Mycopathologia最新文献

Due to the recent unprecedented global rise of Candidozyma auris in hospital environments the members of the Candidozyma haemuli species complex have raised significant interest of clinicians and researchers. Until the finding of C. auris, the species complex did not receive much attention as the known pathogenic species were only rarely encountered in hospitals and clinical diagnostic laboratories. During the past years several new species were described, such as Candidozyma khanbhai and Candidozyma vulturna, that were found to be of clinical importance. Here, we used phylogenetic and phenotypic analyses -including antifungal susceptibility testing- to characterize and describe a new and potentially clinically relevant yeast that we obtained from clinical specimen and flowers, representing the proposed novel species Candidozyma molenica.

Aspergillosis is one of the most common human fungal infections. The invasive form of this infectious disease has high mortality rates. Moreover, antifungal resistance has been increasing, thereby limiting treatment options. In Iran, limited species distribution, genotyping and susceptibility data regarding aspergillosis is available, especially during the COVID-19 pandemic. In the current study, 124 patients with proven (n = 31), probable (n = 24) and possible (n = 46) aspergillosis and aspergillus colonization (n = 19) were investigated. Isolates were identified to species level based on calmodulin sequencing. Antifungal susceptibility testing was performed with microbroth dilution against common antifungal agents, i.e. amphotericin B, azoles and echinocandins. Additionally, short tandem repeat genotyping was conducted on common Aspergillus species to assess genetic relatedness. Aspergillus flavus was the most common species for proven aspergilossis cases, followed by identification of single cases of A. fumigatus, A. terreus, A. niger. These Aspergillus species were also mostly found in other patients with probably aspergillosis, in addition to four cases of possible aspergillosis with rare or cryptic species A. candidus, A. citrinoterreus, A. tubingensis and A. fumigatiaffinis, respectively. Using available epidemiological cutoff values (ECVs) no isolates were non-wild type to the tested antifungal drugs, while the A. fumigatiaffinis and A. citrinoterreus isolate demonstrated reduced susceptibility to respectively amphotericin B and Itraconazole, and amphotericin B only. With high-resolution short tandem repeat genotyping, several A. flavus clusters were found and their spatial and temporal clustering suggested nosocomial origins. To conclude, aspergillosis cases in Iran were caused by diverse but susceptible species, with A. flavus being dominant and associated with several events of potential nosocomial transmission.

The rising incidence of invasive fungal infections has been accompanied by an increasing prevalence of antifungal resistance among fungal pathogens. Rapid identification of causative agents and their antifungal susceptibility profiles is critical for initiating timely, species-specific targeted therapy. In this context, we evaluated a MALDI-TOF MS-based method for the rapid identification of clinically relevant yeast species directly from blood cultures and body fluids, coupled with direct antifungal susceptibility testing (Direct-AFST). Our study evaluated over 700 yeast isolates, encompassing diverse Candida and non-Candida species, using MALDI-TOF MS. Additionally, antifungal susceptibility was assessed for 250 isolates, demonstrating excellent categorical agreement between Direct-AFST and conventional culture-based AFST (Culture-AFST). Our findings highlight the clinical utility of MALDI-TOF MS for accurate and rapid yeast identification directly from positive blood cultures, irrespective of microbial load or sample preparation method. Furthermore, the successful application of Direct-AFST underscores its potential for early detection of antifungal resistance, significantly reducing diagnostic turnaround times and improving patient management.

Background: With the increasing incidence of fungal infection in China, the need for rapid and accurate diagnosis of mycosis is crucial. Therefore, it is necessary to understand the diagnosis capacity for mycosis.

Methods: A cross-sectional online survey was conducted across all 31 provincial-level regions in China from August 2023 to April 2024. The survey comprised 77 questions evaluating fungal diagnostic methods, including culture, microscopy, molecular tests, and related biomarkers. Data from 1,009 valid responses were stratified by hospital tier (tertiary A vs. non-tertiary A) and regional GDP levels to analyze on-site testing capacity and outsourcing patterns.

Results: Among the 1,009 respondents, 78.5% were from tertiary A hospitals. Mycology testing was more commonly performed in tertiary hospitals compared to other. Traditional mycological diagnostic methods showed no significant differences in application across regions, regardless of economic development. However, disparities emerged in novel tests, particularly molecular diagnostics: hospitals in low-GDP regions were more likely to outsource molecular testing or lack in-house capacity.

Conclusions: China's fungal diagnostic capacity remains concentrated in tertiary A hospitals and high-GDP regions. Future efforts should prioritize expanding molecular testing access and optimizing resource distribution across all healthcare settings.

Blastobotrys allociferrii is a yeast involved in human infection and colonization. Here, we present the first draft genome of B. allociferrii, which has been isolated from a human sample (CBS 18616).

Sporotrichosis is a fungal disease caused by the infection of Sporothrix spp. The reference standard method for the diagnosis of sporotrichosis is still the mycological culture from clinical samples. Molecular methods have been developed to facilitate the diagnosis of the disease. The aim of the study was to compare two Polymerase Chain Reaction (PCR) techniques, using species-specific primers and nested PCR, to diagnose human sporotrichosis directly from tissues of patients treated at a public hospital in Pernambuco, Brazil. Tissue fragments samples were subjected to DNA extraction followed by PCR using species-specific primers for S. brasiliensis and S. schenckii and nested PCR. Positive DNA bands for S. brasiliensis were amplified in both methods. Our findings suggest that PCR is an important tool for the rapid and accurate diagnosis of sporotrichosis in humans. Histological analysis of the same number of patients, who had a tissue fragment analyzed by species-specific primers or nested PCR, showed yeast-like cells by periodic acid of Shiff staining in only 10%. Considering hematoxylin and eosin staining, only one case was diagnosed as deep mycosis and the other cases had nonspecific diagnoses. The present work compared different molecular tools for the diagnosis of sporotrichosis from clinical samples. As far as we know, the comparison of these methodologies is pioneering and has the advantage of improving diagnosis and early detection in patients with sporotrichosis caused by Sporothrix sensu lato, especially in new endemic areas, as well as the possibility of implementing these tools in the diagnostic routine.

Fungal infections have emerged as a significant public health concern, especially with the increasing incidence of severe mycoses caused by pathogens such as Aspergillus fumigatus, Candida auris, Candida albicans, and Cryptococcus neoformans. These fungi, listed as critical priorities by the World Health Organization, pose a heightened risk due to rising antifungal resistance and their severe impact on immunocompromised individuals. This article, coordinated by the Portuguese Association of Medical Mycology, highlights the importance of adopting a One Health perspective to address fungal threats comprehensively. Drawing on interdisciplinary collaboration, the association aims to foster greater awareness, improve diagnostic capabilities, and stimulate research and public health policies in Portugal but also at global level. The paper outlines key strategies for surveillance, prevention, and innovation in fungal diagnostics and therapeutics. Moreover, it emphasizes the urgent need for national coordination and international cooperation in managing fungal infections, advocating for integrative approaches that link human, animal, and environmental health. By presenting a consolidated overview of current challenges and future priorities, this work seeks to enhance preparedness and response mechanisms in the face of escalating fungal threats.

Introduction: Invasive candidiasis is a serious healthcare associated infection with a high mortality rate. Emergence of the multi-drug-resistant species Candida (Candidozyma) auris over the past two decades poses further challenges. We aimed to study the epidemiology, clinical profile and outcomes of non-neutropenic adults with C. auris candidemia in comparison with candidemia due to other species.

Methods: We conducted a retrospective study of all non-neutropenic adult patients admitted to our tertiary care centre with blood culture proven candidemia between January 2019 and September 2024. We retrospectively collected their clinical data and investigation records via hospital's electronic records and document management systems.

Results: Out of a total of 372 candidemia episodes, 85 (22.8%) were caused by C. auris, which was the second most common species after C.tropicalis. The incidence of candidemia overall as well as C. auris candidemia increased during the SARS-COV2 pandemic. In comparison to other species, C. auris candidemia was associated with prolonged hospital stay, prior antifungal exposure, a lower SOFA score and was common in patients on ECMO. Candida endocarditis was associated with persistent candidemia and long, tunnelled lines. C. auris showed 100% resistance to fluconazole and very low rate of susceptibility to amphotericin B: only echinocandins were reliably effective. A negative beta-D glucan (BDG) value was seen in a quarter of patients with both C. auris as well as with other species. Overall survival at 28 days was only 40%. Advanced age and a high SOFA score were associated with higher mortality. C. auris was associated with a lower mortality overall but was not associated with higher mortality in a multi-variate analysis.

Conclusion: Multi-drug-resistant Candida (Candidozyma) auris has emerged as a major nosocomial pathogen in Indian ICUs since the SARS-COV-2 pandemic, especially later in the course of hospital stay and with prior antifungal exposure. A negative BDG result alone cannot be used for withholding or discontinuing antifungals. Echinocandins are the empiric antifungals of choice for candidemia in view of the current epidemiology and resistance profile.