19 results on '"Fisher, Matthew C."'
Search Results
2. Environment is associated with chytrid infection and skin microbiome richness on an amphibian rich island (Taiwan).
- Author
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Schmeller, Dirk S., Cheng, Tina, Shelton, Jennifer, Lin, Chun-Fu, Chan-Alvarado, Alan, Bernardo-Cravo, Adriana, Zoccarato, Luca, Ding, Tzung-Su, Lin, Yu-Pin, Swei, Andrea, Fisher, Matthew C., Vredenburg, Vance T., and Loyau, Adeline
- Subjects
SKIN infections ,AMPHIBIANS ,AMPHIBIAN diversity ,LIFE history theory ,BATRACHOCHYTRIUM dendrobatidis ,HABITATS - Abstract
Growing evidence suggests that the origins of the panzootic amphibian pathogens Batrachochytrium dendrobatidis (Bd) and Batrachochytrium salamandrivorans (Bsal) are in Asia. In Taiwan, an island hotspot of high amphibian diversity, no amphibian mass mortality events linked to Bd or Bsal have been reported. We conducted a multi-year study across this subtropical island, sampling 2517 individuals from 30 species at 34 field sites, between 2010 and 2017, and including 171 museum samples collected between 1981 and 2009. We analyzed the skin microbiome of 153 samples (6 species) from 2017 in order to assess any association between the amphibian skin microbiome and the probability of infection amongst different host species. We did not detect Bsal in our samples, but found widespread infection by Bd across central and northern Taiwan, both taxonomically and spatially. Museum samples show that Bd has been present in Taiwan since at least 1990. Host species, geography (elevation), climatic conditions and microbial richness were all associated with the prevalence of infection. Host life-history traits, skin microbiome composition and phylogeny were associated with lower prevalence of infection for high altitude species. Overall, we observed low prevalence and burden of infection in host populations, suggesting that Bd is enzootic in Taiwan where it causes subclinical infections. While amphibian species in Taiwan are currently threatened by habitat loss, our study indicates that Bd is in an endemic equilibrium with the populations and species we investigated. However, ongoing surveillance of the infection is warranted, as changing environmental conditions may disturb the currently stable equilibrium. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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3. Chytrid fungi and global amphibian declines
- Author
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24241075 - Garner, Trenton William John, Fisher, Matthew C., Garner, Trenton W.J., 24241075 - Garner, Trenton William John, Fisher, Matthew C., and Garner, Trenton W.J.
- Abstract
Discovering that chytrid fungi cause chytridiomycosis in amphibians represented a paradigm shift in our understanding of how emerging infectious diseases contribute to global patterns of biodiversity loss. In this Review we describe how the use of multidisciplinary biological approaches has been essential to pinpointing the origins of amphibian-parasitizing chytrid fungi, including Batrachochytrium dendrobatidis and Batrachochytrium salamandrivorans, as well as to timing their emergence, tracking their cycles of expansion and identifying the core mechanisms that underpin their pathogenicity. We discuss the development of the experimental methods and bioinformatics toolkits that have provided a fuller understanding of batrachochytrid biology and informed policy and control measures
- Published
- 2020
4. Microplastics increase susceptibility of amphibian larvae to the chytrid fungus Batrachochytrium dendrobatidis.
- Author
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Bosch, Jaime, Thumsová, Barbora, López-Rojo, Naiara, Pérez, Javier, Alonso, Alberto, Fisher, Matthew C., and Boyero, Luz
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BATRACHOCHYTRIUM dendrobatidis ,MICROPLASTICS ,CHYTRIDIOMYCOSIS ,COMMUNICABLE diseases ,TOADS ,AQUATIC biodiversity - Abstract
Microplastics (MPs), a new class of pollutants that pose a threat to aquatic biodiversity, are of increasing global concern. In tandem, the amphibian chytrid fungus Batrachochytrium dendrobatidis (Bd) causing the disease chytridiomycosis is emerging worldwide as a major stressor to amphibians. We here assess whether synergies exist between this infectious disease and MP pollution by mimicking natural contact of a highly susceptible species (midwife toads, Alytes obstetricans) with a Bd-infected reservoir species (fire salamanders, Salamandra salamandra) in the presence and absence of MPs. We found that MP ingestion increases the burden of infection by Bd in a dose-dependent manner. However, MPs accumulated to a greater extent in amphibians that were not exposed to Bd, likely due to Bd-damaged tadpole mouthparts interfering with MP ingestion. Our experimental approach showed compelling interactions between two emergent processes, chytridiomycosis and MP pollution, necessitating further research into potential synergies between these biotic and abiotic threats to amphibians. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
5. Fungal Genomics in Respiratory Medicine: What, How and When?
- Author
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Brackin, Amelie P., Hemmings, Sam J., Fisher, Matthew C., and Rhodes, Johanna
- Abstract
Respiratory infections caused by fungal pathogens present a growing global health concern and are a major cause of death in immunocompromised patients. Worryingly, coronavirus disease-19 (COVID-19) resulting in acute respiratory distress syndrome has been shown to predispose some patients to airborne fungal co-infections. These include secondary pulmonary aspergillosis and mucormycosis. Aspergillosis is most commonly caused by the fungal pathogen Aspergillus fumigatus and primarily treated using the triazole drug group, however in recent years, this fungus has been rapidly gaining resistance against these antifungals. This is of serious clinical concern as multi-azole resistant forms of aspergillosis have a higher risk of mortality when compared against azole-susceptible infections. With the increasing numbers of COVID-19 and other classes of immunocompromised patients, early diagnosis of fungal infections is critical to ensuring patient survival. However, time-limited diagnosis is difficult to achieve with current culture-based methods. Advances within fungal genomics have enabled molecular diagnostic methods to become a fast, reproducible, and cost-effective alternative for diagnosis of respiratory fungal pathogens and detection of antifungal resistance. Here, we describe what techniques are currently available within molecular diagnostics, how they work and when they have been used. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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6. Development and worldwide use of non-lethal, and minimal population-level impact, protocols for the isolation of amphibian chytrid fungi
- Author
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Fundação para a Ciência e a Tecnologia (Portugal), Sao Paulo Research Foundation, Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brasil), Royal Geographical Society, National Research Foundation of Korea, Leverhulme Trust, Fondo Nacional de Desarrollo Científico y Tecnológico (Chile), Hungarian Academy of Sciences, Fisher, Matthew C., Ghosh, Pria, Shelton, Jennifer M. G., Bates, Kieran A., Brookes, Lola, Wierzbicki, Claudia, Rosa, Gonçalo M., Farrer, Rhys A., Aanensen, David M., Alvarado-Rybak, Mario, Bataille, Arnaud, Berger, Lee R., Böll, Susanne, Bosch, Jaime, Clare, Frances C., Courtois, Elodie A., Crottini, Angelica, Cunningham, Andrew A., Doherty-Bone, Thomas M., Gebresenbet, Fikirte, Gower, David J., Höglund, Jacob, James, Timothy Y., Jenkinson, Thomas S., Kosch, Tiffany A., Lambertini, Carolina, Laurila, Anssi, Lin, Chun-Fu, Loyau, A., Martel, An, Meurling, Sara, Miaud, Claude, Minting, Pete, Ndriantsoa, Serge, O’Hanlon, Simon, Pasmans, Frank, Rakotonanahary, Tsanta, Rabemananjara, Falitiana C. E., Ribeiro, Luisa P., Schmeller, Dirk S., Schmidt, Benedikt R., Skerratt, Lee, Smith, Freya, Soto-Azat, Claudio, Tessa, Giulia, Toledo, Luis Felipe, Valenzuela-Sánchez, Andrés, Verster, Ruhan, Vörös, Judit, Waldman, Bruce, Webb, Rebecca J., Weldon, Che, Wombwell, Emma, Zamudio, Kelly R., Longcore, Joyce E., Garner, Trenton W. J., Fundação para a Ciência e a Tecnologia (Portugal), Sao Paulo Research Foundation, Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brasil), Royal Geographical Society, National Research Foundation of Korea, Leverhulme Trust, Fondo Nacional de Desarrollo Científico y Tecnológico (Chile), Hungarian Academy of Sciences, Fisher, Matthew C., Ghosh, Pria, Shelton, Jennifer M. G., Bates, Kieran A., Brookes, Lola, Wierzbicki, Claudia, Rosa, Gonçalo M., Farrer, Rhys A., Aanensen, David M., Alvarado-Rybak, Mario, Bataille, Arnaud, Berger, Lee R., Böll, Susanne, Bosch, Jaime, Clare, Frances C., Courtois, Elodie A., Crottini, Angelica, Cunningham, Andrew A., Doherty-Bone, Thomas M., Gebresenbet, Fikirte, Gower, David J., Höglund, Jacob, James, Timothy Y., Jenkinson, Thomas S., Kosch, Tiffany A., Lambertini, Carolina, Laurila, Anssi, Lin, Chun-Fu, Loyau, A., Martel, An, Meurling, Sara, Miaud, Claude, Minting, Pete, Ndriantsoa, Serge, O’Hanlon, Simon, Pasmans, Frank, Rakotonanahary, Tsanta, Rabemananjara, Falitiana C. E., Ribeiro, Luisa P., Schmeller, Dirk S., Schmidt, Benedikt R., Skerratt, Lee, Smith, Freya, Soto-Azat, Claudio, Tessa, Giulia, Toledo, Luis Felipe, Valenzuela-Sánchez, Andrés, Verster, Ruhan, Vörös, Judit, Waldman, Bruce, Webb, Rebecca J., Weldon, Che, Wombwell, Emma, Zamudio, Kelly R., Longcore, Joyce E., and Garner, Trenton W. J.
- Abstract
Parasitic chytrid fungi have emerged as a significant threat to amphibian species worldwide, necessitating the development of techniques to isolate these pathogens into culture for research purposes. However, early methods of isolating chytrids from their hosts relied on killing amphibians. We modified a pre-existing protocol for isolating chytrids from infected animals to use toe clips and biopsies from toe webbing rather than euthanizing hosts, and distributed the protocol to researchers as part of the BiodivERsA project RACE; here called the RML protocol. In tandem, we developed a lethal procedure for isolating chytrids from tadpole mouthparts. Reviewing a database of use a decade after their inception, we find that these methods have been applied across 5 continents, 23 countries and in 62 amphibian species. Isolation of chytrids by the non-lethal RML protocol occured in 18% of attempts with 207 fungal isolates and three species of chytrid being recovered. Isolation of chytrids from tadpoles occured in 43% of attempts with 334 fungal isolates of one species (Batrachochytrium dendrobatidis) being recovered. Together, these methods have resulted in a significant reduction and refinement of our use of threatened amphibian species and have improved our ability to work with this group of emerging pathogens.
- Published
- 2018
7. Amphibian chytridiomycosis outbreak dynamics are linked with host skin bacterial community structure
- Author
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Bates, Kieran A., Clare, Frances C., O’Hanlon, Simon, Bosch, Jaime, Brookes, Lola, Hopkins, Kevin, McLaughlin, Emilia J., Daniel, Olivia, Garner, Trenton W. J., Fisher, Matthew C., Harrison, Xavier A., Bates, Kieran A., Clare, Frances C., O’Hanlon, Simon, Bosch, Jaime, Brookes, Lola, Hopkins, Kevin, McLaughlin, Emilia J., Daniel, Olivia, Garner, Trenton W. J., Fisher, Matthew C., and Harrison, Xavier A.
- Abstract
Host-associated microbes are vital for combatting infections and maintaining health. In amphibians, certain skin-associated bacteria inhibit the fungal pathogen Batrachochytrium dendrobatidis (Bd), yet our understanding of host microbial ecology and its role in disease outbreaks is limited. We sampled skin-associated bacteria and Bd from Pyrenean midwife toad populations exhibiting enzootic or epizootic disease dynamics. We demonstrate that bacterial communities differ between life stages with few shared taxa, indicative of restructuring at metamorphosis. We detected a significant effect of infection history on metamorph skin microbiota, with reduced bacterial diversity in epizootic populations and differences in community structure and predicted function. Genome sequencing of Bd isolates supports a single introduction to the Pyrenees and reveals no association between pathogen genetics and epidemiological trends. Our findings provide an ecologically relevant insight into the microbial ecology of amphibian skin and highlight the relative importance of host microbiota and pathogen genetics in predicting disease outcome.
- Published
- 2018
8. Early exposure to Batrachochytrium dendrobatidis causes profound immunosuppression in amphibians
- Author
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Fundación General CSIC, Banco Santander, Leverhulme Trust, Fernández-Loras, Andrés, Fernández-Beaskoetxea, Saioa, Arriero, Elena, Fisher, Matthew C., Bosch, Jaime, Fundación General CSIC, Banco Santander, Leverhulme Trust, Fernández-Loras, Andrés, Fernández-Beaskoetxea, Saioa, Arriero, Elena, Fisher, Matthew C., and Bosch, Jaime
- Abstract
Fungal pathogens have evolved a broad suite of strategies aiming at evading the host immune response. Amphibians are globally infected by the panzootic chytrid fungus Batrachochytrium dendrobatidis (Bd) and, while robust innate immune defences have been characterised, there is little evidence for the existence of effective adaptive immunity. We determine the immune response of the common midwife toad following challenge by Bd as larvae. Immune function was described for both the cell-mediated and antibody-mediated immune responses following infectious challenge as larval amphibians. While there were no significant differences in the ratio of neutrophils/lymphocytes between infected and uninfected individuals, early exposure of tadpoles to Bd significantly dampened the levels of circulating immunoglobulins (IgM and IgY) in the serum of juveniles after metamorphosis. Our results show that Bd immunosuppresses amphibians when infection occurs as larvae with potentially broad effects on the remodelling of immunity during metamorphosis.
- Published
- 2017
9. Evidence for the introduction of lethal chytridiomycosis affecting wild betic midwife toads (Alytes dickhilleni)
- Author
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Bosch, Jaime, García-Alonso, David, Fernández-Beaskoetxea, Saioa, Fisher, Matthew C., Garner, Trenton W. J., Bosch, Jaime, García-Alonso, David, Fernández-Beaskoetxea, Saioa, Fisher, Matthew C., and Garner, Trenton W. J.
- Abstract
Batrachochytrium dendrobatidis is an unpredictable pathogen for European amphibian species, and existing field surveillance studies likely underestimate the scope of its distribution and effects. Mass mortality episodes recorded in Europe indicate that investigations of unstudied species should focus on members of the frog family Alytidae. Here, we report the combined results of a field survey and laboratory observations of field collected Alytes dickhilleni. Our data support the hypothesis that B. dendrobatidis has recently emerged in at least two disjunct locations in the species range and populations across much of the species range lack evidence of infection pathogen. Tadpoles taken into the laboratory from sites with infection experienced 70% mortality, unlike those taken into the laboratory from uninfected sites, and both infection and strength of infection was associated with mortality in animals collected from infected locations. Several conservation interventions are underway in response to our study, including the establishment of a captive assurance colony, a public awareness campaign, and experimental tests of disease mitigation schemes. © 2013 International Association for Ecology and Health.
- Published
- 2013
10. Emerging fungal threats to animal, plant and ecosystem health.
- Author
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Fisher, Matthew C., Henk, Daniel. A., Briggs, Cheryl J., Brownstein, John S., Madoff, Lawrence C., McCraw, Sarah L., and Gurr, Sarah J.
- Subjects
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FUNGI , *VIRUS diseases , *ANIMAL diseases , *PLANT diseases , *BIOLOGICAL extinction , *BIODIVERSITY , *BIOSECURITY - Abstract
The past two decades have seen an increasing number of virulent infectious diseases in natural populations and managed landscapes. In both animals and plants, an unprecedented number of fungal and fungal-like diseases have recently caused some of the most severe die-offs and extinctions ever witnessed in wild species, and are jeopardizing food security. Human activity is intensifying fungal disease dispersal by modifying natural environments and thus creating new opportunities for evolution. We argue that nascent fungal infections will cause increasing attrition of biodiversity, with wider implications for human and ecosystem health, unless steps are taken to tighten biosecurity worldwide. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
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11. The Link Between Rapid Enigmatic Amphibian Decline and the Globally Emerging Chytrid Fungus.
- Author
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Lötters, Stefan, Kielgast, Jos, Bielby, Jon, Schmidtlein, Sebastian, Bosch, Jaime, Veith, Michael, Walker, Susan F., Fisher, Matthew C., and Rödder, Dennis
- Subjects
AMPHIBIAN declines ,BATRACHOCHYTRIUM dendrobatidis ,CHYTRIDIOMYCOSIS ,BIOLOGICAL extinction ,PATHOGENIC microorganisms - Abstract
Amphibians are globally declining and approximately one-third of all species are threatened with extinction. Some of the most severe declines have occurred suddenly and for unknown reasons in apparently pristine habitats. It has been hypothesized that these “rapid enigmatic declines” are the result of a panzootic of the disease chytridiomycosis caused by globally emerging amphibian chytrid fungus. In a Species Distribution Model, we identified the potential distribution of this pathogen. Areas and species from which rapid enigmatic decline are known significantly overlap with those of highest environmental suitability to the chytrid fungus. We confirm the plausibility of a link between rapid enigmatic decline in worldwide amphibian species and epizootic chytridiomycosis. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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12. The Amphibian Trade: Bans or Best Practice?
- Author
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Garner, Trenton W. J., Stephen, Ian, Wombwell, Emma, and Fisher, Matthew C.
- Subjects
AMPHIBIAN trade ,WILD animal trade ,BATRACHOCHYTRIUM dendrobatidis ,PREVENTION of communicable diseases ,ANIMALS ,MARKETING - Abstract
The article discusses the issue concerning the implication of amphibian trade practice. It states that the issues arises since amphibian trade can be a means of mediating the introduction of amphibian infectious diseases which is known as Batrachochytrium dendrobatidis (Bd). The author also admits that the financial benefits of the amphibian pet trade may be less than the food or research trades.
- Published
- 2009
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13. Ecology: In peril from a perfect pathogen.
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Fisher, Matthew C.
- Published
- 2017
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14. Chytrid fungus infection in zebrafish demonstrates that the pathogen can parasitize non-amphibian vertebrate hosts.
- Author
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Liew, Nicole, Mazon Moya, Maria J., Wierzbicki, Claudia J., Hollinshead, Michael, Dillon, Michael J., Thornton, Christopher R., Ellison, Amy, Cable, Jo, Fisher, Matthew C., and Mostowy, Serge
- Abstract
Aquatic chytrid fungi threaten amphibian biodiversity worldwide owing to their ability to rapidly expand their geographical distributions and to infect a wide range of hosts. Combating this risk requires an understanding of chytrid host range to identify potential reservoirs of infection and to safeguard uninfected regions through enhanced biosecurity. Here we extend our knowledge on the host range of the chytrid Batrachochytrium dendrobatidis by demonstrating infection of a non-amphibian vertebrate host, the zebrafish. We observe dose-dependent mortality and show that chytrid can infect and proliferate on zebrafish tissue. We also show that infection phenotypes (fin erosion, cell apoptosis and muscle degeneration) are direct symptoms of infection. Successful infection is dependent on disrupting the zebrafish microbiome, highlighting that, as is widely found in amphibians, commensal bacteria confer protection against this pathogen. Collectively, our findings greatly expand the limited tool kit available to study pathogenesis and host response to chytrid infection. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
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15. Genomic innovations linked to infection strategies across emerging pathogenic chytrid fungi.
- Author
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Farrer, Rhys A., Martel, An, Verbrugghe, Elin, Abouelleil, Amr, Ducatelle, Richard, Longcore, Joyce E., James, Timothy Y., Pasmans, Frank, Fisher, Matthew C., and Cuomo, Christina A.
- Abstract
To understand the evolutionary pathways that lead to emerging infections of vertebrates, here we explore the genomic innovations that allow free-living chytrid fungi to adapt to and colonize amphibian hosts. Sequencing and comparing the genomes of two pathogenic species of Batrachochytrium to those of close saprophytic relatives reveals that pathogenicity is associated with remarkable expansions of protease and cell wall gene families, while divergent infection strategies are linked to radiations of lineage-specific gene families. By comparing the host-pathogen response to infection for both pathogens, we illuminate the traits that underpin a strikingly different immune response within a shared host species. Our results show that, despite commonalities that promote infection, specific gene-family radiations contribute to distinct infection strategies. The breadth and evolutionary novelty of candidate virulence factors that we discover underscores the urgent need to halt the advance of pathogenic chytrids and prevent incipient loss of biodiversity. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
16. Host species vary in infection probability, sub-lethal effects, and costs of immune response when exposed to an amphibian parasite.
- Author
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Bielby, Jon, Clare, Frances C., Fisher, Matthew C., Rosa, Gonçalo M., and Garner, Trenton W. J.
- Subjects
BATRACHOCHYTRIUM dendrobatidis ,HOST-parasite relationships ,INFECTIOUS disease transmission ,PARASITISM ,AMPHIBIANS - Abstract
The amphibian parasite Batrachochytrium dendrobatidis (Bd) is regarded as an extreme generalist, infecting over 500 species, but amongst these hosts there exists a great deal of variation in the susceptibility to and the costs of parasite exposure. We use two infection experiments to determine whether inter-specific variation in the sublethal and lethal effects of parasite exposure exist in two host species. We then tested the relative roles of host density and diversity on infection probability of a focal susceptible host. Our results show significant heterogeneity in host species response to parasite exposure, and that both lethal and sub-lethal costs exist in individuals that are able to resist infection, indicating that successful immune response to infection comes at a cost. Further, we show that increasing host density significantly increased the likelihood of susceptible individuals becoming infected with Bd irrespective of host diversity and variation in host susceptibility. These results suggest that populations of resistant species are likely to suffer ill-effects of exposure to Bd regardless of their infection status, and that at the stage of initial infection there was no support for the dilution of transmission events, in contrast to other studies that focus on subsequent transmission of infection. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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17. Widespread presence of the pathogenic fungus Batrachochytrium dendrobatidis in wild amphibian communities in Madagascar.
- Author
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Bletz, Molly C., Rosa, Gonçalo M., Andreone, Franco, Courtois, Elodie A., Schmeller, Dirk S., Rabibisoa, Nirhy H. C., Rabemananjara, Falitiana C. E., Raharivololoniaina, Liliane, Vences, Miguel, Weldon, Ché, Edmonds, Devin, Raxworthy, Christopher J., Harris, Reid N., Fisher, Matthew C., and Crottini, Angelica
- Subjects
BATRACHOCHYTRIUM dendrobatidis ,MYCOSES ,AMPHIBIANS ,CHYTRIDIOMYCOSIS - Abstract
Amphibian chytridiomycosis, an emerging infectious disease caused by the fungus Batrachochytrium dendrobatidis (Bd), has been a significant driver of amphibian declines. While globally widespread, Bd had not yet been reported from within Madagascar. We document surveys conducted across the country between 2005 and 2014, showing Bd's first record in 2010. Subsequently, Bd was detected in multiple areas, with prevalence reaching up to 100%. Detection of Bd appears to be associated with mid to high elevation sites and to have a seasonal pattern, with greater detectability during the dry season. Lineage-based PCR was performed on a subset of samples. While some did not amplify with any lineage probe, when a positive signal was observed, samples were most similar to the Global Panzootic Lineage (BdGPL). These results may suggest that Bd arrived recently, but do not exclude the existence of a previously undetected endemic Bd genotype. Representatives of all native anuran families have tested Bd-positive, and exposure trials confirm infection by Bd is possible. Bd's presence could pose significant threats to Madagascar's unique 'megadiverse' amphibians. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
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18. Attila Lorincz: Nucleic acid testing for human disease, 2006.
- Author
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Fisher, Matthew C.
- Subjects
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NUCLEIC acids , *NONFICTION - Abstract
The article reviews the book "Nucleic acid testing for human disease 2006," by Attila Lorincz.
- Published
- 2007
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19. Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy.
- Author
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Williamson, Peter R., Jarvis, Joseph N., Panackal, Anil A., Fisher, Matthew C., Molloy, Síle F., Loyse, Angela, Harrison, Thomas S., and Molloy, Síle F
- Subjects
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MENINGITIS diagnosis , *MENINGITIS treatment , *EPIDEMIOLOGY , *SEROPREVALENCE , *ANTIRETROVIRAL agents - Abstract
HIV-associated cryptococcal meningitis is by far the most common cause of adult meningitis in many areas of the world that have high HIV seroprevalence. In most areas in Sub-Saharan Africa, the incidence of cryptococcal meningitis is not decreasing despite availability of antiretroviral therapy, because of issues of adherence and retention in HIV care. In addition, cryptococcal meningitis in HIV-seronegative individuals is a substantial problem: the risk of cryptococcal infection is increased in transplant recipients and other individuals with defects in cell-mediated immunity, and cryptococcosis is also reported in the apparently immunocompetent. Despite therapy, mortality rates in these groups are high. Over the past 5 years, advances have been made in rapid point-of-care diagnosis and early detection of cryptococcal antigen in the blood. These advances have enabled development of screening and pre-emptive treatment strategies aimed at preventing the development of clinical infection in patients with late-stage HIV infection. Progress in optimizing antifungal combinations has been aided by evaluation of the clearance rate of infection by using serial quantitative cultures of cerebrospinal fluid (CSF). Measurement and management of raised CSF pressure, a common complication, is a vital component of care. In addition, we now better understand protective immune responses in HIV-associated cases, immunogenetic predisposition to infection, and the role of immune-mediated pathology in patients with non-HIV associated infection and in the context of HIV-associated immune reconstitution reactions. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
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