Genus Malassezia comprises of 14 species of “yeast like fungi,” 13 of which are lipophilic and 1 is nonlipophilic. They are known commensals and in predisposed individuals they commonly cause a spectrum of chronic recurrent infections. They rarely also cause serious illnesses like catheter-related blood stream infections, CAPD associated peritonitis etc., Though these fungi have been known to man for over 150 years, their fastidious nature and cumbersome culture and speciation techniques have restricted research. Since the last taxonomic revision, seven new species have been added to this genus. Their ability to evade the host immune system and virulence has increased the spectrum of the diseases caused by them. These agents have been implicated as causal agents in common diseases like atopic dermatitis recently. Though culture-based research is difficult, the new molecular analysis techniques and facilities have increased research in this field such that we can devote more attention to this genus to study in detail, their characteristics and their growing implications implications in the clinical scenario.

No abstract

Introduction:Candida auris has been reported from various health care settings and has recently gained importance because of its intrinsic resistance to many classes of antifungal agents and to disinfection. The outbreak potential and high mortality associated with Candida auris infection reinforces the need for speciation. Routine conventional methods are cumbersome and automated systems are unable to confirm up to species level. Materials and Methods:Candida auris isolates from consecutive non-repetitive blood cultures over a 1-year period were speciated based on phenotypic, physiological and biochemical tests and VITEK. Molecular confirmation was done by PCR-RFLP and MALDI-TOF. Anti- fungal susceptibility test was performed according to CLSI guidelines (2021), using suitable controls. Virulence factors such as production of Hemolysin, Phospholipase, Esterase and Bio-film production were demonstrated. RT-PCR was used to screen the COVID-19 status using SD-Biosensor kit. Baseline data and clinical history were collected and analysed. Results: Of 3632 blood cultures (0.77%), 28 Candida sp. were isolated including 9 Candida auris, (9/28, 32.14%). Of these 8 were from COVID-19 positive patients (88.89%), while 1 was from COVID-19 negative patient (11.11%). Two patients survived, while the remaining 7 patients succumbed to the disease. Conclusion: The increasing incidence of Candidiasis especially during the COVID-19 pandemic has raised the concern for early speciation. Through multi-modal strategies such as quick and correct identification, active surveillance, guided reporting, stringent infection control measures and correct use of anti-fungals through proper susceptibility testing, we can prevent the occurrence and spread of new Candida auris cases in the future.

Aspergillosis is a systemic fungal infection that commonly affects immunocompromised individuals and, less frequently, immunocompetent individuals. It is the most common opportunistic fungal disease after candidiasis. This is primarily a pulmonary infection and can also involve other body sites like paranasal sinuses and cutaneous tissues. Aspergillus fumigatus, Aspergillus niger, and Aspergillus flavus are the common species infecting humans. Primary cutaneous aspergillosis (PCA) is usually caused by A. flavus and A. fumigatus. It is commonly seen in immunocompromised patients such as those suffering from diabetes, malignancies, tuberculosis, human immunodeficiency virus, or patients on long-term steroids and antibiotics. In this article, we report a case of PCA, in the immediate postoperative period, following a road traffic accident, in an immunocompetent patient. This posed a diagnostic challenge to the treating physicians. A. flavus was confirmed with 10% potassium hydroxide mount, lactophenol cotton blue, and growth on Sabouraud dextrose agar from tissue culture sample. Antifungal treatment was initiated with oral itraconazole 200 mg after performing antifungal susceptibility testing based on Clinical and Laboratory Standards Institute guidelines. The patient's condition improved and was discharged. Thus, early detection of PCA combined with medical and surgical intervention can successfully eradicate infection and help in preventing disseminated aspergillosis.