Search Results (656)

Candidemia is a major healthcare-associated bloodstream infection with high mortality, requiring ongoing surveillance to guide management. This retrospective study analyzed 306 candidemia episodes diagnosed between 2015 and 2024 at a Spanish tertiary-care hospital, comparing two periods (2015–2019 vs. 2020–2024). The overall incidence was 0.79 episodes per 1.000 admissions, with peaks in 2021 and 2024. Candida albicans was the most common species (44.8%), followed by Candida parapsilosis (19.0%) and Nakaseomyces glabrata (15.7%). A significant epidemiological shift occurred in the later period, with increased C. albicans, decreased C. parapsilosis, and emergence of N. glabrata as the second-most frequent species. ICU-related cases rose significantly during the COVID-19 period. Diagnostic turnaround times improved, including faster blood culture positivity and species identification by MALDI-TOF, supported by rapid PCR testing with high sensitivity (91.7%). Antifungal resistance to fluconazole was notable in N. glabrata (48.1%). Empirical echinocandin use increased, alongside greater targeted fluconazole therapy. Antimicrobial stewardship interventions, mainly de-escalation strategies, were widely implemented after 2019. Overall mortality was 40.8%, with a decline observed in 2023–2024. These findings suggest that integrated diagnostic and stewardship strategies may improve outcomes, though causal relationships require further study. Full article

Vulvovaginal candidiasis (VVC) is a common fungal infection among reproductive-age women and is increasingly challenged by the emergence of non-albicans Candida species and reduced azole susceptibility. This prospective cross-sectional study investigated 235 symptomatic reproductive-age women attending two healthcare facilities in Ho Chi Minh City, Vietnam, to determine VVC prevalence, Candida species distribution, pregnancy-associated patterns, antifungal susceptibility, and diagnostic performance. Vaginal swabs were cultured on Sabouraud Dextrose Agar and CHROMagar™ Candida, while species identification was confirmed by PCR-RFLP targeting the ITS region. Susceptibility to fluconazole and clotrimazole was assessed using the disk diffusion method. Candida spp. was detected in 55.7% of participants. C. albicans accounted for 50.3% of isolates, whereas non-albicans Candida species represented 49.7%, indicating a substantial species shift. VVC was more frequent among pregnant women, particularly in the third trimester. Most C. albicans, C. tropicalis, and C. parapsilosis isolates remained susceptible to azoles; however, C. glabrata showed markedly reduced susceptibility to fluconazole and clotrimazole. CHROMagar™ Candida reliably identified C. albicans but misclassified several non-albicans Candida isolates compared with PCR-RFLP. These findings highlight the need for routine species-level diagnosis, antifungal susceptibility testing, and strengthened VVC surveillance in reproductive and antenatal healthcare settings in Vietnam. Full article

Cryptococcosis is associated with negative serum (1→3)-β-D-glucan (BDG) results, but the clinical significance of serum BDG (sBDG) positivity is unclear. We characterized the clinical features of sBDG-positive cryptococcosis in patients with cryptococcal disease. We measured the sBDG levels and classified patients as BDG-positive (>11 pg/mL) or BDG-negative. Clinical characteristics, diagnostic modalities, antifungal treatment, post-treatment BDG level changes, and 90-day cryptococcosis-related mortality were compared. BDG-positive patients showed disseminated cryptococcosis, higher inflammatory marker levels, lower serum albumin levels, higher culture positivity rates, and higher cryptococcal antigen titers than BDG-negative patients. Combination antifungal therapy was administered more frequently in the BDG-positive group; repeat measurements in 15 patients showed a significant decrease in sBDG levels. The 90-day mortality rate was significantly higher in the BDG-positive than in the BDG-negative group (37.5% vs. 3.9%), and overall survival was significantly lower. sBDG levels may be elevated in cases of disseminated or severe disease. Serum BDG positivity may reflect a higher fungal burden, greater disease severity, and poorer short-term outcomes. Full article

Rapid and accurate diagnosis of infectious diseases in aquaculture is essential for preventing major economic and ecological losses. Traditional culture-based methods focus on isolation of individual pathogens, and often are burdened with extended processing times, particularly during investigations of polymicrobial infections. Application of Oxford Nanopore Technologies (ONT) sequencing offers a rapid, culture-independent workflow for the identification of bacterial and fungal pathogens directly from fish tissues. Swab and organ samples from four cases (1: Salmo spp.; 2: Cyprinus carpio; 3: Salvelinus fontinalis; 4: Heniochus acuminatus) were analyzed using ONT long-read sequencing for metagenomic screening and bioinformatic classification. The results revealed case-, species-, and tissue-specific microbial profiles, with external tissues showing higher microbial diversity and internal organs enriched in pathogenic taxa. Dominant pathogens included Streptococcus iniae, Aeromonas hydrophila, Pseudomonas spp., and Saprolegnia parasitica, alongside opportunistic zoonotic bacteria such as Escherichia coli and Acinetobacter baumannii. We demonstrate the potential for diagnostic application of ONT sequencing in investigations and detection of multi-pathogen infections, including assessments of microbial community structure changes during disease outbreaks in aquatic species. The presented workflow enables rapid, cost-effective, and comprehensive pathogen profiling, supporting early disease surveillance and improved management in aquatic veterinary practice. Full article

Background: The clinical burden of pulmonary diseases associated with the genus Aspergillus is increasing, although diagnostic focus remains largely on A. fumigatus. This study evaluated the diagnostic value of testing for A. flavus and A. niger-specific IgG in patients with chronic respiratory conditions. Methods: A retrospective study was conducted on 274 subjects (156 with chronic respiratory diseases, Bronchiectasis, Hypersensitivity Pneumonitis [HP], and Interstitial Lung Disease [ILD] non-HP, and 67 healthy controls). Cut-off values were established at the 97.5th percentile of the control group: 30 mg/L for A. fumigatus, 13 mg/L for A. flavus, and 8 mg/L for A. niger. Results: Among 109 patients who tested negative for A. fumigatus, 49.5% showed positivity to at least one other species, preventing a significant diagnostic gap in exposure detection. Notably, 40.4% of these patients exhibited simultaneous positivity for both A. flavus and A. niger. In the HP subgroup, 100% of patients who were A. fumigatus-positive also showed concurrent positivity to the two other species. Furthermore, the Bronchiectasis group showed the highest rate of isolated A. flavus at 11.8%. Conclusions: Testing solely for A. fumigatus IgG leads to substantial underestimation of Aspergillus exposure. Integrating A. flavus and A. niger into diagnostic panels is essential for a comprehensive immunological assessment of fungal interaction, particularly in HP and ILD, where identifying specific antigenic exposure is crucial for managing chronic inflammation and preventing disease progression. Full article

Autofluorescence of microorganisms has emerged as a potential tool in diagnostics. However, the temporal behaviour of fungal autofluorescence and its objective quantitative evaluation remain insufficiently characterised. The present in vitro study investigated the temporal dynamics of autofluorescence in 16 reference fungal strains under 405 nm laser excitation, with a particular focus on quantitative colour analysis. Standardised fungal suspensions were cultured on Sabouraud dextrose agar and imaged after 24–168 h of incubation. Fluorescence images were acquired during excitation with a 405 nm diode laser. The images were analysed in ImageJ using the HSV colour model, with the mean hue value of the colony used as the primary quantitative parameter. Multifactorial ANOVA demonstrated significant effects of fungal strain and strain × time interaction on hue values (p < 0.001), whereas time alone was not significant. Most strains exhibited a progressive decrease in mean hue during cultivation, although strain-specific temporal patterns were observed. Blastoschizomyces capitatus maintained a stable high mean hue throughout the observation, while Candida guilliermondii showed a marked increase after 168 h. These findings underline the strain- and time-dependent nature of fungal autofluorescence and the importance of standardised imaging conditions not only for its potential diagnostic application but also for its use as an experimental tool in studies of fungal metabolism or stress responses. Full article

Background Granulomatous lung diseases include a spectrum of disorders, both infectious and noninfectious, unified by the presence of granulomas in the lung parenchyma. Granulomas are microscopic, organized collections of immune cells that arise as a response to persistent antigenic stimulation. Infectious granulomatous lung diseases arise from a variety of microbial agents, that include most frequently Mycobacterium tuberculosis, non-tuberculous mycobacteria, Nocardia, and Borrelia, as well as a wide range of fungal pathogens including Histoplasma, Cryptococcus, Pneumocystis, and Aspergillus species. Methods and Results: Definitive diagnosis is achieved through direct identification and subsequent culture of the causative pathogen in appropriate clinical specimens, including sputum, bronchoscopic samples, gastric aspirates, or pleural fluid. Imaging is fundamental for the detection and characterization of pulmonary granulomas. HRCT allows precise assessment of the number, size, and distribution of granulomatous lesions, can suggest an infectious etiology based on specific imaging patterns, and is essential for monitoring response to therapy over time. Differential diagnosis is challenging due to the numerous different imaging appearances with whom granulomatous lung diseases may manifest. Conclusions: The purpose of our review is to describe the spectrum of infectious granulomatous lung diseases caused by bacterial pathogens, highlighting their diverse radiologic presentations in order to assist radiologists in recognizing these entities and improving diagnostic accuracy. Full article

Phaeohyphomycosis is an opportunistic fungal infection caused by dematiaceous fungi and is considered uncommon in dogs, particularly when associated with visceral or systemic involvement. Pulmonary disease as a primary site of infection is rarely reported in veterinary medicine and is often associated with an unfavorable outcome. This report describes a fatal case of pulmonary phaeohyphomycosis in a dog, characterized by severe granulomatous pneumonia, vascular invasion by pigmented fungal hyphae, and the development of large vessel thrombosis. Histopathological examination revealed septate, pigmented hyphae consistent with dematiaceous fungi associated with an intense granulomatous inflammatory response. Although molecular analysis by polymerase chain reaction was unsuccessful due to the absence of amplifiable DNA in archived FFPE tissue, the clinicopathological correlation and histopathological findings were sufficient to support a diagnosis consistent with phaeohyphomycosis. Severe pulmonary inflammation likely contributed to vascular endothelial injury, resulting in pulmonary hypertension and thrombosis of major veins. This case highlights the diagnostic and clinical challenges associated with phaeohyphomycosis in dogs and emphasizes the importance of considering this infection in the differential diagnosis of chronic or progressive respiratory diseases accompanied by systemic complications. Furthermore, it reinforces the relevance of histopathology and comprehensive clinicopathological evaluation when molecular confirmation of the etiological agent is not achievable. Full article

Exophiala endophthalmitis of exogenous origin is an exceptionally rare but severe ocular infection, characterized by diagnostic delays, limited therapeutic guidance, and frequently poor outcomes. Herein, we report one new case of an 80-year-old woman who presented with severe fungal keratitis progressing to endophthalmitis two years after an uncomplicated cataract surgery. The condition was initially misdiagnosed and treated with topical antibiotics and corticosteroids. By cultivation, microscopy, histopathological, and PCR analysis of the samples, Exophiala dermatitidis was identified as the causative agent. Despite targeted antifungal therapy with voriconazole, the disease rapidly progressed, resulting in corneal perforation and evisceration of the affected eye. The number of confirmed cases of this infection remains very limited. To address this gap, we conducted a structured review of all reported instances of exogenous Exophiala endophthalmitis, in which Exophiala dermatitidis emerged as the predominant causative species. Common predisposing factors included corneal barrier disruption, ocular surgery, diabetes mellitus, and corticosteroid use. Diagnostic confirmation was frequently delayed, and treatment outcomes varied. Amphotericin B-based regimens were associated with poor results, whereas voriconazole, particularly when combined with surgical intervention, demonstrated more favorable outcomes. Exogenous Exophiala endophthalmitis remains underrecognized, with limited evidence to guide management. This entity should be considered in postoperative or trauma-associated intraocular inflammation, and current evidence supports azole-based therapy combined with surgical intervention when indicated. Full article

Pneumocystis jirovecii is an opportunistic fungal pathogen responsible for Pneumocystis pneumonia (PCP), a severe infection that remains a major cause of morbidity and mortality among immunocompromised patients, particularly in non-HIV immunosuppressed populations. Despite its recognized clinical relevance and inclusion in the World Health Organization’s Fungal Priority Pathogens List, important gaps persist in its diagnosis, epidemiology, and therapeutic management. This study provides a comprehensive bibliometric analysis of global scientific production on P. jirovecii using Scopus as the primary data source. Publications were evaluated for temporal trends, document types, authorship patterns, institutional productivity, collaboration networks, funding sources, thematic evolution, and journal distribution, with additional comparison against other major pneumonia-associated pathogens. A total of 27,396 articles published between 1916 and 2025 were identified. Over the last 50 years, scientific output increased from 10,382 publications in 1975–2000 to 16,496 in 2001–2025, representing an overall growth of 58.9%. Early research expansion was strongly shaped by the HIV/AIDS epidemic, whereas the post-2000 period reflected advances in molecular diagnostics, taxonomic clarification, and broader attention to non-HIV immunosuppressed populations. Although the field has become more diversified and clinically integrated, persistent structural inequities and underinvestment continue to limit progress, particularly in low- and middle-income settings. Full article

The clinical cases described in this text add to the limited literature on chronic and allergic rhinosinusitis caused by dematiaceous fungi, particularly Curvularia spicifera. These cases highlight the growing recognition of fungal infections as a significant factor in the etiology of rhinosinusitis, a condition traditionally attributed to bacterial causes It has become evident that a comprehensive clinical approach, involving diagnostic imaging and laboratory examinations, particularly culture-based analysis, has been crucial in identifying the specific fungal pathogen responsible for the infection. Additionally, molecular biology techniques have proven indispensable in enhancing diagnostic accuracy and the understanding of such infections. Importantly, these types of infections are commonly observed in immunocompetent individuals, distinguishing them from other fungal infections that typically affect immunocompromised patients. This study underlines the importance of integrating microbiological findings with clinical, radiological, and histopathological data for the accurate diagnosis of non-invasive fungal rhinosinusitis, particularly given the lack of serological assays specific for this species. The available literature on these infections remains limited, and diagnosis continues to rely on an integrated multimodal approach. Full article

This study aimed to reveal the rhizosphere microbial community structure, carbon–nitrogen–phosphorus (C-N-P) nutrient cycling processes, and functional gene characteristics of Pinus massoniana and Schima superba in mixed forests. Furthermore, we sought to elucidate the microbial mechanisms by which mixed-species afforestation enhances soil quality improvement, providing a theoretical basis in soil microbiology for the cultivation of these mixed forests. The research subjects included pure P. massoniana plantations (CLPs), pure S. superba plantations (CLSs), and individual P. massoniana (HJP) and S. superba (HJS) trees within mixed plantations (HJLs). We collected rhizosphere and bulk soil samples to analyze their physicochemical properties and enzyme activities. Metagenomic sequencing was employed to profile the rhizosphere microbial communities and functional genes involved in C-N-P cycling. Furthermore, by integrating a functional gene co-occurrence network analysis with structural equation modeling (SEM), we systematically elucidated the coupling relationships among the stand types, soil properties, microbial communities, and nutrient cycling. Mixed planting significantly improved soil quality; compared to the CLP and CLS forests, the nitrate nitrogen (NO₃⁻-N) content in the mixed forest soils increased by 121.01% and 120.10% (p < 0.05), and the activity of urease (URE) also significantly increased by 123.99% and 49.56%, respectively. Mixing significantly altered the microbial community structure. In the bacterial community of the mixed forests, the abundance of nitrogen-fixing and potentially phosphorus-solubilizing bacteria from the genera Paraburkholderia and Burkholderia increased. In the fungal community, the arbuscular mycorrhizal fungus Rhizophagus, which possesses a nutrient absorption advantage, exhibited absolute dominance, with its relative abundance ranging from 14.84% to 88.81%. The abundances of genes associated with denitrification and phosphorus starvation regulation were significantly upregulated in the mixed forests; notably, the abundance of phosphorus starvation regulation genes in the HJSs was 18.84% higher than that in the CLSs. A co-occurrence network analysis demonstrated that the proportion of positive correlation edges in the HJP nitrogen cycling network reached as high as 75.0%, and the average degree of the HJS phosphorus cycling network (2.691) surpassed that of the CLSs. The structural equation modeling further revealed that the association strength between the fungi and phosphorus cycling genes in the mixed forests increased to R² = 0.915 (p < 0.01) from R² = 0.213 in the pure forests. This mixed planting practice transforms nutrient cycling from a resource-competitive mode to a microbially synergized mode, thereby forming an efficient endogenous nutrient cycling system. This synergistic rhizosphere microbial effect is a key internal mechanism for overcoming nutrient bottlenecks and should serve as a diagnostic indicator of soil recovery in the ecological restoration of degraded pine forests. Full article

Mucormycosis, triggered by fungi of the order Mucorales, represents a potentially fatal invasive mycosis, with death rates over 50% despite intensive therapy. The COVID-19 pandemic brought a sharp increase in cases, especially in individuals with diabetes mellitus and those undergoing immunosuppressive treatment, emphasizing significant gaps in our comprehension of disease pathogenesis. Emerging molecular studies have highlighted key virulence factors, such as the CotH family of invasins that facilitate endothelial invasion via interaction with glucose-regulated protein 78 (GRP78), complex iron acquisition systems necessary for fungal growth, and the release of mucoricin, a ricin-like toxin that impairs vascular integrity. Host defense depends mainly on innate immunity, with neutrophils and macrophages working as critical effector cells, while adaptive Th1 and Th17 responses aid in the fungal removal. Mucorales use a variety of immune evasion techniques, such as pathogen-associated molecular pattern (PAMP) masking via cell wall transformations, resistance to phagocytic death, and metabolic utilization of host factors including hyperglycemia and increased free iron in diabetic ketoacidosis (DKA). This review summarizes current evidence of the molecular processes underlying mucormycosis pathogenesis, underscoring host–pathogen interactions at the cellular and molecular levels, immune evasion tactics, and translational potential for new diagnostic and therapeutic approaches. Comprehending these molecular processes is crucial for creating efficient therapies against mucormycosis in an era of growing immunocompromised patients and expanding infectious disease synergies. Full article

Invasive fungal respiratory infections (IFRIs) remain a major cause of morbidity and mortality among immunocompromised patients, yet diagnosis continues to be hindered by nonspecific clinical features, limited sample accessibility, and the poor sensitivity or specificity of conventional tests. Microfluidic and microelectromechanical systems (MEMS)-based biosensing platforms have emerged as promising alternatives, enabling rapid, minimally invasive, and highly specific detection of fungal pathogens and host responses. Microfluidic nucleic acid and antigen assays allow on-chip amplification and immunodetection with reduced sample volumes and turnaround times, while CRISPR-enhanced systems further improve analytical sensitivity. Parallel advances in host response profiling—including transcriptomic, proteomic, and cytokine-based signatures—have demonstrated feasibility for integration into lab-on-a-chip platforms. MEMS-based technologies extend this potential by facilitating real-time analysis of exhaled volatile organic compounds, mechanical biosensing of fungal DNA and antigens, and in situ monitoring of device-associated biofilms. Translational studies highlight potential applications across intensive care, hematology–oncology, and transplant settings, as well as in outpatient monitoring of high-risk populations. However, several challenges remain, including limited multicenter validation, matrix-related biofouling effects, and a lack of standardization in fungal biomarker panels. Future directions include AI-driven interpretation of multianalyte data, multiplexed integration of host and pathogen markers, and development of fully cartridge-based systems for near-patient deployment. Collectively, these innovations may shift fungal diagnostics toward earlier, more precise, and patient-tailored interventions, improving outcomes in vulnerable populations. Full article

Talaromyces marneffei is a dimorphic fungal pathogen that can subvert host immune defenses; however, the molecular mechanisms underlying its interactions with host cells remain incompletely understood. Glutathione peroxidase from T. marneffei (TmGpx1) has previously been identified as an antigenic protein that elicits antibody responses in patients with talaromycosis. To elucidate the contribution of TmGpx1 during human–fungal pathogen interaction, the yeast two-hybrid system was performed using TmGpx1 as bait to screen a cDNA library derived from non-induced human macrophage cells. Sixteen candidate host protein partners were identified, with Gene Ontology analysis revealing their predominant association with cytoskeletal and extracellular exosome components. To examine the atomic-level structural interface and dynamic behavior of protein–protein interactions, we employed molecular dynamics (MD) simulations to investigate the interaction between TmGpx1 and FKBP15, a human protein involved in early endosomal regulation and associated with both microtubule and actin filaments. Per-residue decomposition analysis using gmx_MMPBSA identified LEU124 of TmGpx1 and ARG616 of FKBP15 as critical residues mediating the protein–protein interaction. Notably, the key residues of TmGpx1 are located toward the N-terminus and are mapped outside of the catalytic active site, suggesting that the interaction of TmGpx1 with host cytoskeletal components may occur independently of its enzymatic antioxidant activity. Overall, our findings provide novel insights into the repertoire of host cytoskeletal and membrane trafficking proteins that may be targeted for remodeling during T. marneffei infection. Elucidation of these molecular interactions advances our understanding of host–pathogen dynamics and opens new avenues for the development of targeted diagnostics and therapeutic strategies against talaromycosis. Full article