, Hellenic Invasive Candidiasis Study (HELICAS): Identification and Antifungal Susceptibility of Candida species in Greek ICUs

, Biometrics Program Manager, issue.2

, Theageneio Oncology Hospital

, University Hospital of Alexandroupolis, Alexandroupolis, Greece, 12 Microbiology, Evangelismos General Hospital, 11 Microbiology

, Methods: We performed a case-matched analysis with proven or probable IM patients from the FungiScope® Registry. 1st-POSnew and 1st-AMB+POSnew cases were matched with 1st-AMB-based treatment controls, and SAL-POSnew cases were matched with SAL-POSsusp controls. Each case was matched with up to three controls based on severity, haematological/oncological malignancy, surgery and/or renal dysfunction. Results: Five patients receiving first-line POSnew alone, 18 receiving first-line POSnew combined with AMB, and 22 receiving salvage POSnew were identified. By day 42, favourable response was reported for 80.0% (n = 4/5) of patients receiving first-line POSnew, for 27.8% (n = 5/18) receiving first-line POSnew plus AMB, and for 50.0% (n = 11/22) receiving salvage POSnew. Day-42 all-cause mortality of patients receiving POSnew was lower compared to mortality in their respective controls (20.0% (n = 1/5) in 1st-POSnew vs. 53.3% (n = 8/15) in 1st-AMB; 33.3% (n = 6/18) in 1st-AMB+POSnew vs. 52.0% (n = 26/50) in 1st-AMB; 0.0% (n = 0/22) in SAL-POSnew vs. 4.4% (n = 2/45) in SAL-POSsusp). Conclusion: In the observed patients, POSnew was effective in terms of treatment response and associated mortality of IM. POSnew may be an alternative for treatment of IM. 64, 128 and 256 mg/L of citral. Mean size (nm), polydispersity (PDI) and surface charge (?-potential) were evaluated with Malvern ZetaSizer Nano ZS particle analyser, Current first-line (1st) antifungal treatment for invasive mucormycosis (IM) consists of liposomal amphotericin B (AMB). Salvage (SAL) treatment options are limited and often based on posaconazole oral suspension (POSsusp). However, with the approval of posaconazole new formulations (POSnew), patients could benefit from improved pharmacokinetics, safety and tolerability. Therefore,our aim is to assess the effectiveness of POSnew as first-line and SAL treatments for IM

, Non-encapsulated 32 µ g/mL of thymol and carvacrol showed less cytotoxicity levels (76.5% and 74.8% cell viability by MTT assay, respectively; and ? 80% by LDH assay), followed by citral 64 µ g/mL with 68% by MTT assay and 92.9% by LDH. Thymol and carvacrol nanoparticles were the best tolerated by macrophages with a higher cell viability by MTT assay (83.5-112.8% for thymol nanoparticles and 101-137% for carvacrol nanoparticles) when incubated with 18, 36 and 72 µ g/mL of thymol nanoparticles and 18 and 36 µ g/mL of carvacrol nanoparticles. Conclusion: Monoolein-based liposomes of DODAB:MO (1:2) candidiasis, due to their striking physicochemical properties, appropriate encapsulation efficiencies, stability, reduced cytotoxicity and preserved anti-Candida activities. Work supported by Gobierno Vasco-Eusko Jaurlaritza, carvacrol and citral nanoparticles (567.9 ± 13.9, 510 ± 9.6 and 497.6 ± 13.8 nm, respectively)

, Methods: Retrospective analysis of clinical data of adult non-hematologicpatients with IA. The EORTS/MSG 2008 criteria were used for IA diagnosis and assessment of response of therapy. Results: In the study were included 46 non-hematologic patients with IA, median age -48 years (19 -99), females -57%. The background conditions were autoimmune diseases -24%, kidney diseases with acute or chronic renal failure -20%, oncology -15%, heart and vascular diseases -11%, severe viral-bacterial pneumonia -8%, HIV infection -7%, lung pathology -7%, severe influenza H3N2 -4%, other -4%. The risk factors of IA were glucocorticosteroid therapy -50%, prolonged lymphocytopenia (<1,0 ?10 9 /l, median -18 days) -48%, immunosuppressive therapy -35%, ICU stay -30%, precede surgical treatment -28%, organs transplantation -20%, severe neutropenia (median -10 days) -13%, diabetes -11%, allogeneic hematopoetic stem cells transplantation (HSCT) -2%, autologous HSCT -2%. The main sites of infection were lungs -85%, central nervous system (CNS) -11%, and paranasal sinuses -9%. Disseminated (?2 organs) IA was in 17% patients. Clinical signs of IA were fever (? 38,5 0 C) -79%, cough -76%, respiratory failure -59%, chest pain -26%, and hemoptysis -22%. CT scan signs were bilateral lesions -56%, air crescent sign -12%. The main etiological agents were A.fumigatus (62%), A.niger (14%), A.flavus(14%), A.ustus (5%) and A.ochraceus (5%). «Proven» IA was diagnosed in 28% patients, «probable» -72%. Antifungal therapy was used in 93% patients, surgical treatment -7%. Overall 12-weeks survival of patients was 76%. Conclusion: Invasive aspergillosisdeveloped in non-hematologic patientsusually with autoimmune (24%), renal (20%) or oncology diseases (15%). The main risk factors were glucocorticosteroid therapy (50%), lymphocytopenia (48%), immunosuppressive therapy (35%), organs and hematopoetic stem cells transplantation (24%), To investigate the features of invasive aspergillosis (IA) in non-hematologic patients

, Brazil Objectives: The aim of our study was to verify the profile of interaction between S. schenckii sensu stricto and S. brasiliensis and A. castellanii by an in vitro model of coculture as a modulator factor of both microorganisms intrinsic characteristics. Methods: For this purpose the phagocytosis index of S. schenckii sensu stricto and S. brasiliensis by A. castellanii was evaluated; the S. schenckii sensu stricto and S. brasiliensis viability after contact with A. castellanii; the amoeba viability after contact with the fungus; and the influence of S. schenckii sensu stricto and S. brasiliensis in encystment process of A. castellanii were performed. The analyses indicated that S. schenckii and S. brasiliensis have suffered phagocytic events by A. castellanii and this index is significantly higher for S. schenckii in the first two hours compared to S. brasiliensis. Results: Our results showed a significant increase in conidia and hyphae count after 72h of coculture of S. brasiliensis and lysis of amoebae occurred after fungal internalization. Conclusion: S. schenckii sensu stricto and S. brasiliensis probably used amoebae as nutritional source. Our results were obtained in vitro and may not demonstrate the same behavior in vivo, being required in vivo studies with co-infection in order to have a thorough understanding of this relationship, Immunology And Parasitology

C. U1045, C. De-bordeaux, and . Pédiatrique, Beside the main objectives of the multicentric project "MucoFong" (PHRC-19021906) that evaluated the respiratory fungal composition in CF and provided the first French guidelines for mycological analysis of CF sputum, data collected during this two-year follow-up of 299 CF patients (3 visits per patient including biological, radiological, and clinical data) were analyzed to assess associations between the microorganisms identified in the sputum and the clinical evolution. Methods: Relations between microorganisms identified in the sputum and clinical course of patients were longitudinally analyzed taking as output variable FEV1 (Forced Expiratory Volume in 1s expressed as percent of predicted value). As data were collected several times throughout the followup, 5 The Mucofong Investigation Group

P. Aeruginosa, A. Xylosoxidans, S. , C. Albicans-;-emilie-fréalle, Y. Lemeille et al., Project MucoFng 2.0 (RF20160501626/1/1/275) from Vaincre la Mucoviscidose (VLM) bilirubin levels. Multivariate analysis performed in all VRC Cmin/D identified CRP (p<0.0001), bilirubin (p = 0.01) and age (p = 0.007) as independent determinants of VRC Cmin/D, while genetic score had no impact. Genetic score was significantly associated with VRC Cmin/D only in the subgroup of VRC Cmin (n = 51) determined in absence of severe inflammation (defined by CRP level < median CRP of 65 mg/L). Conclusion: Our genetic score that combined genetic variants of CYP2C19, 3A4 and 3A5 seems interesting to predict subtherapeutic VRC Cmin, but its impact is suppressed by severe inflammation, A sensitivity analysis was performed to identify interactions between microbes

, 12-24h) sampling informed consent was obtained from the patients or their relatives. PK parameters were estimated in Excel ® . Results: All patients received veno-venous ECMO and two patients were supported by continuous veno-venous hemodialysis (CVVH). The median area under the curve (AUC0-24), clearance (CL) and volume of distribution (Vd) were 35.69 mg.h/L, 8.42 L/h and 421.0 L, respectively. Exposure documented in the ECMO patients is shown in Table 1, along with the results previously documented in healthy volunteers, patients with hematological disease and critically ill patients. As shown in Figure 1, all trough concentrations (Cmin) were above 0.7 mg/L, which is the suggested threshold for prophylaxis in patients with hematological disease, and 71% of the Cmin were also ? 1 mg/L, which is the suggested hematological threshold for treatment of invasive aspergillosis (ECIL-6 and ESCMID-ECMM-ERS 2017). The median average concentration (Cavg) of both exposure days, 5 Laboratory For Clinical Infectious And Inflammatory Disorders, vol.10

, However, combinations of 1 mg/mL of amphotericin B with 0.25 and 0.5 mg/mL of anidulafungin or caspofungin were additive (<2 log reduction) and fungicidal. There were not significant differences between the use of anidulafungin or caspofungin in combinations with amphotericin B. Conclusion: Combination of amphotericin B with anidulafungin and caspofungin showed promising results. Combinations of 0.5 mg/L of amphotericin B with low doses of echinocandins were synergistic, whereas the interaction with 1 mg/mL of amphotericin B was additive but exerted fungicidal activity. This is a remarkable finding, specially if we take into account that echinocandins do not show fungicidal behaviour against C. auris. The results could support the use of these antifungal combinations for treating C. auris deep infections. Funding: This study was partially financed by GIC, Combinations of 0.5 mg/mL of amphotericin B with 0.5, 1 and 2 mg/mL of anidulafungin or caspofungin were synergistic ( >2 log reduction compared to the drug with greater activity) and fungistatic

C. Serena, In vitro interactions of micafungin with amphotericin B against clinical isolates of Candida spp, Antimicrob Agents Chemother, vol.52, issue.4, p.472, 2008.

, Objectives: The echinocandin caspofungin is used as first-line therapy in candidemia, the most common invasive candida infection. The protein bound fraction of caspofungin is 96.5% (in healthy volunteers), Time-kill Studies of Caspofungin in an Ex vivo model in Relation to Plasma Protein Levels: Is the Protein Binding Less Than Expected? S. Kurland 1 , M. Furebring 1 , A. Shams 1 , E. Chryssanthou, vol.2

, Belgian national survey on tinea capitis: epidemiology and molecular investigations

, Hayette 1 1 Clinical Microbiology-Nrc For Mycoses

C. Dermatology, . St-pierre, . Brussels, . Belgium, . Microbiology et al., This last decade, a huge increase of African anthropophilic strains causing tinea capitis, has been observed in Europe, probably due to immigration waves from African countries. The Belgian National Reference Center for Mycosis (NRC) has conducted a surveillance study about TC, Clinique St Luc Bouge, issue.4, 2018.

, Aspergillus welwitschiae (59/175; 34 %), Aspergillus niger (34/175; 19 %), Aspergillus luchuensis (2/175; 1%), and Aspergillus japonicus (2/175; 1%). When several isolates were available for a given patients, the following isolates belonged to the same species. The species repartition was statistically different when comparing EEC samples to respiratory and air samples with A. welwitschiae overrepresented in otomycosis (53% 34/64) (p<0.001). In contrast, the distribution of the species was not different between respiratory and air samples, with 46% and 61% A. tubingensis respectively (Figure 1). \ Inside each species, the sequence identity was high (96.5% for A. tubingensis, 99.3% A. welwitschiae, and 99.4% A. niger isolates) with no difference according to the isolation site. The phylogenetic tree based on the calmodulin gene partial sequences showed a stackable organization to the tree generated using whole genome sequencing, Conclusion: African anthropophilic dermatophytes such as M.audouinii and T. soudanense are mainly responsible for tinea capitis in Belgium. Large cosmopolitan cities like Brussels and Liege are the most concerned. People from African origin are mostly affected by TC. Among the M. audouinii strains circulating in Belgium, a genotypic diversity has been characterized. the Mycobank database, vol.24, p.65, 2009.