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550 AIDS patients can be saved every day by detecting and treating fungal infections

December 01 2016

Today is WORLD AIDS DAY. In 2013, 1,500,000 people died of AIDs according to the Joint United Nations Programme on HIV/AIDS (UNAIDS) report, and 3,000,000 HIV-infected people globally are at increased risk of acquiring a life-threatening fungal infection. Each year an estimated, 700 000 deaths (47%) due to fungal disease in AIDS were estimated - twice as many deaths as estimated for patients with HIV and tuberculosis (TB) co-infection at 360 000 deaths (24%). If the world could make diagnostic tests and antifungal drugs available, annual deaths could fall for cryptococcal disease by 70,000, Pneumocystis pneumonia by 162,500, disseminated histoplasmosis by 48,000 and chronic pulmonary aspergillosis by 33,500; a total of more than 1,000,000 lives saved over 5 years.
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Burden of fungal disease in the UK Burden of fungal disease in the UK

November 16 2016

A new report published today is the first comprehensive attempt to estimate the burden of serious fungal disease in the United Kingdom. Experts are warning of a significant increase in the number of people in the UK who are living with invasive and serious fungal diseases, partly because of increased survival of otherwise fatal illnesses and an increase in immunosuppression resulting from disease treatment. In the UK there is no formal surveillance programme specific to fungal infections, although an active surveillance network exists for candidaemias and candidaemias in neonates (voluntary reporting). There is a high degree of uncertainty around the total estimate of burden due to: diagnostic limitations, the lack of a systematic national surveillance system, the limited number of studies published on the topic and the methodological limitations of calculating the burden. However crude estimates for PCP, cryptococcal meningitis, invasive aspergillosis, chronic pulmonary aspergillosis , allergic pulmonary aspergillosis, severe asthma with fungal sensitization, invasive candidiasis, candida peritonitis, oesophageal candidiasis, and mucormycosis are published in this report. Invasive aspergillosis is the commonest missed infectious diagnosis in intensive care in the UK. It is always fatal without therapy and affects from 3,288 to 4,257 patients each year, most undiagnosed. Treated invasive aspergillosis has a 30-85 per cent mortality depending on the patient group
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Origin of Sarocladium kiliense outbreak determined by whole-genome sequencing

November 14 2016

Whole-genome sequence typing (WGST) determines the genetic relationships amongst isolates by the phylogenetic analysis of single-nucleotide polymorphism differences. Typically, fewer observed differences means that strains are more closely related, and that they are more likely to have a single point source. This technology is therefore a particularly useful tool in outbreak investigations since differentiating between fungal infections originating from a single contaminated source and those independently acquired from the environment is difficult.
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Fungal mycobiome is linked to Crohn’s disease

November 09 2016

Crohn’s disease (CD) is a relapsing inflammatory bowel disease that is driven by an abnormal immune response to gut microbial antigens, suggesting a complex interplay between host genetic factors and endogenous microbial communities. It is only recently that sequencing-based investigations of the gut microbial community have included the fungal community (mycobiome) confirming the importance of fungal component of the microbiome and confirmed its involvement in Candida-host interplay in CD. The composition of the intestinal microbiota is influenced by the genetic background of the host and other factors such as diet and environmental both of which are shared within families. In a recently published article on CD patients and their healthy relatives (NCDR) vs a control group without CD or history of CD, significant microbial interactions were identified and validated using single-and mixed-species biofilms. The abundance of the fungus Candida tropicalis was significantly higher in CD than in NCDR (P0.003) samples and positively correlated with levels of anti-Saccharomyces cerevisiae antibodies (ASCA). The abundance of C. tropicalis was positively correlated with S. marcescens and E.coli, suggesting that these organisms interact in the gut. CD and NCDR groups clustered together in the mycobiome but not in the bacteriome. Microbiotas of familial (CD and NCDR) samples were distinct from those of non-familial samples. The abundance of Serratia marcescens and Escherichia coli was elevated in CD patients, while that of beneficial bacteria was decreased.
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Improving the treatment of chromoblastomycosis in rural Madagascar

November 07 2016

Even in the more economically developed countries, where multiple treatment options are available and affordable, chromoblastomycosis can be a challenge to diagnose and treat. In less economically developed countries, this challenge becomes many times greater. Madagascar has the highest number of cases of chromoblastomycosis in the world, but limited expertise and access to affordable treatment options. This means that the most effective methods to prevent adverse health outcomes, decrease disfigurement and prevent marginalisation are often unavailable for the patient. In a recently published paper, Aaron Santmyire, reports on a project to implement and evaluate a practice change in the treatment of chromoblastomycosis in the SAVA province in northeast Madagascar.
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