Controlling Aflatoxin and Fumonisin in Maize by Crop Management

Maize is a vital food and feed grain worldwide. Aflatoxin and fumonisin, mycotoxins produced primarily by the fungi Aspergillus flavus and Aspergillus parasiticus Speare, and Fusarium moniliforme J. Sheld, respectively, are very potent carcinogens in both humans and livestock and can readily contaminate maize grain in the field and in storage. Stress on developing maize, particularly during reproductive growth, facilitates infection by the fungi, production of mycotoxins and contamination of the grain. Drought, excessive heat, inadequate plant nutrition, insect feeding on developing kernels, weeds, excessive plant populations, and other plant diseases can produce plant stress and facilitate the infection of maize grain by mycotoxin producing fungi. Timely planting of adapted hybrids, proper plant nutrition, irrigation, and insect control either by insecticides or the use of transgenic hybrids all assist in curbing mycotoxin contamination. Production practices that produce high yields are basically the same ones that help control mycotoxins. Care must also be exercised in harvesting and handling grain in transport and storage to reduce kernel breakage and prevent contamination. Harvesting early and artificial drying helps reduce the incidence of mycotoxins as well as preventing kernel breakage and stored‐grain insect infestations.     

Management and diagnostic guidelines for fungal diseases in infectious diseases and clinical microbiology: critical appraisal

Invasive fungal infections (IFIs) are life-threatening conditions that require rapid diagnostic and optimal management to mitigate their high morbidity and mortality rate. They are also associated with a high economic burden, owing to prolonged hospitalization, the need for intensive supportive care, and the consumption of costly new antifungal agents. To address these issues, several international organizations have proposed guidelines for the management of IFIs. The consistency and reliability of these guidelines have rarely been assessed. This article is a review of the differences between the recommendations of the Infectious Diseases Society of America, the European Conference on Infection in Leukaemia, and the European Society of Clinical Microbiology and Infectious Diseases, and will focus on targeted treatment and diagnostic procedures. Although the conclusions of the three groups of experts are in many points similar we outlined some important differences in the methodology and conclusions of ESCMID. The use of these guidelines has the potential to enhance the management of fungal infections but is probably currently suboptimal.     

Claviform aspergillus‐related vegetation in the left ventricle of a patient with systemic lupus erythematosus

A 38‐year‐old woman was diagnosed with systemic lupus erythematosus and received immunosuppressive therapy. After 6 months of treatment, workup for low‐grade fever yielded elevated enzyme‐linked immunosorbent assay titers for Aspergillus antigen in serum and ascites, leading to the diagnosis of disseminated aspergillosis. Transthoracic echocardiography revealed a claviform vegetation attached to the left ventricular anterior septum. Two days after the start of antifungal Amphotericin‐B therapy, the patient suffered from several neurologic disorders. A second transthoracic echocardiography revealed that the vegetation decreased in size. Two weeks later, the vegetation increased again. Combination therapy of Amphotericin‐B and Voriconazole was initiated, and the vegetation eventually disappeared completely. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 46 :231–232, 2018     

Multi-organ failure due to Mycobacterium tuberculosis and Aspergillus flavus infection after allogeneic bone marrow transplantation

Mycobacterium tuberculosis (MT) is a serious, but rare infectious complication after allogeneic bone marrow transplantation (BMT). We describe a case of fatal sepsis due to MT and Aspergillus flavus after allogeneic BMT for Aplastic Anemia. The diagnosis was made on bone marrow biopsy and asitic fluid culture. Broadspectrum antituberculous and Amphotericin B therapy was started immediately after diagnosis. The patient developed severe hypoxia and finally died of multi-organ failure. Rapid progression of mycobacterial infection as well as fungal infection should be considered in patients post BMT with unexplained fever, particularly in patients from endemic areas.     

Allergic bronchopulmonary aspergillosis in children

Allergic bronchopulmonary aspergillosis (ABPA) is a disease of the lungs resulting from a hypersensitivity reaction to spores of Aspergillus fumigatus. Here we report the case of a 13‐year‐old girl with ABPA who presented with productive cough, bronchiectasis and decline in lung function, and review the clinical features and treatment for pediatric ABPA.     

Efficacy of oleylphosphocholine (OlPC) in vitro and in a mouse model of invasive aspergillosis

Invasive aspergillosis (IA) has become increasingly common and is characterised by high morbidity and mortality. Upcoming resistance threatens treatment with azoles and highlights the continuous need for novel therapeutics. This laboratory study investigated the in vitro and in vivo potential of the alkylphospholipid oleylphosphocholine (OlPC) against Aspergillus. In vitro activities of OlPC, miltefosine, posaconazole and voriconazole were determined for Aspergillus fumigatus, A. niger, A. terreus and A. flavus. In vivo efficacy of OlPC was evaluated in a systemic A. fumigatus mouse model, adopting a short‐term and long‐term oral or intraperitoneal dosing regimen. OlPC showed good in vitro activity against A. fumigatus (IC₅₀ = 1.04 μmol l^?1). Intraperitoneal administration of 50 mg kg^?1 day^?1 OlPC significantly reduced the fungal organ burdens at 4 days post‐infection (dpi). Although 5‐ and 10‐day OlPC treatment improved survival, organ burdens were not affected at 10 and 15 dpi. While this study showed excellent in vitro activity of OlPC against Aspergillus spp., its therapeutic efficacy in an acute mouse model for IA was less convincing. Given the limited therapeutic options in the current antifungal market for invasive infections, OlPC activity should be assessed in a less stringent in vivo model, potentially in combination treatment with other already marketed antifungal drugs.     

Nebulised liposomal amphotericin B for Aspergillus lung diseases: case series and literature review

Over the past 10 years the incidence of Aspergillus spp. has significantly increased, and it is now the most widespread air transmission fungal pathogen in developed countries. Whatever the clinical expression of the pulmonary disease and despite recent progress in antifungal drug therapy, morbidity and mortality related to aspergillosis lung disease still constitute a serious threat for immunosuppressed or mildly immunocompromised patients. Moreover, the treatments currently used have many limitations due to adverse effects and drug interactions. Finally, subjects exposed to azoles present an increased risk of Aspergillus‐resistant strain emergence. We have reported five cases with aspergillosis lung diseases that were either difficult to control or in which patients had a contra‐indication to triazole therapy, but which showed durable improvement following the administration of nebulised liposomal amphotericin B. Our alternative strategy could be of interest for patients with aspergillosis lung disease who otherwise cannot be conventionally treated by triazoles.     

Diagnostic accuracy of the Aspergillus‐specific bronchoalveolar lavage lateral‐flow assay in haematological malignancy patients

We evaluated the performance of the Aspergillus‐specific lateral‐flow device (LFD) test for diagnosing invasive pulmonary aspergillosis (IPA) in patients with underlying haematological malignancies. Participating centres were the two Austrian University Hospitals of Graz and Innsbruck. LFD performance was evaluated with 95 bronchoalveolar lavage fluid (BALF) samples from 72 patients collected prospectively in Graz, and with 24 BALF bio bank samples from 23 patients (21 samples with probable IPA) in Innsbruck. Invasive fungal infections were classified according to the revised European Organization of Research and Treatment of Cancer/Mycoses Study Group criteria. Overall, 27 patients (30 samples) had probable IPA, 32 (43 samples) possible and 36 (46 samples) did not fulfil IPA criteria. The vast majority of patients – in particular those with probable IPA – received mould‐active treatment before bronchoscopy. Sensitivity, specificity, positive predictive value and negative‐predictive‐value for probable IPA diagnosis using the BALF‐LFD test were 71%, 76%, 35% and 94% for the Graz cohort. Sensitivity of the BALF‐LFD test for probable IPA was 57% in Innsbruck bio bank samples. Our results indicate that the BALF‐LFD‐test provides fast results with moderate sensitivities in patients with underlying haematological malignancies. Similar to other diagnostic tests and biomarkers sensitivity of the test may be influenced by ongoing systemic mould‐active treatment.     

八种化学消毒剂对黑曲霉菌杀灭效果的研究

目的了解8种常用化学消毒剂对黑曲霉菌的杀灭效果。方法用悬液定量杀菌试验法进行了观察。结果75%乙醇作用1 m in、4000 mg/L长链季铵盐作用5 m in、4000 mg/L聚醇醚碘作用45 m in、250 mg/L二氧化氯作用2.5 m in、3000 mg/L有效氯的84消毒液作用10 m in,对黑曲霉菌的杀灭对数值均>4.00。用8000 mg/L醋酸氯己定作用20 m in、5000 mg/L对氯间二甲苯酚作用30 m in、4000 mg/L聚维酮碘作用60 m in,对黑曲霉菌的杀灭对数值依次分别为0.60、0.86、0.83。结论在常规使用浓度下,乙醇、长链季铵盐、聚醇醚碘、二氧化氯和84消毒液对黑曲霉菌杀灭效果较好;醋酸氯己定、对氯间二甲苯酚、聚维酮碘对黑曲霉菌杀灭效果较差。