Supplement bij veertiende jaargang, april 2006 - NVMM

choice. Other drugs like amphotericin B and voriconazole
should be considered.
02.11
Black fungal infections in China
Ruo-yu Li
Department of Dermatology, Peking University First Hospital,
Research Center for Medical Mycology, Peking University,
Beijing, China
The black fungi are a large and heterogenous group of
filamentous moulds with dark colored colonies and cell
walls. They could produce brown melanin or melanin-like
pigment in the cell wall of their hyphae or conidia, or both.
Clinically, black fungi could cause the following diseases:
chromoblastomycosis; phaeohyphomycosis; eumycotic
mycetoma; onychomycosis; tinea nigra; black piedra and
mycotic keratitis. Chromoblastomycosis is a distinctive
infection of the skin and subcutaneous tissues caused
by several dematiaceous moulds. It is the most common
black fungal infection in China. The causative agents were
Cladophialophora carrionii (64.7%), Fonsecaea pedrosoi
(24.6%), Phialophora verrucosa (2.4%) and Fonsecaea
compacta (0.8%). Phaeohyphomycosis is a generic term
to be applied to any mycosis involving a dematiaceous
fungus. The pathogenic agents of phaeohyphomycosis
are widespread in the environment include soil, wood,
decomposing plant matter as well as polluted water.
Until 1998, 60 genera, 109 species were reported to be
human pathogenic. The causative agents in China mainly
included: Exophiala spp. (most common), Chaetomium spp.,
Bipolaris spinifera, Alternaria alternata, Veronaea botryosa,
Ochroconis gallopavum, Curvularia clavata, Phialophora
verrucosa, Hendersonula toruloidea. The treatment of black
fungal infection is still difficult. In summary, chromoblastomycosis
is the major type of dematiaceous fungal
infection in China. Phaeohyphomycosis is increasing in
immunocompromised patients and the management of
it still challengeable. The classification and identification
of dematiaceous fungi will depend on the combination of
morphological, physiological, molecular biological as well
as other supplementary methods.
02.12
Colonization of cystic fibrosis patients with Aspergillus
fumigatus is a recurrent phenomenon
H.A. de Valk, I.M. Curfs, C.H.W. Klaassen, J.F.G.M. Meis
Canisius Wilhelmina Hospital, Medical Microbiology and
Infectious Diseases, Nijmegen
Introduction: Aspergillus fumigatus strains often colonize
the respiratory tract of Cystic Fibrosis (CF) patients.
Ned Tijdschr Med Microbiol 2006; 4:Supplement
S2
Previous low discriminatory molecular typing assays
suggested the majority of sequential cultured isolates to
be of the same genotype. We used a novel high-resolution
fingerprinting assay to analyze multiple A. fumigatus
strains from CF patients.
Methods: We collected A. fumigatus strains from nine
patients. From 6 patients each, two isolates were collected
with a one year interval. From 3 patients, isolates were
collected over a period of 3 to 4 years (3, 16 and 13 isolates
respectively). All strains were analyzed using the STRAf
(Short Tandem Repeats of A. fumigatus) assay.
Results: From 6 patients, all intrapatient, isolates were
of different genotypes. One patient with two isolates was
colonized by the same strain over a period of one year. From
the patient with 16 isolates, 13 different genotypes were
found; two types were isolated more than once within a 5
months period. The patient with 13 isolates harbored four
unique isolates and 3 clusters of 3 isolates were from the
same type and succeeded each other during the last year.
Conclusion: Over a long period of time, different genotypes
of A. fumigatus were found in most of the examined CFpatients.
If the same genotype was found more than once,
this only occurred in a short time period. Airway colonization
of CF patients with A. fumigatus is appear to be a
recurrent event. To substantiate this further more isolates
from more CF patients should be analyzed.
02.13
epidemiologic issues in invasive fungal infections
David W. Warnock
Division of Bacterial and Mycotic Diseases, Centers for Disease
Control and Prevention, Atlanta, Georgia, U.S.A.
The last two decades have seen unprecedented changes in
the pattern of serious fungal infections among immunocompromised
individuals, including hematopoietic stem
cell transplant (HSCT) and solid organ transplant (SOT)
recipients, persons with hematological malignancies,
and persons living with AIDS. These infections are being
seen in ever increasing numbers, largely because of the
increasing size of the population at risk. Although gains
have been made in the treatment and prevention of some
fungal infections, medical developments and changing
health care practices have contributed to the emergence of
new pathogens, and new at-risk groups.
Sentinel and population-based surveillance programs
have documented significant changes in the rates of
invasive candidiasis (IC) among different groups of
immunocompromised patients, with the emergence
of non-albicans Candida species, particularly Candida
glabrata, as important pathogens. More cases of IC now
occur among critical care patients than are diagnosed
among neutropenic cancer patients or HSCT recipients.