Current Medical Mycology最新文献

{"title":"Development of a high-resolution melt-based assay to rapidly detect the azole-resistant <i>Candida auris</i> isolates.","authors":"Hamid Morovati, Hamid Badali, Mahdi Abastabar, Keyvan Pakshir, Kamiar Zomorodian, Bahram Ahmadi, Behrouz Naeimi, Sadegh Khodavaisy, Sanam Nami, Esmaeil Eghtedarnejad, Hossein Khodadadi","doi":"10.22034/CMM.2023.345114.1453","DOIUrl":"10.22034/CMM.2023.345114.1453","url":null,"abstract":"<p><strong>Background and purpose: </strong><i>Candida auris</i> is a multidrug-resistant yeast that rapidly spreads, making it the leading Candidate for the next pandemic. One main leading cause of emerging resistant <i>C. auris</i> isolates is nonsynonymous mutations. This study aimed to detect the Y132F mutation, one of the most important azole resistance-associated mutations in the <i>ERG-11</i> gene of <i>C. auris</i>, by developing a reliable high-resolution melt (HRM)-based method.</p><p><strong>Materials and methods: </strong>Five <i>C. auris</i> isolates from Iran, plus three control isolates from other Clades were used in the study. The antifungal susceptibility testing through micro broth dilution was performed to recheck their susceptibility to three azole antifungals, including fluconazole, itraconazole, and voriconazole. Moreover, the polymerase chain reaction (PCR) sequencing of the <i>ERG-11</i> gene was performed. Following the bioinformatic analysis and HRM-specific primer design, an HRM-based assay was developed and evaluated to detect <i>ERG-11</i> mutations.</p><p><strong>Results: </strong>The minimum inhibitory concentrations of fluconazole among Iranian <i>C. auris</i> isolates ranged from 8 to 64 μg/mL. The PCR-sequencing of the <i>ERG-11</i> gene and bioinformatic analyses revealed the mutation of Y132F, a substitution consequence of A to T on codon 395 in one fluconazole-resistant isolate (IFRC4050). The developed HRM assay successfully differentiated the targeted single nucleotide polymorphism between mutant and wild types (temperature [Tm]: 81.79 ℃ - cycle threshold [CT]: 20.06 for suspected isolate). For both mutant and non-mutant isolates, the mean Tm range was 81.79-82.39 °C and the mean CT value was 20.06-22.93. These results were completely in accordance with the findings of DNA sequencing.</p><p><strong>Conclusion: </strong>The fast-track HRM-based method successfully detected one of the most common mechanisms of resistance in the <i>ERG-11</i> gene of <i>C. auris</i> within 3 h. Finally, the development of more panels of HRM assays for the detection of all azole resistance mutations in <i>C. auris</i> <i>ERG-11</i> is recommended to expand the scope of the field and facilitate the elaboration of rapid and accurate methods of antifungal resistance assessment.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 3","pages":"23-32"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740662","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":"Invasive fungal infections in children with leukemia in a tertiary hospital in Oman: An eight-year review.","authors":"Hind Al Hajri, Widad Al-Salmi, Karima Al Hinai, Saif Al-Housni, Ahmed Al-Harrasi, Hilal Al Hashami, Abdullah M S Al-Hatmi","doi":"10.22034/CMM.2023.345108.1447","DOIUrl":"10.22034/CMM.2023.345108.1447","url":null,"abstract":"<p><strong>Background and purpose: </strong>Invasive fungal disease (IFD) is a common and serious consequence of leukemia in children and the incidence of these infections has increased due to chemotherapy. This study aimed to present the epidemiology of IFD in a cohort of children with leukemia from a tertiary reference institution in Oman.</p><p><strong>Materials and methods: </strong>A retrospective study of IFDs in pediatric patients below 13 years of age with newly diagnosed or relapsed leukemia was conducted at the Royal Hospital in Muscat, Oman. From 2010 to 2017, IFD episodes in children with leukemia were evaluated retrospectively, considering age, gender, type of leukemia, chemotherapy regimen, IFD detection phase, neutropenia, prevention, diagnostic method, and treatment.</p><p><strong>Results: </strong>Between 2010 and 2017, 198 children with leukemia were admitted and treated at Royal Hospital. Invasive fungal infection (IFI) was diagnosed in 32 patients out of 198 (16.1%), and IFI was defined as probable and proven in 53% (n=17) and 47% (n=15) of the cases, respectively. At 1.1:1, the male-to-female ratio was roughly equal. According to chest computed tomography scans, 65.6% of patients had radiological features of fungal infections. Positive fungal cultures were found in the bronchoalveolar lavage of three patients, 37.5% of whom had positive blood cultures, and 3% had positive urine cultures as a neonatal invasive candidiasis. In three patients, invasive aspergillosis caused pulmonary IFD, accounting for 9.3% of all infection sites. Candidaemia was found in 28% of IFD patients, and the most common organism was <i>Candida tropicalis</i> (15.6%), followed by <i>Candida parapsilosis</i> (6.25%). Furthermore, the major risk factor was febrile neutropenia.</p><p><strong>Conclusion: </strong>In children with leukemia, invasive fungal infection is common and serious. Despite aggressive treatment, mortality among these high-risk patients remains high.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 3","pages":"16-22"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740663","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":"Onychomycosis caused by dematiaceous fungi: A four-year study on agricultural workers of Assam, India.","authors":"Parismita Borgohain, Purnima Barua, Dipika Shaw, Lakhi Ram Saikia, Jagadish Mahanta, Shivaprakash M Rudramurthy","doi":"10.22034/cmm.2023.345077.1428","DOIUrl":"10.22034/cmm.2023.345077.1428","url":null,"abstract":"<p><strong>Background and purpose: </strong>Onychomycosis caused by dematiaceous fungi is rarely reported and the identification is also quite tricky due to poor sporulation. Recent emergence of dematiaceous fungi as a major cause of onychomycosis is a matter of concern in the field of mycology. Therefore, this study aimed to understand the dematiaceous fungi as a possible cause of onychomycosis, especially among agricultural workers. In addition, the evaluation of the antifungal susceptibility patterns led to the idea of an accurate drug that will help to treat and prevent antifungal resistance.</p><p><strong>Materials and methods: </strong>The standard procedure was followed for direct microscopic examination and fungi isolation. Furthermore, antifungal susceptibility testing was conducted in accordance with the Clinical and Laboratory Standards Institute M-38-A2 protocol.</p><p><strong>Results: </strong>Both potassium hydroxide and fungal positivity were found in 275 out of 356 suspected cases, 52%, 4.3%, 28.7%, and 14.9% of which were non-dermatophytic molds (NDMs), yeast, dermatophytes, and sterile hyphae, respectively. Among NDMs (52%, n=143), 45.5% (n=65) were hyaline hyphomycetes and 54.5% (n=78) were dematiaceous hyphomycetes. Among dematiaceous fungi, <i>Pestalotiopsis</i> spp. and <i>Arthrinium</i> spp. were the commonly isolated ones. Additionally, azoles, amphotericin-B, and anidulafungin showed excellent antifungal activity against tested isolates.</p><p><strong>Conclusion: </strong>Dematiaceous fungi are now becoming a potential cause of onychomycosis. A more detailed study is needed on the identification of these emerging isolates and the mode of action of antifungal drugs for a better treatment strategy.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 3","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740664","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 of prosthetic joint infection due to the rare opportunist yeast, <i>Cyberlindnera fabianii</i>.","authors":"Nurhafiza Ishak, Kallaivani Pachayappan, Chu Lee Hwa, Muhammad Asyraf Mohamad Kamil","doi":"10.22034/CMM.2023.345063.1418","DOIUrl":"10.22034/CMM.2023.345063.1418","url":null,"abstract":"<p><strong>Background and purpose: </strong>Invasive fungal infections caused by <i>Cyberlindnera fabianii</i> (<i>Cy. fabianii</i>) have recently increased despite the low virulence potential of this yeast. However, limited information about the widely-used commercial biochemical identification systems has led to an underestimation of <i>Cy. fabianii</i> infections in clinical settings.</p><p><strong>Case report: </strong>This study reports a case of prosthetic joint infection in a patient who had a previous history of total knee replacement surgery. <i>Cy. fabianii</i> was recovered from intraoperative culture specimens identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and confirmed using molecular assays. It was, however, initially misidentified as <i>Candida utilis</i> by phenotypic identification.</p><p><strong>Conclusion: </strong>Due to the emergence of uncommon yeast species, it is important to accurately identify and perform antifungal susceptibility testing on uncommon yeast isolates for appropriate management.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 3","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740660","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":"Prevalence, predictors, and outcome of pulmonary mucormycosis in COVID-19 associated rhino orbital mucormycosis in a tertiary care center in South India.","authors":"Karthigeyan Thanjavur Sethuraman, Jayaraj Athimanjeri Thiruvengadam, Abinaya Ravichandran, Santhi Thoppappatty Sengottaiyan","doi":"10.22034/cmm.2023.345154.1486","DOIUrl":"10.22034/cmm.2023.345154.1486","url":null,"abstract":"<p><strong>Background and purpose: </strong>India witnessed an explosive rise in mucormycosis following COVID-19 infection. Pulmonary mucormycosis closely followed rhino orbital mucormycosis as the most common presentation. The need for advanced resources and lack of clinical suspicion for COVID-19-associated pulmonary mucormycosis led to widespread underdiagnosis and poor response to late therapy. The present study aimed to assess the prevalence of pulmonary mucormycosis in COVID-19-associated rhino-orbital mucormycosis using non-invasive techniques, such as sputum microscopy and chest imaging.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted at the Institute of Internal Medicine, Rajiv Gandhi Government General Hospital in Chennai, India between June 2021 and July 2021. All hospitalized patients with proven rhino orbital mucormycosis with or without cerebral involvement within three months of confirmed COVID-19 infection who had clinical symptoms compatible with pulmonary mucormycosis were included in this study. These patients were screened for probable and possible COVID-19-associated pulmonary mucormycosis using computed tomography (CT) chest imaging and sputum microscopy within 48 h of hospital admission.</p><p><strong>Results: </strong>Based on the findings, 8 (16%) out of 50 patients with rhino-orbital mucormycosis, had associated possible or probable pulmonary mucormycosis. All 8 patients were diabetics and had characteristic CT chest findings while only half of them had positive sputum microscopy. A higher prevalence of probably disseminated COVID-19-associated mucormycosis was noted among 51-60-year-old males with the use of corticosteroids and oxygen for COVID-19 therapy. The mortality rate was 100% in probably disseminated mucormycosis, 50% in possible disseminated mucormycosis, and only 9.5% in isolated rhino-orbital mucormycosis.</p><p><strong>Conclusion: </strong>Non-invasive and feasible methods, such as sputum microscopy and chest imaging can be considered for early screening and intensive management of probably disseminated mucormycosis to improve prognosis.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 3","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139740665","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":"Comparison of the effects of itraconazole and prednisolone on <i>fibroblast growth factor</i>-2 gene expression and clinical manifestations in patients with persistent severe asthma.","authors":"Mahsa Manafi Varkiani, Majid Mirsadraee, Zahra Anhaee Nasseri, Mohammadreza Khakzad, Shadi Ghaffari, Tayebeh Rabbani Nia","doi":"10.22034/CMM.2023.345036.1401","DOIUrl":"10.22034/CMM.2023.345036.1401","url":null,"abstract":"<p><strong>Background and purpose: </strong>Considering the possible role of fungal sensitization in the treatment of resistant asthma, which may lead to the remodeling of bronchial structure, we theorized that itraconazole could result in better control of asthma. In this regard, this study aimed to compare the effects of itraconazole and prednisolone (routinely prescribed) on clinical, structural, and biomarker findings of the remodeling of asthma.</p><p><strong>Materials and methods: </strong>This double-blind controlled randomized clinical trial was performed on 70 adult patients suffering from severe persistent asthma. The intervention group received 200 mg of itraconazole per day, and the control group received 10 mg of prednisolone per day, for 32 weeks, in addition to the classic treatment of asthma. The subjects were randomly divided into two groups, and assigned by sealed envelope. Blinding was performed by repacking the drug in a similar container. Primary outcomes were asthma control test score, fibroblast growth factor 2, and wall area percentage on RB1 bronchus measured by computed tomography. The outcomes were compared in subjects classified as allergic, eosinophilic, T2 low asthma, and four types of inflammatory cell classification in sputum.</p><p><strong>Results: </strong>Seventy subjects finished the 32-week trial (35 subjects in each group). Baseline data did not show significant differences between groups. A comparison of asthma variants showed significantly more severe cough and dyspnea in the allergic variant and higher spirometry results in T2-low asthma. Sputum cytology revealed a mixed pattern as the most frequent type (47%). After the trial, two groups improved in many parameters; however, FGF-2 improved more significantly by itraconazole (4.66±16.92 decreased to 1.14±2.98), and FEV1/FVC was significantly higher in the itraconazole group, compared to the control group. These results did not change in terms of asthma variants and sputum classification.</p><p><strong>Conclusion: </strong>Itraconazole was superior to prednisolone in the treatment of many clinical and spirometry aspects in severe persistent asthma.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 2","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905276","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":"Molecular epidemiology of clinically relevant single and mixed species in a Malaysian tertiary care hospital.","authors":"Humaira Farooq, Gokul Shankar Sabesan, Tahmina Monowar, Suresh V Chinni, Noor Hasliza Zainol, SweSwe Latt, Rajesh Pk","doi":"10.18502/cmm.2023.345062.1432","DOIUrl":"10.18502/cmm.2023.345062.1432","url":null,"abstract":"<p><strong>Background and purpose: </strong>The increasing rate of opportunistic infections caused by <i>Candida</i> and other yeasts is becoming a major health concern worldwide. However, systematic data on the epidemiology and the yeast species infections in Malaysia is still limited. In this regard, the present research aimed to identify pathogenic yeasts utilizing an economically practical and easily available molecular technique and evaluate the prevalence of pathogenic yeasts in a Malaysian tertiary care hospital.</p><p><strong>Materials and methods: </strong>Yeast isolates were collected from Sultan Abdul Halim Hospital, Kedah, Malaysia, from October 2020 to October 2021. Molecular identification of the isolates was performed by one enzyme-based polymerase chain reaction-restriction fragment length polymorphism method.</p><p><strong>Results: </strong><i>Candida albicans</i> was the most prevalent species, accounting for 120 isolates (59%) in total. The most prevalent non-<i>albicans Candida</i> species were <i>C. tropicalis</i> (n=33, 16%), <i>C. krusei</i> (Pichia kudriavzevii) (n=12, 5.8%), <i>C. glabrata</i> (n=12, 5.8%), and <i>C. parapsilosis</i> (n=6, 3%). Other unusual <i>Candida</i> species were <i>C. guilliermondii</i> (2), <i>C. metapsilosis</i> (2), <i>C. orthopsilosis</i> (1), <i>C. lusitaniae</i> (1), <i>C. rugosa</i> (1), <i>C. haemulonii</i> (1), <i>C. bracarensis</i> (1), and <i>C. dubliniensis</i> (1). Moreover, <i>Talaromyces marneffei</i> (1), <i>Kodamaea ohmeri</i> (1), <i>Cryptococcus neoformans</i> (3), and <i>Cryptococcus laurentii</i> (1) were among the other yeasts identified.</p><p><strong>Conclusion: </strong>The Molecular technique used in this study identified 96% of isolates, including mixed species. According to the findings, the most prevalent species are <i>C. albicans</i>, <i>C. tropicalis</i>, <i>C. krusei</i>, and <i>C. glabrata</i>.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 2","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905278","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":"Vitamin D₃: A promising antifungal and antibiofilm agent against <i>Candida</i> species.","authors":"Zahra Kherad, Somayeh Yazdanpanah, Farshid Saadat, Keyvan Pakshir, Kamiar Zomorodian","doi":"10.18502/cmm.2023.345062.1416","DOIUrl":"10.18502/cmm.2023.345062.1416","url":null,"abstract":"<p><strong>Background and purpose: </strong><i>Candida</i> species are opportunistic fungal pathogens that cause mild to life-threatening infections in both immunocompetent and immunocompromised populations. The increasing prevalence of drug-resistant <i>Candida</i> species has posed a significant challenge to the management of infections in clinical settings. Therefore, this study aimed to investigate the direct antifungal and antibiofilm effect of vitamin D₃ against <i>Candida</i> species.</p><p><strong>Materials and methods: </strong>The antifungal activity of vitamin D₃ was evaluated by broth microdilution method based on the Clinical and Laboratory Standard Institute. Prevention of biofilm formation by <i>Candida albicans</i> was measured using the XTT assay following exposure to different concentrations of vitamin D₃. Moreover, expression of <i>Agglutinin-like sequence</i> gene 1 (<i>ALS</i>1), <i>hyphal wall protein</i> gene (<i>HWP</i>1), <i>secreted aspartyl proteinase</i> 6 gene (<i>SAP</i>6), and <i>morphogenesis pathway regulatory</i> gene (<i>EFG</i>1) were analyzed by real-time polymerase chain reaction using the comparative Ct method (ΔΔ Ct) after exposure to vitamin D₃.</p><p><strong>Results: </strong>Vitamin D₃ showed antifungal activity against <i>Candida</i> species ranging from 1-128 μg/mL. Furthermore, vitamin D₃ inhibited biofilm formation in a dose-dependent manner, with IC50 of 7.5 μg/mL. Treatment with vitamin D₃ resulted in significant upregulation of the <i>EFG</i>1, <i>ALS</i>1, and <i>SAP</i>6 genes under hypha-inducing conditions to overcome environmental challenges.</p><p><strong>Conclusion: </strong>Results of the current study demonstrated that vitamin D₃ has a significant inhibitory effect on <i>Candida</i> growth and biofilm formation. Considering its demonstrated antifungal and antibiofilm properties, vitamin D₃ holds promise as a potential agent for medical applications.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 2","pages":"17-22"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905281","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":"Comparison of acidifying agents and clotrimazole for treatment of otomycosis: a comprehensive one-way mini-review.","authors":"Zeynab Yassin, Behrooz Amirzargar, Reza Ghasemi, Farnaz Valizadeh, Mahsa Fattahi","doi":"10.18502/cmm.2023.345035.1402","DOIUrl":"10.18502/cmm.2023.345035.1402","url":null,"abstract":"<p><strong>Background and purpose: </strong>This review aimed to compare the efficacy of acidifying agents and clotrimazole in the treatment of patients with otomycosis.</p><p><strong>Materials and methods: </strong>The databases, including Research Gate, Google Scholar, ScienceDirect, Embase, Medline, Scopus, Cochrane, and library databases of clinical trials were searched in this study. The keywords were \"Fungal Ear Infection\" and \"Otitis External\" for otomycosis, \"Clotrimazole\", Lotrimin\", \"Mycelex\", \"Desenex\", and \"Clotrimaderm Mycoderm\" for clotrimazole, and \"Boric Acid Alcohol\", \"Alcohol-vinegar solution\", Burow solution (Domeboro), \"Isopropyl Alcohol\", \"VoSol\" and \"Acetic Acid\" for acidifying agents. Regarding search strategy, a total of 53 studies were collected, 11 of which were maintained for assessment. Almost all studies were published after 1990. These articles discussed the role of clotrimazole and acidifying compounds in the treatment of otomycosis. Moreover, the route of administration, dosage, and side effects of these medications were highlighted.</p><p><strong>Results: </strong>Eight studies had similar results and claimed that clotrimazole has the best or most significant effect on the treatment of otomycosis for patients suffering from pain, itching, swelling, and hearing loss.</p><p><strong>Conclusion: </strong>Although all medications appear effective, there is a paucity of evidence to fully support the decision to choose between clotrimazole or acidifying agents for the treatment of otomycosis in terms of both efficacy and safety. However, in the biomedical field, the re-emerging investigation attention is due to the statements of a number of mechanisms defending the use of acidifying agents to treat mycosis (of antifungal-resistant species).</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 2","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905275","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":"Molecular identification and antifungal susceptibility profiles of etiologic agents of oral candidiasis among HIV-positive patients: A multicenter study.","authors":"Hamid Morovati, Malihe Jokari, Saba Eslami, Kamiar Zomorodian, Katayoun Taeri, Nesa Khalaf, Hossein Khodadadi","doi":"10.18502/CMM.2023.345058.1414","DOIUrl":"10.18502/CMM.2023.345058.1414","url":null,"abstract":"<p><strong>Background and purpose: </strong>Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a serious risk factor for oral candidiasis (OC). In this regard, the present study aimed to investigate the frequency of <i>Candida</i> species collected from the oropharyngeal cavity of HIV-positive patients and the sensitivity of these isolates to antifungal drugs.</p><p><strong>Materials and methods: </strong>Oral samples were collected from 169 HIV-positive patients. In addition to culture-based methods, a molecular assay via the polymerase chain reaction-restriction fragment length polymorphism method was applied to identify isolates using the <i>MspI</i> restriction enzyme. The disk diffusion method determined the susceptibility of isolated yeasts to common antifungal drugs according to the CLSI M44-A2 protocol.</p><p><strong>Results: </strong>In total, 81 participants (47.92%) were positive for OC, and <i>Candida albicans</i> was the most prevalent yeast (53.98%). The median age of patients was 36 years old (IQR=10.5; 17-59), and it was found that women are 27% more susceptible to HIV-associated OC (OR=1.268; 95% CI: 0.685-2.348). Patients who received antifungal therapy had a 97.3% reduced chance for OC (OR: 0.027; 95% CI: 0.008-0.091; <i>P-value</i>: 0.000). Antifungal therapy reduced the risk of OC by 97.3% (OR=0.027; 95% CI=0.008-0.091; <i>P</i>=0.000), and antiretroviral therapy decreased the chance of OC 4.42 times (OR=4.423; 95% CI=1.697-11.528; <i>P</i>=0.002). The resistance rates for antifungals, namely fluconazole, ketoconazole, itraconazole, amphotericin B, and nystatin were 15.93%, 8.85%, 7.96%, 5.31%, and 4.42%, respectively.</p><p><strong>Conclusion: </strong>Although several decades have passed since the emergence of HIV/AIDS, little information is available about fungal colonization and infections in this population. Further investigations are suggested using novel and reference molecular identification methods, such as matrix-assisted laser desorption ionization time-of-flight mass spectrometry and sequencing, respectively. In addition, more reliable methods for antifungal susceptibility testing are recommended.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"9 2","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905279","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}