Pathogens

Research

11 pages, 839 KiB

Open AccessArticle

Prevalence of T. rubrum and T. interdigitale Exhibiting High MICs to Terbinafine in Clinical Samples Analyzed in the Portuguese Mycology Reference Laboratory

by Helena Schirmer, Camila Henriques, Helena Simões, Cristina Veríssimo and Raquel Sabino

Pathogens 2025, 14(2), 115; https://doi.org/10.3390/pathogens14020115 - 25 Jan 2025

Cited by 1 | Viewed by 896

Abstract

Cutaneous fungal infections represent a significant burden worldwide with a high impact on public health. Accurate identification of dermatophyte species causing these infections is vital for an appropriate treatment. Terbinafine is the primary agent against Trichophyton species due to its clinical efficacy; however, [...] Read more.

Cutaneous fungal infections represent a significant burden worldwide with a high impact on public health. Accurate identification of dermatophyte species causing these infections is vital for an appropriate treatment. Terbinafine is the primary agent against Trichophyton species due to its clinical efficacy; however, cases of elevated minimum inhibitory concentration (MIC) have been reported, raising clinical and epidemiological concerns. Herein, we aimed to detect Trichophyton rubrum and Trichophyton interdigitale isolates collected from clinical samples with terbinafine-high MICs (TRB-hMIC). A total of 168 isolates, recovered from 2017 to 2023, were identified as T. rubrum complex (140/83.4%) or T. interdigitale (28/16.7%) and further screened regarding their terbinafine susceptibility. Four isolates with capacity to grow in terbinafine media were detected by screening, and these and a further sixteen random isolates were submitted to the broth microdilution method. This methodology confirmed the four (2.4%) isolates as TRB-hMIC. One T. rubrum and three T. interdigitale showed a minimum inhibitory concentration (MIC) higher than 1 mg/L. Partial sequencing of the SQLE gene identified point mutations in T. rubrum (Phe397Iso) and in one T. interdigitale (Phe397Leu) isolate. Notably, in the other two T. interdigitale isolates with TRB-hMIC, no point mutations in the SQLE gene were identified. In conclusion, TRB-hMIC isolates (T. rubrum and T. interdigitale) were identified in clinical samples analyzed in Portugal, as antifungal susceptibility testing is a crucial routine for identifying treatment failures and also for epidemiological purposes aiming to monitor the dynamics of terbinafine resistance. Full article

(This article belongs to the Special Issue An Update on Fungal Infections)

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12 pages, 2329 KiB

Open AccessArticle

Epidemiological Analysis of Fungal Infection Disease in Pediatric Population: Focus on Hospitalization from 2007 to 2022 in Veneto Region in Italy

by Lorenzo Chiusaroli, Claudia Cozzolino, Silvia Cocchio, Mario Saia, Carlo Giaquinto, Daniele Donà and Vincenzo Baldo

Pathogens 2025, 14(1), 93; https://doi.org/10.3390/pathogens14010093 - 18 Jan 2025

Viewed by 850

Abstract

Fungal infections (FIs) are widespread globally, affecting both immunocompromised and immunocompetent children, with varying clinical implications based on age and comorbidities. In immunocompromised children, particularly those with hematologic oncological conditions, FI leads to substantially longer hospital stays and increased in-hospital mortality, with reported [...] Read more.

Fungal infections (FIs) are widespread globally, affecting both immunocompromised and immunocompetent children, with varying clinical implications based on age and comorbidities. In immunocompromised children, particularly those with hematologic oncological conditions, FI leads to substantially longer hospital stays and increased in-hospital mortality, with reported rates ranging from 15% to 20%. Our study aims to analyze the epidemiological trends of fungal infections in the pediatric population within a specific region of Italy. We extracted ICD-9 codes related to fungal infections from hospital discharge records (HDRs) in the pediatric population of Veneto, located in the north-east of Italy, between 2007 and 2022. We included all children admitted to the hospital with a primary or secondary diagnosis during admission for other reasons. Data were stratified based on age, year, ward of admission, and type of diagnosis. Patients older than eighteen and HDRs related to a second admission within thirty days from the previous admission were excluded. A total of 1433 diagnoses were analyzed during the period, with 241 (16.8%) as main diagnoses and 1192 (83.2%) as secondary diagnoses. The overall hospitalization rate was 1084 cases/100,000 (1.69 cases/100,000 as primary diagnosis and 8.95 cases/100,000 as secondary). The hospitalization rate stratified for age was 11,055 cases/100,000 among infants younger than 1 year, 8.48 cases/100,000 among those aged 1-4 years, and 4.4 cases/100,000 among children older than 5. The more frequent infection was Candida spp. (62.8%), followed by Aspergillus spp. (14.6%) and skin mycosis (9.5%). Overall, the pediatric in-hospital case fatality rate due to FI was 2.09%. Our study elucidated the overall experience of fungal infections in the pediatric population of the Veneto region in Italy. Specifically, we underscored a relatively stable hospitalization rate for fungal diseases and a noteworthy mortality rate. Full article

(This article belongs to the Special Issue An Update on Fungal Infections)

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16 pages, 9860 KiB

Open AccessArticle

Evaluation of Primers OPF-01, P54, and 1253 to Identify A. fumigatus, A. flavus, and A. niger from Polymorphic Patterns Obtained by RAPD-PCR

by Carlos Alberto Castro-Fuentes, María Guadalupe Frías-De-León, María del Carmen González-Villaseñor, Esperanza Duarte-Escalante, Omar Esteban Valencia-Ledezma, Areli Martínez-Gamboa, Beatriz Meraz-Ríos and María del Rocío Reyes-Montes

Pathogens 2024, 13(7), 574; https://doi.org/10.3390/pathogens13070574 - 10 Jul 2024

Viewed by 1202

Abstract

We evaluated the specificity of the primers OPF-01, P54, and 1253 to identify A. fumigatus, A. flavus, and A. niger, respectively, with the RAPD-PCR method. Eighty-two isolates belonging to the sections Fumigati, Flavi, and Nigri were used. The [...] Read more.

We evaluated the specificity of the primers OPF-01, P54, and 1253 to identify A. fumigatus, A. flavus, and A. niger, respectively, with the RAPD-PCR method. Eighty-two isolates belonging to the sections Fumigati, Flavi, and Nigri were used. The isolates were identified by phenotypic (macro- and micromorphology) and genotypic (partial sequences of the BenA gene) methods. The RAPD-PCR method was used to obtain polymorphic patterns with the primers OPF-01, P54, and 1253. The specificity of the polymorphic patterns of the isolates of each species was evaluated through the UPGMA clustering method and logistic regression model. All isolates of the genus Aspergillus were identified at the section level by macro- and micromorphology showing the typical morphology of the sections Fumigati, Flavi, and Nigri, and the species were identified by the construction of the phylogeny of the partial sequence of the BenA gene. The patterns’ polymorphic strains obtained with the primers OPF-01, P54, and 1253 for the isolates of A. fumigatus, A. flavus, and A niger, respectively, showed the same polymorphic pattern as the reference strains for each species. To verify the specificity of the primers, they were tested with other species from the sections Fumigati, Flavi and Nigri. The results support that the primers OPF-01, P54, and 1253 generate polymorphic patterns by RAPD-PCR species specific to A. fumigatus, A. flavus, and A. niger, respectively. Full article

(This article belongs to the Special Issue An Update on Fungal Infections)

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12 pages, 4524 KiB

Open AccessArticle

Invasive Fungal Infections of the Head and Neck: A Tertiary Hospital Experience

by Tieying Hou, W. Robert Bell and Hector Mesa

Pathogens 2024, 13(7), 530; https://doi.org/10.3390/pathogens13070530 - 23 Jun 2024

Viewed by 1562

Abstract

From the existing millions of fungal species, only a few cause disease. In this study, we investigated invasive fungal infections in the head and neck (H&N) over a 19-year period (2005 to 2024) at a large academic healthcare system. Among the 413 documented [...] Read more.

From the existing millions of fungal species, only a few cause disease. In this study, we investigated invasive fungal infections in the head and neck (H&N) over a 19-year period (2005 to 2024) at a large academic healthcare system. Among the 413 documented fungal H&N infections, 336 were noninvasive, and 77 were invasive. The highest incidence of invasive infections occurred in the sinonasal cavities, with a 15-fold difference compared to other sites. Most infections affected adults over 40 years old. The most common organisms were Mucorales (51%), hyaline molds (29%), and Candida (11%). Risk factors included malignancy, transplant, diabetes, and illicit drug use. Mortality was high in patients with malignancy and/or transplant. Infections affecting the mandible were usually a complication of osteoradionecrosis and were associated with the coinfection of Candida and Actinomyces. At other sites, infections were rare and were usually the result of penetrating injuries or immunosuppression. Treatment typically involved a combination of antifungals and surgical procedures. Full article

(This article belongs to the Special Issue An Update on Fungal Infections)

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Review

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26 pages, 459 KiB

Open AccessReview

Invasive Candidiasis Coinfection in Patients with Severe COVID-19 Disease: Scoping Review

by Omar Esteban Valencia-Ledezma, María del Rocío Reyes-Montes, Gustavo Acosta-Altamirano, María Guadalupe Frías-De-León, Eduardo García-Salazar, Esperanza Duarte-Escalante, Jesús Santiago-Abundio, Zuleyma González-Miguel, María de Lourdes García-Hernández, Rebeca Martínez-Quezada, Oscar Uriel Torres-Páez, Evelyn Galindo-Oseguera, Patricia Meza-Meneses and Nicolás Santiago-González

Pathogens 2025, 14(5), 466; https://doi.org/10.3390/pathogens14050466 - 10 May 2025

Viewed by 284

Abstract

Coinfection rates of candidiasis in patients affected by COVID-19 had a significantly increase during the sanitary contingency. The objective of this scoping review is to analyze the available scientific evidence around the coinfection of invasive candidiasis in hospitalized patients with severe COVID-19 disease. [...] Read more.

Coinfection rates of candidiasis in patients affected by COVID-19 had a significantly increase during the sanitary contingency. The objective of this scoping review is to analyze the available scientific evidence around the coinfection of invasive candidiasis in hospitalized patients with severe COVID-19 disease. Online databases such as PubMed, EBSCO, SciFinder, Scopus, and SciELO were used to analyze the different scientific studies published from January 2020 to December 2022, selecting 48 publications that reported comorbidity between invasive candidiasis and COVID-19 as a study variable. Based on the PRISMA-ScR extension for scoping reviews, we identified more than half of the publications (57%) as observational, descriptive, and analytic studies, while 43% were systematic reviews. Overall, up to 169,468 adult patients admitted to the intensive care unit were examined. Coinfection was due mainly to Candida albicans (75%), but some more species were reported such as Meyerozyma parapsilosis (formerly Candida parapsilosis); Meyerozyma guilliermondii (formerly Candida guilliermondii); Nakaseomyces glabratus (formerly Candida glabrata); Candida tropicalis; Candida dubliniensis; Clavispora lusitaniae (formerly Candida lusitaniae); and Pichia kudriavzevii (formerly Candida krusei). We concluded that patients infected by SARS-CoV-2 had a higher incidence of fungal coinfections, thus increasing the mortality rate, disease severity, and length of hospital stay in the intensive care unit. Full article

(This article belongs to the Special Issue An Update on Fungal Infections)

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15 pages, 783 KiB

Open AccessReview

Is Pulmonary Mycoses Shadowed by Tuberculosis? Mandate to Hit the Bull’s Eye—An Indian Perspective

by Jeevarahini Regupathy, Priya Rajendran, Vinod Kumar and Sivakumar Shanmugam

Pathogens 2025, 14(5), 435; https://doi.org/10.3390/pathogens14050435 - 30 Apr 2025

Viewed by 371

Abstract

Tuberculosis (TB) poses serious challenges to healthcare personnel as it continues to be highly prevalent in a developing country like India. Several prominent strategies have been adopted to control this contagious infection, but the incidence rate remains high. Many studies have linked fungal [...] Read more.

Tuberculosis (TB) poses serious challenges to healthcare personnel as it continues to be highly prevalent in a developing country like India. Several prominent strategies have been adopted to control this contagious infection, but the incidence rate remains high. Many studies have linked fungal infections to TB, apparently elevating concerns in the TB elimination program. Hence, it is essential to understand the mechanisms underlying TB co-infection and pulmonary mycoses to combat the problems caused by these diseases successfully. In addition, differential diagnosis of TB and fungal infections is equally essential to initiate appropriate treatment. This review attempts to describe misdiagnosis of TB and fungal disease and their relative coexistence in the context of the Indian perspective. Full article

(This article belongs to the Special Issue An Update on Fungal Infections)

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24 pages, 4008 KiB

Open AccessReview

Humans vs. Fungi: An Overview of Fungal Pathogens against Humans

by Kasun M. Thambugala, Dinushani A. Daranagama, Danushka S. Tennakoon, Dona Pamoda W. Jayatunga, Sinang Hongsanan and Ning Xie

Pathogens 2024, 13(5), 426; https://doi.org/10.3390/pathogens13050426 - 17 May 2024

Cited by 6 | Viewed by 7946

Abstract

Human fungal diseases are infections caused by any fungus that invades human tissues, causing superficial, subcutaneous, or systemic diseases. Fungal infections that enter various human tissues and organs pose a significant threat to millions of individuals with weakened immune systems globally. Over recent [...] Read more.

Human fungal diseases are infections caused by any fungus that invades human tissues, causing superficial, subcutaneous, or systemic diseases. Fungal infections that enter various human tissues and organs pose a significant threat to millions of individuals with weakened immune systems globally. Over recent decades, the reported cases of invasive fungal infections have increased substantially and research progress in this field has also been rapidly boosted. This review provides a comprehensive list of human fungal pathogens extracted from over 850 recent case reports, and a summary of the relevant disease conditions and their origins. Details of 281 human fungal pathogens belonging to 12 classes and 104 genera in the divisions ascomycota, basidiomycota, entomophthoromycota, and mucoromycota are listed. Among these, Aspergillus stands out as the genus with the greatest potential of infecting humans, comprising 16 species known to infect humans. Additionally, three other genera, Curvularia, Exophiala, and Trichophyton, are recognized as significant genera, each comprising 10 or more known human pathogenic species. A phylogenetic analysis based on partial sequences of the 28S nrRNA gene (LSU) of human fungal pathogens was performed to show their phylogenetic relationships and clarify their taxonomies. In addition, this review summarizes the recent advancements in fungal disease diagnosis and therapeutics. Full article

(This article belongs to the Special Issue An Update on Fungal Infections)

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Other

Jump to: Research, Review

7 pages, 228 KiB

Open AccessBrief Report

Outcomes of Invasive Fungal Infections Treated with Isavuconazole: A Retrospective Review

by Vanessa Gow-Lee, Omar M. Abu Saleh, Courtney E. Harris, Jennifer J. Gile, Nadia Akhiyat and Supavit Chesdachai

Pathogens 2024, 13(10), 886; https://doi.org/10.3390/pathogens13100886 - 11 Oct 2024

Cited by 1 | Viewed by 1747

Abstract

Background: Isavuconazole (ISA) has a favorable side effect profile that makes it attractive for treatment of invasive fungal infections (IFI). It carries FDA approval for invasive aspergillosis and mucormycosis, but there are fewer data for other organisms and non-pulmonary infections. We conducted this [...] Read more.

Background: Isavuconazole (ISA) has a favorable side effect profile that makes it attractive for treatment of invasive fungal infections (IFI). It carries FDA approval for invasive aspergillosis and mucormycosis, but there are fewer data for other organisms and non-pulmonary infections. We conducted this review to investigate how ISA performed at treating IFI, with an especial interest in these non-approved indications. Methods: We retrospectively identified and reviewed 131 patients who received ISA as treatment for IFI at our institution, some of whom received ISA as their first anti-fungal therapy and others who received ISA as either step-down therapy or salvage therapy. We identified the microbiologic cause of infection as well as the anatomic site involved for each patient. We then classified patients according to their response to ISA: namely cured, partially responded, or stabilized. Results: The majority of patients were immunocompromised (n = 76, 58%). ISA was used primarily as a secondary therapy (n = 116, 89%); either as a step-down/switching from other agents, or as salvage therapy. The most common reasons for switching to ISA were toxicities with prior agents followed by QT prolongation. Although pulmonary aspergillosis and mucormycosis were represented in more than half of the cohort, ISA was also used off-label for treatment of other organisms such as endemic fungi (n = 19, 15%) as well as central nervous system (CNS) infections (n = 15, 11%). We have described the detailed clinical characteristics of these CNS infections cases. The overall clinical response rate varied by type of infection and site involved (57–73% response rate). Conclusions: We demonstrated encouraging clinical responses, particularly outside the FDA-approved indications, as well as good tolerability. This report highlights the critical need for expanded scope of prospective studies to delineate the efficacy of this better-tolerated agent, especially in central nervous system infections. Full article

(This article belongs to the Special Issue An Update on Fungal Infections)

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