Please indicate where the abstract has been published before: The Lancet Infectious Diseases Background: Mucormycosis is a rare disease that may progress rapidly. Although urgent surgical and medical intervention is lifesaving, diagnosis is often delayed and mortality rates are high. Guidance on the complex multidisciplinary management has the potential to improve prognosis. Management pathways depend on recognising disease patterns and availability of diagnostic and therapeutic options. Aims: To address differences between the regions of the world, authors from 33 countries analysed published evidence on mucormycosis management and provide recommendations as part of the "One World One Guideline'' initiative. Methods: Consensus process involving experts from all UN regions, comprising physicians and scientists involved in various aspects of mucormycosis management, representing the fields of microbiology, pathology, radiology, infectious diseases, surgery, paediatrics, haematology, intensive care, dermatology, and pharmacology. Results: This guidance document provides practical help in clinical decision making and identifies areas of uncertainty and future research direction. Summary/Conclusion: Mucormycosis requires different tailored approaches in different regions of the world-This guidance document is the first in a series from One World One Guideline initiative.

Invasive fungal disease due to Candida spp. – Invasive candidiasis/candidaemia, is a life-threatening complication in immunosuppressed patients. The publications on epidemiology of invasive candidiasis (IC) in children after hematopoietic stem cell transplantation (HSCT) is limited. The purpose of the study was to study the epidemiology of IC in children after HSCT for the 7 years in Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation. In 2009–2016 yy have been performed 754 HSCT in children: 494 allogeneic and 260 autologous. The study was approved by the Independent Ethics Committee of the Raisa Gorbacheva Memorial Research Institute of Children's Oncology, Hematology and Transplantation. A retrospective study included 22 cases of invasive candidiasis in after HSCT. EORTC/MSG 2008 criteria were used for the diagnosis of proven invasive candidiasis as well as to evaluate response to therapy. Incidence of IC was 2.9%: allo-HSCT – 3% (n = 15), auto-HSCT – 2,7% (n = 7). The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. The etiology: Candida parapsilosis – 50%, Candida albicans – 27%, Candida krusei – 14%, Candida tropicalis – 5%, Candida dubliniensis – 4%. The most frequent underlying diseases was acute leukemia – 45% (n = 10). The median age was 8 y.o. (3 month–18 years). The median day of onset of IC after allo-HSCT was 63 days (4–243), auto-HSCT – 12 days (3–20). Febrile fever was the main clinical symptom; septic syndrome develops in 32% cases. Antifungal therapy was with echinocandins – 23%, lipid ampho B – 27%, triazole (fluconazole, voriconazole) – 32%, without therapy (due to early mortality) – 18%. Overall survival (OS) at 30 days from diagnosis invasive candidiasis was 50%. The central venous catheter (CVC) removal was the only factor significantly improved OS (70% vs 33%, p = 0,035). Incidence of Invasive candidiasis in children after hematopoietic stem cell transplantation was 2.9%. The main etiology agent was Candida parapsilosis. Invasive candidiasis infections most often affect leukemia patients, after allo-HSCT developed later than auto-HSCT. Overall survival at 30 days from the diagnosis was 50%. Removing of CVC improved overall survival in children with invasive candida infections after HSCT

The problem of timely diagnosis and proper management of patients with cystic fibrosis is crucial not only in our country, but throughout the world. Experts of the Union of Pediatricians of Russia have considered various issues of etiology, pathogenesis, epidemiology, diagnosis, and treatment of this genetic disease in a modern light. Particular attention was paid to screening methods for early diagnosis of cystic fibrosis. The principles of complex therapy were justified, including rational use of antibacterial and mucolytic drugs and enzyme replacement therapy that significantly determine the disease prognosis.

Introduction. There is a potential risk of harm to kid health when using toys, in particular, there is a possibility of micro-fungi entering the oral cavity of a baby when using bath toys, which may be the cause of mycotic diseases. The study was initiated by the appeal of the Russian TV First Channel to the Institute of Medical Mycology named after P.N. Kashkin, where samples of used bath toys with a black scurf inside were transferred for research and evaluation of their safety. The purpose: to evaluate the safety of the presented samples of baby bath toys after their intended use. Materials and methods. The experimental group was represented by four baby toys for the bath, which were used for their intended purpose, and were operated for several months. As a control, 4 similar toys for the bath were used. The study of the inner surface of the toys of the experimental group was carried out using a Leica DM 4020 light microscope,and sowing scrapings on Sabouraud’s solid nutrient medium. Isolates were determined by MALDI-TOF mass spectrometry. The inner surface of the toys was also studied by scanning electron microscopy. The fungus resistance of the samples was assessed according to GOST 9.049-91. Results. The study of the inner surface of prototype toys for the bath established the well-developed and “young” biofilms in the black areas of the inner surface. Biconvex spores (2×3 μm) of fungal origin were identified. Inoculation of swabs from the inner surface revealed a massive growth of opportunistic fungi: yeast fungi Candida guilliermondii (Castell.) Langeron & Guerra and Rhodotorula spp.. Studies on the fungus resistance of control samples of toys show that the material is not a nutrient medium for microfungi (neutral or fungistatic). Limitations: a relatively small sample of samples, the use of expensive high-tech equipment, the difficulty of reproducibility of the result. Conclusion. Colonization of the interior surface of toy specimens used in bathing kids with microscopic fungi and bacteria is indicative of a potential risk of harm to infants due to product design, period of use, and possibly materials used. In this regard, it is necessary to review the hygienic safety requirements for the design of bath toys and make appropriate additions to the Technical Regulations of the Customs Union “On the safety of toys” (TR CU 008/2011). Safety can be ensured by the requirement of tightness of the body of toys, as well as a significant reduction in the service life of such products.

Background: Invasive aspergillosis ia an actual problem of patients with B-cell lymphoma todayAims: To study frequency, etiology, diagnostics and treatment of invasive aspergillosis (IA) in patients with B-cell lymphoma (Hodgkin lymphoma and non-Hodgkin lymphoma), who received cytostatic chemotherapy. Methods: The study included 817 patients with B-cell lymphoma: Hodgkin lymphoma (HL) -363, age from 16 to 65 years (median -33), non-Hodgkin lymphoma (NHL) -450, age from 19 to 74 years (median -50). For the IA diagnosis criteria EORTS/MSG 2008 were used. Results: Frequency of IA in patients with B-cell lymphoma was 4,98% (HL -5,6%; NHL -4,5%, p = 0,49). In patients with NHL, who received anti-relapse therapy, frequency of IA was 10,25%, during induction therapy -2,88% (p = 0,004). The main etiological agents were: A. fumigatus (41%), A. niger (39%), A. flavus (14%). The main risk factors for IA in patients with B-cell lymphoma were: relapse of lymphoma (p = 0,005), B-symptoms and radiation therapy in anamnesis (p = 0,035 and p = 0,041), profound neutropenia (p = 0,000), concurrent lung and renal pathology (p = 0,007 and p = 0,03). The lungs were involved in 100% cases, 4,5% NHL patients had ≥2 organs involvement. Clinical symptoms of IA were nonspecific: fever 68%, cough 48%, dyspnea 32,5%, hemoptysis and pain in the chest were rare -4,7% vs 4% respectively. CT-sings of IA of lungs were also nonspecific: focal changes 63,5%, infiltrates 58,7% and ''ground-glass opacity" 23%; bilateral lung damage -62,7%. Galactomannan test was positive in BAL fluid and serum in 83,6% patients with B-cell lymphoma. The presence of septate mycelium in BAL was observed at microscopy in 15,5% patients. Aspergillus spp. in BAL culture was obtained in 34,7% patients with B-cell lymphoma (HL -20,4%; NHL -46,3%, p = 0,004). ''Probable" IA was diagnosed in 92,9%, ''proven" -in 7,1% of cases. The main antifungal drug was voriconazole -79%. Overall 12-weeks survival in patients with B-cell lymphoma was 84,9% (HL -88,1%; NHL -82,1%). Summary/Conclusion: Frequency of IA in patients with B-cell lymphoma was 4,98% (HL -5,6%; NHL -4,5%), in patients with relapse of NHL -10,25%. The main risk factors for IA were: relapse of lymphoma (p = 0,005), B-symptoms and radiation therapy in anamnesis (p = 0,035 and p = 0,041), profound neutropenia (p = 0,000), concurrent lung and renal pathology (p = 0,007 and p = 0,03). Etiology agents were: A. fumigatus (41%), A. niger (39%), A. flavus (14%). Clinical and CT-signs were nonspecific. The main antifungal drug was voriconazole -79%. Overall 12-weeks survival in patients with B-cell lymphoma was 84,9%.