Disaster mycology

Natural and human-made disasters have long played a role in shaping the environment and microbial communities, also affecting non-microbial life on Earth. Disaster microbiology is a new concept based on the notion that a disaster changes the environment causing adaptation or alteration of microbial populations-growth, death, transportation to a new area, development traits, or resistance-that can have downstream effects on the affected ecosystem. Such downstream effects include blooms of microbial populations and the ability to colonize a new niche or host, cause disease, or survive in former extreme conditions. Throughout history, fungal populations have been affected by disasters. There are prehistoric archeological records of fungal blooms after asteroid impacts and fungi implicated in the fall of the dinosaurs. In recent times, drought and dust storms have caused disturbance of soil fungi, and hurricanes have induced the growth of molds on wet surfaces, resulting in an increased incidence of fungal disease. Probably, the anticipated increase in extreme heat would force fungi adaptation to survive at high temperatures, like those in the human body, and thus be able to infect mammals. This may lead to a drastic rise of new fungal diseases in humans.

Los desastres naturales o los causados por el hombre impactan la formación de ecosistemas y comunidades microbianas, y también afectan las formas de vida no microbianas. Este concepto es conocido como "microbiología de desastres", una subespecialización de la microbiología, basada en los cambios ambientales generados por un desastre y las posibles adaptaciones o alteraciones de las poblaciones microbianas -crecimiento, muerte, trasporte a una nueva región, o adquisición de resistencia o de nuevas características- que influirán en el moldeamiento del ecosistema transformado. Algunos de los efectos de estas adaptaciones pueden ser: el surgimiento de poblaciones microbianas, la habilidad de colonizar nuevos nichos u huéspedes, la generación de nuevas enfermedades, o el crecimiento de microorganismos en condiciones que antes eran "extremas" para ellos. A lo largo de la historia, varias poblaciones de hongos han sido afectadas por desastres. Existen registros arqueológicos prehistóricos que evidencian la presencia y el crecimiento de hongos luego del impacto de asteroides, y otros de hongos relacionados con la extinción de los dinosaurios. Actualmente, las sequías y las tormentas de polvo causan perturbaciones en las comunidades de hongos del suelo, y los huracanes inducen el crecimiento de hongos filamentosos en superficies húmedas, lo que aumenta la cantidad de enfermedades por hongos. Además, con el aumento de las temperaturas extremas es posible que los hongos puedan adaptarse para sobrevivir a temperaturas más altas, equivalentes a las temperaturas corporales, y nuevas especies puedan infectar mamíferos. Esto puede llevar a un aumento drástico de las infecciones fúngicas en humanos.

Brote de tinea capitis tricofítica en un grupo de niños escolares en un área rural del departamento del Cauca, Colombia / An outbreak of trichophytic tinea capitis in a group of schoolchildren in a rural area of the department of Cauca, Colombia

Introducción. La tiña de la cabeza es una micosis que se presenta en el tejido queratinizado, afecta al cuero cabelludo y puede causar alopecia, prurito y descamación. Este tipo de micosis es más frecuente en niños de edad escolar, por lo que puede desencadenar un problema de salud pública. En Colombia, los principales agentes etiológicos reportados son los dermatofitos zoofílicos. Objetivo. En el presente estudio se buscó caracterizar un brote de tinea capitis en 32 niños de un colegio de la zona rural del departamento del Cauca. Materiales y métodos. Se llevó a cabo una investigación epidemiológica de campo en la que se aplicó una encuesta estructurada para caracterizar aspectos sociodemográficos y factores predisponentes para su ocurrencia. Se recolectaron muestras de escamas de cuero cabelludo y cabellos afectados para estudios micológicos. Finalmente, por medio de la Secretaría Departamental del Cauca y del hospital local, se manejó el brote de tinea capitis y se hicieron recomendaciones a los niños, los padres de familia y la población en general para prevenir estas micosis. Este estudio contó con el consentimiento informado verbal por parte de los padres de familia y los niños. Resultados. El agente etiológico aislado en el 63 % de las muestras recolectadas fue Trichophyton tonsurans y el principal factor predisponente para esta micosis fue compartir máquinas rasuradoras (87,5 %). El agente etiológico de este brote de tinea capitis no inflamatoria fue un dermatofito antropofílico. Conclusión. Idealmente, se deben practicar los estudios micológicos con el fin de establecer el agente etiológico y, así, plantear las terapéuticas y recomendaciones según las guías de manejo. Además, se debe realizar un trabajo multidisciplinario para el control del brote y la educación de la población respecto a esta micosis.

Introduction. Tinea capitis is a mycosis of keratinized tissue, which affects the scalp and may cause alopecia, pruritus, and desquamation. This type of mycosis is more frequent in school-age children, and it may represent a public health problem; the main etiological agents reported for Colombia are zoophilic dermatophytes. Objective. To characterize an outbreak of Tinea capitis in 32 children from a rural school in the department of Cauca. Materials and methods. We conducted an epidemiological field study using a structured survey to characterize sociodemographic aspects and predisposing factors for this mycosis. We collected samples of affected scalp scales and hair for mycological studies. The children and the general population received recommendations, about these mycoses' prevention, from Cauca's health authorities and the local hospital. The parents verbally approved the informed consent. Results. The etiological agent isolated in 63% of the collected samples was Trichophyton tonsurans, an anthropophilic dermatophyte, and the main predisposing factor was sharing razors (87.5%). Conclusions. Ideally, mycological studies define the etiological agent to propose therapeutics and recommendations in agreement with management guidelines. Implementation of multidisciplinary measures to control the outbreak and educate the population is required.

Una experiencia de siete años en el laboratorio de Micología del Hospital de Pediatría Juan P. Garrahan / A seven-year experience in the Mycology Laboratory of Hospital de Pediatría Juan P. Garrahan

En noviembre del año 2015 nos incorporamos al Laboratorio de Micología del Servicio de Microbiología del Hospital Garrahan. En este breve resumen queremos compartir los avances logrados a través de nuestra experiencia durante siete años de trabajo profesional. Debido a los diagnósticos realizados y su complejidad, consideramos que el Hospital Garrahan, sus pacientes y la comunidad toda necesitan contar con un laboratorio de Micología que responda a sus necesidades. Creemos haber iniciado un camino que esperamos continúe y culmine con la creación de la Unidad de Micología (AU)

In November 2015 we joined the Mycology Laboratory of the Microbiology Service of the Hospital Garrahan. In this brief summary we want to share the advances achieved through our experience during seven years of professional work. Due to the diagnosis made and their complexity, we believe that the Hospital Garrahan, its patients and the entire community, need to have a Mycology laboratory that responds to their requirements. We believe we have started a path that we hope will continue and culminate with the creation of the Mycology Unit (AU)

Effectiveness of the National Quality Control Program in Mycology of Argentina and performance evaluation of participating laboratorios / Efectividad del Programa Nacional de Control de Calidad en Micología de Argentina y evaluación del desempeño de los laboratorios participantes

Abstract The National Quality Control Program in Mycology (PNCCM) of Argentina was establishedin 1996 to improve the quality of the mycological diagnosis, to help establish and to setup standardized procedures and continuous training of laboratory staff. The aim of this studywas to assess the effectiveness of the PNCCM in the 1996---2018 period. Data from the NationalMycology Laboratory Network (NMLN) and PNCCM database was used to estimate the increasein the number of controlled laboratories and jurisdictions, the percentage of participation, theimprovement in the quality of results and the adherence to the program. Satisfaction surveyswere performed to assess user satisfaction. The number of controlled laboratories increasedfrom 29 to 146; participation increased from 49% to 93% and general adherence was 72% inthe evaluated period (1996---2018). Improvement in the quality of the results was 15% for lowcomplexity samples; 7% for intermediate complexity samples and 14% for the identification ofhigh complexity strains. Up to 84% of the users consider the PNCCM to be ''very good'' and 16%''satisfactory''. These results show the importance of the PNCCM, which is widely accepted bymycological diagnostic laboratories from Argentina.

Resumen En 1996 se creó el Programa Nacional de Control de Calidad en Micología (PNCCM)de Argentina con el objetivo de mejorar la calidad del diagnóstico micológico, colaborar enel establecimiento de procedimientos estandarizados en aquellos laboratorios que carecen deellos y contribuir a la capacitación continua del personal.El objetivo de este estudio fue evaluar la efectividad del PNCCM en el período 1996-2018.Se utilizaron los datos de la base de la Red Nacional de Laboratorios de Micología (RNLM) ydel PNCCM para estimar el aumento en el número de laboratorios controlados y el porcentajede participación, la mejora de la calidad de los resultados y la adhesión al programa. Paraevaluar el grado de satisfacción de los usuarios, se analizaron las encuestas de satisfacción delos participantes. En el período evaluado, el número de laboratorios controlados aumentó de 29a 146, la participación aumentó de 49% a 93% y la adherencia general de los participantes fue del72%. La mejora de la calidad de los resultados de los laboratorios fue del 15% para muestras debaja complejidad, 7% para muestras de complejidad intermedia y 14% para la identificación decepas de alta complejidad. El 84% de los usuarios considera que el PNCCM es muy bueno y el 16%que es satisfactorio. Estos resultados evidencian la importancia del PNCCM, que es ampliamenteaceptado por los laboratorios que realizan diagnóstico micológico en nuestro país.

National production of certified reference fungal cultures / Producción nacional de cultivos fúngicos de referencia certificados

Reference fungal cultures (RFCs) are essential for the internal quality control of laboratories. The production of these cultures requires standardized procedures (IRAM 14950:2016 and ISO 17034:2016 standards) carried out by a recognized and accredited laboratory. The aim of this work was to produce RFC in paper disks of autochthonous strains, characterized by two, homogeneous and stable reference methods traceable at species level. RFC were produced using 14 regional species (7 yeasts and 7 filamentous fungi) from the fungal culture collection (DMic). Paper disks were impregnated with a culture suspension, dried and packed. Homogeneity, viability, identity and purity were verified. Short-and long-term stability at different temperatures and storage times were studied. Characterization of each strain allowed to confirm its identity and to ensure its traceability at international level. Produced batches were homogeneous and stable at -20 ±5 °C for 30 months. This method of production was adequate to produce homogeneous and stable RFC with phenotypic and genotypic characteristics correctly defined and internationally traceable. Standardized procedures were developed for the production of certified RFC that could be transferred to other microorganisms. Providing RFC that represent regional strains allows laboratories to produce more reliable results with a favorable impact on medical diagnosis, the environment or the food industry.

Los cultivos microbianos de referencia (CR) son imprescindibles para el control de calidad interno de los laboratorios. Asegurar su producción requiere de procedimientos estandarizados (IRAM 14950:2016 e ISO 17034:2016) realizados en un laboratorio reconocido y acreditado. El objetivo de este estudio fue producir cultivos fúngicos de referencia en discos de papel, a partir de un panel de cultivos autóctonos caracterizados por dos métodos de referencia, trazables a nivel taxonómico de especie, homogéneos y estables. Se produjeron CR de 14 especies circulantes en Argentina (7 de levaduras y 7 de hongos miceliales), depositadas en la colección de hongos de interés médico (DMic). Los discos de papel fueron embebidos con una suspensión del cultivo por producir, secados y envasados. Se verificó la homogeneidad, viabilidad, identidad y pureza de cada lote. Se evaluó la estabilidad a corto y largo plazo a distintas temperaturas y tiempos de almacenamiento. La caracterización de cada CR nos permitió confirmar su identidad y asegurar su trazabilidad a nivel internacional. Los lotes producidos fueron homogéneos y estables durante 30 meses conservados a -20 ±5 °C. Este método resultó adecuado para producir CR homogéneos y estables, con características fenotípicas y genotípicas correctamente definidas y trazables a nivel internacional. Los procedimientos estandarizados desarrollados en este trabajo pueden ser transferidos para producir CR certificados de otros microorganismos. La provisión de CR que represente cepas regionales permite a los laboratorios producir resultados más confiables con un impacto favorable en el diagnóstico médico, los estudios ambientales y la industria alimenticia.

Métodos de diagnóstico en micología / Diagnostic methods in mycology

Resumen El diagnóstico de las micosis constituye un problema clínico y terapéutico de interés actual debido al incremento y gravedad de las infecciones diseminadas. Por esta razón, en los últimos años se ha priorizado la búsqueda de nuevos métodos para el diagnóstico rápido y preciso. En la actualidad contamos con métodos tradicionales como KOH, cultivo, histopatología y serología, y, de forma más reciente, con métodos moleculares que permiten mayor rapidez y sensibilidad. En esta revisión se hace énfasis en la importancia de los métodos de diagnóstico micológico para la dermatología y la medicina general, ya que debido al desconocimiento en este campo, la preparación del paciente no es la adecuada y, por otro lado, la dificultad en la interpretación de los resultados lleva a confusión y tratamientos incorrectos.

Abstract Diagnosis of fungal infections is a clinical and therapeutic problem of current interest due to the increase and severity of disseminated infections. For this reason in recent years have been mainly seeking new methods for fast and accurate diagnosis. At present we have traditional methods like KOH, culture, histopathology and serology, and more recently molecular methods that allow greater speed and sensitivity in diagnosis. This review emphasizes the importance of mycological diagnosis methods for dermatology and general medicine, as due to ignorance in this field, patient preparation is not adequate and secondly the difficulty in interpreting results and treatment choice are misleading.

Density and diversity of filamentous fungi in the water and sediment of Araçá bay in São Sebastião, São Paulo, Brazil / Densidade e diversidade de fungos filamentosos na água e sedimento da Baía do Araçá, São Sebastião (SP), Brasil

Abstract Araçá Bay, located in the city of São Sebastião, São Paulo, Brazil, is a protected area of substantial complexity. It represents the last remaining mangrove swamp preserve between the cities of Bertioga and Ubatuba on the northern coast of São Paulo State. This mangrove swamp has specific physical and chemical properties, and it shelters a wide variety of life, including fungi. These microorganisms are present in a variety of species with different morphophysiological features, and they have the ability to produce enzymes of biotechnological importance. The goal of this study was to quantify, isolate, and identify filamentous fungi in water and sediment samples from the Araçá Bay mangrove swamp in São Sebastião. Two samplings were performed in the summer and two were performed in the winter. The samples were collected from intertidal zones, and dissolved oxygen (DO), temperature, salinity, and pH were measured in situ. The spread plate technique was used to inoculate the samples collected on plates with a potato dextrose agar (PDA) medium. A total of 208 colonies (68 from water samples and 140 from sediment samples) were isolated, and they were identified based on their morphological characteristics. Filamentous fungus density was higher in the sediment than in the water, and the samplings performed in the winter revealed a higher density than those performed in the summer. Though some of the environmental parameters were not ideal for fungal development, a high quantity of growth was nevertheless observed. When the isolated colonies were analyzed, the greatest diversity and species richness were found in the summer samples. The genera identified in all of the samples were Aspergillus, Penicillium, Cladosporium, and Fusarium. The pathogenic species found from these genera were Aspergillus fumigatus, A. terreus, Penicillium citrinum, and P. chrysogenum. These species are also able to produce enzymes that offer a variety of applications. The fungal community described herein represents the diversity found in this mangrove swamp during the period studied. Many of the fungus species found are pathogenic and may be useful due to their ability to produce specific enzymes applicable in the biotechnological and pharmaceutical industries.

Resumo A Baía do Araçá, localizada no município de São Sebastião (SP), é uma região protegida, de grande complexidade, mantendo o último remanescente preservado de manguezal entre Bertioga e Ubatuba, litoral Norte do Estado de São Paulo. Manguezal caracteriza-se com propriedades físico-químicas específicas e abriga grande diversidade de seres vivos, entre eles os fungos. Estes microrganismos apresentam grande variedade de espécies e diferentes características morfofisiológicas com capacidade de produzir algumas enzimas de importância biotecnológica. Este trabalho teve como objetivo quantificar, isolar e identificar fungos filamentosos em amostras de água e de sedimento do manguezal da Baía do Araçá, São Sebastião, (SP). Foram realizadas 2 coletas no verão e 2 no inverno na região entremarés, medidos "in situ" os parâmetros oxigênio dissolvido (OD), temperatura, salinidade e pH. Utilizou-se a Técnica "Spread Plate" para inocular os materiais coletados, em placas com meio Potato Dextrose Agar (PDA). Foram isoladas 208 colônias (68 das amostras de água e 140 das amostras de sedimento) e identificadas pelas características morfofisiológicas. As densidades de fungos filamentosos foram maiores no sedimento em relação à água e nas coletas realizadas no inverno demonstraram maiores densidades do que no verão. Apesar de alguns parâmetros ambientais não se apresentarem ideais para o desenvolvimento dos fungos, observou-se alta quantidade de crescimento nas amostragens. Analisando as colônias isoladas, a maior diversidade e riqueza foram observadas na amostragem coletado no verão. Foram observados os gêneros Aspergillus sp, Penicillium sp, Cladosporium sp e Fusarium sp em todas as amostragens, dos quais as espécies Aspergillus fumigatus, A. terreus, Penicillium citrinum e P. chrysogenum identificados neste trabalho são considerados patogênicos mas também são espécies capazes de produzir enzimas aplicáveis em diversas atividades. A comunidade fúngica descrita apresenta a diversidade encontrada neste manguezal em relação à variedade ambiental no período estudado, sendo que muitos apresentam patogenicidade e podem ser uteis pela sua capacidade de produzir enzimas específicas aplicáveis nos estudos biotecnológicos e farmacêuticos.

Especialistas graduados en el Instituto Nacional de Higiene "Rafael Rangel", tutoría y trabajos especiales de grado en el área de micología médica durante el periodo 2007 ­ 2014 / Specialists graduated in the National Institute of Hygiene "Rafael Rangel", tutorship and degree theses in the area of medical mycology, period 2007 ­ 2014

El Instituto Nacional de Higiene "Rafael Rangel" (INHRR) inició las actividades académicas de la Especialización en Micología Médica en septiembre de 2007. En los primeros ocho años de actividad, el Instituto ha concluido cuatro cohortes de especialistas. El objetivo del presente trabajo fue presentar una descripción de los especialistas graduados en el INHRR, los tutores y los trabajos especiales de grado (TEG) en el área de micología médica durante el periodo 2007 ­ 2014. Para ello, se realizó una investigación documental y de tipo descriptiva, revisando los expedientes resguardados en los archivos de la Coordinación de Postgrado de la Gerencia de Docencia e Investigación del INHRR. Con este programa de postgrado, el Instituto graduó a 23 especialistas en micología médica con un elevado índice académico (17,5 puntos). La mayoría de los egresados de la especialización fueron mujeres bioanalistas egresadas de la Universidad Central de Venezuela, quienes laboraban en entes públicos al momento de iniciar el programa. El 61% de los TEG defendidos se realizaron dentro de dos de las líneas de investigación que lleva adelante el Departamento de Micología Médica del INHRR, a saber: las micosis en pacientes inmunocompetentes e inmunocomprometidos utilizando el diagnóstico convencional y la resistencia antifúngica de hongos levaduriformes. Ocho profesionales fueron los encargados de dirigir los TEG, bajo la figura de tutor: dos se destacaron por haber dirigido el 52% de los TEG y tres por ser egresados de la especialización. Solo el 38% de los tutores fueron externos al Instituto

The National Institute of Hygiene "Rafael Rangel" (INHRR) began the academic activities of the Medical Mycology Specialization in September 2007. In the first eight years, the Institute has graduated four cohorts of specialists. The aim of this work was to present a description of the specialists graduated in the INHRR, their advisors and degree theses (DT) in the field of medical mycology, during the period 2007 ­ 2014. Documentary and descriptive research were carried out; reviewing the records kept in the Postgraduate Coordination archives of the Management for Teaching and Research, INHRR. With this program, the Institute graduated 23 specialists in medical mycology with a high academic score (17.5 points). Most of the specialists were bioanalyst women graduated from the Central University of Venezuela, who worked in public entities at the beginning of the program. Sixty-one percent of the DT was conducted in two of the research lines carried out by the Department of Medical Mycology, INHRR, namely: mycoses in immunocompetent and immunocompromised patients using conventional diagnosis and antifungal resistance of yeast infections. Eight professionals supervised the DT, under the figure of tutor. Two tutors excelled for supervising 52% of the DT and three tutors for being graduates of the specialization. Only 38% of the tutors were external to the Institute

Gerencia de diagnóstico y vigilancia epidemiológica del Instituto Nacional de Higiene "Rafael Rangel": Una década de avances y logros / Diagnostic and epidemiological surveillance management The National Institute of Hygiene "Rafael Rangel": A decade of advances and achievements

Buscando en los registros de las principales actividades de la Gerencia de Diagnóstico y Vigilancia Epidemiológica ha sido difícil elegir entre tantas vivencias, aquellos elementos que marcaron pauta durante la década 2008 ­ 2018. No obstante, es de resaltar que los desafíos afrontados ante la aparición de brotes, epidemias y la primera pandemia del siglo XXI, trajeron consigo un cúmulo de experiencias que se presentan en este artículo. Como centro nacional de referencia en las áreas de Bacteriología, Micología y Virología, continuamos aportando soluciones a la salud pública nacional mediante la actualización profesional de nuestro personal y la formación de la generación de relevo, en la que participan profesionales de excelencia, altamente especializados y sensibilizados con la problemática y los requerimientos de nuestra población. Asimismo, a través de la coordinación, supervisión y evaluación de la Red de laboratorios de salud pública, se contribuye con el fortalecimiento del diagnóstico de enfermedades transmisibles y vigilancia epidemiológica en el país. El trabajo realizado en estos diez años ha sido excelente, crucial y prioritario para enfrentar las emergencias. Debemos seguir trabajando en dos aspectos claves: 1. Mayor integración del laboratorio con el componente epidemiológico y clínico del país para ser más útiles al sistema de salud, y 2. Consolidar la creación del edificio sede del Centro de Diagnóstico de Enfermedades Transmisibles del Instituto Nacional de Higiene "Rafael Rangel" (INHRR), proyecto en el que estamos trabajando con la asesoría de la OPS/OMS.

Looking at the records of the main activities of the Diagnostic and Epidemiological Surveillance Management, it has been difficult to choose between many experiences, those elements that set the standard during the 2008 ­ 2018 decade. However, it is noteworthy that the challenges faced with the emergence of outbreaks, epidemics and the first pandemic of the 21st century, brought with it a wealth of experiences that are presented in this article. As a national reference center in Bacteriology, Mycology and Virology areas, we continue to provide solutions to public health through the professional updating of our staff and formation of the relief generation, in which participate professionals of excellence, highly specialized and sensitized with the problems and requirements of our population. Likewise, through the coordination, supervision and evaluation of the public health laboratories network, it contributes to the strengthening of the communicable diseases diagnosis and epidemiological surveillance in the country. The work done in these ten years has been excellent, crucial and priority to face emergencies. We must continue working on two key aspects: 1. Greater laboratory integration with the epidemiological and clinical component of the country to be more useful to the health system, and 2. Consolidate headquarters building creation of the National Institute of Hygiene "Rafael Rangel" (INHRR) Diagnostic Center for Communicable Diseases, project in which we are working with the PAHO / WHO advice.

Pneumonia by Cryptococcus neoformans in a goat in the Southern region of Brazil / Pneumonia por Cryptococcus neoformans em um caprino na região Sul do Brasil

ABSTRACT: This report describes the clinical, pathological, and molecular aspects of a pneumonia by Cryptococcus neoformans in a goat in the Southern region of Brazil. A goat with a history of prolonged transportation presented dyspnea, nasal discharge and cough, and was subjected to necropsy, histopathology, and mycological evaluation. Grossly, cranio-ventral pulmonary consolidation was observed, characterized by firm and grayish areas interspersed with dark red foci. Histopathology of the lungs showed areas of parenchymal necrosis, containing blastoconidia with a slightly basophilic central cell, surrounded by an unstained capsule. It was associated with moderate granulomatous inflammatory infiltrate and peripheral fibrosis. The capsule and fungus cell exhibited marked Alcian Blue and periodic acid-Schiff staining, respectively. Diagnosis of fungal pneumonia by C. neoformans was based on clinical, pathological, and molecular findings.

RESUMO: Este relato objetiva descrever os aspectos clínicos, patológicos e moleculares de pneumonia por Cryptococcus neoformans em um caprino na região Sul do Brasil. Um caprino com histórico de transporte prolongado apresentou dispneia, secreção nasal e tosse e foi encaminhado para necropsia, análise histopatológica e micológica. Macroscopicamente, observou-se consolidação pulmonar cranioventral, caracterizada por áreas firmes e acinzentadas, entremeadas por focos vermelho-escuros. Na análise histopatológica dos pulmões foram evidenciadas áreas de necrose do parênquima, que continham blastoconídeos com célula central levemente basofílica, circundada por cápsula não corada, associados a moderado infiltrado inflamatório granulomatoso e fibrose periférica. A cápsula e a célula do fungo foram fortemente coradas pelo azul alciano e pelo ácido periódico de Schiff, respectivamente. O diagnóstico de pneumonia fúngica por C. neoformans foi baseado nos achados clínicos, patológicos e moleculares.

Aportes del Laboratorio de Micología del Instituto de Medicina Tropical Pedro Kourí al desarrollo de la especialidad en Cuba / Contributions of the Mycology Laboratory at Pedro Kouri Tropical Medicine Institute to the development of the specialty in Cuba

En el marco del 80 aniversario del Instituto de Medicina Tropical Pedro Kourí, se exponen en apretada síntesis, las actividades más relevantes en el campo del diagnóstico, la investigación y la docencia desarrolladas hasta el momento por el Laboratorio de Micología de la referida institución. A 38 años de su creación, este sigue siendo uno de los pocos lugares en Cuba que se desempeña en este campo y que se reconoce por los logros científico-técnicos alcanzados. Sin lugar a duda, estos responden básicamente al cuadro de salud nacional, sin descuidar el entorno regional y mundial. Todos los resultados que se exponen, se encuentran sustentados por más de 100 publicaciones y otras obras científicas, lo que avala la calidad y rigor del trabajo desplegado. Sirva este artículo para homenajear al fundador del Instituto de Medicina Tropical Pedro Kourí y a todos los científicos que en el transcurso de estos años contribuyeron a engrandecer su nombre(AU)

In the framework of the 80th anniversary of Pedro Kouri Tropical Medicine Institute, a succinct presentation is provided of the most relevant activities in the fields of diagnosis, research and teaching so far performed by the Mycology Laboratory at the Institute. Thirty-eight years after its founding, the Laboratory continues to be one of the few places in Cuba devoted to this field and recognized for its scientific and technical achievements, which no doubt essentially respond to the national health status, without neglecting the regional and global environment. All the results presented are endorsed by over 100 publications and scientific works, which is evidence of the quality and rigor of the work done. May this paper be a tribute to the founder of Pedro Kouri Tropical Medicine Institute and all the scientists who have brought prestige to its name throughout these years(AU)

IMPORTANCIA DE LAS MICORRIZAS ARBUSCULARES (MA) PARA UN USO SOSTENIBLE DEL SUELO EN LA AMAZONIA COLOMBIANA / IMPORTANCE OF ARBUSCULAR MYCORRHIZAE FOR SUSTAINABLE LAND USE IN THE COLOMBIAN AMAZON RAINFOREST

La Amazonia colombiana es una fuente de diversidad que se ha visto afectada por cultivos comerciales insostenibles que afectan la actividad de la microbiota del suelo y, por ende, el crecimiento de las especies vegetales. La limitación de fósforo y nutrientes en el suelo debe ser compensada por el sistema radicular de las plantas y potenciada por la presencia de las micorrizas arbusculares que aumentan su nivel de movilización. En este sentido, el conocimiento sobre las características fisicoquímicas del suelo y su relación con la presencia de micorrizas, es fundamental para generar procesos agrícolas más productivos y con menor impacto ambiental. Este artículo hace un análisis de publicaciones científicas entre 1995 y 2013 sobre la importancia de las micorrizas para un uso sostenible del suelo en la Amazonia colombiana, dando a conocer su funcionalidad en la estabilidad edáfica y su contribución para una agricultura comercial sostenible. Las micorrizas se encuentran ampliamente distribuidas en el suelo amazónico y su relación sinérgica con otros microorganismos favorece la absorción de nutrientes en las plantas. Asimismo, pueden ser de gran potencial en la agricultura sostenible como fertilizantes orgánicos; aunque, se reconoce que falta investigar más acerca de las comunidades nativas de hongos formadores de micorrizas, el potencial micorrízico del suelo y sus niveles nutricionales.

The Colombian Amazon is a source of diversity that has been affected by unsustainable commercial crops that have a negative effect on the activity of the soil microbiota and therefore, on the growth of plants. Limited phosphorus and nutrients in the soil must be compensated by the plant root system and enhanced by arbuscular mycorrhizae to increase their level of mobilization. In this sense, the knowledge of the physicochemical characteristics of the soil and its relationship with the presence of mycorrhizae is essential to generate more productive agricultural processes with less environmental impact. This article analyzes scientific publications between 1995 and 2013 which deal with the importance of mycorrhizae for a sustainable land use in the Colombian Amazon, thus revealing its functionality on edaphic stability and its contribution to sustainable commercial agriculture. Mycorrhizae are widely distributed in the Amazonian soil and its synergic relationship with other microorganisms favors the absorption of nutrients in plants. Additionally, they can be a great potential in sustainable agriculture as organic fertilizers though, more research is needed about the native communities of mycorrhizal fungi, mycorrhizal soil potential and its nutritional levels.

Aspergillosis of the nose and paranasal sinuses: a review of 54 cases

Aspergillus species are considered opportunistic fungi of increasing clinical importance. Informationregarding extrapulmonary involvement is scarce. The aim of this study was to isolate the differentspecies of Aspergillus from patients with rhinosinusitis. A retrospective study was conducted ina university hospital in Porto Alegre, Brazil (1986–2014). For mycological diagnoses, paranasaltissue obtained at surgery was subjected to histopathology examination and sent for fungal cultures.Of the 54 samples analyzed, 32 were diagnosed positive by culture. The underlying causes ofimmunodeficiency were: six with transplantation (three bone marrow,two lung, one kidney) andtwo with hematological disease (one bone marrow neoplasia and two leukemia). In the presentstudy, the clinical manifestations of rhinosinusitis aspergillosis were: 20 allergic reactions, 20fungus balls, and 14 acute invasive cases. The species isolated from the 54 samples were: Aspergillusfumigatus (n=14); A. flavus (n=6); A. niger (n=2); A. terreus (n=1); A. fischeri (n=1); and Aspergillussp., (n=3). Two concomitant species of Aspergillus were observed in two patients: A. fumigatus andA. flavus; and A. fumigatus and A. niger. In four patients, Aspergillus was associated with other fungi. These were: A. flavus and Fusarium, A. fumigatus and Rhyzopus, A. flavus and Mucorales, and Aspergillus sp. and Mucorales. The most common species of Aspergillus that were responsiblefor paranasal sinus infections were A. fumigatus, A. flavus, and A. niger...

Espécies de Aspergillus são considerados fungos oportunistas de crescente importância clínica.Informações sobre o envolvimento extrapulmonar é escassa. O objetivo deste estudo foi isolaras diferentes espécies de Aspergillus em pacientes com rinossinusite. Um estudo retrospectivofoi realizado em um hospital universitário em Porto Alegre, Brasil (1986-2014). Para diagnósticomicológico, tecido paranasais obtido no momento da cirurgia foi submetido a exame histopatológicoe encaminhados para cultivos de fungos. Das 54 amostras analisadas, 32 foram diagnosticados pelocultivo positivo. As causas subjacentes da imunodeficiência foram: seis com transplante (medulaóssea, três, pulmão, dois; rim, um) e dois com doenças hematológicas (neoplasia osso estreito,um; leucemia, duas). No presente estudo, as manifestações clínicas de rinossinusite aspergilarforam: alérgica, 20; bolas fúngica, 20; e aguda invasiva, 14. As espécies fúngicas isoladas foram:Aspergillus fumigatus, 14; A. flavus, seis; A. niger, dois; A. terreus, um; A. fischeri, um; e Aspergillussp., três. Duas espécies de Aspergillus concomitantes foram observadas em dois pacientes: A.fumigatus e A. flavus; e A. fumigatus e A. niger. Em quatro pacientes, Aspergillus foi associado comoutros fungos: A. flavus e Fusarium, um; A. fumigatus e Rhyzopus, um; A. flavus e Mucorales, um; eAspergillus sp. e Mucorales, um. Os isolados mais comuns de Aspergillus que são responsáveis porinfecções dos seios paranasais são A. fumigatus, A. flavus e A. niger...

Paracoccidioides lutzii: estudo de alguns mecanismos de patogenicidade

A paracoccidioidomicose (PCM) é uma doença granulomatosa sistêmica, causada por Paracoccidioides spp., (P. brasiliensis e P. lutzii), geograficamente, limita-se a América Latina com as áreas endêmicas estendendo-se desde o México até a Argentina, constituindo uma das micoses sistêmicas de maior incidência na região, afetando principalmente trabalhadores rurais. O maior número de pacientes com PCM tem sido reportado principalmente no Brasil, Colômbia e Venezuela. A incidência real desta micose encontra-se subestimada no Brasil e pouco se conhece em relação a nova espécie descrita - P. lutzii. A maioria dos estudos em P. lutzii foram focados em genética, especiação e na geração de novos antígenos para melhorar a especificidade e sensibilidade dos testes sorológicos. Atualmente, as preparações antigênicas tradicionais, preparadas a partir de isolados de P. brasiliensis, são ineficientes. Raros são os trabalhos focados na biologia de P. lutzii e nos fatores de virulência que podem ser comparados com P. brasiliensis nos modelos experimentais. A nossa proposta de estudo foi avaliar alguns aspectos in vitro e in vivo relacionados com a patogenicidade e destacamos: a fagocitose e a morte intracelular de P. lutzii por macrófagos, peritoneais, de camundongos Knockouts (KO) e selvagens para PRRs (TLR2, TLR4 e Dectina) e ativadores intracelulares (MyD88 e NALP3). Paralelamente a este estudo, animais foram infectados com leveduras de P. lutzii e comparados com os modelos de infecção já estabelecidos com leveduras (Pb18) e conídios (ATCCPb60855) de P. brasiliensis. Nossos dados indicam que similar ao que ocorre com P. brasiliensis a fagocitose de P. lutzii depende de TLR2, TLR4 e Dectina- 1, resultados semelhantes também foram observadas na expressão de moléculas envolvidas na co-estimulação e a apresentação de antígenos (MHC II, CD80 e CD86)...

Paracoccidioidomycosis (PCM) is a systemic granulomatous disease caused by Paracoccidioides spp. (P. brasiliensis and P. lutzii), geographically, is limited to Latin America with endemic areas from Mexico to Argentina, as one of the systemic mycoses with the highest incidence in the region, mainly affecting rural workers. The largest number of patients with PCM has been mainly reported in Brazil, Colombia and Venezuela. The true incidence of this mycosis is underestimated in Brazil and little is known about the new species described - P. lutzii. Most studies in P. lutzii were focused on genetics, speciation and the generation of new antigens to improve the specificity and sensitivity of serological tests. Currently, traditional antigenic preparations, prepared with isolates of P. brasiliensis, are inefficient. There are few studies focused on P. lutzii biology and virulence factors that can be compared with P. brasiliensis in experimental models. Our study aimed to evaluate some in vitro and in vivo aspects related to pathogenicity: phagocytosis and intracellular killing of P. lutzii by peritoneal macrophages from knockouts (KO) for PRRs (TLR2, TLR4 and Dectin) and intracellular activators (MyD88 and NALP3). In addition, animals were infected with P. lutzii yeast and compared with the well-established models of infection with yeast cells (Pb18) and conidia (ATCC Pb60855) from P. brasiliensis. Our data indicate that similarly to what happens with the phagocytosis of P. brasiliensis, P. lutzii phagocytosis is dependent on TLR2, TLR4 and Dectin-1. Other molecules, involved in co-stimulation and presentation of antigens such as MHC II, CD80 and CD86 were also shown to participate in the P. lutzii-host interaction...

Controle externo da qualidade em micologia: avaliação do desempenho de laboratórios de análises clínicas participantes do programa nacional de controle de qualidade / External quality control in mycology: performance evaluation of clinical analysis laboratories participating in the national program of quality control

A identificação fúngica ainda é considerada extremamente complexa, exigindo dos profissionais de saúde um grande conhecimento micológico que inclui a biologia, morfologia e ecoepidemiologia dos fungos patogênicos e sintomatologia dos processos micóticos, além de um amplo domínio das técnicas utilizadas para o diagnóstico laboratorial. De maneira geral, a qualificação em micologia não está disponível com facilidade e osprogramas de controle externo da qualidade podem ser uma ferramenta útil para a aquisição de conhecimentos específicos. Claramente, a importância dos laboratórios participarem de um programa de controle externo da qualidade reside no fato dessesprogramas oferecerem aos laboratórios consultoria na área técnica e administrativa, levando à melhoria dos serviços prestados. Dentre os vários benefícios de um programa de controle externo da qualidade, o treinamento continuado de práticas laboratoriaispermite ao profissional de análises clínicas obter a expertise necessária para a execução dos protocolos, de maneira correta e com alto grau de acurácia. O objetivo do presentetrabalho foi identificar os pontos críticos onde ocorreram maior incidência de erros cometidos pelos laboratórios participantes de um programa nacional de controle da qualidade em micologia. Este estudo teve como base o banco de dados do referido programa e compreendeu o período de 1999 a 2009. A análise dos resultados revelouque o desempenho dos participantes nesta especialidade é variável, sendo necessário maior treinamento para que a identificação do agente fúngico seja realizada de forma adequada.

The fungal identification is still considered extremely complex,requiring health professionals a great mycological knowledge thatincludes biology, morphology and eco-epidemiology of pathogenicfungi and symptoms of mycotic processes, as well as a mastery ofnumerous techniques used for laboratory diagnosis. In general, thequalification in mycology is not readily available and the externalquality control programs can be a useful tool for acquiring specificknowledge. Clearly, the importance of laboratories participate in anexternal quality control program lies in the fact that these programsoffer advice to laboratories in technical and administrative areas,leading to improved services. Among the many benefits of an externalquality control program, continued training laboratory practice allowsthe professional clinical analysis to obtain the necessary expertisefor the execution of the protocols, correctly and with high accuracy.The objective of this study was to identify the critical points wherethere were higher incidence of errors committed by the participatinglaboratories of a national program of quality control in mycology.This study was based on the program's database and covered theperiod 1999-2009. The results revealed that the performance of theparticipants in this specialty is variable, requiring more training forthe appropriate identification of the fungal agent.

Historia de la micología médica en Colombia, 1930-1970 / History of medical micology in Colombia, 1930-1970

El objetivo general de esta investigación fue comprender algunos de los acontecimientos históricos que posibilitaron la instauración, difusión y apropiación de la micología médica en Colombia entre 1930 y 1970. Para ello se consultaron revistas científicas y tesis en diferentes bibliotecas, centros documentales y archivos históricos de Medellín y de Bogotá. Se incluyen en el informe los diferentes problemas enfrentados por los médicos y el personal de laboratorio para la clasificación taxonómica de los hongos, la relación entre la micología y la dermatología, el desarrollo del estudio de las micosis sistémicas y el papel de algunas personas en la institucionalización de la micología médica.

The overall objective of this research was to understand the events that made possible the creation, diffusion and appropriation of medical mycology in Colombia between 1930 and 1970. It was based on the review of scientific journals and theses in different libraries, archives and documentation centers in Medellin and Bogota. The report includes the different problems faced by physicians and laboratory personnel concerning the classification of fungi, the relationship between dermatology and mycology, the development of the study of systemic mycoses and the role played by some persons in the institutionalization of medical mycology.

Biological activity of Cryptococcus neoformans and Cryptococcus gattii from clinical and environmental isolates / Atividade biológica de Cryptococcus neoformans e Cryptococcus gattii provenientes de isolados clínicos e ambientais

INTRODUCTION: Cryptococcus neoformans and Cryptococcus gattii are encapsulated basidiomycetous yeasts with worldwide distribution. They cause cryptococcosis with features of systemic infection, affecting the central nervous system, lungs and skin in humans and animals. These fungi present numerous virulence factors that allow them to invade the host and multiply, among which extracellular enzyme capacity and microbial adaptation to different temperatures are worth mentioning. OBJECTIVE: To evaluate the production of protease and investigate possible differences in thermotolerance and urease activity in clinical and environmental yeast isolates. MATERIAL AND METHODS: Culture methods and Pz analysis were applied to assess urease and protease, whereas the optical density method was used to analyze biological activity in thermotolerance. RESULTS: There was no significant results as to microbial growth at the tested temperatures (25º, 37º and 42ºC). It was observed that clinical specimens grew better than environmental ones at elevated temperatures. As to C. neoformans, the moderate production of urease enzyme prevailed in both clinical and environmental isolates within 24h or 48h. Moreover, there was significant production on the seventh day of reading. The best reading time for viewing protease production in both isolates and species was the seventh day: 96% clinical samples and 94% environmental isolates. CONCLUSION: Further studies are required in order to investigate the virulence factors of C. neoformans and C. gattii cerebrospinal isolates from patients with meningoencephalitis and environmental samples from Sergipe. Furthermore, a higher technical accuracy and statistical precision are indispensable.

INTRODUÇÃO: Cryptococcus neoformans e Cryptococcus gattii são leveduras encapsuladas basidiomicéticas com distribuição mundial. Causam criptococose com características de infecção sistêmica, afetando o sistema nervoso central, pulmão e pele em humanos e animais. Esses fungos possuem inúmeros fatores de virulência que permitem invadir o hospedeiro e se multiplicar, entre eles destacam-se a capacidade enzimática extracelular e a adaptação microbiana a diversas temperaturas. OBJETIVO: Avaliar a produção de proteinase por essas leveduras, de isolados clínicos e ambientais, além de verificar possíveis diferenças na termotolerância e na atividade da urease. MATERIAL E MÉTODOS: Para urease e proteinase, foi utilizado o sistema de cultivo e análise Pz. Já para atividade biológica em termotolerância, foi analisado o método de densidade óptica. RESULTADOS: Não há resultado significativo no crescimento, mesmo nas temperaturas testadas (25º, 37º e 42ºC). Foi verificado que, em temperaturas elevadas, as amostras clínicas cresceram melhor que as ambientais. Para C. neoformans, tanto nos isolados ambientais como nos clínicos, em 24h ou 48h, prevaleceu a produção moderada da enzima urease. Já no sétimo dia de leitura, houve produção significativa. O melhor tempo de leitura para visualização da produção de proteinase em ambos isolados e espécies foi no sétimo dia, sendo: 96% amostras clínicas e 94% ambientais. CONCLUSÃO: São necessários novos estudos acerca da determinação dos fatores de virulência de C. neoformans e C. gattii isolados de liquor oriundos de pacientes com meningoencefalite e amostras ambientais em Sergipe, além de maior acuidade técnica e precisão estatística dos resultados.

Avaliação micológica das amostras ungueais de pacientes com diagnóstico clínico de onicomicose atendidos no Hospital Universitário de Brasília / Mycological evaluation of nail samples of patients with clinical diagnosis ofonychomycosis attended at Hospital Universitário de Brasília

Objetivo. Analisar dados obtidos em laboratório especializado em micologia acerca do exame micológico de pacientes com diagnóstico clínico de onicomicose. Método.Foram avaliados os resultados de exames micológicos (análise microscópica direta e cultura) do materialungueal de pacientes atendidos no Hospital Universitário da Universidade de Brasília nos anos 2004 a 2010. Resultados. Dentre as 1.035 amostras incluídas no estudo, 632 tiveram resultado positivo, sendo 228 (22%)para agentes dermatófitos, 185 para Candida spp (18%) e 219 (21%) para fungos filamentosos não dermatófitos. Os dermatófitos foram os principais agentes encontrados em doentes do sexo masculino, responsáveis por 29% das amostras analisadas. Entretanto, tais agentes foram encontrados em apenas 20% das mulheres (p = 0,002) asquais, por sua vez, apresentaram positividade semelhante para Candida spp (20%) e fungos filamentosos não dermatófitos(22%). O gênero Candida spp foi o tipo patógeno mais encontrado nos exames ungueais dos quirodáctilos, com positividade de 28%. As unhas dos pododáctilos foram principalmente acometidas pelos dermatófitos e fungos filamentosos não dermatófitos com índice de positividade de 24% e 23% respectivamente. Conclusões. O presente estudo confirma a variação constante dos agentes etiológicos e do perfil dos pacientesacometidos nos mais diversos espaços geográficos, além da crescente detecção dos fungos filamentosos não dermatófitos comparado a estudos prévios.

Objective. The aim of the present study is to present and analyze data obtained in a laboratory specialized in mycology, regarding the mycological examination of patients with clinical diagnosis of onychomycosis. Method. We evaluated the results of mycological exams from the nail of patients attended at the Hospital Universitário of the University of Brasília in the period comprehended between 2004 and 2010.Results.From the one thousand and thirty five samples included in the study, 632 tested positive, and, from those, 228 (22%) were for dermatophyte agents, 185 for Candida spp (18%) and 219 (21%) for non-dermatophyte filamentous fungi (FFND). Dermatophytes were the most frequently found agents in males, accounting for 29% ofthe samples. These agents were found in yet only 20% of women (p = 0.002) in which, by its turn, it was observed a similar positivity for Candida spp 20% and FFND 22%. Candida spp was the most frequent pathogen in nail examinations of fingers, with a positivity of 28%. However, toenails were affected mainly by dermatophytes and FFND with a positive index of 24 and 23%, respectively. Conclusions.This study confirms the constant change of etiological agents and profile of affected patients in various geographic areas in addition to increasing detection of FFND, as compared to previous studies.

Genetic similarity of Candida albicans isolated from the buccal cavity of children with Down's syndrome and their parents and/or caregivers / Similaridade genética de Candida albicans isolada da cavidade bucal de crianças com síndrome de Down e seus pais e/ou responsáveis

Objective - Candida albicans is the fungus most closely related to the human oral mucosa colonization. Biological characteristics of the fungus allow high adaptation to the environmental conditions presented by the human mucosas, resulting in Candida species often being described as colonizers and pathogens in childrens with Down's syndrome. Methods - The DNA extraction of buccal C albicans simultaneously isolated of CWDS and P and/or R it was done. RAPD was accomplished using intra-specific primers for polymorphism analysis of C. albicans:RSD10 5'-CCGCAGCC A-3? and RSD12 5'-GGTCCGTGTTTCAAGACG-3'. Results - We detected a genetic similarity between Candida albicans isolated from the mouth of children with Down's syndrome and those of their parents and/or caregivers, using RAPD with the primers RSD10 and 12. Nine of the 40 (22.5%) pairs of oral C. albicans analyzed, had genetic homology (identical) in two conjugate pairs (2 / 9) (22.2%) (Similarity coefficient SAB 1). The other two conjugate pairs of buccal C. albicans (2 / 9) (22.2%) showed high relatedness (similarity coefficient SAB between 0.90 and 0.99). In other isolates (5 / 9) (55.6%), no correlation between the strains analyzed (similarity coefficient SAB <0.5) was found. Conclusion - The analysis of genetic similarity of the pairs of buccal C. albicans, isolated concomitantly from children with Down's syndrome and parents and/or caregivers, proved the intrafamilial transmission of this fungus between parents and their Down´s syndrome children, and confirmed the occurrence of isolates from other sources and possible genetic variation among these isolates.

Objetivo - Candida albicans é o fungo mais relatado como colonizador da mucosa bucal humana. Características biológicas do fungo permitem elevada capacidade de adequação às condições ambientais apresentadas pelas mucosas orgânicas humanas, tornando albicans, a espécie de Candida mais descritas nos processos de colonização e patogenidade da boca de crianças com síndrome de Down. Métodos - O DNA de C. albicans bucal simultaneamente isolado de crianças com síndrome de Down e pais e/ou responsáveis foi extraído. RAPD foi realizado usando primers intraespecíficos para a análise do polimorfismo de C. albicans: RSD10 5?-CCGCAGCC A-3' e RSD12 5'-GGTCCGTGTTTCAAGACG-3'. Resultados - Foi detectada uma semelhança genética entre Candida albicans isoladas da boca de crianças com síndrome de Down e de seus pais e/ou responsáveis, utilizando RAPD com os primers RSD 10 e 12. Nove dos 40 (22,5%) pares de C. albicans orais analisadas, possuiam homologia genética (idênticos) em dois pares conjugados (09/02) (22,2%) (coeficiente de similaridade SAB 1). Os outros dois pares conjugados de C. albicans bucais (09/02) (22,2%) apresentaram alta afinidade (SAB coeficiente de similaridade entre 0,90 e 0,99). Em outros isolados (09/05) (55,6%), nenhuma correlação entre as cepas analisadas (coeficiente de similaridade SAB<0,5) foi encontrado. Conclusão - A análise de similaridade genética dos pares de C. albicans bucais, isolado, concomitantemente, de crianças com síndrome de Down e pais e/ou responsáveis, comprovou a transmissão intrafamiliar desse fungo entre pais e filhos com síndrome de Down, e confirmou a ocorrência de isolados provenientes de outras fontes e possível variação genética entre os isolados.