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Objective To study the epidemiology of mold infections in China. Methods Based on the surveillance data of 19 hospitals participating in the China Hospital Invasive Fungal Surveillance Net from Jan 2019 to Jun 2022, the general information of patients and the epidemiological characteristics such as the proportion of different strains and clinical infection were analyzed by WHONET software. Results A total of 16 285 mold infection cases were included in the analysis, of which 49.3% were patients aged 61 and over, with the median age of 60 years old. The proportion of males was significantly higher than that of females (62.1% vs. 37.9%). The patients were mainly from the internal medicine, ICU and surgical wards. Most strains were isolated from lower respiratory tract, accounting for 81.7%, followed by pus and secretions (7.8%). In terms of species distribution, Aspergillus spp. accounted for the highest proportion (84.8%), with Penicillium spp., Fusarium spp., order Mucorales and Sedosporium spp. accounting for 5.1%, 3.0%, 1.3% and 0.4%, respectively. For species distribution among different mold infection, 88.7% of lower respiratory tract mold infections were caused by Aspergillus spp., and Aspergillus fumigatus(47.8%) was the most common species. Otomycosis was mainly caused by Aspergillus spp.(98.7%), of which Aspergillus terreus accounted for 39.7%, and ophthalmomycosis was mainly caused by Fusarium spp.(54.6%). Conclusions By the retrospective analysis of mold isolation from multicenter in China, we found that Aspergillus fumigatus, Aspergillus terreus, and Fusarium spp. were the most common species causing pneumonomycosis, otomycosis, and ophthalmomycosis, respectively. Therefore, it is necessary to pay attention to the differences in species distribution among different mold infections in clinical empirical treatment of fungal infections.

Antifungal‐resistant dermatophytes (ARD) infection is a hotspot issue in clinical microbiology and the dermatology field. Trichophyton indotineae as the dominant species of dermatophyte with terbinafine‐resistance or multidrug resistance, is easy to be missed detection clinically, which brings severe challenges to diagnosis and treatment. ARD infection cases have emerged in China, and it predicts a risk of transmission among human. Based on the existing medical evidence and research data, the Mycology Group of Combination of Traditional and Western Medicine Dermatology and Chinese Antifungal⁃Resistant Dermatophytoses Expert Consensus Group organized experts to make consensus on the management of the infection. Here, the consensus formulated diagnosis and treatment recommendations, to raise attention to dermatophytes drug resistance problem, and expect to provide reference information for the clinical diagnosis, treatment, prevention and control. [ABSTRACT FROM AUTHOR]

Staphylococcal scalded skin syndrome (SSSS) is a rare, toxin-mediated, desquamating bacterial infectious dermatosis. So far, data from Southwestern China is scarce. This study aimed to investigate the clinical characteristics of SSSS patients in our hospital, the relative proportion of methicillin-resistant Staphylococcus aureus (MRSA) in skin and soft tissue secretions, and the drug sensitivity of S. aureus to better assist dermatologists in the diagnosis and treatment of SSSS. We reviewed the demographic characteristics, clinical manifestations, treatment regimens, therapeutic efficacy, laboratory test results, drug sensitivity, and outcome data of 79 SSSS patients from January 2012 to December 2021. Statistical analysis was performed using t tests and chi-square tests. Among the 79 SSSS patients, MRSA was detected in 35 (44.3%) isolates: 34 community-acquired (CA)-MRSA (97.1%) and 1 hospital-acquired (HA)-MRSA. The SSSS incidence increased annually from 2012 to 2014 and then decreased gradually after peaking in 2015. All the isolates were sensitive to vancomycin, tigecycline, linezolid, moxifloxacin, levofloxacin, and ciprofloxacin; were completely resistant to penicillin; and had low sensitivity to clindamycin and erythromycin. Interestingly, the sensitivity of MRSA to tetracycline increased annually after 2015. The resistance rates to common drugs previously used to treat SSSS increased. These findings may accelerate diagnosis and improve empirical antibiotic use, suggesting that clinicians should prescribe drugs according to antimicrobial susceptibility. [ABSTRACT FROM AUTHOR]

Background: Kerion is a severe type of tinea capitis that is difficult to treat and remains a public health problem. Objectives: To evaluate the epidemiologic features and efficacy of different treatment schemes from real‐world experience. Methods: From 2019 to 2021, 316 patients diagnosed with kerion at 32 tertiary Chinese hospitals were enrolled. We analysed the data of each patient, including clinical characteristics, causative pathogens, treatments and outcomes. Results: Preschool children were predominantly affected and were more likely to have zoophilic infection. The most common pathogen in China was Microsporum canis. Atopic dermatitis (AD), animal contact, endothrix infection and geophilic pathogens were linked with kerion occurrence. In terms of treatment, itraconazole was the most applied antifungal agent and reduced the time to mycological cure. A total of 22.5% of patients received systemic glucocorticoids simultaneously, which reduced the time to complete symptom relief. Furthermore, glucocorticoids combined with itraconazole had better treatment efficacy, with a higher rate and shorter time to achieving mycological cure. Conclusions: Kerion often affects preschoolers and leads to serious sequelae, with AD, animal contact, and endothrix infection as potential risk factors. Glucocorticoids, especially those combined with itraconazole, had better treatment efficacy. [ABSTRACT FROM AUTHOR]

Cases of atopic dermatitis (AD)‐like rash induced by IL‐17A inhibitor secukinumab treatment (SI‐AD) have been recently reported in psoriasis patients. To identify immune and inflammatory factors expression in SI‐AD. A panel of 15 immune and inflammatory factors in peripheral blood samples from various groups, including patients with patients with SI‐AD, psoriasis with secukinumab (S‐stable), advanced psoriasis patients (Advanced) and healthy controls (HC). Interleukin‐10 (IL‐10), IL‐4 and IL‐17A were detected in skin tissue biopsy samples by immunohistochemistry and real‐time quantitative polymerase chain reaction. The immunoglobulin E levels in the SI‐AD patients exceeded normal values. The IL‐10 levels in SI‐AD patients were higher than those in S‐stable patients, advanced patients and HC. The IL‐4 levels in SI‐AD patients were higher than that in S‐stable patients and HC. The IL‐17A levels in SI‐AD patients were higher than those in advanced psoriasis patients and HC, but no significant differences were observed between SI‐AD patients and S‐stable patients. IL‐10 and IL‐4 levels were higher in AD‐like rashes than in healthy skin, while IL‐17A did not differ significantly between the two. Upon discontinuing secukinumab, and switching to oral cyclosporine, antihistamines, Janus kinase 1 inhibitor and topical glucocorticoids, SI‐AD patients experienced significant improvement in their skin lesions. Upon reexamination, all 15 immune and inflammatory factors returned to normal levels. Immune shift from Th17 towards Th2 may occur in SI‐AD, as indicated by abnormal expression of multiple immune and inflammatory factors observed in peripheral blood and skin tissues. [ABSTRACT FROM AUTHOR]

Talaromyces marneffei (TM) and Pneumocystis jirovecii (PJ) infection are opportunistic infections that typically affect individuals with compromised immune systems, such as those with HIV or immunodeficiency. However, these infections are rarely seen in patients with systemic lupus erythematosus (SLE). We present a case study of a 52-year-old woman diagnosed with SLE who developed a co-infection of TM and PJ after receiving glucocorticoids, mycophenolate mofetil (MMF), and belimumab therapy. The patient's pneumonia improved following treatment with voriconazole, clarithromycin, and compound sulfamethoxazole. This case highlights the potential risk of serious opportunistic infections in SLE patients receiving a combination of glucocorticoids, MMF, and belimumab. Close monitoring of lymphocyte count, immunoglobulin levels, and chest computed tomography scans can aid in the early detection of infections. To the best of our knowledge, this is the first reported case of TM and PJ co-infection in an SLE patient. [ABSTRACT FROM AUTHOR]

Penicillium marneffei is the only pathogenic species of A Penicillium within this grouping of >270 species. This unique feature is due to the ability of P. marneffei to exhibit temperature-dependent [...]

Talaromyces (Penicillium) marneffei is an emerging pathogen that causes significant morbidity and mortality in immunocompromised patients in endemic regions such as southeast Asia. The diagnosis of disseminated T. marneffei infection remains challenging in clinical practice. In the study, a well-validated real-time quantitative polymerase chain reaction (qPCR) target region of ITS1-5.8S-ITS2 and a Platelia galactomannan (GM) assay were compared for their diagnostic performance using serum samples from patients with or without human immunodeficiency virus (HIV). The results showed that this novel qPCR method is highly sensitive and specific for T. marneffei DNA detection in serum samples, and the limit of detection and species-specificity of qPCR were five copies of DNA and 100%, respectively. For detection in serum samples from 36 talaromycosis patients, the sensitivity of qPCR was 86.11% (31/36), including 20/20 (100%) patients with fungemia and 11/16 (68.75%) patients without fungemia. For the GM assay, the sensitivity was 80.56% (29/36) when the GM optical density cutoff index was ≥0.5, including 19/20 (95%) patients with fungemia and 10/16 (62.5%) patients without fungemia. These results indicate that the novel qPCR and GM assays can be used as a valuable tool in the diagnosis of T. marneffei infection. Serum samples are convenient hematological specimens for T. marneffei DNA quantification. Combining the GM assay and qPCR is more scientific and appropriate for diagnosing T. marneffei infection in endemic areas. [ABSTRACT FROM AUTHOR]

Penicillium marneffei is an important thermal dimorphic fungus that is endemic to Southeast Asia and China and causes penicilliosis, an AIDS-defining disease. Dimorphic switching is considered an important growth characteristic associated with its pathogenicity. In recent years, the molecular mechanisms underlying both dimorphic switching and monomorphic growth have been studied. However, little is known about the physical and chemical factors that impact either dimorphic switching or monomorphic growth of this organism. Further, the natural history of the disease is unclear. Our experiments focus upon the effects of temperature, pH and salinity on both growth phases of P. marneffei. We compared 11 isolates of P. marneffei and found that all could grow at a wide temperature range (8.0-39.8°C), but growth was dramatically inhibited at 40°C. The morphological switch from hyphae to yeast growth was initiated at 32°C. However, the sensitivity to elevated temperatures during this transition varied among isolates. Both hyphae and yeast growth forms grew much better at acidic (pH 5, 6) and neutral pH than at alkaline conditions. While similar sensitivities were observed at high concentrations of NaCl and CaCl2, in general, yeast cells displayed a greater sensitivity to both compounds. Our data demonstrate that isolate differences occur in growth patterns. Importantly, the growth requirements defined in our study may shed light on the environmental conditions that favor its survival, a subject that is not completely resolved in the current literature. [ABSTRACT FROM AUTHOR]

The article presents a case of 22-year-old man with three-month history of progressive nasal and maxillofacial swelling, and Rhinofacial entomophthoromycosis was diagnosed and itraconazole, trimethoprim–sulfamethoxazole and potassium iodide solution were given with symptom resolution.