Mucormycosis: A black fungus – post covid complication, clinical and pathogenic approaches and isolation and characterization of black fungus with correlate its current perspectives of biomedical waste management

The clinically relevant black yeasts and their relatives, i.e., members of the Ascomycete order Chaetothyriales. In order to understand the pathology of these fungi it is essential to know their natural ecological niche. From a relatively low degree of molecular variability of the black yeast Exophiala dermatitidis, potential agent of brain infections in patients from East Asia, it is concluded that this species is an emerging pathogen, currently going through a process of active speciation. It is found to be an oligotrophic fungus in hot, moist environments, such as steam baths. Cladophialophora-Fonsecaea- and Ramichloridium-like strains, known in humans as agents of chromoblastomycosis, are frequently found on rotten plant material, but the fungal molecular diversity in the environment is much higher than that on the human patient, so that it is difficult to trace the etiological agents of the disease with precision, Human to human transmitted disease is the game of corona virus disease (COVID-19) transmission and it had been declared an emergency global pandemic that caused major disastrous in respiratory system to more than five million people and killing more than half a billion deaths across the globe. Besides lower acute respiratory syndrome, there is damage to alveolar with severe inflammatory exudation. COVID-19 patients often have lower immunosuppressive CD4+ T and CD8+ T cells and most patients in intensive care units (ICU) need mechanical ventilation, hence longer stay in hospitals. These patients have been discovered to develop fungal co-infections. COVID-19 patients develop what is known as mucormycosis a black fungal infection which is deadly leading to loss of sight and hearing and eventually death. This chapter will focus on mucormycosis, black fungus caused during post covid complication. This approach has been successful with Cladophialophora carrionii, of which cells resembling muriform cells, the tissue form of chromoblastomycosis, were found to occur in drying spines of cacti. Phagocytosis assays provide a method to distinguish between pathogens and non-pathogens, as the killing rates of strict saprobes proved to be consistently higher than of those species frequently known as agents of disease. therapeutic possibilities for patient chromoblastomycosis. Covid-19 waste is like any other infectious waste and the guidelines for its management are required to be followed in addition to existing practices under regulation. BMWM in context of COVID-19 is a public health concern and is both a legal and social responsibility.

A screening of the MMV Pathogen Box® reveals new potential antifungal drugs against the etiologic agents of chromoblastomycosis

Chromoblastomycosis (CBM) is a chronic subcutaneous mycosis caused by traumatic implantation of many species of black fungi. Due to the refractoriness of some cases and common recurrence of CBM, a more effective and less time-consuming treatment is mandatory. The aim of this study was to identify compounds with in vitro antifungal activity in the Pathogen Box® compound collection against different CBM agents. Synergism of these compounds with drugs currently used to treat CBM was also assessed. An initial screening of the drugs present in this collection at 1μM was performed with a Fonsecaea pedrosoi clinical strain according to the EUCAST protocol. The compounds with activity against this fungus were also tested against other seven etiologic agents of CBM (Cladophialophora carrionii, Phialophora verrucosa, Exophiala jeanselmei, Exophiala dermatitidis, Fonsecaea monophora, Fonsecaea nubica, and Rhinocladiella similis) at concentrations ranging from 0.039 to 10 μM. The analysis of potential synergism of these compounds with itraconazole and terbinafine was performed by the checkerboard method. Eight compounds inhibited more than 60% of the F. pedrosoi growth: difenoconazole, bitertanol, iodoquinol, azoxytrobin, MMV688179, MMV021013, trifloxystrobin, and auranofin. Iodoquinol produced the lowest MIC values (1.25 - 2.5μM) and MMV688179 showed MICs that were higher than all compounds tested (5 - >10μM). When auranofin and itraconazole were tested in combination, a synergistic interaction (FICI = 0.37) was observed against the C. carrionii isolate. In summary, auranofin, iodoquinol, and MMV021013 were identified as promising compounds to be tested in CBM models of infection.

Cromoblastomicosis en hueco poplíteo derecho, reporte de caso. Puebla, México

La Cromoblastomicosis es una micosis subcutánea producida por hongos melanizados conocidos como dematiáceos, comúnmente secundario a un proceso traumático previo. Actualmente la incidencia de esta patología es desconocida. Se presenta el caso de un hombre de 64 años originario de la comunidad de Coyomeapan, Puebla, México, quien acude por falta de cicatrización de una úlcera en hueco poplíteo derecho generada por quemadura con candil de petróleo hace cuatro años. Refiriendo dolor con leve dificultad para la deambulación y sin evidencia de sangrado activo. Se realiza raspado de la lesión con presencia de células fumagoides posteriormente se aisló Cladophialophora carrionii en Agar Boreli. Se inició tratamiento con terbinafina para su recuperación. El conocimiento de este tipo de micosis aumenta la posibilidad de un diagnóstico temprano y certero para evitar complicaciones derivadas de la cronicidad o retraso del diagnóstico.

Combination of Amphotericin B and Terbinafine against Melanized Fungi Associated with Chromoblastomycosis

ABSTRACTOurin vitrostudies showed that a combination of amphotericin B and terbinafine had synergistic effects against the majority of melanized fungi associated with chromoblastomycosis (CBM) and similar infections, including those withCladophialophora carrionii,Cladophialophora arxii,Exophialadermatitidis,Exophialaspinifera,Fonsecaea monophora,Fonsecaea nubica,Fonsecaea pedrosoi, andPhialophora verrucosa.This drug combination could provide an option for the treatment of severe or unresponsive cases of CBM, particularly in cases due to species ofFonsecaeaandCladophialophora.

Presencia de agentes potenciales causantes de infecciones subcutáneas humanas en suelo y plantas en el estado de Puebla, México

Los hongos y actinomicetos asociados a infecciones en humanos, se encuentran ampliamente distribuidos en la naturaleza. El suelo y las plantas son el hábitat de numerosos hongos y bacterias. Los campesinos son altamente vulnerables a sufrir heridas y pueden contaminarse con estos microorganismos. Con la f inalidad de conocer el número de colonias de los agentes causantes de micosis subcutáneas humanas a partir de la naturaleza, se realizó el aislamiento de los microorganismos respectivos a partir de suelo y plantas en 11 municipios del estado de Puebla. De cada municipio se colectaron 50 muestras, cada una consistió de 10 g de suelo y 10 g de hojas de la planta más cercana; se prepararon suspensiones respectivas, las cuales fueron inoculadas en agar dextrosa Sabouraud, incubadas a 28 °C, y revisadas periódicamente para identif icar los microorganismos de interés con base en su morfología. De 1100 muestras procesadas, se obtuvieron 441 aislados, de los cuales 281 fueron hongos (133 de suelo y 148 de plantas) y 160 actinomicetos (96 de suelo y 64 de plantas). Los hongos aislados fueron identif icados por su morfología macroscópica y microscópica. Los actinomicetos fueron identif icados por su morfología macroscópica (colonial) y microscópica, y por pruebas bioquímicas. En mayor proporción se aislaron agentes potenciales de cromoblastomicosis (Fonsecaea pedrosoi y Cladophialophora carrionii), seguidos del agente de esporotricosis (Sporothrix schenckii) y de los agentes de actinomicetoma (Nocardia brasiliensis y N. otitidis-caviarum). Del suelo de Cholula y de plantas de Tecali de Herrera, se obtuvieron el mayor número de aislados fúngicos. Del suelo de Chignahuapan y de plantas de Izúcar de Matamoros se obtuvo el mayor número de aislados de actinomicetos. En este estudio se encontraron, tanto en suelo como en plantas de 11 municipios del estado de Puebla, un alto número de colonias de hongos y actinomicetos causantes de infecciones subcutáneas en humanos, y en una proporción similar a la frecuencia con que las patologías respectivas son reportadas en la literatura mexicana