S2.1 Update on Mucormycosis, September 21, 2022, 3:00 PM - 4:30 PM Introduction: Post-COVID-19 rhino orbital mucormycosis has emerged as an important life-threatening complication adding to mortality. Fungal infections are a major health challenge, especially in the immunocompromised. Mucormycosis is a severe, frequently fatal fungal infection that has a unique predisposition to infect patients with diabetes. The most probable reasons for the emergence of these cases could be the extensive use of steroids in the management of coronavirus disease 2019 (COVID-19) patients and extensive dysregulated immune response due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. A prompt diagnosis is vital for the effective management of invasive rhino-orbital fungal infections due to their propensity for angioinvasion and destructive spread with brain involvement. Materials and Methods: A total of 150 surgical pathology specimens received with a clinical suspicion of invasive fungal infection during the post-COVID-19 outbreak of mucormycosis were retrieved from the archives of the Department of histopathology. The cases were reviewed for the presence of Aspergillus fruiting bodies by senior pathologists and microbiologists on a multi-headed microscope. The morphological features of the fruiting bodies were noted and correlated with the fungal KOH and culture. The tissue reaction pattern, presence of oxalate crystals, and morphology of the fungal hyphae were also noted in each case showing Aspergillus fruiting bodies. Results A total of 8 out of 150 cases (5.3%) showed the presence of Aspergillus fruiting bodies. The histopathological diagnosis given in these 8 cases were—Aspergillus (1), combined Aspergillus and Mucorales (7). Two types of fungal hyphae were noted in all seven cases of combined infection. Granulomatous tissue reaction was noted in two out of seven cases of combined infection. Calcium oxalate crystals were noted in the single case of Aspergillosis and were absent in all cases of mixed infection. Conclusion To conclude Aspergillus fruiting bodies are found in a small but significant number of cases of post-COVID-19 Rhino-Orbital invasive mold infections so while reporting the surgical specimens with clinical suspicion of post-COVID-19 mucormycosis one should be aware of the possibility of mixed fungal infections and look for Aspergillus fruiting bodies as a tell-tale sign of mixed Mucorales and Aspergillus infection. However, their presence does not estimate the true incidence of mixed fungal infections for which immunohistochemistry and polymerase chain reaction are needed.

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Introduction: Coronavirus disease -19 (COVID- 19)  disease, is highly transmissible, has rapidly spread worldwide since December 2019 and caused a wide spectrum of clinical manifestations in humans ranging from a common cold to severe acute respiratory syndrome. A major concern of Severe Acute Respiratory Syndrome Cornonavirus-2 (SARS-CoV-2) infection is vertical maternal-fetal transmission, though reported sparsely; it remains unclear whether these occurred via the transplacental, transcervical route or through environmental exposure. Aim and objectives: To study the Clinico-microbiological profile and COVID status of neonates having sepsis, born to COVID-19 positive mothers in a tertiary care Covid -19 hospital. Material & Methods: 50 cases of neonatal sepsis born to COVID-19 positive mothers admitted to Neonatal Intensive Care Unit (NICU) (January to May 2021) at a COVID dedicated tertiary care hospital. Two ml of venous blood drawn aseptically and inoculated aseptically into a Brain heart Infusion broth (BHIB) containing blood culture bottle. Antimicrobial susceptibility testing (AST) was performed on all the bacterial isolates as per the Clinical Laboratory Standard Institute (CLSI) guidelines 2021. Statistical analysis: A p-value of P < 0.05 was considered to be statistically significant. Statistical package for social sciences (SPSS 19) .software was used for statistical analysis. Result: Bacteremia was observed in 44 patients (88%), whereas 12% patients grew yeast. Among the gram positive isolates from the blood culture, 80% susceptibility was observed for Teicoplanin and Clindamycin. While 84% of the Gram negative microorganisms were susceptible to piperacillin with Tazobactam and cotrimoxazole. Of the 6 Candida isolates, non Candida albicans species was more common (66 %). Conclusion: The current body of evidence from high-burden COVID-19 areas globally suggests that co-infections are common, particularly in severe cases.