A Retrospective Analysis Of Phaeohyphomycosis In The Mainland Of China(1987 To 2017)

The full text consists of two parts:Part one:A Retrospective Analysis of Phaeohyphomycosis In the Mainland of China(1987 to 2017)Objective:To review and analyse the epidemiology and treatment of phaeohyphomycosis in the mainland of China over 30 years,and compare to those reported abroad.Methods:A literature search was performed in CNKI,WanFang,WeiPu,Embase and Pubmed on phaeohyphomycosis of the Chinese mainland from 1987 to 2017.The quality of the reports was evaluated and the data was further analyzed for their respective epidemiological characteristics,risk factors,clinical features,laboratory examinations and management methods.Results:A total of 116 cases were included in the review.The type of phaeohyphomycosis is dominated by the infection of skin and subcutaneous tissue.Other types include systemic infection,keratitis,superficial infection and onychomycosis.The disease was mainly induced by the damage of the skin barrier and abnormal immune function.The second causative factor was the long-term systemic use of glucocorticoids and immunosuppressants.The number of patients who provided the information but found no predisposing factors was 32.65%(32/98).The diagnosis was mainly based on fungal microscopy,histopathology,fungal culture and molecular identification.More than one in two cases(62 strains)were identified by molecular biology.Nearly one-third of the cases(45 strains)were tested antifungal susceptibility test in vitro.The treatment was mainly based on systematic antifungal treatment.Itraconazole was the most commonly used drug in nearly 20 years.Ten patients were dead in 107 patients with prognostic information,accounted for 9.35%(10/107);Mortality of the central nervous system infection was highest,a total of 6 cases,75%(6/8)of the known prognostic population.Conclusion:The number of cases of phaeohyphomycosis in the mainland of China has increased significantly in recent years.The main type of the disease is skin and subcutaneous tissue infection.If the central nervous system involved,it has a higher mortality rate.All health workers should raise the awareness of the disease,making early diagnosis and timely treatment,carrying out the molecular identificationin and in vitro drug sensitivity test at the same time,so as to provide more effective information for clinical treatment.Part two:The Study of the Clinical Application of the Sensititre YeastOne(?)panel for Detecting the Antifungal Susceptibility of Black Fungi in VitroObjectives:To evaluate the in vitro activity of antifungal agents against different dark fungi,and to compare the results of commercially available system(the Sensititre YeastOne(?)panel)with the CLSI reference procedure.Methods:Fifty clinical isolates of dark fungi belonging to 10 species of 7 genuses were collected and YeastOne drug susceptibility tests were performed,and compared with the CLSI M38-A reference procedureResults:The sensitivity of clinical mostly used antifungal drugs to dark fungi was generally consistent with what had been previously reported.The YeastOne method and CLSI M3 8-A had a high EA(essential agreement)of nonechinocandins antifungal drugs.Conclusions:The Sensititre Yeast One(?)method showed good reproducibility and agreement with reference method for most antifungal agents and it is worthwhile to be applied in clinical laboratories;We propose the use of the minimum effective concentration(MEC)rather than MIC as a new endpoint for testing of echinocandins against filamentous fungi.