Researchers in Oman reveal new disease causing fungus

Muscat: A new type of drug-resistant fungus that causes people to suffer from issues such as abdominal pain, bleeding, fever, constipation, and vomiting has been discovered by researchers in Oman.

The new type of fungi, called Basidiobolus omanensis, was found to cause angioinvasive abdominal basidiobolomycosis and drug resistance. Researchers pointed out that this fungus causes infections in the skin and intestines, but its danger lies in the fact that it is resistant to antibiotics and affects adults and young people alike.

Researchers from the University of Nizwa and Sultan Qaboos University Hospital, in cooperation with Radboud University in Nijmegen, Netherlands, discovered this new type of dangerous and drug-resistant fungus after an extensive study of samples from a patient with a fungal infection. The study results were recently published in the scientific journal “Fungi”, which specialises in mycology. The research dealt with an accurate description of the phenotypic and molecular characteristics of the new fungi.

“We report a newly discovered Basidiobolus species causing refractory angioinvasive gastrointestinal basidiobolomycosis (GIB) in a 20-year-old Omani patient with type 1 diabetes mellitus. His disease seemed to have started in the caecum with extended to the major vessels of the lower limbs,” the study stated.

“Physical examination of the lower limbs demonstrated signs of acute ischemia, confirmed by imaging studies including CT and histopathology. From a clinical perspective, the present case is similar in main traits to other reported cases of GIB,” the study went on to add.

“The infection is rare but a possibly emerging disease entity, affecting immunocompetent individuals including children, mainly occurs in hot climates worldwide. In many earlier reported cases, surgery was performed without preceding diagnosis of GIB,” it added.

Dr. Abdullah Al Hatmi, assistant professor at the University of Nizwa and faculty-in-charge of the Microbiology Laboratory at the Natural and Medical Sciences Research Centre at NU, said, “In cooperation with researchers and doctors in the Microbiology Laboratories Department and the Infectious Diseases Department at Sultan Qaboos University Hospital, we performed several careful examinations to find out the type of fungus that was causing fungal infection in the patient.”

“After the initial laboratory analysis, we examined the RNA of the fungus and the initial results showed that the fungus did not match any type of fungi discovered worldwide and belongs to a family previously known to have the ability to infect humans with fungal infection in the skin and intestines,” he added.

The research team carried out several advanced laboratory analyses in cooperation with their colleagues at Radboud University to prove that this type of fungus is new and was discovered for the first time in the world.

The investigation and research were carried out in the gene bank, and the new fungus was found by closely matching existing related genes. They were previously detected in Saudi Arabia in patients across several hospitals, but the fungus was not accurately identified.

“This may indicate that the new fungus is spreading more broadly in the Middle East, but there is not enough information to prove the extent of its presence in several countries so far,” said Al Hatmi. “Researchers hope that the results of this finding will pave the way for more future studies and the disclosure of important information about these fungi.”

Al Hatmi also spoke about the methods of diagnosing fungal infections saying, “The diagnosis and analysis of samples in the laboratory on fungi may take more than five days, but in recent years, new techniques and analyses have been developed for a large number of pathogenic fungi, thus reducing the duration of diagnosis. However, in some cases, it may be difficult to identify the type of fungi to some extent, which may lead to misidentification and wrong treatment.”

“On the other hand, some known strains showed a remarkable ability to resist all available classes of antifungals, which requires the intervention of researchers and specialists to conduct more comprehensive tests to study the properties of the fungus and determine its type,” Al Hatmi added.

The basidiobolus species causes infections in both adult and paediatric populations, with most paediatric cases being reported from Saudi Arabia. Subcutaneous basidiobolomycosis has highly diverse and non-specific symptoms. On the other hand, patients with GIB may present with fever, abdominal pain, chills, weight loss, diarrhoea or constipation, and an abdominal mass can be observed in them.

As basidiobolus is an environmental saprobe residing in soil and decaying vegetables and fruits, the route of transmission in subcutaneous disease appears to be minor trauma resulting from an insect bite, while GIB can be acquired via intravenous catheters, intramuscular injection or ingestion of soil or faeces via contaminated food. The latter transmission route may be very common, as basidiobolus has been detected as a part of the normal mycobiome inhabiting the human gastrointestinal tract.

This type of fungus can be avoided by washing hands before eating as well as washing vegetables and fruits well before eating and maintaining personal hygiene practices in general.

Regarding linking the name of the discovered fungus to Oman, Dr. Abdullah Al Hatmi said, “After discussing with all researchers, we decided to add the name of Oman and named it Basidiobolus Omanensis. In global medical discoveries, this fungus has been registered in the global database related to the discovery of germs, where it has been provided an accurate scientific description, which will help it become a reference for research related to these types of fungi in the future.”

Al Hatmi stated that he was not surprised by the discovery of the new fungus, as he has spent more than 10 years in this field studying and discovering a number of fungi that cause diseases in humans.