Search Results (513)

The risk of healthcare associated infections (HAIs) among hospitalized patients increased with the severity of COVID-19 disease and duration of hospitalization, especially in intensive care units (ICUs). This study retrospectively investigated HAI trends between March 2020 and December 2022 in patients with a COVID-19 diagnosis admitted to the exclusive ICU for the management of severe COVID-19 patients in the Molise region, central Italy. The clinical records of patients were anonymously coded and examined for the number of HAIs and microbiological isolations. Only infections that occurred after 48 h of ICU admission were included for descriptive, univariate and multivariate statistical analysis. Over the three-year period, 185 patients with a COVID-19 diagnosis (69.7% male, mean age 66.1 ± 10.6 years) were admitted to the hospital ICU: 50 (27.0%) in 2020, 94 (50.8%) in 2021, and 41 (22.2%) in 2022. During ICU stays, a high proportion of patients required at least one invasive device and died (97.2% and 88.1%, respectively). Death outcome was significantly associated with pre-existing comorbidities and related treatment, sex, and devices. During ICU stays, 80% received antimicrobial therapy, which was further related to death. At least one microbiological HAI was detected in 103 (55.9%) patients (76.6% male, mean age 65.4 ± 9.6 years). HAI incidence differed by year (p < 0.001), occurring in 36 (35.0%) patients in 2020, 54 (52.4%) in 2021, and 13 (12.6%) in 2022, respectively, and 80.6%, 96.0%, and 92.3% of patients died. A total of 268 isolations were observed: 99 (36.9%), 139 (51.9%) and 30 (11.2) in 2020, 2021 and 2022, respectively, and were mostly fungi in 2020 and 2022 (46.5% and 36.7%, respectively), while Gram-negative bacteria predominated in 2021 (36.7%). The study revealed higher HAI rates among patients in 2021 according to the increasing number of COVID-19 cases and related hospitalizations due to the Alpha variant at the local level, but also reflected the national epidemiology, while the decline in 2022 could be likely associated with the pandemic evolution and improvements in the management of COVID-19 patients. These findings further underline a high rate of lethality, more likely attributed to severe COVID-19 in patients with advanced age and underlying diseases, to which HAI onset could have undoubtedly contributed. The study provides useful epidemiological data regarding HAIs among critically ill COVID-19 patients during different phases of the pandemic across three years. Full article

Anoplophora glabripennis (ALB) is an invasive wood-boring cerambycid that causes extensive damage to hardwood host trees through sequential tissue penetration from the bark to the sapwood. Developmental biology of ALB is well established. However, interactions among its life cycle, environmental contaminants, and fungal associates remain poorly understood. In particular, the ecological relationships among microplastics, entomopathogenic fungi, and the fungal symbiont Fusarium solani (FSSC) within ALB-associated woody tissues remain largely uncharacterized. This review develops a conceptual anatomical framework integrating ALB developmental biology, fungal associations, frass deposition pathways, and potential microplastic interactions within woody host tissues. The framework was constructed through ecological literature synthesis and anatomical reconstruction. To our knowledge, this represents the first conceptual framework integrating ALB developmental anatomy, fungal symbiosis, and potential microplastic interactions within host tree gallery systems. A longitudinal cross-sectional model was developed to illustrate oviposition, larval gallery formation, pupation, and adult emergence in relation to the outer bark, cambium/phloem, sapwood, and heartwood. FSSC isolates previously documented on ALB egg surfaces following oviposition and within ALB frass were examined, thereby positioning the fungal symbiont both within and outside galleries produced by ALB throughout its life cycle. Previous studies have demonstrated that microplastics can be taken up by plant stem tissues and accumulate on the forest floor through atmospheric deposition. This widespread presence suggests that micro- and nanoplastics may penetrate sapwood and heartwood galleries through xylem and phloem flow. These transport pathways may overlap with regions where late-instar larvae actively forage. The integrative framework presented here highlights potential ecological interactions within the gallery microhabitat and provides a foundation for future experimental investigations into contaminant–pathogen–host dynamics in xylophagous insects. While we refrain from proposing specific management strategies, we present a conceptual framework to elucidate how microplastics may serve as incidental contact points for cerambycid anatomy and fungal propagules. We hypothesize that these interactions link microplastic pollution to invertebrate ecology. Microplastics may function as substrates for fungal spores within forest canopies and gallery systems, potentially influencing fungal persistence, contaminant transport, and ecological dynamics within infested forest habitats. Full article

Diagnostic failure in invasive fungal infections (IFIs) remains a relevant and underrecognized cause of mortality, morbidity, delayed therapy, unnecessary antifungal exposure, and pharmacological selective pressure. Although major advances have been achieved in biomarkers, rapid diagnostic tests, molecular methods, imaging studies, and microbiological identification, timely diagnosis continues to be influenced by the interaction among host factors, pathogen-related factors, diagnostic tools, and healthcare system–related factors. This narrative review analyzes diagnostic failure in IFIs as a dynamic process that includes delayed, incorrect, and incomplete diagnosis. It examines its determinants and consequences in high-risk populations—critically ill patients, patients with hematologic diseases or hematopoietic stem cell transplant recipients, and neonates—as well as in invasive candidiasis, aspergillosis, mucormycosis, cryptococcosis, endemic mycoses, and infections caused by rare or emerging fungi. It also reviews how delayed sampling, decontextualized interpretation of biomarkers, incomplete microbiological identification, absence of antifungal susceptibility testing when clinically relevant, and fragmentation between clinical and laboratory teams contribute to adverse outcomes. Finally, it proposes a diagnostic-centered antifungal stewardship framework (AFSP-Dx) based on syndromic bundles, population-specific diagnostic algorithms, 48–72 h reassessment, and auditable indicators intended to support earlier recognition, more precise therapeutic decisions, and rational antifungal use. Full article

Clinical suspicion and diagnosis of Pneumocystis infections rely on a combination of compatible clinical, radiologic, and diagnostic findings. We noted an extrapulmonary Pneumocystis infection when evaluating residual plasma samples from patients with possible invasive fungal infections using cell-free DNA (cfDNA) Giant Magnetoresistance (GMR) (FungiFlex^®, Zepto Life Technology). A man, immunocompromised for 27 years due to kidney transplantations, developed fever and rising aminotransferase enzyme levels during transient escalation of immunosuppressive therapy. Except for an elevated (1,3)-beta-D-glucan, further laboratory testing did not find the highly suspected histoplasmosis. Daily plasma blood samples for cfDNA fungal GMR testing were examined for histoplasmosis; however, the fungal GMR signal was only positive for Pneumocystis jirovecii in all four samples. In retrospect, the transient escalation of immunosuppressive dosing created a temporary net state of over-immunosuppression that was permissive for Pneumocystis. Additionally, the assay corroborated pulmonary pneumocystosis for a second patient, was negative for a third patient with colonization, and was negative for a fourth patient when fevers correlated with an abdominal bacterial process. Within the exploratory nature of the findings, we find that the reference standard for defining Pneumocystis is imperfect and may not accurately identify all cases. cfDNA testing may supplement existing laboratory testing and improve the diagnosis of Pneumocystis. Full article

In resource-poor sandy habitats, alien plant co-invasion often triggers intense belowground competition mediated by rhizosphere microorganisms. However, the mechanisms by which these plants overcome nutrient limitations remain unclear. Here, we conducted an eight-month in situ monitoring of single- and co-invasion plots of Solanum rostratum and Cenchrus pauciflorus Benth. in the Horqin Sandy Land. By integrating soil enzyme assays with 16S rRNA and internal transcribed spacer (ITS) amplicon sequencing, we characterized their rhizosphere microbial community assembly. Co-invasion exposed both species to convergent biotic stress, characterized by the significant enrichment of the pathogenic fungi Didymella and Pseudogymnoascus (linear discriminant analysis (LDA) > 4.0). To mitigate these pressures, the dominant competitor, S. rostratum, specifically recruited a cross-kingdom phosphate-solubilizing consortium comprising Bacillus and Penicillium (LDA > 4.0). This targeted recruitment significantly enhanced rhizosphere activities, increasing phosphatase and sucrase to 86.10 U/g and 2.17 U/g, respectively, thereby maintaining available phosphorus at a high level (35.55 mg/kg). Conversely, the subordinate competitor, C. pauciflorus, lost key native stress-resistant bacteria such as Rubrobacter (relative abundance dropping from 5.39% to 3.27%) and failed to recruit effective microbes, leading to the rapid depletion of available phosphorus (dropping to 21.38 mg/kg). Ultimately, under dual nutrient and pathogenic stress, the precise recruitment and functional integration of cross-kingdom phosphate-solubilizing microbes are strongly linked to the divergent belowground competitive outcomes between these co-invading plants. Full article

Non-indigenous or alien macroalgae are increasingly recognized as ecological threats, sources of raw material, and reservoirs of bioactive compounds for industry and agriculture. This review analyses the valorization potential of this biomass, focusing on their antifungal and elicitor activities against phytopathogenic fungi, particularly Mediterranean (De Bary) Whetzel, 1945. The literature published since 2020 was retrieved from Scopus using targeted keyword combinations. Three major topics were examined: (i) invasive and beach-cast macroalgal and their ecological context, (ii) antifungal and elicitor properties of macroalgal extracts, and (iii) the use of deep eutectic solvents (DES) for the green extraction of bioactive compounds. Species such as Asparagopsis armata, Rugulopteryx okamurae, and Sargassum muticum have shown promising antifungal and elicitor effects, frequently associated with phenolic compounds and polysaccharides. Extracts from these algae can inhibit the growth of fungi or activate plant defense pathways, providing environmentally friendly alternatives to synthetic pesticides. Moreover, DES and natural DES (NADES) offer tunable, biodegradable solvents capable of efficiently extracting these bioactive molecules while reducing the environmental impact associated with conventional organic solvents. Overall, the valorization of this biomass represents a sustainable strategy that simultaneously mitigates ecological and economic impacts and contributes to the development of sustainable inputs in agriculture. Full article

Following the elucidation of the fungal bioluminescence pathway (FBP), it was quickly adopted as a reporter system in plants; however, no such application has been documented in fungi to date. In this study, we established for the first time a luminescent reporter in the commercially important mushroom Hypsizygus marmoreus by expressing the luciferase gene from the luminous fungus Neonothopanus nambi. Using an established Agrobacterium-mediated transformation method, we separately introduced the wild-type luciferase gene nnLuz and the previously reported optimized variant nnLuz-v4 that can enhance bioluminescence expression into H. marmoreus arthroconidia. Both genes were stably integrated into the genome and expressed under the control of the H. marmoreus Glycerol 3-phosphate dehydrogenase (GPD) gene promoter. Upon addition of exogenous luciferin, transformants carrying the wild-type nnLuz produced clear, readily detectable bioluminescence signals, whereas no luminescence was observed in untransformed controls. Unexpectedly, the wild-type luciferase consistently exhibited substantially higher luminescence intensity than the optimized nnLuz-v4 variant. This finding suggests that codon optimization may be unnecessary or even detrimental when the donor and host are phylogenetically close basidiomycetes. The successful deployment of the fungal luciferase gene in H. marmoreus provides a sensitive and non-invasive genetic tool that does not require external excitation. This system opens new avenues for promoter characterization, real-time gene expression monitoring during mushroom development, and molecular breeding efforts aimed at improving agronomically important traits. Full article

Mucormycosis is a devastating invasive fungal infection primarily caused by Mucor and Rhizopus species, presenting significant clinical challenges due to limited therapeutic options and emerging drug resistance in opportunistic yeasts such as Candida albicans. This study explores foliar endophytic fungi from Thai medicinal plants as potential reservoirs for novel bioactive metabolites targeting both fungal growth and virulence factors. We report the first isolation of Fusarium proliferatum as an endophyte from Lantana camara L. foliage (voucher number 01562), with its identity confirmed through morphological characterization and sequencing of the fungal ITS4/ITS5 regions. Antifungal susceptibility testing showed potent activity against a panel of environmental Mucorales, with minimum inhibitory concentrations (MICs) ranging from 0.3 to 1 mg/L. In dual-culture assays, F. proliferatum demonstrated significant mycelial inhibition rates of 93.30% to 93.67% against Mucor spp. and 88.67% to 93.67% against Rhizopus spp. Furthermore, the crude extract exhibited a potent anti-virulence effect by suppressing the C. albicans yeast-to-hyphal transition, achieving up to 68% germination inhibition in resistant strains. Liquid chromatography–mass spectrometry (LC-MS) analysis identified 51 secondary metabolites, including the cyclic peptide beauvericin and various polyketides and indole derivatives. These findings suggest that F. proliferatum utilizes metabolic mimicry and adaptive synergy with its host plant to produce a diverse chemical arsenal. This study positions foliar endophytes of L. camara as promising candidates for the development of dual-action therapeutics to combat invasive and resistant mycoses. 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

Aspergillosis encompasses a heterogeneous spectrum of diseases caused by filamentous fungi of the genus Aspergillus, ranging from allergic airway disorders and chronic pulmonary infection to rapidly progressive invasive disease. Aspergillus fumigatus is the predominant pathogen worldwide, although other species, including Aspergillus flavus, Aspergillus terreus and cryptic species, contribute to morbidity and may exhibit intrinsic or acquired antifungal resistance. Early and accurate laboratory diagnosis is essential for timely treatment, appropriate antifungal selection, and stewardship. Traditional culture remains foundational, enabling confirmation of viable organisms, species-level identification, and antifungal susceptibility testing, but sensitivity is limited and turnaround times are prolonged. Non-culture approaches—including galactomannan, β-D-glucan, lateral flow assays, PCR, and next-generation sequencing—enhance diagnostic sensitivity, facilitate early detection, and allow identification of resistance-associated mutations. Optimal diagnostic performance is achieved through integrated, multimodal strategies combining laboratory tests with clinical and radiological findings. In invasive disease, concurrent use of biomarkers and molecular assays improves specificity and positive predictive value, while in allergic bronchopulmonary aspergillosis, immunological markers remain central. Future directions include standardised molecular protocols, novel antigenic and host-based biomarkers, and cost-effective, risk-adapted diagnostic algorithms to refine detection, guide therapy, and improve patient outcomes. Full article

Arbuscular mycorrhizal (AM) fungi form mutualistic symbioses with about 80% of land plants and play a key role in improving host inorganic phosphate (Pi), nitrogen, and water acquisition. Traditional AM fungi research relies on field trials, compartmented cultivation, and pot cultures—methods that are time-consuming (taking months to years) and unable to monitor dynamic transport, thus limiting efficient strain screening. We developed a real-time fluorescence imaging platform integrating sterile symbiotic microchambers with photodiode array detection. This system enables the non-invasive, quantitative tracking of hyphal cytoplasmic streaming and transport kinetics at the plant–fungal interface. Distinct AM fungi strains exhibit significant differences in fluorescence kinetics—such as accumulation rate and peak intensity—providing measurable indicators of transport efficiency. Our method overcomes the temporal and technical limitations of conventional AM fungi screening approaches. By enabling simultaneous real-time monitoring, it shortens screening cycles and provides new insights for the (1) precise screening of AM fungi strains for efficient nutrient transport; (2) investigation of nutrient exchange mechanisms; (3) development of sustainable microbial inoculants. 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

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

With the rapid expansion of avocado cultivation in southern Italy, growers have had to deal with the emergence of new diseases often caused by invasive and polyphagous pathogens responsible for leaf spot, branch cankers, dieback and fruit and root rot. Given the severity of these emerging diseases, a study was conducted in the main avocado growing areas in Sardinia and Sicily (Italy) to isolate and characterize the causal agents. Specifically, a total of 430 symptomatic leaf, fruit, branch, stem and root samples were collected and examined. Isolations performed on both non-selective and selective growth media yielded 22 species (fungi and oomycetes) belonging to the genera Botryosphaeria, Colletotrichum, Diplodia, Dothiorella, Macrophomina, Neofusicoccum and Phytophthora, including 14 new host–pathogen records in Italy. Notably, Neofusicoccum australe, Phytophthora cinnamomi and Phytophthora palmivora emerged as the main pathogens involved in the emerging avocado diseases. The identified pathogens were often isolated simultaneously from the same plants, which exhibited a complex of symptoms. Pathogenicity bioassays have helped to clarify the differences in aggressiveness among the different species and their specificity towards the different plant organs. The results achieved suggest that avocado orchards’ productivity and profitability is threatened by a plethora of unrelated pathogens whose control represents a major challenge for the success of this crop in Italy. Full article

Soil-borne diseases pose a severe threat to global agricultural production and food security. Traditional chemical control methods face significant challenges, including environmental pressure, pathogen resistance, and food safety concerns. The rhizosphere microbial community, often termed the plant’s ‘second genome’, plays a pivotal role in maintaining plant health and defending against pathogen invasion. Recent advances in multi-omics technologies, synthetic microbial communities (SynComs) construction, and rhizosphere metabolomics have significantly advanced our understanding of the mechanisms by which rhizosphere microbiomes suppress soil-borne diseases. This review systematically summarizes the following: 1. key drivers of rhizosphere microbial community assembly, particularly plant “cry for help” signaling; 2. core beneficial microbial taxa and their disease-suppressive mechanisms; 3. the critical role of microbial interaction networks; 4. microbiome-based management strategies and their application progress; and 5. current challenges and future research directions. Compared with previous reviews that separately discussed rhizosphere microbiota, disease-suppressive soils, synthetic microbial communities (SynComs), or prebiotics, this review uniquely integrates multiple levels of regulation, from plant genetic determinants (‘M genes’) and root exudate-mediated ‘crying for help’ to microbiome engineering (SynComs and prebiotics) and cross-kingdom interactions (bacteria–fungi–protists–phages). A central conceptual axis of ‘M genes → microbiome engineering → breeding’ is proposed, bridging plant genetics, microbial ecology, and crop improvement for durable disease suppression. Ultimately, this work aims to provide a theoretical foundation for developing efficient and sustainable green control technologies against soil-borne diseases. Full article