Journal of Fungi

Research

Jump to: Other

11 pages, 1048 KiB

Open AccessArticle

Superficial Candidiasis: Cluster Analysis of Species Distribution and Their Antifungal Susceptibility In Vitro

by Marina Ranđelović, Aleksandra Ignjatović, Milica Đorđević, Maša Golubović, Marko Stalević, Nataša Rančić and Suzana Otašević

J. Fungi 2025, 11(5), 338; https://doi.org/10.3390/jof11050338 - 25 Apr 2025

Viewed by 129

Abstract

Background: Superficial candidiasis (SC) is widespread in humans worldwide. This study aimed to evaluate species distribution patterns and antifungal susceptibility through cluster analysis. Methods: A total of 180 Candida strains isolated from skin and nail samples of 1593 examined patients with suspected superficial [...] Read more.

Background: Superficial candidiasis (SC) is widespread in humans worldwide. This study aimed to evaluate species distribution patterns and antifungal susceptibility through cluster analysis. Methods: A total of 180 Candida strains isolated from skin and nail samples of 1593 examined patients with suspected superficial fungal infection were identified by Matrix-assisted laser desorption in ionization-time of flight mass spectrometry (MALDI-TOF MS; Zybio EXS2600, China). Antifungal susceptibility was assessed using the commercial Integral System YEASTS Plus test (ISYPT; Liofilchem^®, Italy). Agglomerative hierarchical cluster analysis was used to analyze species distribution and susceptibility. Results: Candida parapsilosis (44.4%) and C. albicans (40%) were the most prevalent causative agents of SC. Cluster analysis established two defined clusters. Cluster 1 (121 isolates) showed a statistically significant difference compared to Cluster 2 (54 isolates) in species distribution (C. albicans was dominant in the first and C. parapsilosis in the second cluster) as well as in susceptibility to ECN (p ≤ 0.001), KCA (p = 0.030), CLO (p ≤ 0.001), MCZ (p ≤ 0.001), ITZ (p ≤ 0.001), and FLU (p ≤ 0.006). Conclusion: The fact that one-third of isolates exhibited low sensitivity to antifungals highlights the need for a new approach in SC treatment, emphasizing the importance of mycological analyses, including in vitro testing of antifungal effectiveness. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Superficial Fungal Infections)

► Show Figures

Figure 1

13 pages, 2960 KiB

Open AccessArticle

New Challenges in the Diagnosis and Treatment of Primary Cutaneous Aspergillosis in Extensive Pediatric Burns

by Doina Iulia Nacea, Dan Mircea Enescu, Raluca Tatar, Olguta Anca Orzan and Laura Sorina Diaconu

J. Fungi 2025, 11(4), 281; https://doi.org/10.3390/jof11040281 - 2 Apr 2025

Viewed by 303

Abstract

The aim of this study is to share our experience regarding the diagnosis and therapeutic management of primary cutaneous aspergillosis (PCA) in the burn patient, an uncommon infection associated with increased mortality, morbidity, and treatment costs. The uniqueness of this article is the [...] Read more.

The aim of this study is to share our experience regarding the diagnosis and therapeutic management of primary cutaneous aspergillosis (PCA) in the burn patient, an uncommon infection associated with increased mortality, morbidity, and treatment costs. The uniqueness of this article is the presence of PCA in pediatric patients where the Meek micrografting technique was used. We performed a retrospective study from June 2020 to November 2024. The inclusion criteria were the concomitant presence of burn injuries and confirmed PCA. We identified six patients, aged between 12 and 17 years, admitted with deep burns ranging from 55% to 90% of the total body surface area (TBSA). They required complex ICU treatment and underwent extensive excision–grafting surgeries. The suspicion of infection was raised by changes in the appearance of wounds. Systemic and topical antifungal treatment was established in patients after a PCA diagnosis. Five out of the six cases had a favorable outcome. The use of the Meek micrografting technique in burn treatment represents a new challenge in the treatment of PCA due to the polyamide gauze that covers the micrografts. Early detection and appropriate topical antifungal agents combined with systemic treatment may save the infected grafts and limit the infection spread without necessarily removing the polyamide gauze. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Superficial Fungal Infections)

► Show Figures

Figure 1

16 pages, 2777 KiB

Open AccessArticle

Etiological Agents and Predisposing Factors of Superficial Fungal Infections in Northeastern Argentina

by Ana Clara Almada, Beda Mereles-Rodríguez, Miriam Chade, Isabel Belinchón-Romero, Enrique-Jorge Deschutter and José-Manuel Ramos-Rincón

J. Fungi 2025, 11(4), 245; https://doi.org/10.3390/jof11040245 - 23 Mar 2025

Viewed by 289

Abstract

Superficial fungal infections (SFIs) account for approximately 2% of outpatient visits. Individual, environmental, and socioeconomic factors may increase susceptibility. The objective was to identify the etiological agents of SFIs and the predisposing factors. A cross-sectional descriptive study was conducted on patients attending the [...] Read more.

Superficial fungal infections (SFIs) account for approximately 2% of outpatient visits. Individual, environmental, and socioeconomic factors may increase susceptibility. The objective was to identify the etiological agents of SFIs and the predisposing factors. A cross-sectional descriptive study was conducted on patients attending the Level I Hospital in Puerto Piray, Misiones Province, Argentina, during a community intervention between 2022 and 2023. Statistical analysis was performed on the studied variables and their association with the identified etiological agents. A total of 138 clinical samples were collected from 107 patients with lesions suggestive of SFIs. Of the samples studied, 37% had an identified etiological agent. The majority were women (65%), those aged over 45 years (29%), and patients with underlying conditions (50%). A lack of access to sewage systems (100%) and potable water (19%) and overcrowding (19%) were observed. Dermatophytes (46%) were the most frequent etiological agents, with Trichophyton tonsurans being the primary species. An association was found between dermatophytosis and male sex (odds ratio [OR]: 4.4), ages 1–14 years (OR: 8.04), and overcrowding (OR: 5.38). In conclusion, the prevalence of SFIs was high in the studied population. The main etiological agents involved were anthropophilic dermatophyte fungi. Socioenvironmental conditions may contribute to the incidence of these pathologies. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Superficial Fungal Infections)

► Show Figures

Figure 1

9 pages, 451 KiB

Open AccessCommunication

Advancing Dermatomycosis Diagnosis: Evaluating a Microarray-Based Platform for Rapid and Accurate Fungal Detection—A Pilot Study

by Vittorio Ivagnes, Elena De Carolis, Carlotta Magrì, Riccardo Torelli, Brunella Posteraro and Maurizio Sanguinetti

J. Fungi 2025, 11(3), 234; https://doi.org/10.3390/jof11030234 - 19 Mar 2025

Viewed by 272

Abstract

Dermatomycosis, including the most prevalent onychomycosis, significantly impacts patients’ quality of life due to its chronic nature and high recurrence rate. Conventional diagnostic methods are often limited by low sensitivity and specificity and prolonged turnaround times. This study evaluates the EUROArray Dermatomycosis Platform, [...] Read more.

Dermatomycosis, including the most prevalent onychomycosis, significantly impacts patients’ quality of life due to its chronic nature and high recurrence rate. Conventional diagnostic methods are often limited by low sensitivity and specificity and prolonged turnaround times. This study evaluates the EUROArray Dermatomycosis Platform, a microarray-based molecular assay, for its performance in identifying fungi causing dermatomycosis. Forty reference fungal strains, covering on-panel and off-panel species, and 120 clinical samples from patients with suspected dermatomycosis were analyzed. The platform’s accuracy was compared to microscopy and/or culture as the diagnostic standard. The assay demonstrated 100% analytical sensitivity and 97.1% analytical specificity, correctly identifying 33 of 34 fungal species while misclassifying one. In clinical samples, the assay showed good sensitivity (78.6%) and high specificity (91.7%), detecting additional positive cases missed by culture, which highlights the assay’s ability to identify non-viable fungi and low fungal loads. The assay achieved a positive predictive value of 75.9% and a negative predictive value of 92.8%, reinforcing its diagnostic reliability. Despite some discordances, the assay provides rapid results and broad-spectrum fungal detection, positioning it as a valuable complement to conventional diagnostics. Future improvements, including expanding the identification panel and optimizing sample handling, could further enhance its clinical utility. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Superficial Fungal Infections)

► Show Figures

Figure 1

13 pages, 4444 KiB

Open AccessArticle

Amphotericin B Ocular Films for Fungal Keratitis and a Novel 3D-Printed Microfluidic Ocular Lens Infection Model

by Chrysi Rapti, Francis C. Luciano, Brayan J. Anaya, Bianca I. Ramirez, Baris Ongoren, María Auxiliadora Dea-Ayuela, Aikaterini Lalatsa and Dolores R. Serrano

J. Fungi 2024, 10(11), 762; https://doi.org/10.3390/jof10110762 - 2 Nov 2024

Cited by 2 | Viewed by 1460

Abstract

Fungal keratitis (FK), a severe eye infection that leads to vision impairment and blindness, poses a high risk to contact lens users, and Candida albicans remains the most common underpinning fungal pathogen in temperate climates. Patients are initially treated empirically (econazole 1% drops [...] Read more.

Fungal keratitis (FK), a severe eye infection that leads to vision impairment and blindness, poses a high risk to contact lens users, and Candida albicans remains the most common underpinning fungal pathogen in temperate climates. Patients are initially treated empirically (econazole 1% drops hourly for 24–48 h), and if there is no response, amphotericin B (AmB) 0.15% eye drops (extemporaneously manufactured to be stable for a week) are the gold-standard treatment. Here, we aim to develop a sustained-release AmB ocular film to treat FK with an enhanced corneal retention time. As there is a paucity of reliable in vitro models to evaluate ocular drug release and antifungal efficacy under flow, we developed a 3D-printed microfluidic device based on four chambers stacked in parallel, in which lenses previously inoculated with a C. albicans suspension were placed. Under the flow of a physiological fluid over 24 h, the release from the AmB-loaded film that was placed dry onto the surface of the wetted contact lenses was quantified, and their antifungal activity was assessed. AmB sodium deoxycholate micelle (dimeric form) was mixed with sodium alginate and hyaluronic acid (3:1 w/w) and cast into films (0.48 or 2.4%), which showed sustained release over 24 h and resulted in a 1.23-fold reduction and a 5.7-fold reduction in CFU/mL of C. albicans, respectively. This study demonstrates that the sustained delivery of dimeric AmB can be used for the treatment of FK and provides a facile in vitro microfluidic model for the development and testing of ophthalmic antimicrobial therapies. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Superficial Fungal Infections)

► Show Figures

Figure 1

11 pages, 523 KiB

Open AccessArticle

Fungal Keratitis in Northwestern Spain: Epidemiology, Risk Factors and Outcomes

by David Lamas-Francis, Daniel Navarro, Raquel Mansilla, Victoria de-Rojas, Claudio Moreno, Enrique Dios, Jesús Rigueiro, Dolores Álvarez, Paloma Crego, Teresa Rodríguez-Ares and Rosario Touriño

J. Fungi 2024, 10(10), 689; https://doi.org/10.3390/jof10100689 - 1 Oct 2024

Cited by 1 | Viewed by 1183

Abstract

Purpose: To review the clinical features, risk factors, microbiological profile, and treatment regimens of fungal keratitis in Galicia, a region in Northwestern Spain with temperate humid weather. Patients and methods: A retrospective case series was employed, including patients with fungal keratitis from nine [...] Read more.

Purpose: To review the clinical features, risk factors, microbiological profile, and treatment regimens of fungal keratitis in Galicia, a region in Northwestern Spain with temperate humid weather. Patients and methods: A retrospective case series was employed, including patients with fungal keratitis from nine hospitals within the region of Galicia, Spain, between 2010 and 2020. Data obtained from clinical records were analysed. Results: Out of 654 cases of infectious keratitis, 77 cases (9.9%) were identified as fungal keratitis. The median age of affected patients was 68.0 years, with a higher incidence in rural areas (62.3%). Candida spp. infections were the most frequent type (55.8%) and were associated with a higher median age than were the non-dermatophyte mould infections. The primary risk factors included steroid eyedrop use (29.9%), recent keratoplasty (18.2%), ocular trauma (19.5%), and contact with vegetable matter (11.7%). Most ulcers displayed stromal involvement, and 37.7% presented corneal thinning. The median duration of infection was longer in fungal than in bacterial keratitis, and surgical intervention was required in 48.1% of cases. Conclusions: Fungal keratitis, mainly involving Candida spp., accounted for 9.9% of microbial keratitis cases in Galicia, Spain, with significant risk factors being topical steroid use, ocular trauma, and contact with vegetable matter. Delayed diagnosis often resulted in poor outcomes, highlighting the need for early detection through awareness and new technologies to improve prognosis. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Superficial Fungal Infections)

► Show Figures

Figure 1

Other

Jump to: Research

6 pages, 416 KiB

Open AccessBrief Report

Evaluation of the DendrisKIT^®DP for the Diagnosis of Superficial Fungal Infections

by Pauline Tirard-Collet, François Durupt, Marion Hérault, Charline Miossec, Jean-Philippe Lemoine, Martine Wallon, Damien Dupont, Florence Persat and Jean Menotti

J. Fungi 2025, 11(4), 269; https://doi.org/10.3390/jof11040269 - 1 Apr 2025

Viewed by 214

Abstract

Conventional diagnosis of fungal infections of the skin, nail, and hair requires both expertise in mycology and prolonged cultures. We evaluated a new molecular tool based on an innovative technology, the DendrisKIT^®DP, combining a pan-fungal PCR, a DNA chip and a [...] Read more.

Conventional diagnosis of fungal infections of the skin, nail, and hair requires both expertise in mycology and prolonged cultures. We evaluated a new molecular tool based on an innovative technology, the DendrisKIT^®DP, combining a pan-fungal PCR, a DNA chip and a decision algorithm using machine learning, for the diagnosis of superficial fungal infections directly from clinical samples. It enables the simultaneous detection of Candida albicans and twelve dermatophytes, providing faster results than conventional techniques. Among 85 clinical samples (50 skin scrapings, 29 nail specimens, and 6 hair specimens) routinely tested by microscopic examination and cultures that were retrospectively tested by the DendrisKIT^®DP, we found a sensitivity of 83.9% and a specificity of 88.9%. This performance appeared satisfactory compared to microscopy and culture, and results were achieved much faster than with cultures, saving time for patient management. Moreover, thanks to the continuous improvement in the identification algorithm due to enriching the database, its performance is likely to be further enhanced. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Superficial Fungal Infections)

► Show Figures

Figure 1

9 pages, 19776 KiB

Open AccessCase Report

Dermoscopy and Ultraviolet-Enhanced Fluorescence Dermoscopy (UEFD) Increase the Accuracy of Diagnosis and Are Useful in Assessing the Effectiveness of Kerion celsi Treatment

by Justyna Putek, Danuta Nowicka and Alina Jankowska-Konsur

J. Fungi 2025, 11(1), 52; https://doi.org/10.3390/jof11010052 - 9 Jan 2025

Viewed by 883

Abstract

Microsporum canis, a zoophilic dermatophyte, infects the stratum corneum and keratinized tissues like hair and nails in cats and dogs, with cats serving as the primary reservoir. Most human infections arise from animal contact. We present the case of a girl aged [...] Read more.

Microsporum canis, a zoophilic dermatophyte, infects the stratum corneum and keratinized tissues like hair and nails in cats and dogs, with cats serving as the primary reservoir. Most human infections arise from animal contact. We present the case of a girl aged 8 with skin scalp lesions persisting for two months. Several scalp lesions, with a maximum diameter of 4 cm, presented as erythematous plaques with superficial scaling, yellow crusts, and edematous areas with purulent exudate. Dermoscopy revealed yellow crusts on an erythematous background, along with white scales, pustules, broken hairs, and comma hairs. Ultraviolent-enhanced fluorescence dermoscopy (UEFD) showed slight celadon green fluorescence, which enhanced the diagnosis and further helped to monitor the treatment. The PCR test confirmed the presence of M. canis. Treatment included topical ciclopirox and oral terbinafine. Lesions on the scalp and noticeable hair regrowth were observed in the areas of hair loss after two months. Kerion celsi can result in severe alopecia. To prevent scarring associated with hair loss in children, early mycological diagnostics, supported by dermoscopy and UEFD, is recommended. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Superficial Fungal Infections)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Diagnosis and Treatment of Superficial Fungal Infections

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (8 papers)

Research

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI