Fungal Infection Trust
April 2017
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Highlights of this month...

ECCMID

One of the primary meetings of the year for diagnosis and treatment is the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) which happens annually and has just run in Vienna for its 2017 iteration.
 
This year for the first time the organisers have recorded all oral presentations and have made them available for general access, so if you missed the conference or would like to listen again you can! There were many talks that are relevant to the diagnosis and treatment of aspergillosis including sessions on fungal infection, diagnosis of fungal infection, infections in transplant and cancer patients, pathogenesis and virulence, epidemiology & antifungal drugs. There are also two collections of 'top ten' papers to watch courtesy of Michaela Lackner (Diagnostics) & Bart Jan Kullberg (Infectious disease).
 
We have linked out to 28 of the most relevant talks from the Slides Presentation section of the Aspergillus Website.
 
Carolina Vidal and Paul Verweij present complementary talks entitled 'Aspergillosis - the role of the host' and 'Aspergillosis - the role of the fungus' respectively.
 
Two new antifungal drugs in development to treat aspergillosis (F901318 & SCY-078) are mentioned and shown to be effective against multiple Aspergillus strains & species and azole drug resistance strains respectively (the latter in a conference abstract #2899 by Mahmoud A. Ghannoum).
 
A first of kind study is reported by Felix Bongomin that suggests several immune system defects in patients with chronic pulmonary aspergillosis: low CD3 count.
 
NOTE there are 110 abstracts & posters from this meeting that will be added over the next few days
News
New Antifungal Toolkit 2017: The Pharmacopeia and Beyond is an Internet CME curriculum that provides current information about newer FDA-approved agents/formulations for the management of invasive fungal infections (IFIs) and evaluates their role in strategies to optimize antifungal therapy. In the 2017 updates, discussion of newer agents/formulations, emerging agents/diagnostics, and pharmacologic principles/data have been updated.
 
This educational activity is provided free of charge by University of Nebraska Medical Center, Center for Continuing Education; the Mycoses Study Group Education & Research Consortium; and Terranova Medica, LLC.
 
Abstract deadlines looming for TIMM-8 (1st June) and ICC 2017 (31st May)
 
Exciting Funding Opportunity at MRC Centre for Medical Mycology at The University of Aberdeen Early Career Research Fellowships – Closing date extended to 12 June 2017
 
As evidence of increasing interest in aspergillosis in all parts of the world we welcome Aspergillosis Meeting Report, Sari, Iran (November 2016).
 
The latest newsletter from Leading International Fungal Education has been published LIFE Newsletter April 2017
Featured Website Section
The Aspergillus Website has a section devoted to new antifungal drugs - those in development before they are routinely used in clinics. As a general rule this section contains drugs once they are in phase 1 trials and contains information about trials, original reference papers, conference abstracts and some of the news articles published occasionally. The aim is to follow the progress of these drugs as they are successfully or otherwise developed as treatments for aspergillosis (primarily).
Diagnostics
The detection of glucans in blood samples is a promising rapid non-culture technique for diagnosis of fungal infection. This paper compared the Dynamiker glucan assay with another glucan assay kit called Fungitell and Platelia, a kit for the detection of circulating galactomonnans.
121 patients (64 controls) were assessed, 21 with probable invasive aspergillosis and several other groups with different fungal infections, probable and possible. The authors conclude that the Dynamiker test results showed fair and good comparison with Fungitell and Platelia respectively. This kit may well be a useful adjunct test to invasive fungal disease, further much larger scale research is needed to assess clinical validity & utility.
Articles
Specific and Novel microRNAs Are Regulated as Response to Fungal Infection in Human Dendritic Cells.
The authors quantify micro-RNA expression in dendritic cells after infection with Aspergillus fumigatus  and Candida albicans and suggest that these molecules are involved in fine tuning the immune response of the host. Five are specific for fungal infections after 6 and 12 hours and three of the micro-RNA molecules discovered are novel.
This information adds to our knowledge of gene regulation during fungal infection and thus enhances the number of potential targets for new antifungal therapies. 
Diagnostic accuracy of low-mA chest CT reconstructed with Model Based Iterative Reconstruction in the detection of early pleuro-pulmonary complications following a lung transplantation.
A standard CT scan of the chest result in a patient dose of approximately 7mSv equivalent to two years exposure to background radiation. Patients with chronic chest conditions can have many CT scans so it would be preferable to minimise the amount of radiation exposure per scan.
This research group have tested the accuracy of carrying out reduced dose (0.65mSv) CT scans compared with standard dose scans and found it adequate and accurate for the regular scans following pulmonary transplant.
Invasive Orbital Apex Aspergillosis with Mycotic Aneurysm Formation and Subarachnoid Hemorrhage in Immunocompetent Patients.
Invasive orbital apex aspergillosis (IOAA) is an aggressive form of aspergillus infection that usually affects immunocompromised patients. It can cause orbital apex syndrome and, if not treated promptly, may progress rapidly causing fatal complications. Subarachnoid hemorrhage (SAH) secondary to ruptured mycotic aneurysms is a very rare complication of invasive aspergillosis. The authors aim to describe management and outcome of six immunocompetent patients with IOAA with subsequent SAH secondary to ruptured mycotic aneurysms.
Reviews
The authors describe the purpose of this review "To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting."
 
Damp buildings have been recognised as impacting on health (mostly respiratory health) but attempts to define any microbial cause of that impact have thus far been inconclusive. Consequently there is still a need for an accurate and robust metric to 'score' the degree of risk of health problems caused by a damp building. 
The authors of this review find that several simple (though not particularly objective) signs of damp correlate well with respiratory health problems in a damp home, better than counting the numbers of microbes that might be present in the air for example.
Mould odour, obvious signs of mould growth on walls and obvious signs of moisture in a home are good guidelines to assess potential harm to health. They are however not yet useful as clear indicators of the maximal permissable amount of damp in a home to prevent health impacts. More research is called for.
 
 
Veterinary
Although nasal masses are uncommon in sheep and may have several causes, including neoplasia and bacterial, fungal and viral infections, these lesions may lead to economic losses resulting from weight loss and even death. It is therefore important to differentiate between various categories of upper respiratory tract obstructions and lower respiratory tract infections. The correct aetiological diagnosis of obstructive masses is essential for appropriate treatment and management to be given or action to be taken. The presentation, clinical signs, treatment and pathology of a case of suspected mycotic rhinitis in a 6-year-old Mutton Merino ewe, are described.
 
ISHAM Working Group Veterinary Mycology Workshop Amsterdam, The Netherlands June 27-28th, 2017
 
Courses
We have modified our listing of courses so that you can now see them as a list as well as on a calendar.
 
 
16th ESCMID Summer School, Borstel,Germany July 1-8 2017
 
 
Omics of host and pathogens during infections, La Tronche, France September 6-8 2017
 
Specialization Course in Medical Mycology, KU Leuven Campus Gasthuisberg, Belgium Sept 11-21 2017 (Registration deadline 1st May).
 
Attention!
Contribute to clinical data on rare infections:

Patients & Carers
National Aspergillosis Centre new consultant Paschalis Vergidis introduced himself and his research plans for his time at NAC to our Aspergillosis Community meeting this month. Paschalis originates from Athens, Greece prior to extensive training at several US medical institutions including the well known Mayo Clinic. Paschalis has extensive experience working in transplant and haematology where fungal infections are prominent problems.
 
The group that are promoting singing to improve respiratory health came back after their taster session last month and decided that the interest in the meeting was not yet sufficient to start building a choir however we will offer the opportunity also to larger groups such as asthma in an attempt to boost numbers. We are also going to seek help in how we might run singing via Skype so that the many people who keep in touch via computer from all over the UK might be able to join in.
 
Finally University of Manchester student Katie Holmes visited with her student project which is a video of the dangers of mould in the home. Katie assessed people s reactions to damp homes before and after they have seen the video.
 
Watch the slides of the meeting here Katies video is also linked.
 
We are also running a successful Skype meeting every week! We are a chatty group of 8 - 12 most weeks but we can accomodate up to 24. If you have a computer or phone that has APP's you will be able to install Skype and join in - instructions at the link below. Skype at 11am BST every Thursday. Instructions will change over the next few weeks so go to http://www.nacpatients.org.uk/content/skype-group for the latest information.
 
Aspergillosis Community (National Aspergillosis Centre) normally meets on the first friday of each month at the Altounyan Suite, North West Lung Centre, Manchester at 1.30pm BST/GMT. If you can't make it in person, you are welcome to listen in to our live broadcast.

If you want a text reminder when each meeting is approaching (UK only) then send us an email at admin@aspergillus.org.uk with your mobile phone number.
 
Fungal Infection Trust, PO Box 482, Macclesfield, Cheshire SK10 9AR