Aspergillus Newsletter
March 2015

In hospital transfer a risk for IPA

Invasive pulmonary aspergillosis (IPA) is known to be both a relatively common infection in immunocompromised patients after transplant surgery and extremely difficult to treat with high mortality. Consequently prevention is a high priority.
 
Those factors that increase the risk of infection have been looked at extensively and include air, food, furniture, dust, local building works, staff, visitors and more. Attempt to provide air cleaned of moulds to those at high risk have been successful at reducing numbers of infections and this recent paper attempts to analyse further the relative importance of several risk factors by carrying out a retrospective matched case analysis of 29 patients with invasive fungal infection against 102 matched control cases hospitalised at the same time.
 
The main risk identified was when patients were transferred out of the protected hematology ward for relatively short periods of time as they were taken to undergo procedures in different parts of the hospital. The authors conclude that more attention needs to be paid to protecting patients from inhalation of spores at all times during their stay at hospital, especially while being moved to and through other parts of the hospital. This was achieved by better control of the sources of the moulds using fungal prophylaxis, better air filter maintenance, barriers, ensuring doors on wards closed automatically, protected bed & clothing for patients while being transported and ensuring all staff were aware of the additional measures needed to cut risk of infection.
News
 
 
7th Advances Against Aspergillosis will be held in Manchester, UK on 3-5th March 2016.
 
Fungal disease deaths - for $30 per patient a drastic reduction in AIDS deaths globally. The early detection and treatment of fungal meningitis and pneumonia can save hundreds of thousands of lives, for a cost of 'only $30' per HIV patient, the world's first stakeholder meeting on fungal diseases has concluded. The meeting in Seattle, was hosted by GAFFI (Global Action Fund for Fungal Infections) and held in Seattle. Policy makers, doctors and researchers from around the world called for immediate action on fungal infections to save lives across the world.
 
We have uploaded a series of presentations recorded at the recent Antifungal Drug Development Summit (2015)
 
NIAID January 2015 Concepts. Of particular note to the mycology community in the January cleared concepts within the SBIR Contract Solicitation Topics is Vaccines Against Pathogens With Small Market Potential which plans to support investigators ‘developing vaccines against pathogens affecting a relatively small segment of the U.S. population [that includes most of our invasive fungi] as a critical priority.
 
Dr Jenny Long is going to run the London Marathon 2015 in aid of the Fungal Infection Trust. A trainee ENT surgeon Jenny will be running this distance for the first time and we should offer her all the encouragement we can!
 
Read about this challenge and donate to support FIT at www.fit.care.
 
Articles
NOTE access to all articles now requires registration (free of charge)
 
In-Hospital Transfer Is a Risk Factor for Invasive Filamentous Fungal Infection among Hospitalized Patients with Hematological Malignancies: A Matched Case-Control Study.
This IFFI outbreak was characterized by a strong association with exposure to the unprotected environment outside the hematology ward during patient transfer. The independent associations of a high number of transfers with the presence of neutropenia suggest that affected patients were probably not sufficiently protected during transport in the corridors. Our study highlights that a heightened awareness of the need for preventive measures during the entire care process of at-risk patients should be promoted among healthcare workers.
 
High Resolution Computer Tomography Angiography Improves the Radiographic Diagnosis of Invasive Mold Disease in Patients with Hematology Malignancies
Computer tomography pulmonary angiography (CTPA) may improve the diagnostic capabilities of CT imaging for invasive mold disease, but its performance relative to other signs (i.e. halo sign, hypodense sign, pleural effusion, reverse halo sign) is unknown. Conclusions: Vessel occlusion detected by CTPA is a more sensitive and possibly more specific radiographic sign versus other common CT findings of invasive mold disease in patients with hematological malignancies.
 
Sputum and bronchial secretion samples are equally useful as bronchoalveolar lavage samples for the diagnosis of invasive pulmonary aspergillosis in selected patients.
 In the absence of histopathology studies of lung biopsies, the bronchoalveolar lavage (BAL) sample is preferred for the diagnosis of invasive pulmonary aspergillosis. Isolation of Aspergillus fumigatus from sputum and bronchial secretion samples are commonly interpreted as colonization or laboratory contamination, particularly in nonneutropenic patients. We studied if sputum/bronchial secretions and BAL samples are equally useful for the diagnosis of invasive pulmonary aspergillosis. Matches between BAL and sputum/bronchial secretions were observed in patients with identical genotypes in BAL and sputum/bronchial secretions.
 In 13 of the 14 patients (93%), we found matching genotypes in the BAL and the sputum/bronchial secretion samples. Genotyping showed that samples of sputum or bronchial secretions were equally useful as samples of BAL for the diagnosis of invasive pulmonary aspergillosis.
 
 
Aspergillus fumigatus mycovirus causes mild hypervirulent effect on pathogenicity when tested on Galleria mellonella.
Mycoviruses are a specific group of viruses that naturally infect and replicate in fungi. The importance of mycoviruses was revealed after their effects were identified not only in economically important fungi but also in the human pathogenic fungus Aspergillus fumigatus. Here we show, for the first time, the effects of a partitivirus and an uncharacterized A78 virus on the pathogenicity of A. fumigatus.
Reviews/Overviews
The Cell Factory Aspergillus Enters the Big Data Era: Opportunities and Challenges for Optimising Product Formation.
Living with limits. Getting more from less. Producing commodities and high-value products from renewable resources including waste. What is the driving force and quintessence of bioeconomy outlines the lifestyle and product portfolio of Aspergillus, a saprophytic genus, to which some of the top-performing microbial cell factories belong: Aspergillus niger, Aspergillus oryzae and Aspergillus terreus. What makes them so interesting for exploitation in biotechnology and how can they help us to address key challenges of the twenty-first century? How can these strains become trimmed for better growth on second-generation feedstocks and how can we enlarge their product portfolio by genetic and metabolic engineering to get more from less? On the other hand, what makes it so challenging to deduce biological meaning from the wealth of Aspergillus -omics data? And which hurdles hinder us to model and engineer industrial strains for higher productivity and better rheological performance under industrial cultivation conditions? In this review, we will address these issues by highlighting most recent findings from the Aspergillus research with a focus on fungal growth, physiology, morphology and product formation.
 
The growing use of immunosuppressive therapies has resulted in a dramatic increased incidence of invasive fungal infections (IFIs) caused by Aspergillus fumigatus, a common pathogen, and is also associated with a high mortality rate. Azoles are the primary guideline-recommended therapy agents for first-line treatment and prevention of IFIs. However, increased azole usage in medicinal and agricultural settings has caused azole-resistant isolates to repeatedly emerge in the environment, resulting in a significant threat to human health. In this review, we present and summarize current research on the resistance mechanisms of azoles in A. fumigatus as well as efficient susceptibility testing methods. Moreover, we analyze and discuss the putative clinical (bedside) indication of these findings from bench work.
Deadlines
 
 
Courses
Masters in Medical Mycology, University of Manchester, UK 2015-2016 Applications for this one-year taught Masters programme in Medical Mycology are now open. Following its launch in 2013 this unrivaled degree has attracted scientists and clinicians from all over the globe who have acquired practical and clinical science skills which will help them succeed in becoming mycology ambassadors and practitioners in their home countries. The Faculty for the Manchester Medical Mycology programme is world-renowned with a number of leading scientists, clinician scientists and medical mycologists.
 
 
 
Molecular Mycology: Current Approaches to Fungal Pathogenesis Woods Hole, Falmouth, MA, USA. 14 - 30 June 2015
Veterinary

Update on Fungal Respiratory Disease in Horses.

Fungal respiratory disease is a rare occurrence in horses. Fungal organisms are ubiquitous in the equine environment; however, there is a geographic predisposition for disease development, with fungal respiratory infections seen more commonly by practitioners working in tropical or subtropical environments. Diagnosis and treatment of fungal respiratory infections pose a challenge for the equine practitioner, and the prognosis for complete resolution of infection is often guarded; however, new antifungal medications are likely to improve treatment success. This article summarizes the available literature regarding the cause, diagnosis, and treatment of equine fungal respiratory disease.
Attention Clinicians & Scientists
Nominate fungal (incl. non-pathogenic) genomes for sequencing at the Joint Genome Institute (JGI) here
 
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Patients
Please note that the Aspergillosis Community Meeting for 3rd April 2015 will now be held on the 2nd as the 3rd is Good Friday and there is no clinic - see newsletter for details. The location will be moved to the Education and Research Centre, UHSM - meet at reception.
 
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Dr Jenny LongJenny Long running the 2015 London Marathon
 
Floral Teddy in Memory of Denise Barnes
Wendy Fuller's runners in memory of Denise Barnes
 
 
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