Fungal infection after endothelial keratoplasty: association with hypothermic corneal storage

2018 ◽  
Vol 103 (10) ◽  
pp. 1487-1490 ◽  
Author(s):  
Nicola Lau ◽  
Aida Hajjar Sesé ◽  
Victor A Augustin ◽  
Geert Kuit ◽  
Mark R Wilkins ◽  
...  
Keyword(s):  
Organ Culture ◽  
Fungal Infection ◽  
Fungal Infections ◽  
Case Definition ◽  
Endothelial Keratoplasty ◽  
Donor Tissue ◽  
Purpureocillium Lilacinum ◽  
Eye Banks ◽  
The Usa ◽  
Host Cornea

PurposeTo compare the incidence of fungal infection after endothelial keratoplasty (EK) when donor tissue had been stored in hypothermic medium or organ culture.MethodsWe describe the clinical features of 10 cases of fungal infection (keratitis or endophthalmitis) following EK identified at three European centres. Case definition was the culture of fungus or a positive PCR from the host cornea or anterior chamber after EK. A survey of the incidence of infection after EK was conducted by the European Eye Bank Association. The main outcome measure was the number of cases in which donor tissue had been stored in hypothermic medium compared with organ culture.ResultsThe 10 cases occurred between 2014 and 2017. All donor corneas had been stored in hypothermic medium sourced from three US eye banks. Three pairs of mate corneas caused infections in six recipients. Candida spp were identified from nine cases, with one isolate of Purpureocillium lilacinum. Data on 16 862 corneas supplied for EK were available from 16 European eye banks for the 5-year period from 2012. There were 17 reported cases of infection, of which 15 (88%) were fungal infections and 14 (82%) were Candida spp. Fungal infection was reported from 3 of 14 476 (0.02%) corneas supplied in organ culture compared with 12 of 2386 (0.50%) corneas supplied in hypothermic medium (p<0.0001). The incidence of infection after hypothermic storage was similar for material sourced from Europe (0.52%) or the USA (0.61%).ConclusionsInfection after EK is strongly associated with Candida spp. The possible explanations for the higher incidence of infection when tissue is stored in hypothermic medium are discussed.

Fungal infection after keratoplasty and the role of antifungal supplementation to storage solution: a review

2019 ◽  
Vol 104 (8) ◽  
pp. 1036-1036 ◽  
Author(s):  
Tarika Thareja ◽  
Regis Kowalski ◽  
Roheena Kamyar ◽  
Deepinder Dhaliwal ◽  
Bennie H Jeng ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Corneal Transplantation ◽  
Eye Banking ◽  
Eye Banks ◽  
Corneal Toxicity ◽  
Randomised Control Trials ◽  
Corneal Storage ◽  
Storage Solution

Fungal infection after corneal transplantation is a rare, yet potentially devastating, postoperative complication and has become a growing concern for the transplant surgeon and eye banking community. The Eye Bank Association of America (EBAA) has reported an increasing trend in the rate of postkeratoplasty fungal infections and a reversal in the previously documented predominance of bacterial over fungal infections. Additionally, several studies have confirmed a high correlation between positive corneoscleral donor rim fungal cultures and postoperative infections. Optisol GS (Bausch & Lomb, Irvine, California, USA), the most extensively used corneal storage solution in US eye banks, does not currently contain any antifungal supplementation. Although large randomised control trials evaluating the efficacy and safety of routine antifungal supplementation to corneal storage solution are lacking, several investigative studies have assessed the role of antifungal agents in reducing fungal contamination of donor corneas without causing undue corneal toxicity. This review will present the current epidemiology of postkeratoplasty fungal infections and evidence for obtaining routine fungal rim cultures and antifungal supplementation of storage solution.

scholarly journals The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea

2021 ◽  
Vol 7 (8) ◽  
pp. 639
Author(s):  
Yae-Jee Baek ◽  
Yun-Suk Cho ◽  
Moo-Hyun Kim ◽  
Jong-Hoon Hyun ◽  
Yu-Jin Sohn ◽  
...  
Keyword(s):  
Cohort Study ◽  
South Korea ◽  
Fungal Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lung Transplant ◽  
Fungal Infections ◽  
Transplant Recipients ◽  
Tertiary Center ◽  
Lung Transplant Recipients

(1) Background: Lung transplant recipients (LTRs) are at substantial risk of invasive fungal disease (IFD), although no consensus has been reached on the use of antifungal agents (AFAs) after lung transplantation (LTx). This study aimed to assess the risk factors and prognosis of fungal infection after LTx in a single tertiary center in South Korea. (2) Methods: The study population included all patients who underwent LTx between January 2012 and July 2019 at a tertiary hospital. It was a retrospective cohort study. Culture, bronchoscopy, and laboratory findings were reviewed during episodes of infection. (3) Results: Fungus-positive respiratory samples were predominant in the first 90 days and the overall cumulative incidence of Candida spp. was approximately three times higher than that of Aspergillus spp. In the setting of itraconazole administration for 6 months post-LTx, C. glabrata accounted for 36.5% of all Candida-positive respiratory samples. Underlying connective tissue disease-associated interstitial lung disease, use of AFAs before LTx, a longer length of hospital stay after LTx, and old age were associated with developing a fungal infection after LTx. IFD and fungal infection treatment failure significantly increased overall mortality. Host factors, antifungal drug resistance, and misdiagnosis of non-Aspergillus molds could attribute to the breakthrough fungal infections. (4) Conclusions: Careful bronchoscopy, prompt fungus culture, and appropriate use of antifungal therapies are recommended during the first year after LTx.

scholarly journals Estimated Burden of Fungal Infections in Oman

2020 ◽  
Vol 7 (1) ◽  
pp. 5
Author(s):  
Abdullah M. S. Al-Hatmi ◽  
Mohammed A. Al-Shuhoumi ◽  
David W. Denning
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Epidemiological Studies ◽  
Vaginal Candidiasis ◽  
Skin Infections ◽  
Opportunistic Pathogens ◽  
Fungal Rhinosinusitis ◽  
Populations At Risk ◽  
Different Populations ◽  
Underlying Pathology

For many years, fungi have emerged as significant and frequent opportunistic pathogens and nosocomial infections in many different populations at risk. Fungal infections include disease that varies from superficial to disseminated infections which are often fatal. No fungal disease is reportable in Oman. Many cases are admitted with underlying pathology, and fungal infection is often not documented. The burden of fungal infections in Oman is still unknown. Using disease frequencies from heterogeneous and robust data sources, we provide an estimation of the incidence and prevalence of Oman’s fungal diseases. An estimated 79,520 people in Oman are affected by a serious fungal infection each year, 1.7% of the population, not including fungal skin infections, chronic fungal rhinosinusitis or otitis externa. These figures are dominated by vaginal candidiasis, followed by allergic respiratory disease (fungal asthma). An estimated 244 patients develop invasive aspergillosis and at least 230 candidemia annually (5.4 and 5.0 per 100,000). Only culture and microscopy are currently available for diagnosis, so case detection is suboptimal. Uncertainty surrounds these figures that trigger the need for urgent local epidemiological studies with more sensitive diagnostics.

scholarly journals Rapidly dissolving microneedle patch of amphotericin B for intracorneal fungal infections

2021 ◽  
Author(s):  
Alyaa A. Albadr ◽  
Ismaiel A. Tekko ◽  
Lalitkumar K. Vora ◽  
Ahlam A. Ali ◽  
Garry Laverty ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Fungal Growth ◽  
Significant Inhibition ◽  
Corneal Tissue ◽  
Biodegradable Poly ◽  
Invasive Method ◽  
Poorly Soluble ◽  
Microneedle Patch

AbstractChronic fungal infection of the cornea could lead to blindness if not treated properly. Topical amphotericin B (AMP-B) is considered the first treatment of choice for ocular fungal infection. However, factors related to its poor solubility and penetration through intact cornea lead to poor bioavailability. Microneedles (MNs) are emerging as a minimally invasive method to enhance ocular drug delivery. This study aims to investigate the potential use of biodegradable poly(vinylpyrrolidone) (PVP) and hyaluronic acid (HA)–based rapidly dissolving MNs for delivery of AMP-B to treat fungal infection. The data obtained illustrates PVP/HA MN arrays’ reproducibility, good mechanical strength, and faster dissolution with 100% drug recovery. Multiphoton microscopic results revealed that MNs successfully penetrate the corneal tissue and enhance AMP-B permeation through corneal layers. Furthermore, PVP/HA MN arrays showed high solubility. Both PVP and HA successfully decreased AMP-B cytotoxicity when compared to free drug. More interestingly, the biocompatible MN formulations preserved the antifungal activity of AMP-B, as demonstrated by significant inhibition of fungal growth. Therefore, this study shows the feasibility of ocular delivery of the poorly soluble AMP-B using a fast-dissolving MN patch. Graphical abstract

Endothelial Keratoplasty Using Donor Tissue Not Suitable for Full-Thickness Penetrating Keratoplasty

Cornea ◽  
2007 ◽  
Vol 26 (5) ◽  
pp. 515-519 ◽  
Author(s):  
Rebecca L Armour ◽  
Paula J Ousley ◽  
Jennifer Wall ◽  
Karen Hoar ◽  
Chris Stoeger ◽  
...  
Keyword(s):  
Penetrating Keratoplasty ◽  
Endothelial Keratoplasty ◽  
Full Thickness ◽  
Donor Tissue

scholarly journals Effect of Prophylactic Antifungal Protocols on the Prognosis of Liver Transplantation: A Propensity Score Matching and Multistate Model Approach

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Yi-Chan Chen ◽  
Ting-Shuo Huang ◽  
Yu-Chao Wang ◽  
Chih-Hsien Cheng ◽  
Chen-Fang Lee ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Propensity Score ◽  
Fungal Infection ◽  
Propensity Score Matching ◽  
Fungal Infections ◽  
Transition Probability ◽  
Antifungal Prophylaxis ◽  
Chang Gung Memorial Hospital ◽  
Multistate Model ◽  
End Stage

Background. Whether routine antifungal prophylaxis decreases posttransplantation fungal infections in patients receiving orthotopic liver transplantation (OLT) remains unclear. This study aimed to determine the effectiveness of antifungal prophylaxis for patients receiving OLT.Patients and Methods. This is a retrospective analysis of a database at Chang Gung Memorial Hospital. We have been administering routine antibiotic and prophylactic antifungal regimens to recipients with high model for end-stage liver disease scores (>20) since 2009. After propensity score matching, 402 patients were enrolled. We conducted a multistate model to analyze the cumulative hazards, probability of fungal infections, and risk factors.Results. The cumulative hazards and transition probability of “transplantation to fungal infection” were lower in the prophylaxis group. The incidence rate of fungal infection after OLT decreased from 18.9% to 11.4% (p=0.052); overall mortality improved from 40.8% to 23.4% (p<0.001). In the “transplantation to fungal infection” transition, prophylaxis was significantly associated with reduced hazards for fungal infection (hazard ratio: 0.57, 95% confidence interval: 0.34–0.96,p=0.033). Massive ascites, cadaver transplantation, and older age were significantly associated with higher risks for mortality.Conclusion. Prophylactic antifungal regimens in high-risk recipients might decrease the incidence of posttransplant fungal infections.

scholarly journals Endothelial keratoplasty with infant donor tissue

2014 ◽  
pp. 1827 ◽  
Author(s):  
Akira Kobayashi ◽  
Hideaki Yokogawa ◽  
Natsuko Yamazaki ◽  
Toshinori Masaki ◽  
Kazuhisa Sugiyama
Keyword(s):  
Endothelial Keratoplasty ◽  
Donor Tissue

scholarly journals Histopathological Pattern of Fungal Infections Seen in Usmanu Danfodiyo University Teaching Hospital Sokoto from 2014 To 2018

2020 ◽  
pp. 30-37
Author(s):  
M. O. Mohammed ◽  
M. Sirajo ◽  
O. O. Okechi ◽  
A. T. Muhammad ◽  
R. I. Tsamiya ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Fungal Infection ◽  
Teaching Hospital ◽  
Fungal Infections ◽  
University Teaching ◽  
Report Cards ◽  
Referral Centre ◽  
Subcutaneous Mycosis ◽  
Common Manifestation ◽  
Ethical Clearance

Introduction: Fungal infection is a common manifestation in this part of the country and worldwide. It is essential to define the epidemiology of fungal infection in a particular environment. Aim: This study aims to analyze the diagnosis of fungal infection carried out in patients attending the histopathology department (UDUTH) Sokoto from 2014 to 2018. Method: This study is a retrospective study of all fungal infection biopsies carried out from 2014 – 2019 in Usmanu Danfodiyo University Teaching Hospital, Sokoto, northwestern Nigeria, a referral centre for the neighbouring northern states Kebbi and Zamfara. Ethical clearance was obtained from the ethical committee of UDUTH, data was collected from histological report cards and analyze manually. Some tissue blocks of the case were retrieved to confirm the diagnosis. A total of 66 requests for fungal diagnosis were received from January 2014 to December 2018, which represent about 0.7% of the total biopsies received over the study period. Result: Out of the 66 of request for fungal diagnosis 32(48.5%) were fungal positive. Subcutaneous mycosis was the most frequent fungal infection with a frequency of 18(56.25%). Males were more frequently affected than females with the frequencies of 18(56.25%) and 14 (43.75%) respectively.

scholarly journals Autopsy dissection techniques and investigations in deaths due to COVID-19 triggered fungal infections - A diagnostic review

2021 ◽  
Vol 8 (4) ◽  
pp. 207-213
Author(s):  
Himanshi Narang ◽  
Amit Patil
Keyword(s):  
Fungal Infection ◽  
Paranasal Sinuses ◽  
Fungal Infections ◽  
Invasive Disease ◽  
Invasive Fungal Infections ◽  
Correct Interpretation ◽  
Research Papers ◽  
Dissection Techniques ◽  
Second Wave

The COVID-19 pandemic, which originated from Wuhan, China, has rapidly spread worldwide, including India. As India grappled with the second wave, COVID-triggered fungal infection has suddenly risen tremendously, raising a sense of panic in the country. The fungal infection in COVID-19 includes Mucormycosis and Aspergillosis, as common fungal infections primarily affecting rhino-orbital structures. Many research papers have published postmortem findings in autopsies conducted on COVID-19 decedents, thereby helping to understand this contagious disease's pathogenesis. But, with the arrival of COVID-triggered fungal infection, which is a crucial invasive disease responsible for fatality, very few research papers have commented on the postmortem findings of invasive fungal infections affecting the rhino-orbital and craniocerebral structures in COVID-19 deaths. Therefore, the role of invasive fungal infection due to COVID-19 illness must be established in the causation of deaths in COVID-19 patients. This review research deals with autopsy dissection techniques and possible postmortem findings of invasive fungal infections involving the nasal and paranasal sinuses and orbital structures in COVID-19 deaths. The findings of fungal infection affecting nasal and paranasal systems may not differ in live patients and in a deceased; however, it is essential that correct interpretation of the postmortem findings aided by pre-or post-autopsy investigations is necessary to establish the role of covid triggered fungal infection in such deaths.

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