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The Genus Leccinum: Global Advances in Taxonomy, Ecology, Nutritional Value, and Environmental Significance. 卵磷脂属:分类、生态学、营养价值和环境意义的全球进展。
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-16 DOI: 10.3390/jof12010070
Ruben Budau, Simona Ioana Vicas, Mariana Florica Bei, Danut Aurel Dejeu, Lucian Dinca, Danut Chira

Leccinum is an ecologically significant and taxonomically complex genus of ectomycorrhizal fungi widely distributed across boreal, temperate, Mediterranean, and selected tropical regions. Despite its ecological, nutritional, and applied importance, no comprehensive review has previously synthesized global knowledge on this genus. This work provides the first integrative assessment of Leccinum research, combining a bibliometric analysis of 293 peer-reviewed publications with an in-depth qualitative synthesis of ecological, biochemical, and environmental findings. Bibliometric results show increasing scientific attention since the mid-20th century, with major contributions from Europe, Asia, and North America, and dominant research themes spanning taxonomy, ecology, chemistry, and environmental sciences. The literature review highlights substantial advances in phylogenetic understanding, species diversity, and host specificity. Leccinum forms ectomycorrhizal associations with over 60 woody host genera, underscoring its functional importance in forest ecosystems. Nutritionally, Leccinum species are rich in proteins, carbohydrates, minerals, bioactive polysaccharides, phenolic compounds, and umami-related peptides, with demonstrated antioxidant, immunomodulatory, and antitumor activities. At the same time, the genus exhibits notable bioaccumulation capacity for heavy metals (particularly Hg, Cd, and Pb) and radionuclides, making it both a valuable food source and a sensitive environmental bioindicator. Applications in biotechnology, environmental remediation, forest restoration, and functional food development are emerging but remain insufficiently explored. Identified research gaps include the need for global-scale phylogenomic frameworks, expanded geographic sampling, standardized biochemical analyses, and deeper investigation into physiological mechanisms and applied uses. This review provides the first holistic synthesis of Leccinum, offering an integrated perspective on its taxonomy, ecology, nutritional composition, environmental significance, and practical applications. The findings serve as a foundation for future mycological, ecological, and biotechnological research on this diverse and understudied fungal genus.

Leccinum是一种生态意义重大、分类复杂的外生菌根真菌属,广泛分布于北方、温带、地中海和部分热带地区。尽管它的生态,营养和应用的重要性,没有全面的审查,以前对该属的综合全球知识。这项工作首次对Leccinum研究进行了综合评估,结合了对293份同行评审出版物的文献计量学分析,并对生态、生化和环境研究结果进行了深入的定性综合。文献计量结果显示,自20世纪中期以来,科学的关注日益增加,主要来自欧洲、亚洲和北美,主要研究主题涵盖分类学、生态学、化学和环境科学。文献综述强调了系统发育理解、物种多样性和宿主特异性方面的实质性进展。卵磷脂与60多个木本寄主属形成外生菌根联系,在森林生态系统中具有重要的功能。从营养上讲,卵磷脂富含蛋白质、碳水化合物、矿物质、生物活性多糖、酚类化合物和鲜味相关肽,具有抗氧化、免疫调节和抗肿瘤活性。同时,该属对重金属(特别是汞、镉和铅)和放射性核素具有显著的生物积累能力,是一种有价值的食物来源和敏感的环境生物指标。在生物技术、环境修复、森林恢复和功能性食品开发方面的应用正在出现,但仍未得到充分探索。已确定的研究缺口包括需要全球范围的系统基因组框架、扩大地理采样、标准化生化分析以及对生理机制和应用用途的更深入研究。本文首次对卵磷脂的分类、生态学、营养成分、环境意义和实际应用等方面进行了全面的综述。这些发现为未来对这一多样性和研究不足的真菌属进行真菌学、生态学和生物技术研究奠定了基础。
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引用次数: 0
Identification and Multigene Phylogenetic Analysis Reveal Alternaria as the Primary Pathogen Causing European Plum (Prunus domestica) Brown Spot in Xinjiang, China. 新疆欧洲李褐斑病的原发病原菌鉴定及多基因系统发育分析
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-15 DOI: 10.3390/jof12010069
Shuaishuai Sha, Qiuyan Han, Hongyue Li, Wenwen Gao, Jiyuan Ma, Lingkai Xu, Canpeng Fu, Pan Xie

European plum (Prunus domestica) orchards in the Kashi region, Xinjiang, China, suffer from fruit brown spot disease. The disease typically appears as red spots on the fruit surface that expand into brown necrotic lesions; affected fruit flesh can shrink, and fruits can harden and drop. We isolate and identify pathogens associated with this disease in this plum from five Kashi counties. Of 210 fungal isolates obtained through standard tissue isolation, Alternaria accounted for 84.8%, with the remainder comprising species of Aspergillus (9.5%), Diplodia (3.3%), and Neoscytalidium (2.4%). Using PCR amplification and sequencing of five loci, pathogens were identified using multi-gene phylogenetic analyses, combined with observations of colony and spore morphology. Multi-locus sequences of Alternaria isolates were highly homologous to those of the Alternaria alternata type strain, and we refer them to an A. alternata species complex. Pathogenicity tests confirm that Alternaria isolates reproduce brown spot symptoms on European plum fruits. By demonstrating that Alternaria is the primary pathogen causing brown spot disease in European plum in Xinjiang, we clarify both the fungal species composition and taxonomic placement of the dominant pathogen associated with this disease.

中国新疆喀什地区的欧洲李(Prunus domestica)果园遭受果实褐斑病的困扰。这种疾病通常表现为果实表面的红色斑点,然后扩展成棕色坏死灶;受影响的果肉会萎缩,果实会变硬、掉落。我们从喀什五县的李中分离鉴定出与此病相关的病原菌。通过标准组织分离获得的210株真菌中,Alternaria占84.8%,其余分别为曲霉(9.5%)、双plodia(3.3%)和Neoscytalidium(2.4%)。利用PCR扩增和5个位点测序,结合菌落和孢子形态观察,利用多基因系统发育分析鉴定病原菌。该菌株的多位点序列与交替孢霉型菌株高度同源,属于交替孢霉种复合体。致病性试验证实,稻瘟菌分离株可在欧洲李果实上产生褐斑症状。通过证明Alternaria是新疆欧洲梅褐斑病的主要病原菌,我们明确了与该疾病相关的优势病原菌的种类组成和分类位置。
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引用次数: 0
Wheat SWI3B Subunit of SWI/SNF Chromatin Remodeling Complex Governs Powdery Mildew Susceptibility by Suppressing Salicylic Acid Biosynthesis. 小麦SWI/SNF染色质重塑复合体SWI3B亚基通过抑制水杨酸生物合成调控白粉病易感性
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-14 DOI: 10.3390/jof12010068
Wanzhen Chen, Yixian Fu, Mengdi Zhang, Wenrui Zhao, Pengfei Zhi, Cheng Chang

The fungal pathogen Blumeria graminis forma specialis tritici (B.g. tritici) infects bread wheat (Triticum aestivum L.) to cause wheat powdery mildew disease. Elucidating the molecular mechanism underlying wheat susceptibility to the pathogenic fungus B.g. tritici could facilitate wheat genetic improvement. In this study, we identified the wheat TaSWI3B gene as a novel Susceptibility gene positively regulating wheat susceptibility to B.g. tritici. The TaSWI3B gene encodes the SWI3B subunit of the SWI/SNF chromatin remodeling complex. The overexpression of the TaSWI3B gene enhances wheat powdery mildew susceptibility, whereas TaSWI3B silencing results in attenuated wheat powdery mildew susceptibility. Importantly, we found that TaSWI3B could be enriched at the promoter regions of the salicylic acid (SA) biosynthesis activator gene TaSARD1, facilitating nucleosome occupancy and thereby suppressing TaSARD1 transcription and inhibiting SA biosynthesis. Silencing of TaSARD1 and TaICS1 encoding a key enzyme in SA biosynthesis could attenuate the SA biosynthesis and powdery mildew resistance potentiated by knockdown of TaSWI3B expression. Collectively, these results suggest that the SWI3B subunit of the wheat SWI/SNF chromatin remodeling complex negatively regulates SA biosynthesis by suppressing TaSARD1 transcription at the epigenetic level and thus facilitates wheat powdery mildew susceptibility.

摘要小麦白粉病是一种以小麦为主要病原菌的真菌,主要侵染面包小麦。阐明小麦对小麦黑穗病病原菌易感的分子机制有助于小麦的遗传改良。本研究鉴定了小麦TaSWI3B基因为小麦对小麦黑穗病的易感基因,该基因正调控小麦对黑穗病的易感。TaSWI3B基因编码SWI/SNF染色质重塑复合体的SWI3B亚基。TaSWI3B基因的过表达增强了小麦对白粉病的敏感性,而TaSWI3B基因的沉默则减弱了小麦对白粉病的敏感性。重要的是,我们发现TaSWI3B可以富集在水杨酸(SA)生物合成激活因子基因TaSARD1的启动子区域,促进核小体的占据,从而抑制TaSARD1的转录,抑制SA的生物合成。沉默编码SA生物合成关键酶的TaSARD1和TaICS1可以减弱SA生物合成和通过敲低TaSWI3B表达而增强的白粉病抗性。综上所述,这些结果表明,小麦SWI/SNF染色质重塑复合体的SWI3B亚基在表观遗传水平上通过抑制TaSARD1转录负调控SA的生物合成,从而促进小麦白粉病的易感性。
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引用次数: 0
Environmental Filtering Drives Microbial Community Shifts and Functional Niche Differentiation of Fungi in Waterlogged and Dried Archeological Bamboo Slips. 环境过滤驱动浸水干燥考古竹简微生物群落迁移和真菌功能生态位分化
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-14 DOI: 10.3390/jof12010066
Liwen Zhong, Weijun Li, Guoming Gao, Yu Wang, Cen Wang, Jiao Pan

Changes in preservation conditions act as an important environmental filter driving shifts in microbial communities. However, the precise identities, functional traits, and ecological mechanisms of the dominant agents driving stage-specific deterioration remain insufficiently characterized. This study investigated microbial communities and dominant fungal degraders in waterlogged versus dried bamboo slips using amplicon sequencing, multivariate statistics, and microbial isolation. Results revealed compositionally distinct communities, with dried slips sharing only a small proportion of operational taxonomic units (OTUs) with waterlogged slips, while indicating the persistence of a subset of taxa across preservation states. A key discovery was the dominance of Fonsecaea minima (92% relative abundance) at the water-solid-air interface of partially submerged slips. Scanning electron microscopy (SEM) and pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) indicate that this fungus forms melanin-rich, biofilm-like surface structures, suggesting enhanced surface colonization and stress resistance. In contrast, the fungal community isolated from dried slips was characterized by Apiospora saccharicola associated with detectable xylanase activity. Meanwhile, the xerophilic species Xerogeomyces pulvereus dominated (99% relative abundance) the storage box environment. Together, these results demonstrate that preservation niches select for fungi with distinct functional traits, highlighting the importance of stage-specific preservation strategies that consider functional traits rather than taxonomic identity alone.

保存条件的变化是驱动微生物群落变化的重要环境过滤器。然而,导致特定阶段退化的主导因子的确切身份、功能特征和生态机制仍未得到充分表征。本研究利用扩增子测序、多元统计和微生物分离等方法研究了涝渍竹简和干渍竹简的微生物群落和优势真菌降解物。结果表明,干枯泥板与涝渍泥板在组成上存在明显的差异,仅共享一小部分可操作分类单元(otu),同时表明一个分类群子集在不同的保存状态下具有持久性。一个关键的发现是Fonsecaea minima在部分淹没滑动的水-固-气界面占主导地位(相对丰度92%)。扫描电镜(SEM)和热解-气相色谱/质谱分析(Py-GC/MS)表明,该真菌形成了富含黑色素的生物膜样表面结构,表明其表面定植能力和抗逆性增强。相比之下,从干燥的纸片中分离到的真菌群落特征是与检测到的木聚糖酶活性相关的Apiospora saccharicola。同时,干燥菌(Xerogeomyces pulvereus)以99%的相对丰度占主导地位。总之,这些结果表明,保存生态位选择具有不同功能性状的真菌,突出了考虑功能性状而不是单独的分类特性的阶段特异性保存策略的重要性。
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引用次数: 0
Cryptococcosis in Colombia: Analysis of Data from Laboratory-Based Surveillance 2017-2024. 哥伦比亚隐球菌病:2017-2024年实验室监测数据分析
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-14 DOI: 10.3390/jof12010067
Jairo Lizarazo, Clara Inés Agudelo, Patricia Escandón, Elizabeth Castañeda

Since 1997, a laboratory-based survey on cryptococcosis has been conducted in Colombia. We present the results for the period 2017-2024. A total of 891 surveys were received. The overall incidence was 0.22 cases per 100,000 people. Among those living with HIV, the incidence was 38, and among HIV-negative people, it was 0.08. Cryptococcosis demonstrated a higher prevalence among men than women (3.2:1). Among patients living with Human Immunodeficiency Virus (HIV), the condition primarily affected younger adults (26-40 years). In contrast, among HIV-negative people, it was mostly observed in older adults (≥60 years). HIV infection was the most significant risk factor (63%), but another cause of immunosuppression was identified in 21.2% cases. Neurocryptococcosis was the most common form of presentation (62.2%), followed by disseminated cryptococcosis (31.1%). The diagnosis was confirmed by culture in 99.4% of patients; the most important sample was cerebrospinal fluid (67.3%), followed by blood (35.4%). Cryptococcus neoformans was identified in 93.1% of cases, and Cryptococcus gatti in 6.9%. Predominant molecular patterns were VNI (92.4%) and VGII (45.3%). The epidemiology of cryptococcosis in Colombia is changing, with a progressive decrease in HIV coinfection and an increase in other immunosuppressive conditions in older people. This study highlights the importance of cryptococcosis in Colombia and the need to report it in order to improve knowledge and thereby promote the quality of diagnosis and the opportunity for more effective treatment.

自1997年以来,在哥伦比亚开展了隐球菌病实验室调查。我们提出了2017-2024年期间的结果。我们共收到891份调查问卷。总发病率为每10万人0.22例。在艾滋病毒感染者中,发病率为38,在艾滋病毒阴性人群中,发病率为0.08。隐球菌病在男性中的患病率高于女性(3.2:1)。在感染人类免疫缺陷病毒(HIV)的患者中,这种情况主要影响年轻人(26-40岁)。相反,在hiv阴性人群中,主要发生在老年人(≥60岁)。HIV感染是最重要的危险因素(63%),但在21.2%的病例中确定了免疫抑制的另一个原因。神经隐球菌病是最常见的表现形式(62.2%),其次是播散性隐球菌病(31.1%)。99.4%的患者经培养确诊;脑脊液是最重要的样本(67.3%),其次是血液(35.4%)。新生隐球菌占93.1%,加蒂隐球菌占6.9%。主要分子型为VNI(92.4%)和VGII(45.3%)。哥伦比亚隐球菌病的流行病学正在发生变化,老年人中艾滋病毒合并感染逐渐减少,而其他免疫抑制疾病有所增加。这项研究强调了哥伦比亚隐球菌病的重要性和报告隐球菌病的必要性,以便改进知识,从而提高诊断质量和提供更有效治疗的机会。
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引用次数: 0
Diversity, Pathogenicity, and Biological Characteristics of Root Rot Pathogens from Lycium barbarum L. in Qinghai Province, China. 青海枸杞根腐病病原菌多样性、致病性及生物学特性研究
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-13 DOI: 10.3390/jof12010062
Yongbao Zhao, Lingshan Wang, Kaifu Zheng, Chengwen Zheng, Lijie Liu, Hexing Qi

Lycium barbarum L. is an important economic crop in Qinghai province, China. However, root rot seriously reduces the economic results of L. barbarum. Here, we collected the diseased L. barbarum roots from Nuomuhong Farm of Haixi Mongolian and Tibetan Autonomous Prefecture, Qinghai Province, China, to clarify the diversity, pathogenicity, and biological characteristics of its root rot pathogens. A total of 125 isolates were collected, and based on morphological characteristics and rDNA ITS, TEF-, and RPB2 genes sequence analysis, they were identified as Fusarium equiseti, F. avenaceum, F. solani, F. citri, F. acuminatum, F. culmorum, F. sambucinum, F. incarnatum, F. oxysporum, F. tricinctum, Microdochium bolleyi, and Clonostachys rosea. These fungi were used to inoculate the roots of 1-year-old L. barbarum seedlings using scratching and root-irrigation inoculation methods, and all isolates caused root rot. This is the first report that M. bolleyi, F. avenaceum, and F. citri caused root rot in L. barbarum. And the best media, the lethal temperatures, and the optimum carbon sources and nitrogen sources of the 12 pathogen species were determined in this study. Moreover, our findings provide a theoretical foundation for root rot management in the future.

枸杞是青海省重要的经济作物。但根腐病严重降低了枸杞的经济效益。本研究收集了青海省海西蒙古族藏族自治州诺木红农场的枸杞根腐病根,以阐明其根腐病病原的多样性、致病性和生物学特性。通过形态特征和rDNA ITS、TEF-1α、RPB2基因序列分析,鉴定为镰刀菌(Fusarium equiseti)、镰刀菌(F. avenaceum)、枯萎菌(F. solani)、柑橘镰刀菌(F. citri)、尖锐镰刀菌(F. culmorum)、sambucinum、incarnatum、尖孢镰刀菌(F. oxysporum)、tricinctum、bolleyi Microdochium)和玫瑰红梭菌(Clonostachys rosea)。将这些真菌分别用刻划法和灌根法接种于1年生枸杞幼苗根部,所有分离株均引起根腐病。本文首次报道了M. bolleyi、F. avenaceum和F. citri在枸杞中引起根腐病。确定了12种病原菌的最佳培养基、致死温度、最佳碳源和氮源。研究结果为今后根腐病的防治提供了理论依据。
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引用次数: 0
An Overview of the Alternaria Genus: Ecology, Pathogenicity and Importance for Agriculture and Human Health. Alternaria属综述:生态学、致病性及其对农业和人类健康的重要性。
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-13 DOI: 10.3390/jof12010064
Stanislava A Vinogradova, Konstantin V Kiselev, Andrey R Suprun

Alternaria is a widespread genus and a diverse taxonomic group of fungi, whose members exhibit a wide range of ecological roles, from endophytes and saprophytes to potent plant pathogens, and in some cases, to opportunistic pathogens or allergens affecting humans. Their high adaptability to various environmental conditions determines their widespread distribution and resilience. A key feature of the genus Alternaria is its substantial species diversity. According to the Species Fungorum database, it currently comprises 792 registered species, which are grouped into 29 sections. It should be noted that this number reflects the current state of taxonomic classification and is subject to ongoing revision. The ecological role of representatives of this genus is particularly relevant in the context of agriculture, as many species are pathogens and causative agents of Alternaria leaf spot in important agricultural plants such as tomatoes, potatoes, apples, wheat, and others. This disease causes significant economic losses. At the same time, some strains demonstrate potential for use in biotechnology due to their ability to produce biologically active metabolites. This review examines the taxonomy, morphological characteristics, ecological role, pathogenicity, and control methods of fungi of the genus Alternaria, as well as their biotechnological potential.

互交菌是一种分布广泛的真菌属和一个多样化的真菌分类群,其成员表现出广泛的生态作用,从内生菌和腐生菌到强效植物病原体,在某些情况下,到影响人类的机会性病原体或过敏原。它们对各种环境条件的高适应性决定了它们的广泛分布和弹性。Alternaria属的一个关键特征是其丰富的物种多样性。根据物种真菌数据库,它目前包括792个注册物种,分为29个部分。应该指出的是,这个数字反映了分类学分类的现状,并受到正在进行的修订。该属代表的生态作用与农业背景特别相关,因为许多物种是互花孢叶斑病的病原体和病原体,在重要的农业植物中,如西红柿、土豆、苹果、小麦等。这种疾病造成重大的经济损失。与此同时,一些菌株由于能够产生具有生物活性的代谢物而显示出在生物技术方面的应用潜力。本文综述了Alternaria属真菌的分类、形态特征、生态作用、致病性、防治方法及其生物技术潜力。
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引用次数: 0
Genetic Manipulation in Sporothrix Species: Molecular Tools, Challenges, and Applications. 孢子菌物种的遗传操作:分子工具、挑战和应用。
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-13 DOI: 10.3390/jof12010061
Mafalda Barros, Matheus Tavares, Ricardo Silvestre, Roberta Peres da Silva, Fernando Rodrigues

Sporothrix species are thermally dimorphic fungi responsible for sporotrichosis, a globally prevalent subcutaneous mycosis and an emerging zoonotic threat, particularly in South America. The high virulence of Sporothrix brasiliensis and its efficient transmission from cats to humans have intensified recent outbreaks, underscoring the importance of understanding the pathogenic mechanisms. While several putative virulence factors have been identified, such as melanin production, cell wall remodeling, extracellular vesicles, and thermotolerance, functional studies remain hampered by limited molecular tools. Recent advances, including random mutagenesis, protoplast-mediated transformation, Agrobacterium tumefaciens-mediated transformation, RNA interference and CRISPR/Cas9-based genome editing, are changing this landscape. These methods have enabled the functional validation of key virulence factors and the investigation of gene function in both environmental and clinical strains. In this review, we summarize the genetic toolbox available for Sporothrix, outline current challenges, and discuss how these strategies are reshaping the study of fungal virulence and host-pathogen interactions.

孢子丝菌属热二态真菌,可导致孢子毛病,这是一种全球流行的皮下真菌病,也是一种新出现的人畜共患威胁,特别是在南美洲。巴西孢子丝菌的高毒力及其从猫向人类的有效传播加剧了最近的疫情,强调了了解致病机制的重要性。虽然已经确定了几个假定的毒力因素,如黑色素产生、细胞壁重塑、细胞外囊泡和耐热性,但功能研究仍然受到有限的分子工具的阻碍。最近的一些进展,包括随机突变、原生质体介导的转化、农杆菌介导的转化、RNA干扰和基于CRISPR/ cas9的基因组编辑,正在改变这一格局。这些方法使关键毒力因子的功能验证和基因功能的研究在环境和临床菌株。在这篇综述中,我们总结了孢子丝菌可用的遗传工具箱,概述了当前的挑战,并讨论了这些策略如何重塑真菌毒力和宿主-病原体相互作用的研究。
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引用次数: 0
Advancing the Identification of Risk Factors for Invasive Fungal Disease in Children with Cancer. 癌症患儿侵袭性真菌病危险因素的研究进展
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-13 DOI: 10.3390/jof12010060
Marlon Barraza, Romina Valenzuela, Valentina Gutiérrez, Claudia Greppi, Ana M Álvarez, Jaime Cerda, María Elena Santolaya

Invasive fungal disease (IFD) is one of the leading causes of morbidity and mortality in immunocompromised pediatric patients. This is a multicenter prospective cohort study with a nested retrospective analysis aimed at identifying risk factors for IFD in immunocompromised children with cancer and episodes of persistent high-risk febrile neutropenia (HRFN). One hundred and seventy-four episodes of persistent HRFN were analyzed, of which 34 (19.5%) were confirmed as IFD, 52.9% were caused by filamentous fungi, and 47.1% by yeasts. Logistic regression and survival analyses identified the following significant risk factors for IFD: male sex (OR 4.04), adolescence (OR 4.65), C-reactive protein ≥ 90 mg/L at admission (OR 3.13), and transfer to a critical care unit (OR 10.73). The predictive model demonstrated strong discriminatory capacity (AUC 0.84), with 79.4% sensitivity and 82.1% specificity. These findings highlight that adolescents, particularly males with severe clinical conditions and elevated inflammatory markers, are at the highest risk for IFD during episodes of HRFN. The proposed risk factor-based model may support early risk stratification and guide targeted antifungal prophylaxis or therapy, potentially improving outcomes in this population. Validation an external cohort is required to confirm these results and optimize clinical applicability.

侵袭性真菌病(IFD)是免疫功能低下儿童患者发病和死亡的主要原因之一。这是一项多中心前瞻性队列研究,采用嵌套回顾性分析,旨在确定患有癌症和持续性高危发热性中性粒细胞减少症(HRFN)的免疫功能低下儿童发生IFD的危险因素。分析了174例持续性HRFN,其中34例(19.5%)确诊为IFD, 52.9%由丝状真菌引起,47.1%由酵母引起。Logistic回归和生存分析确定了IFD的以下重要危险因素:男性(OR 4.04),青春期(OR 4.65),入院时c反应蛋白≥90 mg/L (OR 3.13),转移到重症监护病房(OR 10.73)。该预测模型具有较强的鉴别能力(AUC 0.84),敏感性为79.4%,特异性为82.1%。这些发现强调,青少年,特别是有严重临床症状和炎症标志物升高的男性,在HRFN发作期间发生IFD的风险最高。提出的基于风险因素的模型可能支持早期风险分层,并指导有针对性的抗真菌预防或治疗,可能改善这一人群的预后。验证需要外部队列来确认这些结果并优化临床适用性。
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引用次数: 0
Early Antifungal Treatment in Immunocompromised Patients, Including Hematological and Critically Ill Patients. 免疫功能低下患者的早期抗真菌治疗,包括血液病和危重患者。
IF 4.2 2区 生物学 Q2 MICROBIOLOGY Pub Date : 2026-01-13 DOI: 10.3390/jof12010059
Galina Klyasova, Galina Solopova, Jehad Abdalla, Marina Popova, Muhlis Cem Ar, Murat Sungur, Riad El Fakih, Reem S Almaghrabi, Murat Akova

(1) Background: Invasive fungal diseases (IFDs) represent significant challenges in clinical practice, particularly among immunocompromised individuals, leading to substantial morbidity and mortality. The present document aims to provide evidence-based consensus for the timely initiation of antifungal treatment, focusing on early empiric approaches among immunocompromised patients. (2) Methods: A multidisciplinary expert panel of nine healthcare professionals (HCPs) reviewed the literature, including guidelines and consensus reports (2013-2023; PubMed, Scopus). The panel defined appropriate empiric antifungal approaches for invasive candidiasis, aspergillosis, and mucormycosis among hematological and critically ill patients. Consensus was defined as ≥75% agreement. (3) Results: A total of 47 statements were included. The experts recommend that early targeted antifungal therapy is critical for high-risk patients with suspected IFDs. Empiric therapy may be initiated before definitive diagnosis, considering the local fungal prevalence and the patient's risk category. Close monitoring is essential, and switching between antifungal classes may be necessary for patients who experience deterioration or side effects. The transition from intravenous to oral therapy depends on the specific infection, the availability of therapeutic drug monitoring, and the patient's progress. (4) Conclusions: Implementing this targeted, early approach may improve the outcomes of vulnerable patients with IFDs.

(1)背景:侵袭性真菌疾病(IFDs)是临床实践中的重大挑战,特别是在免疫功能低下的个体中,导致大量发病率和死亡率。本文件旨在为及时启动抗真菌治疗提供循证共识,重点关注免疫功能低下患者的早期经验性方法。(2)方法:由9名卫生保健专业人员(HCPs)组成的多学科专家小组回顾文献,包括指南和共识报告(2013-2023;PubMed, Scopus)。专家组确定了血液病和危重病人侵袭性念珠菌病、曲霉病和毛霉病的适当经验性抗真菌方法。一致定义为≥75%的同意。(3)结果:共纳入47条陈述。专家建议,早期靶向抗真菌治疗对疑似ifd的高风险患者至关重要。经验性治疗可在确诊前开始,考虑到当地的真菌流行和患者的风险类别。密切监测是必要的,对于出现恶化或副作用的患者,可能需要在抗真菌药物类别之间切换。从静脉注射到口服治疗的过渡取决于具体的感染、治疗药物监测的可用性和患者的进展。(4)结论:实施这种有针对性的早期方法可能会改善易感ifd患者的预后。
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Journal of Fungi
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