scholarly journals Low sensitivity of conventional fungal agars in fungemia by Rhodotorula mucilaginosa: description of two cases

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Carmen Alicia Garcia-Gutiérrez ◽  
María Soledad Cuétara-García ◽  
María Dolores Moragues ◽  
Jorge Ligero ◽  
Sara María Quevedo ◽  
...  
Keyword(s):  
Culture Media ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Common Species ◽  
Diagnostic Tools ◽  
Rhodotorula Mucilaginosa ◽  
Alternative Culture ◽  
Panfungal Pcr ◽  
Low Sensitivity ◽  
Specific Symptoms

Abstract Background Although most bloodstream yeast infections are caused by Candida spp., infections by rare or less common species have increased in recent years. Diagnosis of infections caused by these species is difficult due to the lack of specific symptoms and adequate diagnostic tools. Cases presentation We describe two cases of fungemia by Rhodotorula mucilaginosa within a few months of each other, in a secondary Spanish hospital. In both cases, diagnosis was challenging. Blood subcultures in conventional fungal media were persistently negatives and the use of non-conventional fungal media was essential for isolating the yeasts and achieving a correct diagnosis. 1–3 beta-d-glucan detection and a panfungal PCR assay were helpful techniques to confirm the diagnosis Conclusion It is highly important to establish an early diagnosis for fungemia. The process is challenging because often non-specific symptoms are presents. When yeasts grow in blood cultures other genera than Candida spp. could be the cause of infection. Patient risk factors should be assessed to incorporate alternative culture media and the available rapid diagnostic test, in order to provide an early recognition of the pathogen.

scholarly journals Microbiological diagnostics of fungal infections

2013 ◽  
Vol 4 (1S) ◽  
pp. 33-37
Author(s):  
Corrado Girmenia
Keyword(s):  
Pediatric Patients ◽  
Culture Media ◽  
Fungal Infections ◽  
Correct Diagnosis ◽  
Empiric Therapy ◽  
Fungal Colonization ◽  
Laboratory Findings ◽  
Close Cooperation ◽  
Fungal Antigens ◽  
Low Sensitivity

Laboratory tests for the detection of fungal infections are easy to perform. The main obstacle to a correct diagnosis is the correlation between the laboratory findings and the clinical diagnosis. Among pediatric patients, the most common fungal pathogen is Candida. The detection of fungal colonization may be performed through the use of chromogenic culture media, which allows also the identification of Candida subspecies, from which pathogenicity depends. In neonatology, thistest often drives the decision to begin a empiric therapy; in this regard, a close cooperation between microbiologists and clinicians is highly recommended. Blood culture, if positive, is a strong confirmation of fungal infection; however, its low sensitivity results in a high percentage of false negatives, thus decreasing its reliability. Molecular diagnostics is still under evaluation, whereas the detection of some fungal antigens, such as β-D-glucan, galactomannan, mannoprotein, and cryptococcal antigen in the serum is used for adults, but still under evaluations for pediatric patients.

scholarly journals Fungal Taxa Responsible for Mucormycosis/“Black Fungus” among COVID-19 Patients in India

2021 ◽  
Vol 7 (8) ◽  
pp. 641
Author(s):  
Pradeep K. Divakar
Keyword(s):  
Culture Media ◽  
Correct Diagnosis ◽  
Fungal Spores ◽  
Genetic Material ◽  
Common Species ◽  
Rapid Identification ◽  
Antifungal Drugs ◽  
Rhizopus Microsporus ◽  
Germination And Growth

Mucormycosis is caused by fungi belonging to the order Mucorales. The term “Black Fungus” has been widely applied to human pathogenic Mucorales in India. They mainly infect the sinuses and brain, lungs, stomach and intestines, and skin. While this has been considered a rare disease, thousands of cases have been reported during the second wave of COVID-19 in India, between the months of April and June 2021. Hitherto, more than 45,374 cases and over 4300 deaths have been reported among COVID-19 patients across India from April 2021 to July 21, 2021. Though the mortality rate is estimated to be 50%, it could be above 90% if left untreated. In India, Rhizopus arrhizus has been related to be the most common species to cause human mucormycosis, followed by Apophysomyces variabilis, Rhizopus microsporus, and R. homothallicus. Accurate sample identification of human pathogenic Mucorales species is challenging especially due to the frequent lack of diagnostic morphological features. Traditionally, the culture-based approach has been extensively used to isolate and characterize human pathogenic Mucorales. However, this may not be an appropriate approach to objectively isolate and characterize all species, as the germination and growth of fungal spores are highly dependent on culture media and environmental conditions. Therefore, a robust approach to the accurate and rapid identification of human pathogenic Mucorales species is a prerequisite. The metagenomic approach comprehensively sequences and analyzes all genetic material in a complex biological sample and, consequently, this could be an appropriate approach to objectively characterize human pathogenic Mucorales taxa without the need for in vitro culture. The precise identification of the species will not only be useful for the correct diagnosis of this disease, but also for the development of antifungal drugs specific for each species. Accurate and rapid species identification is desperately needed to save lives in the mucormycosis outbreak among COVID-19 patients in India and neighboring countries.

scholarly journals Alternative Growth Behavior ofMycobacterium AviumSubspecies and Staphylococci with Implications for Clinical Microbiology and Blood Culture

2016 ◽  
Author(s):  
Peilin Zhang ◽  
Lawrence M. Minardi ◽  
J. Todd Kuenstner ◽  
Steve M. Zekan
Keyword(s):  
Blood Culture ◽  
Bacterial Growth ◽  
Culture Media ◽  
Hospital Setting ◽  
Culture Method ◽  
Growth Behavior ◽  
Molecular Diagnostic ◽  
Diagnostic Tools ◽  
Molecular Diagnostic Techniques ◽  
Alternative Culture

AbstractRapid culture ofMycobacteriumavium subspecies paratuberculosis (MAP) from patients remains a challenge. During the process of developing a rapid culture method for MAP, we found that there is an alternative growth behavior present in MAP, MAH (Mycobacterium aviumsubspecies hominissuis) and other bacteria such asStaphylococcus aureus, andStaphylococcus pseudintermedius. The bacterial DNA, RNA and proteins are present in the supernatants of the liquid culture media after routine microcentrifugation. When cultured in the solid media plate, there are a limited number of colonies developed for MAP and MAH disproportionate to the growth. We believe there is an alternative growth behavior for MAP, MAH and other bacteria similar to “phenoptosis”. Based on the alternative bacterial growth behavior, we tested 62 blood culture specimens that have been reported negative by routine automated blood culture method after 5 days of incubation. We used alternative culture media and molecular diagnostic techniques to test these negative culture bottles, and we found a large percentage of bacterial growth by alternative culture media (32%) and by molecular PCR amplification using 16s rDNA primer set and DNA sequencing (69%). The sensitivity of detection by the molecular PCR/sequencing method is significantly higher than by routine automated blood culture. Given the challenge of early diagnosis of sepsis in the hospital setting, it is necessary to develop more sensitive and faster diagnostic tools to guide clinical practice and improve the outcome of sepsis management.

scholarly journals Early recognition of PIMS-TS: a single centre retrospective review

2021 ◽  
Vol 5 (1) ◽  
pp. e001011
Author(s):  
Roshni Mistry ◽  
Nicola Scanlon ◽  
James Hibberd ◽  
Fionnghuala Fuller
Keyword(s):  
Early Recognition ◽  
Febrile Illness ◽  
Final Diagnosis ◽  
University Hospital ◽  
Single Centre ◽  
Retrospective Case ◽  
Reactive Protein ◽  
Review Reports ◽  
Specific Symptoms

IntroductionResearch into paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) has focused on tertiary level management. This review reports on symptoms and investigations at presentation.MethodsSingle centre retrospective case note analysis of patients fulfilling PIMS-TS diagnostic criteria from March to May 2020 in a London district level university hospital.ResultsSix patients presented in the week prior to their final diagnosis with fever and non-specific symptoms. Raised C-reactive protein (CRP), lymphopenia and hyponatraemia were noted. Kawasaki-like symptoms were under-represented in all patients.InterpretationThe results suggest that a proportion of children with early PIMS-TS present with a non-specific febrile illness and abnormal blood results. Further research is needed to determine the most appropriate identification and follow-up of these children.

scholarly journals Preparedness of pre-intern medical graduates of three universities in Sri Lanka to diagnose and manage anaphylaxis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Cross Sectional Study ◽  
Intravenous Route ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Medical Graduates ◽  
Self Confidence ◽  
Case Diagnosis

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.

scholarly journals Diagnosis and Treatment Algorythm in Lyme Neuroborreliosis

2016 ◽  
Vol 62 (1) ◽  
pp. 121-127
Author(s):  
Brîndușa Țilea ◽  
Rodica Bălașa ◽  
Andrea Fodor ◽  
Țilea Ioan
Keyword(s):  
Borrelia Burgdorferi ◽  
Bacterial Species ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Lyme Neuroborreliosis ◽  
Early Administration ◽  
Serological Tests ◽  
Initiation Of Therapy ◽  
Low Sensitivity ◽  
Third Generation Cephalosporins

AbstractLyme neuroborreliosis is an infection of the nervous system caused by spirochetes of the Borrelia burgdorferi sensulato group. Neurological clinical manifestations usually present a steady evolution and are different in patients from Europe compared to those from America, possibly due to vector agents and different bacterial species. Various diagnostic markers were studied in consideration of a clear or possible diagnosis of the disease, because evolution and complications depend on early diagnosis and initiation of therapy. The isolation of the bacterium is difficult, microscopic examination and the bacterial dezoxiribonucleic acid amplification shows low sensitivity. However, the diagnosis of Lyme neuroborreliosis is mainly based on serological methods that have a satisfactory sensitivity and specificity. A correct diagnosis can be performed by strictly respecting clinical guidelines and protocols and carefully interpreting the serological tests. The presence of anti-borrelia burgdorferi antibodies in the cerebrospinal fluid with evidence of intrathecal antibody production is the gold standard diagnosis of Lyme neuroborreliosis. Early administration of antibiotic treatment (third generation cephalosporins, cyclins, aminopenicillins) can produce the remission of neurological symptoms, the eradication of spirochetes in acute phase of the disease, thus avoiding the development of the chronic disease.

MEDICAL FILMS

PEDIATRICS ◽  
1962 ◽  
Vol 30 (6) ◽  
pp. 1018-1018
Keyword(s):  
Cystic Fibrosis ◽  
New York ◽  
New York City ◽  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Tools ◽  
Single Test ◽  
Presenting Symptoms ◽  
The Many ◽  
Therapy And Diagnosis

Cystic Fibrosis—NCFRF. 16 mm., color, sound, showing time 32 minutes. Produced in 1961 by Samuel L. Schulman for the National Cystic Fibrosis Research Foundation, medical supervision by Giulio J. Barbero, M.D. Philadelphia. Procurable on purchase from National Cystic Fibrosis Research Foundation, 521 Fifth Avenue, New York City 17. Procurable on loan from American Medical Association, Motion Picture Library, 535 N. Dearborn Street, Chicago 10. This film has been prepared to aid physicians in making a correct diagnosis and to instruct them in the techniques currently being used to prolong life in cases of cystic fibrosis. Following the introductoy remarks there is a good discussion of the presenting symptoms, the differential diagnosis, the multiple system involvement, hereditary aspects, therapy, and prognosis. The film brings out well the panexocrine involvement, the clinical variability, and the fact that the disease is not an all or none phenomenon but rather a disease of all grades of severity and is a disease in which no single test is applicable to the exclusion of others. The diagrams and patient demonstrations are good. Perhaps too much review of older methods of therapy and diagnosis is given, but this serves as a background for the newer recommended procedures. More emphasis could have been given to the tremendous burden, both financial and emotional, this disease is on parents. This is an excellent instructive film and it emphasizes the many problems of cystic fibrosis as related to the diagnostic tools available and to forms of therapy. The photography and sound are satisfactory. It is recommended for pediatricians, general practitioners, house staff, and medical students.

scholarly journals Application of Volatilome Analysis to the Diagnosis of Mycobacteria Infection in Livestock

2021 ◽  
Vol 8 ◽  
Author(s):  
Pablo Rodríguez-Hernández ◽  
Vicente Rodríguez-Estévez ◽  
Lourdes Arce ◽  
Jaime Gómez-Laguna
Keyword(s):  
Analytical Techniques ◽  
Diagnostic Techniques ◽  
Diagnostic Tools ◽  
Future Research ◽  
Control Programs ◽  
Targeted Analysis ◽  
Low Sensitivity ◽  
And Control

Volatile organic compounds (VOCs) are small molecular mass metabolites which compose the volatilome, whose analysis has been widely employed in different areas. This innovative approach has emerged in research as a diagnostic alternative to different diseases in human and veterinary medicine, which still present constraints regarding analytical and diagnostic sensitivity. Such is the case of the infection by mycobacteria responsible for tuberculosis and paratuberculosis in livestock. Although eradication and control programs have been partly managed with success in many countries worldwide, the often low sensitivity of the current diagnostic techniques against Mycobacterium bovis (as well as other mycobacteria from Mycobacterium tuberculosis complex) and Mycobacterium avium subsp. paratuberculosis together with other hurdles such as low mycobacteria loads in samples, a tedious process of microbiological culture, inhibition by many variables, or intermittent shedding of the mycobacteria highlight the importance of evaluating new techniques that open different options and complement the diagnostic paradigm. In this sense, volatilome analysis stands as a potential option because it fulfills part of the mycobacterial diagnosis requirements. The aim of the present review is to compile the information related to the diagnosis of tuberculosis and paratuberculosis in livestock through the analysis of VOCs by using different biological matrices. The analytical techniques used for the evaluation of VOCs are discussed focusing on the advantages and drawbacks offered compared with the routine diagnostic tools. In addition, the differences described in the literature among in vivo and in vitro assays, natural and experimental infections, and the use of specific VOCs (targeted analysis) and complete VOC pattern (non-targeted analysis) are highlighted. This review emphasizes how this methodology could be useful in the problematic diagnosis of tuberculosis and paratuberculosis in livestock and poses challenges to be addressed in future research.

scholarly journals Biosynthetic Conversion of Ag+ to highly Stable Ag0 Nanoparticles by Wild Type and Cell Wall Deficient Strains of Chlamydomonas reinhardtii

Molecules ◽  
2018 ◽  
Vol 24 (1) ◽  
pp. 98 ◽  
Author(s):  
Ashiqur Rahman ◽  
Shishir Kumar ◽  
Adarsh Bafana ◽  
Si Dahoumane ◽  
Clayton Jeffryes
Keyword(s):  
Cell Culture ◽  
Chlamydomonas Reinhardtii ◽  
Inductively Coupled Plasma ◽  
Culture Media ◽  
Atomic Emission ◽  
Diagnostic Tools ◽  
Inductively Coupled ◽  
Specialized Equipment ◽  
Different Strains ◽  
Over Time

In the current study, two different strains of the green, freshwater microalga Chlamydomonas reinhardtii bioreduced Ag+ to silver nanoparticles (AgNPs), which have applications in biosensors, biomaterials, and therapeutic and diagnostic tools. The bioreduction takes place in cell cultures of C. reinhardtii at ambient temperature and atmospheric pressure, thus eliminating the need for specialized equipment, harmful reducing agents or the generation of toxic byproducts. In addition to the visual changes in the cell culture, the production of AgNPs was confirmed by the characteristic surface plasmon resonance (SPR) band in the range of 415–425 nm using UV-Vis spectrophotometry and further evolution of the SPR peaks were studied by comparing the peak intensity at maximum absorbance over time. X-ray diffraction (XRD) determined that the NPs were Ag0. Micrographs from transmission electron microscopy (TEM) revealed that 97 ± 2% AgNPs were <10 nm in diameter. Ag+ to AgNP conversion was determined by inductively coupled plasma atomic emission spectroscopy (ICP-AES). The AgNPs were stable over time in the cell culture media, acetone, NaCl and reagent alcohol solutions. This was verified by a negligible change in the features of the SPR band after t > 300 days of storage at 4 °C.

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