Current Medical Mycology最新文献

{"title":"Acute fungal endometritis in women with abnormal uterine bleeding: Clinical and microbiological insights.","authors":"Soheila Abbaszadeh Godarzi, Fatemeh Zahra Ranjbar Golafshani, Firoozeh Kermani, Saeid Mahdavi Omran","doi":"10.22034/cmm.2025.345248.1650","DOIUrl":"10.22034/cmm.2025.345248.1650","url":null,"abstract":"<p><strong>Background and purpose: </strong>Fungal endometritis, an uncommon yet severe condition affecting the uterine lining, typically manifests with abnormal uterine bleeding (AUB), pelvic discomfort, and vaginal discharge. This investigation aimed to present a pioneering study focused on fungal endometritis in women presenting with these clinical symptoms.</p><p><strong>Materials and methods: </strong>A cohort of 43 female patients experiencing abnormal uterine bleeding was comprehensively evaluated at Babol University of Medical Sciences in Babol, Iran, between March 21, 2023, and March 19, 2024. Diagnostic procedures encompassed ultrasound imaging, a range of laboratory tests, hysteroscopy for direct visualization and tissue sampling, microscopic examination, fungal culture with subsequent colony count, and polymerase chain reaction for enhanced accuracy in fungal identification. Additionally, drug susceptibility patterns were assessed for all isolated fungal species.</p><p><strong>Results: </strong>Among the 43 patients, five (11.62%) received a definitive diagnosis of fungal endometritis. The identified species included two isolates of <i>Candida albicans</i>, two isolates of <i>Nakaseomyces glabratus</i> (previously known as <i>C. glabrata</i>), and one isolate of <i>Candida orthopsilosis</i>. A notable diagnostic observation was that all confirmed cases yielded negative results from vaginal discharge cultures, emphasizing the necessity of direct endometrial sampling. Antifungal susceptibility testing revealed varying minimum inhibitory concentrations among the isolates, though all responded effectively to the combined treatment of voriconazole and surgical debridement.</p><p><strong>Conclusion: </strong>This study highlighted the critical importance of prompt evaluation and precise diagnosis, including comprehensive antifungal susceptibility testing, in individuals presenting with acute endometritis and AUB. Such rigorous considerations are essential for guiding clinical management and mitigating the risk of adverse outcomes, particularly given the increasing antifungal resistance and the emergence of non-<i>albicans Candida</i> species as significant pathogens.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>In vitro</i> study of antifungal effects of earthworm coelomic fluid obtained from <i>Eisenia fetida</i> on three opportunistic fungal pathogens.","authors":"Saeed Sanaiirad, Mehrdad Seifi, Negar Hemmati, Alireza Khosravi, Donya Nikaein","doi":"10.22034/cmm.2025.345248.1637","DOIUrl":"10.22034/cmm.2025.345248.1637","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and purpose: &lt;/strong&gt;Pathogenic fungi, including both true and opportunistic pathogens, pose significant health risks, particularly in immunocompromised individuals. Species, such as &lt;i&gt;Candida albicans&lt;/i&gt;, &lt;i&gt;Aspergillus fumigatus&lt;/i&gt;, and &lt;i&gt;Cryptococcus neoformans&lt;/i&gt;, cause fatal infections and frequently develop resistance to conventional antifungal therapies. Limitations of current antifungal medications, such as drug toxicity, resistance development, and environmental concerns, highlight the urgent need for novel therapeutic strategies. Earthworm extracts, particularly those derived from &lt;i&gt;Eisenia fetida&lt;/i&gt;, have been recognized as a promising alternative in traditional Chinese medicine. This study aimed to assess the antifungal effects of a peptide extract from &lt;i&gt;E. fetida&lt;/i&gt; against these opportunistic fungal pathogens.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The earthworm extract was obtained from &lt;i&gt;E. fetida&lt;/i&gt; through electroporation and centrifugation to isolate bioactive components. Composition of the extract was analyzed in detail; accordingly, protein content was determined using the Bradford and Kjeldahl methods, fat content was measured via Soxhlet extraction, and moisture, dry matter, and ash contents were also quantified to provide a comprehensive profile. To evaluate antifungal activity, fungal cultures of &lt;i&gt;A. fumigatus&lt;/i&gt;, &lt;i&gt;C. albicans&lt;/i&gt;, and &lt;i&gt;C. neoformans&lt;/i&gt; were grown on Sabouraud dextrose agar. The disk diffusion method was used to assess antifungal activity by measuring inhibition zones surrounding extract-containing disks. A dilution series of the &lt;i&gt;E. fetida&lt;/i&gt; extract was also prepared to further analyze antifungal effects. The broth microdilution method was employed to determine the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) for each fungal species, providing quantitative data on the effectiveness of the extract.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The coelomic fluid extracted from &lt;i&gt;E. fetida&lt;/i&gt; contained 60.03% protein, 8.136% fat, 6.91% ash, 6.03% moisture, and 8.65% dry matter. Disk diffusion assays revealed significant inhibition of &lt;i&gt;A. fumigatus&lt;/i&gt; and &lt;i&gt;C. albicans&lt;/i&gt;, with the extract exhibiting stronger effects at higher concentrations. In broth microdilution assays, the extract achieved MIC/MFC values of 12.5%/25% against &lt;i&gt;A. fumigatus&lt;/i&gt; and 3.125%/6.25% against &lt;i&gt;Candida albicans&lt;/i&gt;. However, its efficacy against &lt;i&gt;C. neoformans&lt;/i&gt; was lower, while the commercial antifungal drug, itraconazole, demonstrated superior efficacy against all tested strains.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Earthworm extracts, rich in antimicrobial peptides, exhibit promising antifungal properties, particularly against &lt;i&gt;C. albicans&lt;/i&gt;. Although not as effective as itraconazole, the potential of the extract as a safer and environmentally friendly alternative underscores its significance in antifungal research. Further studies ar","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of mucormycosis in COVID-19 patients in northwest Iran: <i>Rhizopus arrhizus</i> as the predominant species.","authors":"Kambiz Diba, Rahim Nejadrahim, Kosar Jafari, Marzieh Safari, Rasool Jafari, Narges Aslani","doi":"10.22034/cmm.2025.345248.1591","DOIUrl":"10.22034/cmm.2025.345248.1591","url":null,"abstract":"<p><strong>Background and purpose: </strong>The current study aimed to assess the demographic features, clinical characteristics, species diversity, and contributing factors among patients with severe acute respiratory syndrome coronavirus-2 pneumonia-associated mucormycosis in northwestern Iran.</p><p><strong>Materials and methods: </strong>This cross-sectional descriptive study was performed on patients who tested positive for COVID-19 via reverse-transcriptase-polymerase chain reaction and were suspected of having invasive fungal infection. Mucormycosis was confirmed by histopathology of biopsy samples and species identification was performed using morphological and internal transcribed spacer-rDNA sequencing methods.</p><p><strong>Results: </strong>Mucormycosis was observed in 63 COVID-19 patients. Mean age of patients was 56.65±14.49 years (range of 22-85 years) and 63.5% of the involved patients were male. The most common involvement site of patients with mucormycosis was the sinus (63.5%). Among all participants, 84% of patients (n=53) had received intravenous dexamethasone, and 25.4% of them had diabetes mellitus. All patients with proven invasive mucormycosis received intravenous amphotericin B. In total, 21 (33%) positive cultures were identified and <i>Rhizopus arrhizus</i> was the main causative agent.</p><p><strong>Conclusion: </strong>Awareness among physicians should be raised that corticosteroid therapy not only causes dysfunction of the immune system but may also lead to the development of this neglected mycosis through corticosteroid-induced diabetes in vulnerable patients.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graphene nanomaterials: A new frontier in preventing respiratory fungal infections.","authors":"Bahram Naderi-Nabi, Iman Haghani, Abbas Raeisabadi, Akbar Hoseinnejad, Hakimeh Sarshad, Nazanin Rahmanian, Mohammad Haghighi","doi":"10.22034/cmm.2025.345248.1618","DOIUrl":"10.22034/cmm.2025.345248.1618","url":null,"abstract":"<p><p>Nano-graphene oxide is a promising <i>Candidate</i> for therapeutic applications, particularly due to its notable antifungal and antibacterial properties, which stem from the unique physicochemical characteristics of this innovative nanocarrier. Antifungal efficacy of nano-graphene oxide is increasingly attracting attention, particularly in light of the rising resistance of pathogens to conventional drug therapies. Upon exposure to graphene oxide, fungal cells generate reactive oxygen species, a key indicator of cellular oxidative stress. This mechanism accounts for the apoptotic-like cell death observed in the presence of graphene oxide. This nano-drug delivery system holds the potential to achieve therapeutic efficacy at reduced doses, minimize side effects, enable controlled drug release, prolong circulation time, reduce toxicity, and enhance the stability of the nano-formulation, particularly when administered as an inhaled dry powder. However, the factors influencing the antifungal activity of nano-graphene oxide and the underlying mechanisms remain poorly understood. This article aimed to review the anti-pathogenic properties of nano-graphene oxide, focusing on its antifungal mechanisms and its role in biofilm formation associated with pulmonary fungal infections.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of disseminated histoplasmosis not responding to primary treatment by itraconazole.","authors":"Prashant Gupta, Kalpana Kuntal, Nishant Gupta, Anand Srivastava","doi":"10.22034/cmm.2025.345248.1613","DOIUrl":"10.22034/cmm.2025.345248.1613","url":null,"abstract":"<p><strong>Background and purpose: </strong>Histoplasmosis, caused by <i>Histoplasma capsulatum</i>, typically presents as a pulmonary infection but can disseminate, with oral lesions being common among immunocompromised individuals. However, this is rare among immunocompetent patients. Preferred treatments include itraconazole for mild cases and liposomal amphotericin B for severe forms.</p><p><strong>Case presentation: </strong>This study aimed to report a 28-year-old female who developed disseminated histoplasmosis following a right oroantral fistula after dental surgery. It was initially misdiagnosed as Actinomycosis; however, a positive urinary <i>Histoplasma</i> antigen test confirmed histoplasmosis. Despite itraconazole therapy (200 mg twice daily, later increased to 600 mg), her condition continued to deteriorate, with disease progression seen on imaging. Switching to six weeks of intravenous liposomal amphotericin B led to marked improvement, resolution of lung nodules, and negative antigen testing. She was discharged with a 12-month course of itraconazole therapy.</p><p><strong>Conclusion: </strong>This case highlights the importance of timely recognition and adjustment of treatment in non-severe histoplasmosis, particularly for patients who do not respond adequately to itraconazole therapy.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"30-day mortality in invasive candidiasis and candidemia in a multidisciplinary hospital in Moscow, Russia.","authors":"Sergey S Andreev, Polina O Narusova, Anton A Chernov, Alexander D Dushkin, Olga D Dukhanina, Rustam T Iskhakov, Daria S Fomina, Mariana A Lysenko","doi":"10.22034/cmm.2025.345248.1590","DOIUrl":"10.22034/cmm.2025.345248.1590","url":null,"abstract":"<p><strong>Background and purpose: </strong>One of the most severe mycotic infections caused by <i>Candida</i> spp. is invasive candidiasis. According to the literature, among all healthcare- associated infections, it has the highest mortality rate. This study aimed to assess 30-day and overall mortality in invasive candidiasis and candidemia patients depending on the antifungal therapy (AFT) regimens.</p><p><strong>Materials and methods: </strong>This single-center retrospective study of 30-day survival was conducted at Clinical City Hospital No. 52, Moscow Healthcare Department in Moscow, Russia. The participants were 169 patients aged 19-94 years who had verified invasive candidiasis with candidemia during hospitalization in 2020-2023. This study included patients with <i>Candida</i> spp. isolated from blood culture using matrix-assisted laser desorption/ionization with time-of-flight mass spectrometry, and proven invasive candidiasis according to EORTC/MSG criteria. Patient survival analysis was performed using the Kaplan-Meier method, which is a nonparametric approach for estimating time- to-event. Risk of death was compared between the group of patients receiving AFT after pathogen verification and the group of patients receiving AFT before and after blood culture results.</p><p><strong>Results: </strong>Based on the findings, the likelihood of death was lower in the group of patients who received AFT both after and before blood culture results compared to the group of patients who received it after verification of the diagnosis. By day 50 of hospitalization, the risks of death were comparable between the two groups. However, when analyzing the overall mortality, the odds of death in patients with AFT before and after receiving blood culture results were 2.56 times higher (OR=0.391; 95% CI: 0.177-0.865; <i>p</i>=0.019) compared with patients to whom antifungal therapy was prescribed only after blood culture results.</p><p><strong>Conclusion: </strong>This study provided the first data regarding the assessment of 30-day mortality and risk factors for death. Risk of 30-day mortality was lower in the group of patients receiving AFT both before and after the blood culture, but overall mortality in this group was higher, compared to patients who received AFT after the blood culture.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the combined efficacy of inhibitors of heat shock protein 90 and calcineurin with commonly used antifungals against <i>Aspergillus</i>, <i>Rhizopus</i>, and <i>Fusarium isolates</i>.","authors":"Nuri Kiraz, Sümeyye Şen Kaya, Ayşe Barış, Deniz Turan, Yasemin Öz, İlknur Dağ","doi":"10.22034/cmm.2025.345248.1601","DOIUrl":"10.22034/cmm.2025.345248.1601","url":null,"abstract":"<p><strong>Background and purpose: </strong>The high morbidity and mortality caused by invasive mold infections require new and effective treatment strategies. Heat shock proteins, which are found in all living organisms, play a role in the homeostatic control of the cell and the stress response mediated by calcineurin. Their release increases especially under stress conditions, and they play a role in ensuring the stability of cellular proteins. Therefore, inhibition of Hsp90 or calcineurin may be an effective method in antifungal therapy. This study aimed to evaluate the <i>in vitro</i> activity of four different antifungal agents (caspofungin, amphotericin B, itraconazole, and voriconazole) in combination with fungal stress response regulators, Hsp90 inhibitors, and calcineurin inhibitors, against clinical isolates of <i>Aspergillus</i>, <i>Rhizopus</i>, and <i>Fusarium</i>.</p><p><strong>Materials and methods: </strong>In this study, the effectiveness of Hsp90 inhibitors geldanamycin, 17-(allylamino)-17-demethoxygeldanamycin (17-AAG), radicicol, novobiocin (NOV), and calcineurin inhibitors cyclosporine, tacrolimus (TAC), and rapamycin (RAP) combined with common antifungals itraconazole (ITRA), voriconazole (VOR), caspofungin (CAS), and amphotericin B (AMB) were investigated against four <i>Aspergillus</i>, three <i>Rhizopus</i>, and three <i>Fusarium</i> isolates using checkerboard method.</p><p><strong>Results: </strong>The minimum inhibitory concentration (MIC)/minimum effective concentration (MEC) values of ITRA, VOR, CAS, and AMB were ≤ 0.25, ≤ 0.06-0.125, ≤ 0.03-> 4, and 1-4 µg/mL for <i>Aspergillus</i> spp.; 2-8, > 4, > 4, and 2 µg/mL for <i>Rhizopus</i> spp.; 8- > 16, 1-4, > 4, and 2-4 µg/mL for <i>Fusarium</i> spp., respectively. Although tacrolimus was found to have generally low MIC values (≤0.03 µg/mL) for <i>Aspergillus</i> and <i>Rhizopus</i> isolates, NOV, and 17-AAG did not exhibit antifungal activity (MICs>128 and ≥16 µg/mL, respectively) against almost all of the isolates. In combination testing against <i>Aspergillus</i> and <i>Rhizopus</i> spp., synergistic interactions were prevalent (≥75%) for the combinations of ITRA and all inhibitory substances, except for TAC. The effects of CAS and TAC in combination tests were weak. Moreover, synergistic interactions were not frequent in all combinations against <i>Fusarium</i> spp. However, antagonistic interaction was observed only in one ITRA and RAP combination throughout this study.</p><p><strong>Conclusion: </strong>The Hsp90 and calcineurin inhibitors did not have significant antifungal activity alone. Moreover, they did not show a significant antagonistic effect in combination and even increased the efficacy of antifungals at some concentrations.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disseminated cryptococcosis in an HIV patient with hepatitis C as the associated risk factor.","authors":"Pallavi Dhawan, Varsha Gupta, Monica Gupta, Parakriti Gupta, Nidhi Singla","doi":"10.22034/cmm.2025.345248.1600","DOIUrl":"10.22034/cmm.2025.345248.1600","url":null,"abstract":"<p><strong>Background and purpose: </strong>In the context of HIV/AIDS, cryptococcosis emerges as one of the most common opportunistic infections, with a predilection for affecting individuals with compromised immune function.</p><p><strong>Case report: </strong>This study aimed to present a compelling case of disseminated cryptococcosis in a 29-year-old male with a complex medical history, marked by HIV infection, hepatitis C, and a longstanding history of intravenous drug abuse. Blood sample of the patient as well as the cerebrospinal fluid sample grew <i>Cryptococcus neoformans</i>. Immunochromatographic test performed on CSF and serum sample was also positive.</p><p><strong>Conclusion: </strong>Chronic Hepatitis C Virus can disrupt the blood-brain barrier and cause neuroinflammation predisposing the central nervous system to hematogenous seeding during fungemia. Multifaceted medical background of the patient underscored the challenges in the management of comorbidities.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a difference in the expression levels of genes responsible for fluconazole resistance in <i>Candida albicans</i> isolated from people with different underlying diseases? A systematic review.","authors":"Akbar Hoseinnejad, Mehrnoush Maheronnaghsh, Mojtaba Taghizadeh Armaki, Jalal Jafarzadeh, Mahnaz Fatahinia","doi":"10.22034/cmm.2025.345313.1589","DOIUrl":"10.22034/cmm.2025.345313.1589","url":null,"abstract":"<p><strong>Background and purpose: </strong>Fluconazole is one of the primary antifungal agents in the treatment of candidiasis. However, long-term treatment and indiscriminate use of drugs from the azole family have created resistant isolates. <i>Candida albicans</i> cells can develop resistance to fluconazole through various mechanisms. The present study aimed to investigate the expression of genes involved in fluconazole resistance in <i>C. albicans</i> in people with different underlying diseases.</p><p><strong>Materials and methods: </strong>Databases, such as PubMed, Scopus, and Web of Science were used to collect studies evaluating the expression levels of key <i>C. albicans</i> genes associated with fluconazole resistance from 1997 to 2024. Finally, 25 out of the 1,096 extracted studies were selected based on the inclusion and exclusion criteria.</p><p><strong>Results: </strong> This systematic review identified the genes encoding the ATP-binding cassette membrane pump (CDR1, CDR2) and the genes encoding the major facilitator superfamily pumps (MDR1), as well as the <i>ERG11</i> gene, are the most important effective genes in creating resistance of <i>C. albicans</i> to fluconazole. Based on the studies conducted since 1995, the CDR1 gene has the highest gene expression among the genes involved in resistance, followed by ERG11, MDR1, and CDR2, respectively.</p><p><strong>Conclusion: </strong>Comprehensive information about the activity of the genes and more studies on the genes involved in resistance, could provide valuable insights for further studies, prevent the occurrence of resistance to fluconazole and other azoles, and provide suitable treatments. The disease, as well as the dosage and duration of the antifungal therapy, may play an important role in determining the type of resistance mechanism of <i>C. albicans</i>. Therefore, further evaluation of the role of these genes in fluconazole-resistant species, along with their related gene products, is necessary.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing filamentous fungi-related onychomycosis in the era of antifungal resistance: assessment of <i>Zataria multiflora</i> nanostructured lipid carrier topical gel in a double-blinded clinical trial.","authors":"Maryam Moazeni, Hamidreza Kelidari, Armaghan Kazeminejad, Nasim Gholizadeh, Iman Haghani, Abolfazl Saravani, Shima Parsay, Yaser Nasirzadehfard, Ramin Mofarrah, Alireza Amini","doi":"10.22034/cmm.2024.345248.1582","DOIUrl":"10.22034/cmm.2024.345248.1582","url":null,"abstract":"<p><strong>Background and purpose: </strong>Onychomycosis, a prevalent fungal infection affecting the nails, presents considerable difficulties in clinical treatment. <i>Zataria multiflora</i> (Zat), with its known antifungal properties, presents a promising approach for treatment. The present study focused on the evaluation of the effectiveness of Zat-NLC 1% gel against mold-associated onychomycosis, compared to a placebo.</p><p><strong>Materials and methods: </strong>The Zat-loaded nanostructured lipid carriers (Zat-NLCs) were prepared and optimized by utilizing an ultrasonic probe approach. Antifungal susceptibility testing followed Clinical and Laboratory Standards Institute M38-A3 guidelines on the most common dermatophytes and non-dermatophytes fungal species. A double-blind trial with 40 participants (20 volunteers from each gender, equally divided into two groups, namely Zat-NLCs 1% gel and placebo receivers) evaluated Zat-NLC 1% gel efficacy. Causative agents were identified at the species level using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.</p><p><strong>Results: </strong>A mono-dispersed suspension of spherical nanoparticles with zeta potential, Z-average, and polydispersity index of -26.6±7.7 mV, 273.9±3 nm, and 0.369±0.03, respectively, was achieved with no cytotoxicity. The Zat-NLCs demonstrated a significant inhibitory effect on both dermatophytes and non-dermatophyte fungal growth, <i>in vitro</i>. Effective improvement was observed in mycological criteria, compared to the placebo group (<i>P</i><0.005) after 2 weeks of treatment. The mycological cure rate was 70% for Zat-NLCs gel after only 2 weeks. The results were notably different from those observed in the placebo group following the same duration of application (70% vs. 55%). However, the difference was insignificant in the mentioned groups after 4 weeks of application due to the prescription of routine antifungals for onychomycosis. The PCR-RFLP outputs revealed <i>T. mentagrophytes</i>/<i>interdigitale</i> complex and <i>A.</i> section Flavi as the predominant isolated species of dermatophytes and non-dermatophytes, respectively.</p><p><strong>Conclusion: </strong>Nanoscale colloidal systems loading with antifungals might be strongly considered a better and more efficient cure for mold-related dermatophytosis.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}