Special Issue "Fungal Infections in the Developing World"

A special issue of Journal of Fungi (ISSN 2309-608X).

Deadline for manuscript submissions: closed (30 November 2016)

Special Issue Editors

Guest Editor
Prof. Dr. Arnaldo Lopes Colombo

Division of Infectious Diseases, Department of Medicine, Federal University of São Paulo, Rua Botucatu 740, CEP: 04023-062, Sao Paulo, Brazil
Website | E-Mail
Interests: epidemiology of invasive candidiasis and aspergillosis; epidemiology and molecular mechanisms of antifungal resistance; emerging fungal pathogens; new strategies for the diagnosis of fungal infections; new strategies for treating fungal infections
Guest Editor
Dr. Flavio Queiroz-Telles

Department of Public Health, Hospital de Clinicas, Federal University of Parana; Serviço de Infectologia, Hospital de Clinicas da Universidade Federal do Paraná, Rua General Carneiro, 260, Curitiba, Paraná, 80060-900, Brazil
E-Mail
Interests: endemic mycoses; mycoses of implantation; paracoccidioidomycosis; cryptococcois; inherited immunodeficiencies and mycoses

Special Issue Information

Dear Colleagues,

Fungal infections have shaped the landscape of contemporary medicine worldwide due to a substantial increase in the population at risk, including organ transplant recipients, patients with neoplastic malignancies, individuals with chronic pulmonary infections, patients under immunosuppressive therapy, advanced ages, as well as critically ill patients requesting intensive care and indwelling medical devices.

In the setting of fungal health care associated infections, Candida and Aspergillus species remain the most common pathogens in different countries. Otherwise, considering the ever-increasing number of individuals presenting medical conditions associated to immunosuppression, the spectrum of opportunistic fungal agents able to cause systemic human infections has increased dramatically, including a large number of emerging yeasts (Thrichosporon spp, Rhodotorula spp, etc.) and molds (Fusarium spp, agents of mucormycosis, etc.). These infections are usually difficult to diagnose and hard to treat, and are associated with high mortality rates.

In addition to the high rate of nosocomial acquired fungal infections, developing countries present a large number of individuals exposed to agents of endemic mycoses. Agriculture is still the backbone of the economic growth of developing countries where there is a large number of people living in rural areas, as well as agricultural workers. Rural workers may get infected by true pathogenic soil-related fungi via direct inoculation into wounds or following the inhalation of bioaerosols containing fungal agents of endemic mycoces as paracoccidioidomycosis, histoplasmosis, and coccidioidomycosis. Unfortunatly, most medical centers from resource-limited countries are not appropriated equipped to early-diagnose and treat fungal infections, and patients with systemic mycoses usually present high rates of mortality and sequels.

Despite the substantial number of patients suffering from endemic and opportunistic mycoses living in our region, clinical and epidemiological data remain scarce and fragmentary. The objective of this Special Issue is to review the main epidemiological aspects of the most clinically significant systemic mycoses reported in developing countries, providing a critical evaluation of the burden of the disease, populations that are typically affected, and clinical outcomes. This information should be helpful, not only for academic proposals, but also to alert clinicians and public health authorities to take note of fungal infections.

The efforts of the Guest Editors to coordinate this special supplement is in consonance with our mission working for the Global Action Fund for Fungal Infection, in order to reduce illness and death associated with fungal diseases worldwide

Prof. Dr. Arnaldo Lopes Colombo
Dr. Flavio Queiroz Telles
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Fungi is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) is waived for well-prepared manuscripts submitted to this issue. Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.


Keywords

  • fungal infections
  • Candida
  • Aspergillus
  • Thrichosporon spp
  • Rhodotorula spp
  • Fusarium spp
  • developing countries
  • soil-related fungi
  • resource-limited countries
  • endemic and opportunistic mycoses
  • Cryptococcus

Published Papers (7 papers)

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Review

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Open AccessReview Ecoepidemiology of Cryptococcus gattii in Developing Countries
J. Fungi 2017, 3(4), 62; https://doi.org/10.3390/jof3040062
Received: 27 September 2017 / Revised: 28 October 2017 / Accepted: 30 October 2017 / Published: 3 November 2017
Cited by 1 | PDF Full-text (698 KB) | HTML Full-text | XML Full-text
Abstract
Cryptococcosis is a systemic infection caused by species of the encapsulated yeast Cryptococcus. The disease may occur in immunocompromised and immunocompetent hosts and is acquired by the inhalation of infectious propagules present in the environment. Cryptococcus is distributed in a plethora of
[...] Read more.
Cryptococcosis is a systemic infection caused by species of the encapsulated yeast Cryptococcus. The disease may occur in immunocompromised and immunocompetent hosts and is acquired by the inhalation of infectious propagules present in the environment. Cryptococcus is distributed in a plethora of ecological niches, such as soil, pigeon droppings, and tree hollows, and each year new reservoirs are discovered, which helps researchers to better understand the epidemiology of the disease. In this review, we describe the ecoepidemiology of the C. gattii species complex focusing on clinical cases and ecological reservoirs in developing countries from different continents. We also discuss some important aspects related to the antifungal susceptibility of different species within the C. gattii species complex and bring new insights on the revised Cryptococcus taxonomy. Full article
(This article belongs to the Special Issue Fungal Infections in the Developing World)
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Open AccessReview Strategies to Reduce Mortality in Adult and Neonatal Candidemia in Developing Countries
J. Fungi 2017, 3(3), 41; https://doi.org/10.3390/jof3030041
Received: 8 June 2017 / Revised: 13 July 2017 / Accepted: 16 July 2017 / Published: 19 July 2017
Cited by 3 | PDF Full-text (316 KB) | HTML Full-text | XML Full-text
Abstract
Candidemia, the commonest invasive fungal infection, is associated with high morbidity and mortality in developing countries, though the exact prevalence is not known due to lack of systematic epidemiological data from those countries. The limited studies report a very high incidence of candidemia
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Candidemia, the commonest invasive fungal infection, is associated with high morbidity and mortality in developing countries, though the exact prevalence is not known due to lack of systematic epidemiological data from those countries. The limited studies report a very high incidence of candidemia and unique epidemiology with a different spectrum of Candida species. The recent global emergence of multi-drug resistant Candida auris is looming large as an important threat in hospitalized patients of developing countries. While managing candidemia cases in those countries several challenges are faced, which include poor infrastructure; compromised healthcare and infection control practices; misuse and overuse of antibiotics and steroids; lack of awareness in fungal infections; non-availability of advance diagnostic tests and antifungal drugs in many areas; poor compliance to antifungal therapy and stewardship program. Considering the above limitations, innovative strategies are required to reduce mortality due to candidemia in adults and neonates. In the present review, we have unraveled the challenges of candidemia faced by low resource countries and propose a ten part strategy to reduce mortality due candidemia. Full article
(This article belongs to the Special Issue Fungal Infections in the Developing World)
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Open AccessReview Revisiting Species Distribution and Antifungal Susceptibility of Candida Bloodstream Isolates from Latin American Medical Centers
J. Fungi 2017, 3(2), 24; https://doi.org/10.3390/jof3020024
Received: 24 March 2017 / Revised: 12 May 2017 / Accepted: 12 May 2017 / Published: 17 May 2017
Cited by 3 | PDF Full-text (1231 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The epidemiology of candidemia varies geographically, and there is still scarce data on the epidemiology of candidemia in Latin America (LA). After extensive revision of medical literature, we found reliable and robust information on the microbiological aspects of candidemia in patients from 11
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The epidemiology of candidemia varies geographically, and there is still scarce data on the epidemiology of candidemia in Latin America (LA). After extensive revision of medical literature, we found reliable and robust information on the microbiological aspects of candidemia in patients from 11 out of 21 medical centers from LA countries and 1 out of 20 from Caribbean countries/territories. Based on 40 papers attending our search strategy, we noted that C. albicans remains the most common species causing candidemia in our region, followed by C. parapsilosis and C. tropicalis. In Argentina, Brazil, and Colombia, a trend towards an increase in frequency of C. glabrata candidemia was observed. Although resistance rates to fluconazole is under 3%, there was a slight increase in the resistance rates to C. albicans, C. parapsilosis and C. tropicalis isolates. Echinocandin resistance has been reported in a few surveys, but no single study confirmed the resistant phenotype reported by using molecular methods. We highlight the importance of conducting continuous surveillance studies to identify new trends in terms of species distribution of Candida and antifungal resistance related to episodes of candidemia in LA. This information is critical for helping clinicians to prevent and control Candida bloodstream infections in their medical centers. Full article
(This article belongs to the Special Issue Fungal Infections in the Developing World)
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Open AccessReview Cutaneous Disseminated and Extracutaneous Sporotrichosis: Current Status of a Complex Disease
J. Fungi 2017, 3(1), 6; https://doi.org/10.3390/jof3010006
Received: 1 December 2016 / Revised: 31 January 2017 / Accepted: 7 February 2017 / Published: 10 February 2017
Cited by 2 | PDF Full-text (1474 KB) | HTML Full-text | XML Full-text
Abstract
Sporotrichosis is an implantation or inoculation mycosis caused by species of Sporothrix schenckii complex; its main manifestations are limited to skin; however, cutaneous-disseminated, disseminated (visceral) and extracutaneous variants of sporotrichosis can be associated with immunosuppression, including HIV-AIDS, chronic alcoholism or more virulent strains.
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Sporotrichosis is an implantation or inoculation mycosis caused by species of Sporothrix schenckii complex; its main manifestations are limited to skin; however, cutaneous-disseminated, disseminated (visceral) and extracutaneous variants of sporotrichosis can be associated with immunosuppression, including HIV-AIDS, chronic alcoholism or more virulent strains. The most common extracutaneous form of sporotrichosis includes pulmonary, osteoarticular and meningeal. The laboratory diagnosis requires observing yeast forms and isolating the fungus; the two main causative agents are Sporothrix schenckii (ss) and Sporothrix brasiliensis. Antibody levels and species recognition by Polimerase Chain Reaction using biological samples or cultures are also useful. The treatment of choice for most cases is amphotericin B and subsequent itraconazole for maintenance therapy. Full article
(This article belongs to the Special Issue Fungal Infections in the Developing World)
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Open AccessReview Global Aspects of Triazole Resistance in Aspergillus fumigatus with Focus on Latin American Countries
J. Fungi 2017, 3(1), 5; https://doi.org/10.3390/jof3010005
Received: 25 November 2016 / Revised: 6 February 2017 / Accepted: 7 February 2017 / Published: 10 February 2017
Cited by 1 | PDF Full-text (363 KB) | HTML Full-text | XML Full-text
Abstract
Azole resistance in Aspergillus has emerged as an escalating problem in health care, and it has been detected in patients exposed, or not, to these drugs. It is known that azole antifungals are widely applied not only in clinical treatments for fungal infections,
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Azole resistance in Aspergillus has emerged as an escalating problem in health care, and it has been detected in patients exposed, or not, to these drugs. It is known that azole antifungals are widely applied not only in clinical treatments for fungal infections, but also as agricultural fungicides, resulting in a significant threat for human health. Although the number of cases of azole-resistant aspergillosis is still limited, various resistance mechanisms are described from clinical and environmental isolates. These mechanisms consist mainly of alterations in the target of azole action (CYP51A gene)—specifically on TR34/L98H and TR46/Y121F/T289A, which are responsible for over 90% of resistance cases. This review summarizes the epidemiology, management, and extension of azole resistance in A. fumigatus worldwide and its potential impact in Latin American countries, emphasizing its relevance to clinical practice. Full article
(This article belongs to the Special Issue Fungal Infections in the Developing World)
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Open AccessReview New Trends in Paracoccidioidomycosis Epidemiology
J. Fungi 2017, 3(1), 1; https://doi.org/10.3390/jof3010001
Received: 29 November 2016 / Revised: 22 December 2016 / Accepted: 28 December 2016 / Published: 3 January 2017
Cited by 9 | PDF Full-text (3867 KB) | HTML Full-text | XML Full-text
Abstract
Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America and more prevalent in South America. The disease is caused by the dimorphic fungus Paracoccidioides spp. whose major hosts are humans and armadillos. The fungus grows in soil and its infection is associated
[...] Read more.
Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America and more prevalent in South America. The disease is caused by the dimorphic fungus Paracoccidioides spp. whose major hosts are humans and armadillos. The fungus grows in soil and its infection is associated with exposure to the rural environment and to agricultural activities, with a higher risk in coffee and tobacco plantations. Population studies assessing the reactivity to Paracoccidioides spp. antigens by intradermal reaction or serological tests have detected previous subclinical infections in a significant proportion of healthy individuals living in various endemic countries. Paracoccidioidomycosis-disease is manifested by a small minority of infected individuals. The risk of developing the disease and its type of clinical form are related to the personal and life style characteristics of infected individuals, including genetic background, age, sex, ethnicity, smoking habit, alcohol drinking, and eventual cellular immunosuppression. Brazil, Colombia, Venezuela, Argentina, and Ecuador have endemic areas that had already been defined in the 20th century. The incidence of paracoccidioidomycosis can be altered by climate phenomena and mainly by human migration and occupation of poorly explored territories. In Brazil, the endemy tends to expand towards the North and Center-West around the Amazon Region. Full article
(This article belongs to the Special Issue Fungal Infections in the Developing World)
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Other

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Open AccessCommentary Preemptive Therapy for Cryptococcal Meningitis: A Valid Strategy for Latin America?
J. Fungi 2016, 2(2), 14; https://doi.org/10.3390/jof2020014
Received: 7 April 2016 / Revised: 11 May 2016 / Accepted: 16 May 2016 / Published: 23 May 2016
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Abstract
AIDS-related cryptococcal meningitis continues to cause a substantial burden of death in low and middle income countries. Better diagnostics allow detection of cryptococcosis in the asymptomatic phase and using these technologies to screen at-risk persons would likely reduce mortality. The World Health Organization
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AIDS-related cryptococcal meningitis continues to cause a substantial burden of death in low and middle income countries. Better diagnostics allow detection of cryptococcosis in the asymptomatic phase and using these technologies to screen at-risk persons would likely reduce mortality. The World Health Organization recommends cryptococcal antigen screening among populations with a prevalence of cryptococcal antigenaemia (CRAG) > 3%. There is scarce data about CRAG prevalence in Latin America. Four studies (only one published as a full text) showed asymptomatic CRAG prevalence between 2.7% and 6.2% in several sub-sets of HIV-infected patients. The CRAG lateral flow assay (LFA) has several advantages over other techniques for actual implementation of a screening program. Although more studies are necessary to confirm available data, implementation of the CRAG screening strategy seems to be opportune in Latin America. Full article
(This article belongs to the Special Issue Fungal Infections in the Developing World)
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