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Diversity, Pathogenicity and Drug Resistance of Medically Important Fungi
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Diversity, Pathogenicity and Drug Resistance of Medically Important Fungi

A special issue of Journal of Fungi (ISSN 2309-608X). This special issue belongs to the section "Fungal Pathogenesis and Disease Control".

Deadline for manuscript submissions: closed (10 September 2023) | Viewed by 13452

Special Issue Editor

Prof. Dr. Richard D. Cannon

E-Mail Website
Guest Editor
Sir John Walsh Research Institute, University of Otago Faculty of Dentistry, P.O. Box 56, Dunedin 9054, New Zealand
Interests: oral microbiology; antifungal drug resistance; antifungal drug discovery; oral adhesion; Candida albicans
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Many fungi are opportunistic pathogens that cause infections when host defences are impaired. There are an increasing number of ways in which people are becoming immunocompromised. Medical treatments for cancer, immunosuppression for organ transplantation, the deterioration of immune defences due to ageing and stress on the immune system from other microbial infections, including COVID-19, can all have an effect on fungal infections. Therefore, it is important to have up-to-date information on the diversity of fungi causing infections in humans. While the pathogenicity of certain fungi has been extensively studied, there is a need to understand the pathogenesis of emerging fungal infections. Understanding how fungi cause disease and interact with host defences can inform the development of new drugs and novel treatment or prophylaxis as well as strategies. With the limited antifungal armamentarium currently available, understanding trends in the prevalence and nature of antifungal drug resistance is paramount. This Special Issue will collate important reports and reviews on the diversity of fungi currently causing fungal infections in humans, their pathogenicity, drug susceptibility and mechanisms of drug resistance.

Prof. Dr. Richard D. Cannon
Guest Editor

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Keywords

  • emerging fungal diseases
  • fungal diversity
  • fungal disease prevalence
  • pathogenesis
  • fungal drug resistance

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Published Papers (6 papers)

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Research

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11 pages, 2181 KiB  
Article
First Confirmed Description of Acremonium egyptiacum from Greece and Molecular Identification of Acremonium and Acremonium-like Clinical Isolates
by Michael Arabatzis, Philoktitis Abel, Eleni Sotiriou and Aristea Velegraki
J. Fungi 2024, 10(9), 664; https://doi.org/10.3390/jof10090664 - 21 Sep 2024
Viewed by 837
Abstract
Acremonium and the recently separated acremonium-like genera, such as Sarocladium, are emerging causes of opportunistic disease in humans, mainly post-traumatic infections in immunocompetent hosts, but also invasive infections in immunocompromised patients, such as those undergoing transplantation. Acremonium egyptiacum has emerged as the [...] Read more.
Acremonium and the recently separated acremonium-like genera, such as Sarocladium, are emerging causes of opportunistic disease in humans, mainly post-traumatic infections in immunocompetent hosts, but also invasive infections in immunocompromised patients, such as those undergoing transplantation. Acremonium egyptiacum has emerged as the major pathogenic Acremonium species in humans, implicated mainly in nail but also in disseminated and organ specific infections. In this first study of acremonium-like clinical isolates in Greece, 34 isolates were identified and typed by sequencing the internal transcribed spacer, and their antifungal susceptibility was determined by a modified CLSI standard M38 3rd Edition method for filamentous fungi. A. egyptiacum was the primary species (18 isolates) followed by Sarocladium kiliense (8), Acremonium charticola, Gliomastix polychroma, Proxiovicillium blochii, Sarocladium terricola, Sarocladium zeae, and Stanjemonium dichromosporum (all with one isolate). Two isolates, each with a novel ITS sequence, possibly represent undescribed species with an affinity to Emericellopsis. All three A. egyptiacum ITS barcode types described to date were identified, with 3 being the major type. Flutrimazole, lanoconazole, and luliconazole presented the lower minimum inhibitory concentration (MIC) values against A. egyptiacum, with a geometric mean (GM) MIC of 2.50, 1.92, and 1.57 μg/mL, respectively. Amphotericin B, itraconazole, posaconazole, voriconazole, terbinafine, amorolfine, and griseofulvin MICs were overall high (GM 12.79–29.49 μg/mL). An analysis of variance performed on absolute values showed that flutrimazole, lanoconazole, and luliconazole were equivalent and notably lower than those of all the other drugs tested against A. egyptiacum. Antifungal susceptibility of the three different A. egyptiacum genotypes was homogeneous. Overall, the high MICs recorded for all systemically administered drugs, and for some topical antifungals against the tested A. egyptiacum and other acremonium-like clinical isolates, justify the routine susceptibility testing of clinical isolates. Full article
(This article belongs to the Special Issue Diversity, Pathogenicity and Drug Resistance of Medically Important Fungi)
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15 pages, 1350 KiB  
Article
Surveillance of Amphotericin B and Azole Resistance in Aspergillus Isolated from Patients in a Tertiary Teaching Hospital
by Lívia Maria Maciel da Fonseca, Vanessa Fávaro Braga, Ludmilla Tonani, Patrícia Helena Grizante Barião, Erika Nascimento, Roberto Martinez and Marcia Regina von Zeska Kress
J. Fungi 2023, 9(11), 1070; https://doi.org/10.3390/jof9111070 - 1 Nov 2023
Cited by 3 | Viewed by 1715
Abstract
The genus Aspergillus harbors human infection-causing pathogens and is involved in the complex one-health challenge of antifungal resistance. Here, a 6-year retrospective study was conducted with Aspergillus spp. isolated from patients with invasive, chronic, and clinically suspected aspergillosis in a tertiary teaching hospital. [...] Read more.
The genus Aspergillus harbors human infection-causing pathogens and is involved in the complex one-health challenge of antifungal resistance. Here, a 6-year retrospective study was conducted with Aspergillus spp. isolated from patients with invasive, chronic, and clinically suspected aspergillosis in a tertiary teaching hospital. A total of 64 Aspergillus spp. clinical isolates were investigated regarding molecular identification, biofilm, virulence in Galleria mellonella, antifungal susceptibility, and resistance to amphotericin B and azoles. Aspergillus section Fumigati (A. fumigatus sensu stricto, 62.5%) and section Flavi (A. flavus, 20.3%; A. parasiticus, 14%; and A. tamarii, 3.1%) have been identified. Aspergillus section Flavi clinical isolates were more virulent than section Fumigati clinical isolates. Furthermore, scant evidence supports a link between biofilm formation and virulence. The susceptibility of the Aspergillus spp. clinical isolates to itraconazole, posaconazole, voriconazole, and amphotericin B was evaluated. Most Aspergillus spp. clinical isolates (67.2%) had an AMB MIC value equal to or above 2 µg/mL, warning of a higher probability of therapeutic failure in the region under study. In general, the triazoles presented MIC values above the epidemiological cutoff value. The high triazole MIC values of A. fumigatus s.s. clinical isolates were investigated by sequencing the promoter region and cyp51A locus. The Cyp51A amino acid substitutions F46Y, M172V, N248T, N248K, D255E, and E427K were globally detected in 47.5% of A. fumigatus s.s. clinical isolates, and most of them are associated with high triazole MICs. Even so, the findings support voriconazole or itraconazole as the first therapeutic choice for treating Aspergillus infections. This study emphasizes the significance of continued surveillance of Aspergillus spp. infections to help overcome the gap in knowledge of the global fungal burden of infections and antifungal resistance, supporting public health initiatives. Full article
(This article belongs to the Special Issue Diversity, Pathogenicity and Drug Resistance of Medically Important Fungi)
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14 pages, 4611 KiB  
Article
Trends in the Epidemiological and Clinical Profile of Paracoccidioidomycosis in the Endemic Area of Rio de Janeiro, Brazil
by Eduardo Mastrangelo Marinho Falcão, Dayvison Francis Saraiva Freitas, Ziadir Francisco Coutinho, Leonardo Pereira Quintella, Mauro de Medeiros Muniz, Rodrigo Almeida-Paes, Rosely Maria Zancopé-Oliveira, Priscila Marques de Macedo and Antonio Carlos Francesconi do Valle
J. Fungi 2023, 9(9), 946; https://doi.org/10.3390/jof9090946 - 20 Sep 2023
Cited by 6 | Viewed by 1300
Abstract
Paracoccidioidomycosis (PCM) is a neglected endemic mycosis in Latin America. Most cases occur in Brazil. It is classified as PCM infection and PCM disease and is subdivided into chronic (adult type) or acute (juvenile type) disease, with the latter being less frequent and [...] Read more.
Paracoccidioidomycosis (PCM) is a neglected endemic mycosis in Latin America. Most cases occur in Brazil. It is classified as PCM infection and PCM disease and is subdivided into chronic (adult type) or acute (juvenile type) disease, with the latter being less frequent and more severe. In 2016, we reported an increase in the numbers of patients diagnosed with acute PCM after a highway’s construction. We conducted a study at INI-Fiocruz, a reference center for infectious diseases, including endemic mycoses, in Rio de Janeiro, Brazil, aiming to deepen the analysis of this new clinical and epidemiological profile of PCM. The authors developed a retrospective study including 170 patients diagnosed with PCM between 2010 and 2019. There was an increase in the number of atypical and severe forms, starting in 2014. In subsequent years, we detected a higher incidence of adverse outcomes with patients requiring more hospitalizations and an increased mortality rate. We estimate that PCM has become more severe throughout the Rio de Janeiro state, affecting a greater number of young individuals and leading to a greater number of and longer hospitalizations. Surveillance measures and close monitoring of future notification data in the state, with emphasis on children, adolescents, and young adults are necessary for a better understanding of the perpetuation of this public health challenge. Full article
(This article belongs to the Special Issue Diversity, Pathogenicity and Drug Resistance of Medically Important Fungi)
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11 pages, 1601 KiB  
Article
Fast and Accurate Identification of Candida auris by High Resolution Mass Spectrometry
by Azadeh Jamalian, Joanna Freeke, Anuradha Chowdhary, G. Sybren de Hoog, J. Benjamin Stielow and Jacques F. Meis
J. Fungi 2023, 9(2), 267; https://doi.org/10.3390/jof9020267 - 16 Feb 2023
Cited by 3 | Viewed by 2793
Abstract
The emerging pathogen Candida auris has been associated with nosocomial outbreaks on six continents. Genetic analysis indicates simultaneous and independent emergence of separate clades of the species in different geographical locations. Both invasive infection and colonization have been observed, warranting attention due to [...] Read more.
The emerging pathogen Candida auris has been associated with nosocomial outbreaks on six continents. Genetic analysis indicates simultaneous and independent emergence of separate clades of the species in different geographical locations. Both invasive infection and colonization have been observed, warranting attention due to variable antifungal resistance profiles and hospital transmission. MALDI-TOF based identification methods have become routine in hospitals and research institutes. However, identification of the newly emerging lineages of C. auris yet remains a diagnostic challenge. In this study an innovative liquid chromatography (LC)—high resolution OrbitrapTM mass spectrometry method was used for identification of C. auris from axenic microbial cultures. A set of 102 strains from all five clades and different body locations were investigated. The results revealed correct identification of all C. auris strains within the sample cohort, with an identification accuracy of 99.6% from plate culture, in a time-efficient manner. Furthermore, application of the applied mass spectrometry technology provided the species identification down to clade level, thus potentially providing the possibility for epidemiological surveillance to track pathogen spread. Identification beyond species level is required specially to differentiate between nosocomial transmission and repeated introduction to a hospital. Full article
(This article belongs to the Special Issue Diversity, Pathogenicity and Drug Resistance of Medically Important Fungi)
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11 pages, 2222 KiB  
Article
What Is Hiding in the Israeli Mediterranean Seawater and Beach Sand
by Michael Frenkel, Hanan Serhan, Shlomo E. Blum, Marcelo Fleker, Edward Sionov, Sharon Amit, Zeela Gazit, Shiraz Gefen-Halevi and Esther Segal
J. Fungi 2022, 8(9), 950; https://doi.org/10.3390/jof8090950 - 10 Sep 2022
Cited by 5 | Viewed by 2272
Abstract
Objective: In the present study, we aimed to investigate the presence of fungi that may affect human health in sand and water on Israeli Mediterranean Sea coast beaches. Methods: The study included screening of the sand and water of six urban beaches from [...] Read more.
Objective: In the present study, we aimed to investigate the presence of fungi that may affect human health in sand and water on Israeli Mediterranean Sea coast beaches. Methods: The study included screening of the sand and water of six urban beaches from north to south on the Israeli Mediterranean coast. Sand samples were extracted with water, and the water wash was cultured and quantitated. Water samples were quantitated as well. MALDI-TOF MS analysis and ITS sequencing identified the fungi. Results: The study considered several parameters: 1. Presence of fecal-contamination-related fungi; 2. Presence of dermal-infection-related fungi. 3. Presence of allergy-related fungi; 4. Presence of fungi posing risk for immunocompromised individuals. The screen revealed that about 80% of the isolates were molds and about 20% yeasts. The mold species included opportunistic pathogens and potential allergens: Aspergillus fumigatus and other Aspergillus species, Fusarium, Penicillium, and Mucorales species. Yeast isolates included Candida—including the human commensals Candida albicans and Candida tropicalis—Cryptococcus, and Rhodotorula species. Conclusions: The results suggest that beaches should be monitored for fungi for safer use, better management, and the benefit of public health. Full article
(This article belongs to the Special Issue Diversity, Pathogenicity and Drug Resistance of Medically Important Fungi)
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Review

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16 pages, 4309 KiB  
Review
Oral Manifestations of Mucormycosis: A Systematic Review
by Alejandro Mora-Martínez, Laura Murcia and Francisco Javier Rodríguez-Lozano
J. Fungi 2023, 9(9), 935; https://doi.org/10.3390/jof9090935 - 16 Sep 2023
Cited by 4 | Viewed by 3663
Abstract
Mucormycosis is a rare, opportunistic, and emerging fungal infection that can rapidly develop into a severe, highly fatal clinical picture. In most cases, it is caused by fungi of the order Mucorales, which are usually avirulent but become pathogenic when the host’s immune [...] Read more.
Mucormycosis is a rare, opportunistic, and emerging fungal infection that can rapidly develop into a severe, highly fatal clinical picture. In most cases, it is caused by fungi of the order Mucorales, which are usually avirulent but become pathogenic when the host’s immune system is compromised. This systematic review was conducted according to PRISMA guidelines. The databases searched included PubMed, Scopus, and Web of Science. We chose articles that analyzed the oral manifestations of patients with mucormycosis, were published between 2018 and 2023, and met our search terms. The risk of bias in the articles was assessed using the CARE guideline for case reports and STROBE for a cross-sectional study. After the selection process, 20 articles were included in this review, all containing information about the different oral manifestations presented by people with mucormycosis. The most common oral manifestations are mainly bone exposures and oral ulcers, halitosis, pus discharge, gingival thickening, and periodontitis. However, despite the importance of recognizing these oral manifestations in the early stages of mucormycotic infection, providing early treatment, and reducing the high mortality rate of the infection, more studies are needed. Full article
(This article belongs to the Special Issue Diversity, Pathogenicity and Drug Resistance of Medically Important Fungi)
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