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1.
Nat Microbiol ; 6(8): 1066-1081, 2021 08.
Article in English | MEDLINE | ID: mdl-34183813

ABSTRACT

Fungi produce millions of clonal asexual conidia (spores) that remain dormant until favourable conditions occur. Conidia contain abundant stable messenger RNAs but the mechanisms underlying the production of these transcripts and their composition and functions are unknown. Here, we report that the conidia of three filamentous fungal species (Aspergillus nidulans, Aspergillus fumigatus, Talaromyces marneffei) are transcriptionally active and can synthesize mRNAs. We find that transcription in fully developed conidia is modulated in response to changes in the environment until conidia leave the developmental structure. Environment-specific transcriptional responses can alter conidial content (mRNAs, proteins and secondary metabolites) and change gene expression when dormancy is broken. Conidial transcription affects the fitness and capabilities of fungal cells after germination, including stress and antifungal drug (azole) resistance, mycotoxin and secondary metabolite production and virulence. The transcriptional variation that we characterize in fungal conidia explains how genetically identical conidia mature into phenotypically variable conidia. We find that fungal conidia prepare for the future by synthesizing and storing transcripts according to environmental conditions present before dormancy.


Subject(s)
Aspergillus fumigatus/genetics , Aspergillus nidulans/genetics , Spores, Fungal/growth & development , Talaromyces/genetics , Antifungal Agents/pharmacology , Aspergillus fumigatus/drug effects , Aspergillus fumigatus/growth & development , Aspergillus fumigatus/metabolism , Aspergillus nidulans/drug effects , Aspergillus nidulans/growth & development , Aspergillus nidulans/metabolism , Fungal Proteins/genetics , Fungal Proteins/metabolism , Gene Expression Regulation, Fungal/drug effects , Microbial Viability , Spores, Fungal/drug effects , Spores, Fungal/genetics , Spores, Fungal/metabolism , Talaromyces/drug effects , Talaromyces/growth & development , Talaromyces/metabolism , Transcriptome/drug effects
2.
Int J Antimicrob Agents ; 58(1): 106349, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33905861

ABSTRACT

Morphologically identified Penicillium (n = 103) and Talaromyces marneffei (n = 8) isolates were collected from various clinical sources between 2016 and 2017 at a medical centre in Beijing, China. Identification to species level was confirmed by sequencing of the internal transcribed spacer (ITS) region, ß-tubulin gene (benA) and RNA polymerase II second largest subunit (RPB2) gene. Of the 111 isolates, 56 (50.5%) were identified as Penicillium spp. and 55 (49.5%) as Talaromyces spp. Eleven species of Penicillium were detected, of which Penicillium oxalicum was the commonest, accounting for 51.8% (29/56), followed by Penicillium rubens (10.7%; 6/56) and Penicillium citrinum (10.7%; 6/56). Among the 55 Talaromyces isolates, nine species were identified, with Talaromyces funiculosus (36.4%; 20/55), Talaromyces stollii (27.3%; 15/55) and Talaromyces marneffei (14.5%; 8/55) being the most common. Of note, 89.3% (50/56) of the Penicillium isolates and 98.2% (54/55) of the Talaromyces isolates exhibited growth at 37°C. The isolates were mainly recovered from patients with pulmonary disorders (56.8%; 63/111), autoimmune disease (12.6%; 14/111) and AIDS (5.4%; 6/111). The azoles and amphotericin B exhibited potent activity against T. marneffei, while various levels of activity were observed against Penicillium and other Talaromyces species The echinocandins had the lowest MECs (MEC90, ≤0.12 mg/L) against most Penicillium and Talaromyces species, with the exception of T. marneffei whose MEC90 (4 mg/L) was five or more dilutions higher than that of the other species tested. These data on the species distribution and antifungal susceptibility expand the current clinical knowledge of Penicillium and Talaromyces species.


Subject(s)
Antifungal Agents/pharmacology , Lung Diseases/microbiology , Mycoses/microbiology , Penicillium/drug effects , Talaromyces/drug effects , Adolescent , Adult , Aged , Child , Child, Preschool , China/epidemiology , DNA, Fungal , Female , Humans , Infant , Infant, Newborn , Male , Microbial Sensitivity Tests , Middle Aged , Mycoses/drug therapy , Penicillium/classification , Penicillium/genetics , Prevalence , RNA Polymerase II/genetics , Talaromyces/classification , Talaromyces/genetics , Tubulin/genetics , Young Adult
3.
Med Mycol ; 59(4): 392-399, 2021 Apr 06.
Article in English | MEDLINE | ID: mdl-33644813

ABSTRACT

Talaromycosis is a leading cause of AIDS-associated opportunistic infections and death in Southeast Asia. We have recently shown in the Itraconazole versus Amphotericin for Talaromycosis (IVAP) trial that induction therapy with amphotericin B reduced mortality over 24 weeks, but not during the first 2 weeks. Antifungal treatment effects in real-world settings have not been rigorously evaluated. Using data obtained from patient records at the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam from 2004 to 2009, we first developed a prognostic model using Bayesian logistic regression to identify predictors of death. Second, we developed a causal model using propensity score matching to assess the treatment effects of amphotericin B and itraconazole. Our prognostic model identified intravenous drug use (odds ratio [OR] = 2.01), higher respiratory rate (OR = 1.12), higher absolute lymphocyte count (OR = 1.62), a concurrent respiratory infection (OR = 1.67) or central nervous system infection (OR = 2.66) as independent predictors of death. Fever (OR = 0.56) was a protective factor. Our prognostic model exhibits good in-sample performance and out-of-sample validation, with a discrimination power of 0.85 and 0.91, respectively. Our causal model showed no significant difference in treatment outcomes between amphotericin B and itraconazole over the first 2 weeks (95% credible interval: 0.62, 2.50). Our prognostic model provides a simple tool based on routinely collected clinical data to predict individual patient outcome. Our causal model shows similar results to the IVAP trial at 2 weeks, demonstrating an agreement between real-world data and clinical trial data.


Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/microbiology , Antifungal Agents/therapeutic use , Mycoses/drug therapy , Mycoses/mortality , Talaromyces/drug effects , Adult , Amphotericin B/therapeutic use , Bayes Theorem , Cohort Studies , Female , Humans , Itraconazole/therapeutic use , Male , Prognosis , Risk Factors , Treatment Outcome , Vietnam , Young Adult
4.
J Appl Microbiol ; 130(5): 1508-1522, 2021 May.
Article in English | MEDLINE | ID: mdl-33010096

ABSTRACT

AIMS: This study aimed to isolate actinomycetes from marine environments and examine their antifungal activity against Talaromyces marneffei both in vitro and in vivo. METHODS AND RESULTS: Nineteen out of 101 actinomycete extracts were active and further determined for their minimum inhibitory concentrations (MIC). Three extracts of AMA50 that isolated from sediment showed strong antifungal activity against T. marneffei yeast (MICs ≤0·03-0·25 µg ml-1 ) and mould (MICs 0·5-16 µg ml-1 ) forms. The hexane extract from the cells of AMA50 (AMA50CH) exhibited the best activity against both the forms (MIC ≤ 1 µg ml-1 ). Three extracts from AMA50 killed the melanized yeast cells at 0·5 µg ml-1 . The AMA50CH was further tested for protective effects in Caenorhabditis elegans model. At concentrations of 1-8 µg ml-1 , the AMA50CH prolonged survival of T. marneffei-infected C. elegans with a 60-70% survival rate. The composition of AMA50CH was determined by gas chromatography-mass spectrometry. The major components were n-hexadecanoic acid, tetradecanoic acid and pentadecanoic acid. Sequencing analysis revealed that isolate AMA50 belonged to the genus Streptomyces. CONCLUSIONS: The AMA50CH from Streptomyces sp. AMA50 was the most effective extract against T. marneffei. SIGNIFICANCE AND IMPACT OF THE STUDY: Talaromyces marneffei is one of the most important thermally dimorphic pathogenic fungi. These results indicated the potency of marine-derived actinomycete extracts against T. marneffei both in vitro and in vivo.


Subject(s)
Actinobacteria/physiology , Antibiosis , Antifungal Agents/pharmacology , Talaromyces/drug effects , Talaromyces/physiology , Actinobacteria/chemistry , Actinobacteria/isolation & purification , Animals , Antifungal Agents/isolation & purification , Antifungal Agents/toxicity , Aquatic Organisms/microbiology , Caenorhabditis elegans/drug effects , Caenorhabditis elegans/microbiology , Geologic Sediments/microbiology , Microbial Sensitivity Tests , Talaromyces/ultrastructure
5.
Am J Trop Med Hyg ; 104(2): 744-747, 2020 11 23.
Article in English | MEDLINE | ID: mdl-33236714

ABSTRACT

Talaromyces marneffei (T. marneffei), formerly Penicillium marneffei, is a dimorphic fungus prevalent in Southeast Asia that can cause severe systemic infection, especially in immunocompromised patients. There are few reports about the use of posaconazole in T. marneffei infection. Here, we present a case of pulmonary T. marneffei infection in a renal transplant recipient. The patient responded rapidly to oral posaconazole administration but experienced serum creatinine fluctuation because of the interaction between posaconazole and immunosuppressants. Seven months after adjusting the dose of immunosuppressants, the patient recovered completely. Posaconazole is a potentially promising therapy for T. marneffei infection, but it should be administered under close monitoring.


Subject(s)
Antifungal Agents/therapeutic use , Kidney Transplantation/adverse effects , Mycoses/diagnostic imaging , Mycoses/drug therapy , Respiratory Tract Infections/diagnostic imaging , Respiratory Tract Infections/drug therapy , Triazoles/therapeutic use , Adult , Humans , Immunocompromised Host , Lung/microbiology , Lung/pathology , Male , Respiratory Tract Infections/microbiology , Talaromyces/drug effects , Tomography, X-Ray Computed , Transplant Recipients
6.
Int J STD AIDS ; 31(8): 747-752, 2020 07.
Article in English | MEDLINE | ID: mdl-32631212

ABSTRACT

The objective of this study was to evaluate whether combination antiretroviral therapy (cART) has an effect on the clinical manifestations, radiological characteristics, and disease severity of human immunodeficiency virus (HIV)-associated Talaromyces marneffei infection. The clinical manifestations, chest computed tomography (CT) images, and disease severity were compared between 14 patients with culture-confirmed T. marneffei infections who received cART and 38 patients who did not receive cART. Clinical manifestations included high fever (>38°C), cough, shortness of breath, chills, and skin rash. Chest CT scans were evaluated for the presence of ground-glass opacities, consolidation, miliary nodules, nodules, masses, cavitation, pericardial effusion, pleural effusion, mediastinal lymphadenitis, and the distribution of parenchymal abnormalities. Disease severity was estimated by clinical manifestations and chest CT findings. Fever (>38°C), cough, shortness of breath, and chills were significantly less frequent in patients who received cART than in those who did not receive cART (P < 0.05). The frequencies of miliary nodules, mediastinal lymphadenitis, and the proportion of diffuse lesions were significantly lower in patients who received cART than in those who did not receive cART (P < 0.05). The disease severity was significantly decreased in patients who received cART compared with patients who did not receive cART (P < 0.001). T. marneffei-infected patients who received cART had fewer clinical manifestations and decreased disease severity compared with those who did not receive this treatment. The use of cART is associated with modified chest CT characteristics in HIV-associated T. marneffei infections.


Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , Antiretroviral Therapy, Highly Active/methods , HIV Infections/drug therapy , Mycoses/complications , Talaromyces/drug effects , Thorax/diagnostic imaging , AIDS-Related Opportunistic Infections/diagnosis , Adult , China/epidemiology , Cough/etiology , Exanthema , Female , Fever/etiology , HIV Infections/complications , HIV Infections/microbiology , Humans , Male , Middle Aged , Mycoses/epidemiology , Mycoses/microbiology , Radiography, Thoracic , Severity of Illness Index , Talaromyces/isolation & purification , Tomography, X-Ray Computed
7.
Mycopathologia ; 185(3): 569-575, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32232764

ABSTRACT

Otomycosis is a common finding in otorhinolaryngology clinics and is usually caused by species of Candida and Aspergillus, particularly black aspergilli. Meanwhile, other fungi can give rise to this infection, and the identification of these requires accurate methods. Here, we report three cases of otomycosis due to rare fungal pathogens. All the patients were young females, and manipulation of the ear canal was identified as a common potentially predisposing factor. In direct examination, filamentous fungal elements (in one case) and yeast cells (in two other cases) were seen. Culture was positive in all cases. Based on PCR-sequencing of internal transcribed spacers and ß-tubulin (for mold isolate), the isolated fungi were identified as Talaromyces purpurogenus, Naganishia albida and Filobasidium magnum. By susceptibility testing of the isolates to fluconazole, itraconazole, voriconazole and amphotericin B, the lowest minimum inhibitory concentration values were observed for amphotericin B followed by voriconazole. Patients were successfully treated by a combination of antifungals and corticosteroids with no relapse over the next year, except for the case due to F. magnum, in which, despite partial recovery, a course of relapse was reported in the 1-year follow-up call.


Subject(s)
Basidiomycota/isolation & purification , Otomycosis/microbiology , Talaromyces/isolation & purification , Adult , Basidiomycota/classification , Basidiomycota/drug effects , Basidiomycota/genetics , Causality , DNA, Fungal/isolation & purification , Female , Humans , Talaromyces/classification , Talaromyces/drug effects , Talaromyces/genetics
8.
Biosci Biotechnol Biochem ; 84(7): 1373-1383, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32163007

ABSTRACT

PENICILLIUM MARNEFFEI: is a thermally dimorphic fungus that causes penicilliosis, and become the third-most-common opportunistic fungal infection in immunocompromised patients in Southeast Asia. Azoles and amphotericin B have been introduced for the treatment, however, it is important to investigate possible mechanisms of azole resistance for future treatment failure. We identified 177 putative MFS transporters and classified into 17 subfamilies. Among those, members of the Drug:H+ antiporter 1 subfamily are known to confer resistance to antifungals. Out of 39 paralogs, three (encoded by PmMDR1, PmMDR2, and PmMDR3) were heterologously overexpressed in S. cerevisiae AD∆ conferred resistance to various drugs and compounds including azoles, albeit to different degrees. PmMDR1-expressing strain showed resistance to the broadest range of drugs, followed by the PmMDR3, and PmMDR2 conferred weak resistance to a limited range of drugs. We conclude that PmMDR1 and PmMDR3, may be able to serve as multidrug efflux pumps.


Subject(s)
ATP Binding Cassette Transporter, Subfamily B/chemistry , ATP Binding Cassette Transporter, Subfamily B/metabolism , Amphotericin B/pharmacology , Antifungal Agents/pharmacology , Mycoses/metabolism , Talaromyces/metabolism , Triazoles/pharmacology , ATP Binding Cassette Transporter, Subfamily B/genetics , Amino Acid Sequence , Amphotericin B/therapeutic use , Asia, Southeastern/epidemiology , Candida albicans/drug effects , Candida albicans/metabolism , Drug Resistance, Fungal/drug effects , Humans , Immunocompromised Host , Microbial Sensitivity Tests , Mycoses/drug therapy , Mycoses/epidemiology , Mycoses/microbiology , Phylogeny , Saccharomyces cerevisiae/drug effects , Saccharomyces cerevisiae/metabolism , Saccharomyces cerevisiae Proteins/genetics , Talaromyces/drug effects , Transcriptome , Triazoles/therapeutic use
9.
Comb Chem High Throughput Screen ; 23(2): 126-140, 2020.
Article in English | MEDLINE | ID: mdl-31985370

ABSTRACT

AIMS AND OBJECTIVE: The infectious disease treatment remains a challenging concern owing to the increasing number of pathogenic microorganisms associated with resistance to multiple drugs. A promising approach for combating microbial infection is to combine two or more known bioactive heterocyclic pharmacophores in one molecular platform. Herein, the synthesis and biological evaluation of novel thiazole-thiazolidinone hybrids as potential antimicrobial agents were dissimilated. MATERIALS AND METHODS: The preparation of the substituted 5-benzylidene-2-thiazolyimino-4- thiazolidinones was achieved in three steps from 2-amino-5-methylthiazoline. All the compounds have been screened in PASS antibacterial activity prediction and in a panel of bacteria and fungi strains. Minimum inhibitory concentration and minimum bacterial concentration were both determined by microdilution assays. Molecular modeling was conducted using Accelrys Discovery Studio 4.0 client. ToxPredict (OPEN TOX) and ProTox were used to estimate the toxicity of the title compounds. RESULTS: PASS prediction revealed the potentiality antibacterial property of the designed thiazolethiazolidinone hybrids. All tested compounds were found to kill and to inhibit the growth of a vast variety of bacteria and fungi, and were more potent than the commercial drugs, streptomycin, ampicillin, bifomazole and ketoconazole. Further, in silico study was carried out for prospective molecular target identification and revealed favorable interaction with the target enzymes E. coli MurB and CYP51B of Aspergillus fumigatus. Toxicity prediction revealed that none of the active compounds was found toxic. CONCLUSION: Substituted 5-benzylidene-2-thiazolyimino-4-thiazolidinones, endowing remarkable antibacterial and antifungal properties, were identified as a novel class of antimicrobial agents and may find a potential therapeutic use to eradicate infectious diseases.


Subject(s)
Anti-Bacterial Agents/pharmacology , Antifungal Agents/pharmacology , Software , Thiazoles/pharmacology , Thiazolidines/pharmacology , Anti-Bacterial Agents/chemical synthesis , Anti-Bacterial Agents/chemistry , Antifungal Agents/chemical synthesis , Antifungal Agents/chemistry , Aspergillus fumigatus/drug effects , Aspergillus niger/drug effects , Drug Design , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Microbial Sensitivity Tests , Models, Molecular , Molecular Structure , Penicillium/drug effects , Talaromyces/drug effects , Thiazoles/chemistry , Thiazolidines/chemical synthesis , Thiazolidines/chemistry
10.
Med Mycol ; 58(4): 560-563, 2020 Jun 01.
Article in English | MEDLINE | ID: mdl-31504774

ABSTRACT

We performed morphology, molecular study and antifungal susceptibility test on 10 Talaromyces sp. isolates: eight clinical isolates (human immunodeficiency virus (HIV) and non-HIV-patient) and two isolates from rats. All strains produced red soluble pigment and microscopically showed Penicillium-like structure in room temperature and yeast-like structure in 37°C. Based on molecular analysis, nine isolates were identified as Talaromyces atroroseus (including the isolates from rats) and one as T. marneffei. Our susceptibility result of T. marneffei supports the use of amphotericin B, itraconazole for talaromycosis marneffei management. Talaromyces atroroseus showed variable MIC to echinocandin, azole derivatives, 5-flucytosine and amphotericin B.


Subject(s)
Antifungal Agents/pharmacology , HIV Infections/microbiology , Talaromyces/classification , Animals , Humans , Indonesia , Microbial Sensitivity Tests , Mycoses/microbiology , Pigmentation , Rats/microbiology , Talaromyces/drug effects , Talaromyces/genetics , Talaromyces/isolation & purification
11.
Emerg Microbes Infect ; 8(1): 367-376, 2019.
Article in English | MEDLINE | ID: mdl-31851879

ABSTRACT

The dimorphic fungus Talaromyces marneffei (TM) is a common cause of HIV-associated opportunistic infections in Southeast Asia. Cotrimoxazole (CTX) inhibits folic acid synthesis which is important for the survival of many bacteria, protozoa, and fungi and has been used to prevent several opportunistic infections among HIV/AIDS patients. We question whether CTX is effective in preventing TM infection. To investigate this question, we conducted an 11-year (2005-2016) retrospective observational cohort study of all patients on the Chinese national antiretroviral therapy (ART) programme in Guangxi, a province with high HIV and TM burden in China. Survival analysis was conducted to investigate TM cumulative incidence, and Cox regression and propensity score matching (PSM) were used to evaluate the effect of CTX on TM incidence. Of the 3359 eligible individuals contributing 10,504.66 person-years of follow-up, 81.81% received CTX within 6 months after ART initiation, and 4.73% developed TM infection, contributing 15.14/1,000 person-year TM incidence rate. CTX patients had a significantly lower incidence of TM infection than non-CTX patients (4.11% vs. 7.53%; adjusted hazard ratio (aHR) = 0.50, 95% CI 0.35-0.73). CTX reduced TM incidence in all CD4+ cell subgroups (<50 cells/µL, 50-99 cells/µL, 100-199 cells/µL), with the highest reduction observed in patients with a baseline CD4+ cell count <50 cells/µL in both Cox regression and the PSM analyses. In conclusion, in addition to preventing other HIV-associated opportunistic infections, CTX prophylaxis has the potential to prevent TM infection in HIV/AIDS patients receiving ART.


Subject(s)
AIDS-Related Opportunistic Infections/prevention & control , Acquired Immunodeficiency Syndrome/complications , HIV Infections/complications , Mycoses/prevention & control , Talaromyces/drug effects , Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosage , AIDS-Related Opportunistic Infections/microbiology , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Anti-Retroviral Agents/therapeutic use , China , Female , HIV Infections/drug therapy , Humans , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Survival Analysis
12.
Mycopathologia ; 184(6): 735-745, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31473910

ABSTRACT

Knowledge about the clinical and laboratory characteristics and prognosis of Talaromyces marneffei infection in children is limited. A retrospective study was conducted on pediatric patients with disseminated T. marneffei infection in a clinical setting. Extracted data included demographic information (age and sex), clinical features, laboratory findings, treatment, and prognosis. Eleven HIV-negative children were enrolled. The male/female ratio was 8:3. The median age of onset was 17.5 months (3.5-84 months). The mortality rate in these children was 36.36% (4/11). Seven children had underlying diseases. All of the children had multiple immunoglobulin abnormalities and immune cell decline. Ten children received voriconazole treatment, and most of the children (7/10) had a complete response to therapy at primary and long-term follow-up assessment; only three children died of talaromycosis. One patient recovered from talaromycosis but died of leukemia. The child who received itraconazole treatment also showed clinical improvement. No adverse events associated with antifungal therapies were recorded during and after the treatment. Talaromycosis is an indicator disease for undiagnosed severe immunodeficiencies in children. Awareness of mycoses in children by pediatricians may prompt diagnosis and timely treatment. Voriconazole is an effective, well-tolerated therapeutic option for disseminated T. marneffei infection in non-HIV-infected children.


Subject(s)
AIDS-Related Opportunistic Infections , Mycoses , Talaromyces , Voriconazole/therapeutic use , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/immunology , AIDS-Related Opportunistic Infections/microbiology , AIDS-Related Opportunistic Infections/mortality , Antifungal Agents/adverse effects , Antifungal Agents/therapeutic use , Child , Child, Preschool , China , Female , HIV-1 , Humans , Infant , Itraconazole/adverse effects , Itraconazole/therapeutic use , Male , Mycoses/drug therapy , Mycoses/immunology , Mycoses/microbiology , Mycoses/mortality , Retrospective Studies , Talaromyces/drug effects , Talaromyces/pathogenicity , Voriconazole/adverse effects
13.
Chin Med J (Engl) ; 132(16): 1909-1918, 2019 Aug 20.
Article in English | MEDLINE | ID: mdl-31348027

ABSTRACT

BACKGROUND: Little study has investigated the differences between Talatomyces marneffei (T. marneffei) respiratory infection and tuberculosis and the prognostic factors of such infection. This study investigated the characteristics and prognostic factors of T. marneffei infections with respiratory lesions and the causes of misdiagnosis. METHODS: Clinical characteristics and prognoses of patients with T. marneffei infections with respiratory system lesion were investigated. T. marneffei diagnosis followed isolation from clinical specimens using standard culture, cytology, and histopathology. Survival curves were estimated by using Kaplan-Meier analysis, with log-rank test to compare differences in survival rates between groups. Univariate and multivariate Cox regression analyses were also performed to assess significant differences in clinical characteristics of overall survival. RESULTS: Of 126 patients diagnosed with T. marneffei infections, 63 (50.0%) had T. marneffei respiratory system infections; 38.1% (24/63) were misdiagnosed as having tuberculosis. Human immunodeficiency virus (HIV) infection, CD4/CD8 < 0.5, percentage of CD4 T cells <42.8%, and length of time from onset to confirmation of diagnosis >105 days were potential risk factors for poor prognoses. Length of time from onset to confirmation of diagnosis persisted as an independent predictor of all-cause mortality in multivariate analysis (odds ratio: 0.083, 95.0% confidence interval: 0.021-0.326, P < 0.001). However, the size of the lung lesions, dyspnea, thoracalgia, mediastinal lymphadenopathy, and pleural effusion did not significantly predict overall survival. There was no significant difference in prognosis according to the type of treatment. CONCLUSIONS: T. marneffei infections involving the respiratory system are common. The critical determinants of prognosis are HIV infection, CD4/CD8, percentage of CD4 T cells, type of treatment, and the time range from onset to confirmation of diagnosis. Rapid and accurate diagnosis is crucial for improving prognosis.


Subject(s)
Respiratory System/microbiology , Talaromyces/pathogenicity , Adolescent , Adult , Aged , Antifungal Agents/therapeutic use , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Mycoses/drug therapy , Mycoses/microbiology , Mycoses/pathology , Prognosis , Retrospective Studies , Talaromyces/drug effects , Young Adult
14.
Fungal Genet Biol ; 130: 54-61, 2019 09.
Article in English | MEDLINE | ID: mdl-31075360

ABSTRACT

Talaromyces marneffei (T. marneffei) is a medically important opportunistic dimorphic fungus that infects both humans and bamboo rats. However, the mechanisms of transmission and pathogenicity of T. marneffei are poorly understood. In our study, we combined Illumina and PacBio sequencing technologies to sequence and assemble a complete genome of T. marneffei. To elucidate the transmission route and source, we sequenced three additional T. marneffei isolates using Illumina sequencing technology. Variations among isolates were used to develop a multilocus sequence typing (MLST) system comprising five housekeeping genes that can be used to discriminate between isolates derived from different sources. Our analysis revealed that human and bamboo rat share identical genotypes in these five loci. Thus, we hypothesized that T. marneffei is transmitted to humans through inhalation of spores in the surrounding environment into the lungs and that the bamboo rat can serve as an important natural reservoir for pathogens. Furthermore, we also identified temperature-dependent polyketide synthases, non-ribosomal peptide synthetases and secreted proteins as putative pathogenicity-related factors. In addition, we identified antifungal drug targets that can be investigated in future studies to elucidate the mechanisms underlying drug resistance. In summary, our study presents the basic features of the T. marneffei genome and provides insights into the transmission and pathogenicity of T. marneffei, which warrant fundamental experimental research.


Subject(s)
Genome, Fungal/genetics , Genomics , Talaromyces/genetics , Virulence Factors/genetics , Animals , Antifungal Agents , DNA, Fungal , Fungal Proteins/genetics , Genes, Essential/genetics , Genotype , Humans , Multilocus Sequence Typing , Peptide Synthases/genetics , Phylogeny , Polyketide Synthases/genetics , Rats , Secondary Metabolism/genetics , Talaromyces/drug effects , Talaromyces/isolation & purification , Virulence , Whole Genome Sequencing
15.
Indian J Pathol Microbiol ; 62(1): 156-158, 2019.
Article in English | MEDLINE | ID: mdl-30706885

ABSTRACT

Penicilliosis is a rare opportunistic fungal infection caused by Talaromyces marneffei, especially in the HIV-infected patients. The untreated disease is highly fatal. The infection is endemic in Southeast Asia and Northeast India. The present case is the first case of disseminated penicilliosis from North India and Delhi in a 31-year-old male, recently diagnosed with HIV. This case highlights the importance of considering an unusual organism as the cause of disseminated disease in the nonendemic area.


Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Mycoses/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/microbiology , Adult , Antifungal Agents/therapeutic use , Bone Marrow Cells/microbiology , Fluconazole/administration & dosage , HIV Infections/diagnosis , HIV Infections/microbiology , Humans , India , Lymphadenopathy/diagnostic imaging , Male , Mycoses/drug therapy , Talaromyces/drug effects , Talaromyces/isolation & purification , Tomography, X-Ray Computed
16.
Mycopathologia ; 184(2): 295-301, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30805832

ABSTRACT

Talaromyces (Penicillium) marneffei can cause fatal disseminated infection in immunocompromised hosts. However, therapeutic strategies for the mycosis are limited. Reports of the other fungi suggest that berberine, a component of traditional herb, inhibitors interact with antifungal agents to improve the treatment outcomes. In the study, we evaluated the in vitro efficacy of berberine in combination with conventional antifungal agents against the pathogenic yeast form of T. marneffei. We demonstrate the synergistic effect of combination of berberine with fluconazole (52.38%), itraconazole (66.67%), voriconazole (71.43%), amphotericin B (71.43%) or caspofungin (52.38%) of T. marneffei strains, respectively. Time-kill curves confirmed the synergistic interaction, and no antagonistic was observed in all of the combinations. In conclusion, berberine could enhance the efficacy of conventional antifungal agents against the yeast form of T. marneffei in vitro. The results indicated berberine might have a potential role in combination therapy for talaromycosis.


Subject(s)
Antifungal Agents/pharmacology , Berberine/pharmacology , Drug Synergism , Talaromyces/drug effects , Amphotericin B/pharmacology , Azoles/pharmacology , Caspofungin/pharmacology , Microbial Sensitivity Tests , Microbial Viability/drug effects
17.
Mycoses ; 62(5): 450-457, 2019 May.
Article in English | MEDLINE | ID: mdl-30597630

ABSTRACT

Although case series of talaromycosis have been reported in China, their detailed clinical and microbiological characteristics have never been systematically profiled. In this study, we report the clinical characteristics, molecular epidemiology, rapid identification and antifungal susceptibilities of talaromycosis in The University of Hong Kong-Shenzhen Hospital in Shenzhen. Seven cases of talaromycosis were observed since commencement of hospital service in 2012. Three patients were local Shenzhen residents, whereas the other four were immigrants from other parts of China. Two patients were HIV-negative, but with underlying diseases requiring immunosuppressive therapy. Two of the seven patients succumbed. All the seven isolates were successfully identified as T. marneffei by MALDI-TOF MS using Bruker database expanded with in-house generated T. marneffei mass spectra. MLST showed that the seven strains belonged to six different, novel sequences types. Phylogenetic analyses of the concatenated five-locus sequence revealed that the seven strains were scattered amongst other T. marneffei strains. The MICs of itraconazole, isavuconazole, posaconazole and voriconazole against the seven clinical isolates were low but MICs of anidulafungin were high. Underlying diseases other than HIV infection are increasingly important risk factors of talaromycosis. MALDI-TOF MS is useful for rapid identification. Highly diverse T. marneffei sequence types were observed.


Subject(s)
Antifungal Agents/pharmacology , Microbiological Techniques/methods , Mycoses/epidemiology , Mycoses/pathology , Talaromyces/isolation & purification , Adult , Aged , Female , Genotype , Hong Kong , Hospitals, University , Humans , Male , Middle Aged , Molecular Epidemiology , Multilocus Sequence Typing , Mycological Typing Techniques , Mycoses/diagnosis , Mycoses/microbiology , Retrospective Studies , Risk Factors , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods , Survival Analysis , Talaromyces/classification , Talaromyces/drug effects , Talaromyces/genetics
18.
Article in English | MEDLINE | ID: mdl-30420478

ABSTRACT

Amphotericin B deoxycholate (DAmB) is a first-line agent for the initial treatment of talaromycosis. However, little is known about the population pharmacokinetics and pharmacodynamics of DAmB for talaromycosis. Pharmacokinetic data were obtained from 78 patients; among them, 55 patients had serial fungal CFU counts in blood also available for analysis. A population pharmacokinetic-pharmacodynamic model was fitted to the data. The relationships between the area under the concentration-time curve (AUC)/MIC and the time to blood culture sterilization and the time to death were investigated. There was only modest pharmacokinetic variability in the average AUC, with a mean ± standard deviation of 11.51 ± 3.39 mg·h/liter. The maximal rate of drug-induced kill was 0.133 log10 CFU/ml/h, and the plasma concentration of the DAmB that induced the half-maximal rate of kill was 0.02 mg/liter. Fifty percent of patients sterilized their bloodstreams by 83.16 h (range, 13 to 264 h). A higher initial fungal burden was associated with a longer time to sterilization (hazard ratio [HR], 0.51; 95% confidence interval [CI], 0.36 to 0.70; P < 0.001). There was a weak relationship between AUC/MIC and the time to sterilization, although this did not reach statistical significance (HR, 1.03; 95% CI, 1.00 to 1.06, P = 0.091). Furthermore, there was no relationship between the AUC/MIC and time to death (HR, 0.97; 95% CI, 0.88 to 1.08; P = 0.607) or early fungicidal activity {slope = log[(0.500 - 0.003·(AUC/MIC)]; P = 0.319} adjusted for the initial fungal burden. The population pharmacokinetics of DAmB are surprisingly consistent. The time to sterilization of the bloodstream may be a useful pharmacodynamic endpoint for future studies. (This study has been registered at the ISRCTN registry under no. ISRCTN59144167.).


Subject(s)
Antifungal Agents/therapeutic use , Talaromyces/pathogenicity , Adult , Amphotericin B/pharmacokinetics , Amphotericin B/therapeutic use , Antifungal Agents/pharmacokinetics , Area Under Curve , Deoxycholic Acid/pharmacokinetics , Deoxycholic Acid/therapeutic use , Drug Combinations , Female , Humans , Male , Microbial Sensitivity Tests , Penicillium/drug effects , Penicillium/pathogenicity , Talaromyces/drug effects
19.
Enzyme Microb Technol ; 118: 44-49, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30143198

ABSTRACT

The process economics of fermentable sugar production is dependent on the performance of cellulase cocktail on realistic lignocellulosic biomass and their capability to be recovered and recycled. Feasibility studies were conducted to enhance the digestibility of acid pretreated sugarcane bagasse using novel cellulase cocktail obtained from stable mutant UV-8 of Talaromyces verruculosus IIPC 324 in presence of lignin blocking additives. PEG 6000 was shortlisted as the best additive as it could simultaneously enhance saccharification and overall cellulase recoveries namely cellobiohydrolase, endoglucanase and cellobiase. Addition of 0.3 g PEG 6000/g acid-insoluble lignin content, resulted in 55% and 49.2% saccharification yields in terms of reducing sugars and glucose respectively using this cellulase cocktail (25 mg protein/g cellulose content) after 72 h from acid pretreated sugarcane bagasse loaded at 7.5%. The study also suggested that the endoglucanase of this mutant was unique with high desorption capability as 85% activity was observed in the saccharified broth devoid of any lignin blocking additive. At its optimum concentration, PEG 6000 was able to retain 94 ± 0.79% cellobiohydrolase I and 97.97 ± 1.16% cellobiase enzyme in the saccharified broth which were otherwise lost in residual biomass by ∼80%, in the absence of this polymeric additive. These results suggest that PEG 6000 was the most promising facilitator for recycling of cellulases obtained from mutant UV-8 of Talaromyces verruculosus IIPC 324 in particular. It paved a way towards the production of cheaper fermentable sugars which serve as a starting raw material for the production of green chemicals and fuels.


Subject(s)
Cellulase/metabolism , Cellulose/metabolism , Fungal Proteins/metabolism , Lignin/antagonists & inhibitors , Saccharum/chemistry , Talaromyces/metabolism , Biomass , Biotechnology , Cellulase/genetics , Feasibility Studies , Fermentation , Fungal Proteins/genetics , Hydrolysis , Lignin/metabolism , Mutation , Polyethylene Glycols/pharmacology , Saccharum/metabolism , Talaromyces/drug effects , Talaromyces/genetics , Talaromyces/growth & development
20.
Eur J Clin Microbiol Infect Dis ; 37(6): 1099-1102, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29536323

ABSTRACT

Talaromyces marneffei (T. marneffei) can cause talaromycosis, a fatal systemic mycosis, in patients with AIDS. With the increasing number of talaromycosis cases in Guangdong, China, we aimed to investigate the susceptibility of 189 T. marneffei clinical strains to eight antifungal agents, including three echinocandins (anidulafungin, micafungin, and caspofungin), four azoles (posaconazole, itraconazole, voriconazole, and fluconazole), and amphotericin B, with determining minimal inhibition concentrations (MIC) by Sensititre YeastOne™ YO10 assay in the yeast phase. The MICs of anidulafungin, micafungin, caspofungin, posaconazole, itraconazole, voriconazole, fluconazole, and amphotericin B were 2 to > 8 µg/ml, >8 µg/ml, 2 to > 8 µg/ml, ≤ 0.008 to 0.06 µg/ml, ≤ 0.015 to 0.03 µg/ml, ≤ 0.008 to 0.06 µg/ml, 1 to 32 µg/ml, and ≤ 0.12 to 1 µg/ml, respectively. The MICs of all echinocandins were very high, while the MICs of posaconazole, itraconazole, and voriconazole, as well as amphotericin B were comparatively low. Notably, fluconazole was found to have a higher MIC than other azoles, and exhibited particularly weak activity against some isolates with MICs over 8 µg/ml. Our data in vitro support the use of amphotericin B, itraconazole, voriconazole, and posaconazole in management of talaromycosis and suggest potential resistance to fluconazole.


Subject(s)
Amphotericin B/pharmacology , Antifungal Agents/pharmacology , Azoles/pharmacology , Echinocandins/pharmacology , HIV Infections/microbiology , Talaromyces/drug effects , Anidulafungin , HIV Infections/complications , Humans , Lipopeptides/pharmacology , Micafungin , Microbial Sensitivity Tests , Mycoses/drug therapy , Mycoses/microbiology , Reagent Kits, Diagnostic , Talaromyces/isolation & purification , Talaromyces/physiology , Voriconazole/pharmacology
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