against contemporary molds. EUCAST susceptibility testing was performed for 161 isolates. Interlaboratory and intermethod reproducibility were determined by comparison with published manogepix MECs. Colorimetric MICs (measuring metabolic activity) were evaluated using three Aspergillus fumigatus isolates and one Aspergillus flavus isolate with four inocula at 24 to 48 h of incubation and 1 to 3 h 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide salt (XTT)/menadione (MEN) exposure. Manogepix modal MECs (range in mg/liter) against Aspergillus species were 0.03 to 0.06 (0.008 to 0.125) and unaffected by itraconazole resistance. Manogepix was as active against two Fusarium isolates but inactive against Trichophyton interdigitale, Lichtheimia ramosa, and Rhizomucor pusillus isolates (MECs >0.5). Modal MEC/MICs were ≥3 2-fold dilutions apart without overlapping ranges comparing manogepix with amphotericin B, isavuconazole, and voriconazole against Aspergillus isolates. Manogepix and posaconazole MECs/MICs correlated for Aspergillus niger (Pearson’s r = 0.711; P = 0.0044). The MEC at which 50% of the isolates tested are inhibited (MEC50), mode, and MEC90 values were within ±1 dilution in all cases compared with published EUCAST and CLSI data. The colorimetric method showed excellent agreement with the MECs when plates were inoculated with the lowest inoculum (1 × 102 CFU/ml to 2.5 × 102 CFU/ml), incubated for 24 h, and exposed for 1 to 3 h to XTT/MEN. Broad-spectrum in vitro activity of manogepix against clinically relevant molds was confirmed with excellent agreement across EUCAST and CLSI methods reported from experienced mycology laboratories. Colorimetric MIC determination warrants further investigation as a potential alternative that is less dependent on mycology expertise.