Pub Date : 2026-03-21DOI: 10.1016/j.riam.2026.01.003
Ayşe Semra Güreser, Nilgün Karabıçak, Serap Süzük Yıldız, Mert Emre Ölmez, İpek Mumcuoğlu, Neşe İnan, Turgay Ulaş, Mehmet Sinan Dal, Gülşen İskender, Tuba Dal
Background: Fungal infections affect especially to patients with cancer and those who are immunocompromised.
Aims: We analysed the prevalence of filamentous fungi in patients at Ankara Oncology Education and Research Hospital from 2022 to 2024; antifungal susceptibility tests were also carried out.
Methods: Filamentous fungi were analyzed by MALDI-TOF (matrix-assisted laser desorption ionization-time of flight), and antifungal susceptibility was tested by the broth microdilution method.
Results: Filamentous fungi were recovered from 66 (6.5%) of 1,020 samples: 31(47%) deep tracheal aspirates, 13 (19.7%) sputum, 10 (15.2%) ear swabs, 9 (13.6%) biopsies, and three (4.5%) bronchoalveolar lavage samples. Filamentous fungi other than Aspergillus grew from 10 (15.2%) samples, while Aspergillus species were recovered in 56 (84.8%). Of the 56 Aspergillus, 21 (31.8%) were Aspergillus fumigatus, 15 (22.7%) were Aspergillus flavus, 14 (21.2%) were Aspergillus niger, 3 (4.5%) were Aspergillus terreus, and one strain (1.5%) each of the following species were identified: Aspergillus tamarii, Aspergillus nidulans, and Aspergillus calidoustus. Of 66 patients from whom a fungal isolate was recovered, 50 (75.8%) had cancer. Minimum inhibitory concentrations (MICs) were determined in 45 (80.4%) Aspergillus isolates. Eight (8/19) A. fumigatus, seven (7/13) A. flavus, and three (3/11) A. niger were non-wild type (WT) according to amphotericin B MIC values. Four (4/13) A. flavus and two (2/19) A. fumigatus were non-WT according to itraconazole MIC values. One (1/13) A. flavus was non-WT according to voriconazole MIC value.
Conclusions: The filamentous fungi recovered from the patients showed high antifungal MIC/MEC values, and some isolates had high amphotericin B MICs. Voriconazole was effective in vitro against A. fumigatus.
{"title":"Filamentous fungi, and their antifungal susceptibilities, isolated from patients at an oncology hospital in Turkey.","authors":"Ayşe Semra Güreser, Nilgün Karabıçak, Serap Süzük Yıldız, Mert Emre Ölmez, İpek Mumcuoğlu, Neşe İnan, Turgay Ulaş, Mehmet Sinan Dal, Gülşen İskender, Tuba Dal","doi":"10.1016/j.riam.2026.01.003","DOIUrl":"https://doi.org/10.1016/j.riam.2026.01.003","url":null,"abstract":"<p><strong>Background: </strong>Fungal infections affect especially to patients with cancer and those who are immunocompromised.</p><p><strong>Aims: </strong>We analysed the prevalence of filamentous fungi in patients at Ankara Oncology Education and Research Hospital from 2022 to 2024; antifungal susceptibility tests were also carried out.</p><p><strong>Methods: </strong>Filamentous fungi were analyzed by MALDI-TOF (matrix-assisted laser desorption ionization-time of flight), and antifungal susceptibility was tested by the broth microdilution method.</p><p><strong>Results: </strong>Filamentous fungi were recovered from 66 (6.5%) of 1,020 samples: 31(47%) deep tracheal aspirates, 13 (19.7%) sputum, 10 (15.2%) ear swabs, 9 (13.6%) biopsies, and three (4.5%) bronchoalveolar lavage samples. Filamentous fungi other than Aspergillus grew from 10 (15.2%) samples, while Aspergillus species were recovered in 56 (84.8%). Of the 56 Aspergillus, 21 (31.8%) were Aspergillus fumigatus, 15 (22.7%) were Aspergillus flavus, 14 (21.2%) were Aspergillus niger, 3 (4.5%) were Aspergillus terreus, and one strain (1.5%) each of the following species were identified: Aspergillus tamarii, Aspergillus nidulans, and Aspergillus calidoustus. Of 66 patients from whom a fungal isolate was recovered, 50 (75.8%) had cancer. Minimum inhibitory concentrations (MICs) were determined in 45 (80.4%) Aspergillus isolates. Eight (8/19) A. fumigatus, seven (7/13) A. flavus, and three (3/11) A. niger were non-wild type (WT) according to amphotericin B MIC values. Four (4/13) A. flavus and two (2/19) A. fumigatus were non-WT according to itraconazole MIC values. One (1/13) A. flavus was non-WT according to voriconazole MIC value.</p><p><strong>Conclusions: </strong>The filamentous fungi recovered from the patients showed high antifungal MIC/MEC values, and some isolates had high amphotericin B MICs. Voriconazole was effective in vitro against A. fumigatus.</p>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-06DOI: 10.1016/j.riam.2026.01.002
João Batista Camargo Neto, Maiara Medeiros Cunha, Wanessa Maria Dos Santos, Leonardo Euripedes Andrade Silva, Paulo Roberto da Silva, David Nascimento Silva Teixeira, Mario Leon Silva-Vergara, Alexandre Paula Rogerio
Background: The innate immune response and cytokine milieu in airway mucosa, mediated by bronchial epithelial cells, are critical in determining susceptibility or protection against cryptococcosis. In experimental models, Th2 and Th1 responses are linked to susceptibility and protection, respectively, while the roles of other cytokines remain less understood.
Aims: To evaluate the in vitro effects of IL-4, IFN-γ, and IL-27 (100 ng/mL) on human bronchial epithelial cells (BEAS-2B) infected with a strain of C. neoformans sensu stricto (multiplicities of infection [MOI] 1-100).
Methods: Cells were stimulated with each cytokine, followed by C. neoformans infection (MOI 100). After 24 h, supernatants were collected to measure CCL2, IL-6, and IL-8 production. STAT1 and STAT6 activation was analyzed by flow cytometry. Phagocytosis and colony-forming unit assays assessed fungal internalization and growth.
Results: Cytokine-stimulated, infected cells displayed reduced IL-6 and/or CCL2 production and decreased STAT6 activation (IL-4) or STAT1 activation (IL-27, IFN-γ) compared with cells stimulated with C. neoformans sensu stricto or cytokines alone. IL-27 reduced fungal internalization, while IL-4 and IFN-γ increased it. All cytokines promoted higher fungal growth.
Conclusions: The interaction of bronchial epithelial cells stimulated with IL-4, IFN-γ, or IL-27, with yeasts of C. neoformans induced an anti-inflammatory profile in the cells that impaired STAT activation and favored fungal proliferation. These findings suggest that certain cytokine environments within the airway epithelium may create conditions conducive to C. neoformans persistence, potentially influencing the progression of the infection.
{"title":"In vitro effects of IFN-γ, IL-4 and IL-27 on human bronchial epithelial cells infected with Cryptococcus neoformans sensu stricto.","authors":"João Batista Camargo Neto, Maiara Medeiros Cunha, Wanessa Maria Dos Santos, Leonardo Euripedes Andrade Silva, Paulo Roberto da Silva, David Nascimento Silva Teixeira, Mario Leon Silva-Vergara, Alexandre Paula Rogerio","doi":"10.1016/j.riam.2026.01.002","DOIUrl":"https://doi.org/10.1016/j.riam.2026.01.002","url":null,"abstract":"<p><strong>Background: </strong>The innate immune response and cytokine milieu in airway mucosa, mediated by bronchial epithelial cells, are critical in determining susceptibility or protection against cryptococcosis. In experimental models, Th2 and Th1 responses are linked to susceptibility and protection, respectively, while the roles of other cytokines remain less understood.</p><p><strong>Aims: </strong>To evaluate the in vitro effects of IL-4, IFN-γ, and IL-27 (100 ng/mL) on human bronchial epithelial cells (BEAS-2B) infected with a strain of C. neoformans sensu stricto (multiplicities of infection [MOI] 1-100).</p><p><strong>Methods: </strong>Cells were stimulated with each cytokine, followed by C. neoformans infection (MOI 100). After 24 h, supernatants were collected to measure CCL2, IL-6, and IL-8 production. STAT1 and STAT6 activation was analyzed by flow cytometry. Phagocytosis and colony-forming unit assays assessed fungal internalization and growth.</p><p><strong>Results: </strong>Cytokine-stimulated, infected cells displayed reduced IL-6 and/or CCL2 production and decreased STAT6 activation (IL-4) or STAT1 activation (IL-27, IFN-γ) compared with cells stimulated with C. neoformans sensu stricto or cytokines alone. IL-27 reduced fungal internalization, while IL-4 and IFN-γ increased it. All cytokines promoted higher fungal growth.</p><p><strong>Conclusions: </strong>The interaction of bronchial epithelial cells stimulated with IL-4, IFN-γ, or IL-27, with yeasts of C. neoformans induced an anti-inflammatory profile in the cells that impaired STAT activation and favored fungal proliferation. These findings suggest that certain cytokine environments within the airway epithelium may create conditions conducive to C. neoformans persistence, potentially influencing the progression of the infection.</p>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-26DOI: 10.1016/j.riam.2026.01.001
Victor Garcia-Bustos
Candidozyma auris (formerly Candida auris) has emerged within just over a decade as one of the most relevant multidrug-resistant fungal pathogens affecting human health worldwide. Its pathogenicity, capacity for skin colonization, environmental persistence, and resistance to antifungal drugs and disinfectants have all contributed to its consolidation as a leading cause of healthcare-associated outbreaks. Nevertheless, increasing evidence indicates that C. auris should not be viewed solely as a nosocomial yeast, but rather as part of a broader environmental continuum encompassing natural habitats, anthropogenic niches, and multiple host species. Environmental isolates have been documented in coastal wetlands, wastewater systems, agricultural products, as well as in diverse animals - including companion animals, reptiles, amphibians, and insects -supporting its classification as a sapronotic pathogen. The near-simultaneous emergence of distinct clades across continents strongly suggests that climate change, agricultural azole exposure, and ecological adaptation have collectively selected strains exhibiting thermotolerance, antifungal resistance, and cross-kingdom persistence, thereby enabling recurrent spillover into human populations. Recent advances in wastewater-based epidemiology demonstrate that C. auris can be detected at the community level, often preceding clinical recognition, while animal colonization underscores its overlooked role in pathogen maintenance and transmission networks. This review synthesizes current evidence on the ecological, evolutionary, and epidemiological determinants of C. auris, positioning outbreaks as amplification phenomena within interconnected ecological systems rather than isolated nosocomial events. Adoption of a One Health framework, integrating environmental, veterinary, and human health surveillance, will be essential for predictive outbreak modeling, early detection, and the development of sustainable strategies to mitigate the ongoing and future threats posed by this emerging fungal pathogen.
{"title":"Environmental continuum of Candidozyma auris: from sapronotic ecology to outbreak prediction and control with a One Health perspective.","authors":"Victor Garcia-Bustos","doi":"10.1016/j.riam.2026.01.001","DOIUrl":"https://doi.org/10.1016/j.riam.2026.01.001","url":null,"abstract":"<p><p>Candidozyma auris (formerly Candida auris) has emerged within just over a decade as one of the most relevant multidrug-resistant fungal pathogens affecting human health worldwide. Its pathogenicity, capacity for skin colonization, environmental persistence, and resistance to antifungal drugs and disinfectants have all contributed to its consolidation as a leading cause of healthcare-associated outbreaks. Nevertheless, increasing evidence indicates that C. auris should not be viewed solely as a nosocomial yeast, but rather as part of a broader environmental continuum encompassing natural habitats, anthropogenic niches, and multiple host species. Environmental isolates have been documented in coastal wetlands, wastewater systems, agricultural products, as well as in diverse animals - including companion animals, reptiles, amphibians, and insects -supporting its classification as a sapronotic pathogen. The near-simultaneous emergence of distinct clades across continents strongly suggests that climate change, agricultural azole exposure, and ecological adaptation have collectively selected strains exhibiting thermotolerance, antifungal resistance, and cross-kingdom persistence, thereby enabling recurrent spillover into human populations. Recent advances in wastewater-based epidemiology demonstrate that C. auris can be detected at the community level, often preceding clinical recognition, while animal colonization underscores its overlooked role in pathogen maintenance and transmission networks. This review synthesizes current evidence on the ecological, evolutionary, and epidemiological determinants of C. auris, positioning outbreaks as amplification phenomena within interconnected ecological systems rather than isolated nosocomial events. Adoption of a One Health framework, integrating environmental, veterinary, and human health surveillance, will be essential for predictive outbreak modeling, early detection, and the development of sustainable strategies to mitigate the ongoing and future threats posed by this emerging fungal pathogen.</p>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-26DOI: 10.1016/j.riam.2025.11.002
Débora Matilde de Almeida, Gabriel Peres Messenburger, Eduarda Santos Bierhals, Sérgio Jorge, Márcia de Oliveira Nobre
Background: Sporotrichosis is a subcutaneous mycosis caused by the traumatic inoculation of dimorphic fungi from the genus Sporothrix. Traditional diagnostic methods, including direct microscopy and fungal culture, are time-consuming, require specialized expertise, and may yield false-negative results.
Aims: This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of the enzyme-linked immunosorbent assay (ELISA) technique in detecting sporotrichosis in humans and animals.
Methods: A comprehensive literature search was conducted across PubMed, LILACS, EMBASE, Scopus, Web of Science, ScienceDirect, CAPES Periodicals, and the Cochrane Library using both free-text terms and MeSH descriptors. The methodological quality of the studies included was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity were estimated using a random-effects model. Secondary outcomes included the positive and negative likelihood ratios and the diagnostic odds ratio (DOR).
Results: Twelve studies met the inclusion criteria, comprising 1,612 samples (1,350 human and 262 feline). ELISA demonstrated a pooled sensitivity of 91% (95% CI: 85-94) and specificity of 90% (95% CI: 86-93), with a DOR of 94.2 (95% CI: 46.9-189.1). Subgroup analysis revealed higher diagnostic performance in feline samples, particularly when crude antigen extracts and combined fungal forms were used.
Conclusions: ELISA exhibits high diagnostic accuracy for sporotrichosis in both human and veterinary contexts. Its performance, especially in feline hosts, supports its potential role as a reliable diagnostic alternative to conventional methods.
{"title":"Diagnostic accuracy of ELISA in sporotrichosis: a systematic review and meta-analysis.","authors":"Débora Matilde de Almeida, Gabriel Peres Messenburger, Eduarda Santos Bierhals, Sérgio Jorge, Márcia de Oliveira Nobre","doi":"10.1016/j.riam.2025.11.002","DOIUrl":"https://doi.org/10.1016/j.riam.2025.11.002","url":null,"abstract":"<p><strong>Background: </strong>Sporotrichosis is a subcutaneous mycosis caused by the traumatic inoculation of dimorphic fungi from the genus Sporothrix. Traditional diagnostic methods, including direct microscopy and fungal culture, are time-consuming, require specialized expertise, and may yield false-negative results.</p><p><strong>Aims: </strong>This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of the enzyme-linked immunosorbent assay (ELISA) technique in detecting sporotrichosis in humans and animals.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, LILACS, EMBASE, Scopus, Web of Science, ScienceDirect, CAPES Periodicals, and the Cochrane Library using both free-text terms and MeSH descriptors. The methodological quality of the studies included was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity were estimated using a random-effects model. Secondary outcomes included the positive and negative likelihood ratios and the diagnostic odds ratio (DOR).</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria, comprising 1,612 samples (1,350 human and 262 feline). ELISA demonstrated a pooled sensitivity of 91% (95% CI: 85-94) and specificity of 90% (95% CI: 86-93), with a DOR of 94.2 (95% CI: 46.9-189.1). Subgroup analysis revealed higher diagnostic performance in feline samples, particularly when crude antigen extracts and combined fungal forms were used.</p><p><strong>Conclusions: </strong>ELISA exhibits high diagnostic accuracy for sporotrichosis in both human and veterinary contexts. Its performance, especially in feline hosts, supports its potential role as a reliable diagnostic alternative to conventional methods.</p>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-11-25DOI: 10.1016/j.riam.2025.09.002
Laura Rosio Castañón Olivares, Yurixhi Paola Aguilera León, Fernanda Marlene Moreno Manrique, José Enrique Reyes Lira, Elva Bazán Mora, Edith Sánchez Paredes
Background
In Mexico, Cryptococcus gattii sensu lato has been identified as the etiologic agent in approximately 10.8% of cryptococcosis cases; however, its isolation from natural sources, which would confirm its existence in the environment, has not been successful.
Objective
To isolate C. gattii from environmental samples collected from trees within the movement area of a patient diagnosed with cryptococcosis caused by this species.
Methods
Based on a database of clinical isolates characterized as C. gattii, a patient was contacted and his route of movement was obtained; through a geospatial analysis, nearby trees were located. Tree hollows were sampled and the Cryptococcus isolates obtained were biochemically and genetically typed.
Results
Four Cryptococcus isolates were obtained from the trees Schinus molle, Erythrina coralloides and from a specimen of the genus Pinus: three of them were characterized as Cryptococcus neoformans sensu stricto and one as C. gattii sensu stricto.
Conclusions
Using a geographic information system led to delimit an environmental sampling area, resulting in the first documented report in Mexico of the isolation of C. gattii genotype VGI in nature.
{"title":"Isolation of Cryptococcus gattii (genotype VGI) from a specimen of Pinus. An approach to its natural habitat in México City","authors":"Laura Rosio Castañón Olivares, Yurixhi Paola Aguilera León, Fernanda Marlene Moreno Manrique, José Enrique Reyes Lira, Elva Bazán Mora, Edith Sánchez Paredes","doi":"10.1016/j.riam.2025.09.002","DOIUrl":"10.1016/j.riam.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>In Mexico, <em>Cryptococcus gattii sensu lato</em> has been identified as the etiologic agent in approximately 10.8% of cryptococcosis cases; however, its isolation from natural sources, which would confirm its existence in the environment, has not been successful.</div></div><div><h3>Objective</h3><div>To isolate <em>C. gattii</em> from environmental samples collected from trees within the movement area of a patient diagnosed with cryptococcosis caused by this species.</div></div><div><h3>Methods</h3><div>Based on a database of clinical isolates characterized as <em>C. gattii</em>, a patient was contacted and his route of movement was obtained; through a geospatial analysis, nearby trees were located. Tree hollows were sampled and the <em>Cryptococcus</em> isolates obtained were biochemically and genetically typed.</div></div><div><h3>Results</h3><div>Four <em>Cryptococcus</em> isolates were obtained from the trees <em>Schinus molle</em>, <em>Erythrina coralloides</em> and from a specimen of the genus <em>Pinus</em>: three of them were characterized as <em>Cryptococcus neoformans sensu stricto</em> and one as <em>C. gattii sensu stricto</em>.</div></div><div><h3>Conclusions</h3><div>Using a geographic information system led to delimit an environmental sampling area, resulting in the first documented report in Mexico of the isolation of <em>C. gattii</em> genotype VGI in nature.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"43 1","pages":"Pages 1-6"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145638235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-16DOI: 10.1016/j.riam.2025.10.002
Maria Jose Amaya , Ana Maria del Pilar Monroy , Natalia Perez , Paula Daniela Villamizar , Juan Pablo Cardenas , Diego Alejandro Pinto Pinzón
Background
Infective endocarditis caused by Trichosporon inkin is an exceptionally rare fungal infection, particularly in immunocompetent patients. This microorganism is part of the normal microbiota of the skin and gastrointestinal tract, but can cause invasive infections associated with prosthetic devices or complex clinical conditions. Reported cases in the literature are scarce, making it difficult to establish standardized diagnostic and therapeutic guidelines.
Case report
We report the case of an immunocompetent female patient with rheumatic fever due to which she underwent a mitral valve replacement procedure using a mechanical prosthesis, who developed infective endocarditis caused by T. inkin. The initial diagnosis was delayed due to misinterpretation as contaminant of the fungal isolate recovered. The patient developed intracerebral hemorrhage and was considered high-risk for surgical intervention; thus, medical management was pursued. The microorganism was finally identified by MALDI-TOF mass spectrometry, a validated tool for identifying Trichosporon species. The patient received voriconazole, with favorable clinical response, followed by prolonged suppressive fluconazole therapy.
Conclusions
This is the second case reported in the Americas and the fifth worldwide of T. inkin infective endocarditis in an immunocompetent patient. It highlights the importance of considering this pathogen in prosthetic valve endocarditis in cases of unusual culture results, and demonstrates the diagnostic value of MALDI-TOF. Long-term antifungal therapy with triazoles, particularly voriconazole followed by fluconazole, may be an effective alternative for patients who are not surgical candidates.
{"title":"Infective endocarditis of a prosthetic mechanical valve caused by Trichosporon inkin in an immunocompetent patient: Case report","authors":"Maria Jose Amaya , Ana Maria del Pilar Monroy , Natalia Perez , Paula Daniela Villamizar , Juan Pablo Cardenas , Diego Alejandro Pinto Pinzón","doi":"10.1016/j.riam.2025.10.002","DOIUrl":"10.1016/j.riam.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Infective endocarditis caused by <em>Trichosporon inkin</em> is an exceptionally rare fungal infection, particularly in immunocompetent patients. This microorganism is part of the normal microbiota of the skin and gastrointestinal tract, but can cause invasive infections associated with prosthetic devices or complex clinical conditions. Reported cases in the literature are scarce, making it difficult to establish standardized diagnostic and therapeutic guidelines.</div></div><div><h3>Case report</h3><div>We report the case of an immunocompetent female patient with rheumatic fever due to which she underwent a mitral valve replacement procedure using a mechanical prosthesis, who developed infective endocarditis caused by <em>T. inkin</em>. The initial diagnosis was delayed due to misinterpretation as contaminant of the fungal isolate recovered. The patient developed intracerebral hemorrhage and was considered high-risk for surgical intervention; thus, medical management was pursued. The microorganism was finally identified by MALDI-TOF mass spectrometry, a validated tool for identifying <em>Trichosporon</em> species. The patient received voriconazole, with favorable clinical response, followed by prolonged suppressive fluconazole therapy.</div></div><div><h3>Conclusions</h3><div>This is the second case reported in the Americas and the fifth worldwide of <em>T. inkin</em> infective endocarditis in an immunocompetent patient. It highlights the importance of considering this pathogen in prosthetic valve endocarditis in cases of unusual culture results, and demonstrates the diagnostic value of MALDI-TOF. Long-term antifungal therapy with triazoles, particularly voriconazole followed by fluconazole, may be an effective alternative for patients who are not surgical candidates.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"43 1","pages":"Pages 23-26"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During the COVID-19 pandemic, Rhizopus arrhizus and Rhizopus homothallicus were identified as causative agents of rhino-cerebral mucormycosis in COVID-19 patients. Clinical management typically includes surgical debridement and antifungal treatment, with amphotericin B (AMB) and posaconazole (PCZ) as primary options. However, long-term use of AMB can lead to toxicity, necessitating PCZ as a follow-up treatment.
Aims
This study aimed to examine the combined effect of AMB and PCZ on R. homothallicus.
Methods
The combined effect of AmB and PCZ on R. homothallicus was studied by examining their minimum inhibitory concentration (MIC) values, fractional inhibitory concentration index (FICI), spore germination properties, viability, and intracellular reactive oxygen species accumulation; Raman spectroscopy was also performed.
Results
The MIC values for AmB and PCZ were 4 and 8 μg/mL, respectively, with a combined MIC of 2 μg/mL and an FICI index of <0.28. The germination rates at MIC values after 48 h of exposure were 28% for AmB, 36% for PCZ, and only 3% for the combination. Viability assays revealed dead sporangiospores following combination treatment. AmB and its combination generated more ROS (68.18% and 64.45%, respectively) than did PCZ alone (42.6%).
Conclusions
Combination therapy reduced the AMB dose without loss of efficacy, suggesting a synergistic effect against R. homothallicus. These results may support this alternative strategy to mitigate the side effects of AMB.
{"title":"Evaluating the combined impact of amphotericin B and posaconazole on the germination of a rare Rhizopus homothallicus isolate responsible for COVID-19 associated mucormycosis","authors":"Aishwarya Nikhil , Atul Kumar Tiwari , Suchita Gautam , Ragini Tilak , Mohit Bhatia , Munesh Kumar Gupta , Roger J. Narayan","doi":"10.1016/j.riam.2025.10.003","DOIUrl":"10.1016/j.riam.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 pandemic, <em>Rhizopus arrhizus</em> and <em>Rhizopus homothallicus</em> were identified as causative agents of rhino-cerebral mucormycosis in COVID-19 patients. Clinical management typically includes surgical debridement and antifungal treatment, with amphotericin B (AMB) and posaconazole (PCZ) as primary options. However, long-term use of AMB can lead to toxicity, necessitating PCZ as a follow-up treatment.</div></div><div><h3>Aims</h3><div>This study aimed to examine the combined effect of AMB and PCZ on <em>R. homothallicus</em>.</div></div><div><h3>Methods</h3><div>The combined effect of AmB and PCZ on <em>R. homothallicus</em> was studied by examining their minimum inhibitory concentration (MIC) values, fractional inhibitory concentration index (FICI), spore germination properties, viability, and intracellular reactive oxygen species accumulation; Raman spectroscopy was also performed.</div></div><div><h3>Results</h3><div>The MIC values for AmB and PCZ were 4 and 8<!--> <!-->μg/mL, respectively, with a combined MIC of 2<!--> <!-->μg/mL and an FICI index of <0.28. The germination rates at MIC values after 48<!--> <!-->h of exposure were 28% for AmB, 36% for PCZ, and only 3% for the combination. Viability assays revealed dead sporangiospores following combination treatment. AmB and its combination generated more ROS (68.18% and 64.45%, respectively) than did PCZ alone (42.6%).</div></div><div><h3>Conclusions</h3><div>Combination therapy reduced the AMB dose without loss of efficacy, suggesting a synergistic effect against <em>R. homothallicus</em>. These results may support this alternative strategy to mitigate the side effects of AMB.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"43 1","pages":"Pages 7-16"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2026-01-29DOI: 10.1016/j.riam.2025.11.001
Fei Wang , Yake Yao , Qing Yang , XueMei Lin , Yihua Zheng , Hua Zhou , Qin Huang
Background
In China, the isolation rate of fluconazole-resistant isolates of Candida tropicalis, together with fatality in cases of bloodstream infections due to this yeast, have increased annually.
Aims
This study investigates the clinical characteristics, risk factors, and prognostic factors of fluconazole-resistant C. tropicalis bloodstream infections (BSI).
Methods
A retrospective study analyzed clinical data of patients with C. tropicalis BSI from July 2013 to June 2019, focusing on clinical characteristics, risk factors, treatment regimens, and prognosis. Univariate analysis of risk factors and prognosis was conducted using χ2 test or Fisher's exact tests. Binary logistic regression model for risk factors, and Cox regression method for prognosis, were used for multivariate analysis.
Results
The study enrolled 100 patients with C. tropicalis BSI, including 44 fluconazole-resistant and 56 fluconazole-sensitive cases; 64 patients were cured and 36 died, resulting in a mortality rate of 36%. Logistic regression analysis identified exposure to azole antifungal agents during the 2 weeks prior to the onset of the BSI as a risk factor for fluconazole resistance. Cox regression analysis showed that hematological malignancy, fluconazole-resistant strains, indwelling catheters, and chronic obstructive pulmonary disease were independent risk factors for patient mortality. Conversely, targeted therapy with sensitive antifungal agents and removal of drainage tubes were protective factors for survival.
Conclusions
Azole exposure led to the development of fluconazole resistance in C. tropicalis BSI; hematologic malignancies, azole resistance, chronic obstructive pulmonary disease and having intravenous catheters increased mortality rate. The use of echinocandins or amphotericin B and catheter removal improved outcomes, underscoring the need for early resistance detection and targeted treatment.
{"title":"Analysis of risk factors and prognosis of fluconazole-resistant Candida tropicalis bloodstream infection","authors":"Fei Wang , Yake Yao , Qing Yang , XueMei Lin , Yihua Zheng , Hua Zhou , Qin Huang","doi":"10.1016/j.riam.2025.11.001","DOIUrl":"10.1016/j.riam.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>In China, the isolation rate of fluconazole-resistant isolates of <em>Candida tropicalis</em>, together with fatality in cases of bloodstream infections due to this yeast, have increased annually.</div></div><div><h3>Aims</h3><div>This study investigates the clinical characteristics, risk factors, and prognostic factors of fluconazole-resistant <em>C. tropicalis</em> bloodstream infections (BSI).</div></div><div><h3>Methods</h3><div>A retrospective study analyzed clinical data of patients with <em>C. tropicalis</em> BSI from July 2013 to June 2019, focusing on clinical characteristics, risk factors, treatment regimens, and prognosis. Univariate analysis of risk factors and prognosis was conducted using <em>χ</em><sup>2</sup> test or Fisher's exact tests. Binary logistic regression model for risk factors, and Cox regression method for prognosis, were used for multivariate analysis.</div></div><div><h3>Results</h3><div>The study enrolled 100 patients with <em>C. tropicalis</em> BSI, including 44 fluconazole-resistant and 56 fluconazole-sensitive cases; 64 patients were cured and 36 died, resulting in a mortality rate of 36%. Logistic regression analysis identified exposure to azole antifungal agents during the 2 weeks prior to the onset of the BSI as a risk factor for fluconazole resistance. Cox regression analysis showed that hematological malignancy, fluconazole-resistant strains, indwelling catheters, and chronic obstructive pulmonary disease were independent risk factors for patient mortality. Conversely, targeted therapy with sensitive antifungal agents and removal of drainage tubes were protective factors for survival.</div></div><div><h3>Conclusions</h3><div>Azole exposure led to the development of fluconazole resistance in <em>C. tropicalis</em> BSI; hematologic malignancies, azole resistance, chronic obstructive pulmonary disease and having intravenous catheters increased mortality rate. The use of echinocandins or amphotericin B and catheter removal improved outcomes, underscoring the need for early resistance detection and targeted treatment.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"43 1","pages":"Pages 17-22"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-09-18DOI: 10.1016/j.riam.2025.07.001
Gustavo Giusiano
Blastomycosis, coccidioidomycosis, histoplasmosis, paracoccidioidomycosis, emergomycosis, and talaromycosis are sapronoses restricted to specific geographical areas associated with particular environmental niches that can lead to high morbidity and mortality if diagnosed or treated late. Challenges in clinical awareness arise from their nonspecific clinical presentations and the limited availability of sensitive diagnostic tools. Although advances in molecular diagnosis and antigen detection-based tests are promising, they are not available for all systemic endemic mycoses (SEM). Treatment guidelines emphasize the importance of early antifungal treatment, although only a few limited therapeutic options have remained available over the years. Most SEM are not notifiable diseases, resulting in underreporting and a poor understanding of their true burden. The inclusion of several SEM-causing dimorphic fungi in the WHO Fungal Priority Pathogens List highlights their growing public health impact, the lack of prevention methods, and unmet research needs. Recognizing SEM as neglected diseases, improving surveillance, expanding diagnostic access, and developing affordable vaccines and therapeutics are essential steps toward addressing this evolving global health challenge. Coordinated international efforts are urgently needed.
{"title":"Systemic endemic mycoses: From a geographical risk to a concern expansion","authors":"Gustavo Giusiano","doi":"10.1016/j.riam.2025.07.001","DOIUrl":"10.1016/j.riam.2025.07.001","url":null,"abstract":"<div><div>Blastomycosis, coccidioidomycosis, histoplasmosis, paracoccidioidomycosis, emergomycosis, and talaromycosis are sapronoses restricted to specific geographical areas associated with particular environmental niches that can lead to high morbidity and mortality if diagnosed or treated late. Challenges in clinical awareness arise from their nonspecific clinical presentations and the limited availability of sensitive diagnostic tools. Although advances in molecular diagnosis and antigen detection-based tests are promising, they are not available for all systemic endemic mycoses (SEM). Treatment guidelines emphasize the importance of early antifungal treatment, although only a few limited therapeutic options have remained available over the years. Most SEM are not notifiable diseases, resulting in underreporting and a poor understanding of their true burden. The inclusion of several SEM-causing dimorphic fungi in the WHO Fungal Priority Pathogens List highlights their growing public health impact, the lack of prevention methods, and unmet research needs. Recognizing SEM as neglected diseases, improving surveillance, expanding diagnostic access, and developing affordable vaccines and therapeutics are essential steps toward addressing this evolving global health challenge. Coordinated international efforts are urgently needed.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"42 3","pages":"Pages 87-92"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-11-19DOI: 10.1016/j.riam.2025.10.001
Silvana Ramadán , Lucia Bulacio , Hernán Dalmaso , Adriana Rocaspana , Alicia Quarta , Rita David , Cecilia Capitelli , Paula Funes , María Mercedes Romero , Constanza Taverna , Susana Córdoba , Maximiliano Sortino
Background
Fungal diseases caused by species of the genus Cryptococcus are a growing public health problem, with the species belonging to the Cryptococcus neoformans and Cryptococcus gattii complexes being the most common and studied. In recent years, other species belonging to related genera have emerged, including Naganishia diffluens. As there are few reports on this species, it is important to emphasize its significance, particularly given that it has been found in skin lesions in immunocompromised patients, as in the case presented here. This highlights the importance of paying due attention to this species and recognizing its clinical relevance.
Case report
A 27-year-old male patient with a diagnosis of acute promyelocytic leukemia M3 (APL M3) experienced a febrile episode with skin lesions compatible with fungal infection, coinciding with marked neutropenia and the start of chemotherapy. Mycological analysis of skin lesions allowed the isolation of a fungus that was identified as N. diffluens.
Conclusions
The increase in the frequency of N. diffluens infections can be attributed to the rising number of patients with risk factors. The use of new microbial identification tools, such as molecular biology, which made it possible to accurately identify the causative agent, is highlighted.
{"title":"Isolation of Naganishia diffluens (formerly Cryptococcus diffluens) from skin lesions of a patient with leukemia","authors":"Silvana Ramadán , Lucia Bulacio , Hernán Dalmaso , Adriana Rocaspana , Alicia Quarta , Rita David , Cecilia Capitelli , Paula Funes , María Mercedes Romero , Constanza Taverna , Susana Córdoba , Maximiliano Sortino","doi":"10.1016/j.riam.2025.10.001","DOIUrl":"10.1016/j.riam.2025.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Fungal diseases caused by species of the genus <em>Cryptococcus</em> are a growing public health problem, with the species belonging to the <em>Cryptococcus neoformans</em> and <em>Cryptococcus gattii</em> complexes being the most common and studied. In recent years, other species belonging to related genera have emerged, including <em>Naganishia diffluens</em>. As there are few reports on this species, it is important to emphasize its significance, particularly given that it has been found in skin lesions in immunocompromised patients, as in the case presented here. This highlights the importance of paying due attention to this species and recognizing its clinical relevance.</div></div><div><h3>Case report</h3><div>A 27-year-old male patient with a diagnosis of acute promyelocytic leukemia M3 (APL M3) experienced a febrile episode with skin lesions compatible with fungal infection, coinciding with marked neutropenia and the start of chemotherapy. Mycological analysis of skin lesions allowed the isolation of a fungus that was identified as <em>N. diffluens</em>.</div></div><div><h3>Conclusions</h3><div>The increase in the frequency of <em>N. diffluens</em> infections can be attributed to the rising number of patients with risk factors. The use of new microbial identification tools, such as molecular biology, which made it possible to accurately identify the causative agent, is highlighted.</div></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":"42 3","pages":"Pages 103-106"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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