April 2020
  Research highlight
Knowledge into invasive fungal diseases during COVID-19 continues to develop
Influenza can be complicated by invasive aspergillosis, as first described in 1952. About 35% of critically ill patients with COVID-19 are treated with corticosteroids and we know from meta-analyses that these patients have nearly double the mortality, lower ICU stay and more secondary infections, probably including aspergillosis (Rodrigo et al., 2015 and Ni et al., 2019). This link with corticosteroids is likely with COVID-19. Aspergillus antigen testing of respiratory fluids should be routine for these very ill patients.
Research into COVID-19 is taking place at an incredible pace but there is still much we don’t know. One key unknown is the frequency and impact of co-infections. Gangneux et al., 2020 highlights the fact that invasive fungal infections are still rarely reported and may be underdiagnosed. It reports what is not known and what should be done.
Studies are starting to emerge reporting fungal co-infection rates. Koehler et al., published this week that clinicians caring for patients with ARDS due to COVID-19 should consider invasive pulmonary aspergillosis and subject respiratory samples to comprehensive analysis to detect co-infection. They noted that five of 19 critically ill patients (26%) developed COVID-19 associated invasive pulmonary aspergillosis.  A pre-published report from Alanio et al. found putative IPA in almost one third of successive critically ill COVID-19 patients (not yet peer-reviewed). A further early release article describes a fatal case of invasive pulmonary aspergillosis in an immunocompetent patient in France who had severe coronavirus disease–associated pneumonia (Blaize et al., 2020).
As further research is undertaken we will collate it and make it available on the LIFE Worldwide website. The page will be updated as more information becomes available.
  News and notices
Association of Medical Microbiology and Infectious Disease Canada - Canadian Annual Meeting in Infectious Diseases and Microbiology 2020 has been cancelled. It was due to take place from 29 April to 2 May. Deferral of registration fees to 2021 is not possible. AMMI Canada – CACMID Annual Conference 2021 will take place from 28 April to 1 May, in Toronto, ON at the Westin Harbour Castle.
The Congress of the International Society for Human and Animal Mycology (ISHAM) Asia Fungal Working Group (ISHAM Asia) 2020 is scheduled to take place on 6-8 August, 2020 at the Royal Orchid Sheraton Hotel & Towers, Bangkok, Thailand. Abstract submission closes on 29 May.
The 4th ISHAM-International Veterinary Mycology Course will be held in Romania from 7th to 11th September, 2020. Registration is open until 5th July.
Myc2020, the 54th Scientific Conference of the German speaking Mycological Society, is scheduled to take place on 16-19 September 2020 in WŌčrzburg.
The MSGERC biennial meeting "Clinical Mycology Today" is scheduled to take place on 22-25 September 2020 in Albuquerque, New Mexico, USA. 
  Research articles
Deep cutaneous fungal infections in solid-organ transplant recipients (Galezowski et al., 2020)
This retrospective, observational, multicentre study was conducted in France to determine deep cutaneous fungal infections (DCFIs) diagnostic characteristics and outcomes with treatments in adult solid-organ transplant recipients. It describes the diversity and occurrence frequency of DCFIs. Phaeohyphomycoses were the most frequent DCFIs, representing a prevalence of 46%. Aspergillus species represented 8.7%.
Prevalence of fungal infection in nasal polyposis - A cross-sectional study, conducted at a tertiary care hospital in Karachi (Qaisar Sajjad et al., 2020)
This cross sectional study, carried out from October 2010 to January 2015 on 221 patients in a tertiary care centre in Karachi was undertaken to determine the prevalence of fungal infections in nasal polyposis. Data was collected, a descriptive analysis was performed and a Computed Tomography (CT) grading was done. On the basis of histopathology, 90 (40.7%) patients were found to have fungal infection.
Functional characterization of clinical isolates of the opportunistic fungal pathogen Aspergillus nidulans (Bastos et al., 2020)
Aspergillus nidulans has mainly been studied in the context of chronic granulomatous disease (CGD), with characterisation of clinical isolates obtained from non-CGD patients remaining elusive. This study reports a detailed biological characterisation of two A. nidulans clinical isolates (CIs), obtained from a patient with breast carcinoma and pneumonia and from a patient with cystic fibrosis that underwent lung transplantation, and compared them to the reference, nonclinical FGSC A4 strain. Differences in metabolic responses, growth rates and other strain-specific virulence traits and pathogenicity are described.
Diversity of secondary metabolism in Aspergillus nidulans clinical isolates (Drott et al., 2020)
Despite its importance, there is little information about the natural diversity of secondary metabolism (SM) in A. nidulans. This paper describes six novel clusters that contribute to the considerable variation in both biosynthetic gene clusters content and SM production within A. nidulans. The authors emphasize that A. nidulans may also be a strong model to use within-species diversity to elucidate regulatory cross talk, fungal ecology, and drug discovery systems.
Exposure to mold proteases stimulates mucin production in airway epithelial cells through Ras/Raf1/ERK signal pathway. (Wu et al., 2020).
This paper seeks to understand the underlying molecular mechanisms of airway obstruction and immune hyper-responsiveness caused by mucus overproduction in A.fumigatus induced lung diseases. It identifies and describes a novel downstream signal pathways that mediate A.fumigatus induced mucin production in airway epithelial cells. The discovery of this novel pathway contributes to the understanding of the pathogenesis of fungal sensitisation in allergic diseases such as fungal asthma.
  Veterinary article
Simultaneous detection of Aspergillus nidulans, Aspergillus luchuensis and Lichtheimia sp. in a bovine abortion (Pesca et al., 2020)
A mixed infection due to more than one fungus in abortion is rarely demonstrated but this report describes an abortion case in a Chianina cow due to Aspergillus nidulans, Aspergillus luchuensis and Lichtheimia sp. diagnosed by histology, cytology, culture and molecular assays.
Treatment of allergic bronchopulmonary aspergillosis: from evidence to practice (Dhooria et al., 2020)
This review illustrates the treatment pathway for ABPA in different situations, using a case-based approach. In each case, the options for treatment based on the available evidence from recent clinical trials is presented.
Detecting azole-antifungal resistance in Aspergillus fumigatus by pyrosequencing (van der Torre et al., 2020)
Failure to detect azole-resistance dramatically increases the mortality rates of azole-treated patients. Despite drug susceptibility tests not being routinely performed currently, the authors of this review suggest including resistance testing whilst diagnosing Aspergillus disease. It also describes current diagnostic methods and highlights the potential of pyrosequencing to aid in a diagnosis complete with a resistance profile to improve clinical outcomes.
Role of lipid transporters in fungal physiology and pathogenicity (Rizzo et al., 2019).
This review focuses on the structural and biological aspects of ATP-driven lipid transporters, comprising P-type ATPases and ATP-binding cassette transporters, (ii) the role of these transporters in fungal physiology and virulence, and (iii) the potential of lipid transporters as targets for the development of novel antifungals. These recent observations indicate that the lipid-trafficking machinery in fungi is a promising target for studies on physiology, pathogenesis and drug development.
  Patients and carers
Coronavirus Outbreak 2020 ANNOUNCEMENT: A notice for all patients that attend the National Aspergillosis Centre, Manchester, UK, 10th April.
As you will be aware the NHS faces unprecedented times due to the Coronavirus pandemic. The National Aspergillosis Centre (NAC) team are extremely busy working on the frontline.
NAC is currently still trying to offer telephone consultations in place of face to face appointments. However, they are currently overwhelmed with the numbers of calls still required. NAC politely requests that you call them to postpone all non-urgent telephone appointments.
Further information on this, and other COVID-19 information is available on aspergillosis.org.
Other meetings and support
We host a weekly video phone call with around 4-8 patients and a member of NAC staff each week. You can use a computer or mobile device to join the video but you need to register in advance. This meeting runs from 10:00-11:00 BST every Thursday.
To receive a text reminder when each meeting is approaching send us your mobile phone number (NB this doesn't operate in the US) to admin@aspergillus.org.uk.
Join our Facebook Groups
  • Our Aspergillosis Support Facebook Group has over 2000 members and is a safe place to meet and talk to other people with aspergillosis.
  • We also have a Facebook group for carers, friends and family of someone who is affected by the disease - join here
  • To find our regional and international groups, search for 'aspergillosis' in Facebook.
Clinical networks
Many conferences have been cancelled or postponed as a result of the Coronavirus pandemic. We advise you to check directly with the organisers of the conference you are interested in for the most up to date information. The conferences below are scheduled to proceed (correct at time of writing)
Veterinary Mycology Course, Romania7th to 11th September, 2020
54th Scientific Conference of the German Speaking Mycological Society. 3rd Interational Symposium of the CRC/Transregio FungiNet.Wurzburg, Germany 16th-19th September 2020
See more groups and societies
Visit our sites
(free online microscopy course)
(fungal education for clinicians)

Fungal Infection Trust, PO Box 482, Macclesfield, Cheshire SK10 9AR