Current Medical Mycology最新文献

{"title":"Formulation, characterization, and <i>in vitro</i> antifungal evaluation of liposomal terbinafine prepared by the ethanol injection method.","authors":"Aylar Arbabi, Iman Haghani, Farshad Naghshvar, Jamshid Yazdani, Mahdi Abastabar, Mohammad Taghi Hedayati, Lotfollah Davoodi, Tahereh Shokohi, Fereshteh Talebpour Amiri, Zahra Yahyazadeh, Robab Ebrahimi Barough, Abbas Raeisabadi, Seyed Reza Aghili, Hamid Badali, Mehdi Karimi, Javad Akhtari","doi":"10.22034/cmm.2025.345248.1686","DOIUrl":"10.22034/cmm.2025.345248.1686","url":null,"abstract":"<p><strong>Background and purpose: </strong>Fungal infections necessitate advanced delivery systems to improve antifungal therapy. Terbinafine, a potent allylamine antifungal, faces clinical limitations due to poor solubility, low bioavailability, and toxicity. Liposomal encapsulation addresses these challenges by enhancing solubility, enabling controlled release, and reducing toxicity. In this study, a scalable ethanol injection method was used to develop terbinafine-loaded liposomes with optimized physicochemical properties. This study aimed to focus on central nervous system-targeted delivery to combat resistant fungal infections while minimizing systemic toxicity.</p><p><strong>Materials and methods: </strong>Twenty liposomal formulations were prepared using phospholipids (e.g., dipalmitoylphosphatidylcholine [DPPC], hydrogenated soybean phosphatidylcholine) and characterized for size, zeta potential, polydispersity index, and morphology via dynamic light scattering and transmission electron microscopy. Encapsulation efficiency, drug release kinetics, colloidal stability (3 months), and cytotoxicity (human foreskin fibroblast 2 cells, 48-hour exposure) were evaluated. The M38-A2 method of the Clinical and Laboratory Standards Institute was used to calculate minimum inhibitory concentrations (MICs) of 16 azole-susceptible and -resistant <i>Aspergillus fumigatus</i> and <i>Aspergillus flavus</i>.</p><p><strong>Results: </strong>Liposomes exhibited sizes of 72-174 nm, zeta potentials between +2 and -15 mV, and a low polydispersity index (<0.3). Moreover, F12 (DPPC-based) demonstrated superior cumulative release, compared to F20, and attributed to the fluid bilayer of DPPC. Both formulations retained stability during storage. Cytotoxicity assays revealed minimal toxicity for free terbinafine (14.73% at 25 mg/mL) and significantly reduced toxicity for liposomal forms (6.77% for F12, <i>p</i><0.05). The DPPC-based formulation achieved an encapsulation efficiency of 73.48%, ensuring a high drug payload and biocompatibility. The DPPC-based formulation achieved an encapsulation efficiency of 73.48%, ensuring a high drug payload and biocompatibility. Liposomal terbinafine and voriconazole exhibited good <i>in vitro</i> activity against both triazole-susceptible and -resistant <i>Aspergillus</i> isolates (MIC₅₀=0.5 µg/mL).</p><p><strong>Conclusion: </strong>Based on the results, F12, with its sub-100 nm size, sustained release, and reduced cytotoxicity, emerged as a promising candidate for brain-targeted antifungal therapy. Its stability and high encapsulation efficiency support further evaluation in fungal isolates and <i>in vivo</i> models to optimize central nervous system biodistribution and therapeutic efficacy. In addition, this study underscored the promising <i>in vitro</i> activities of terbinafine and liposomal terbinafine against both triazole-resistant/susceptible <i>A. fumigatus</i> and <i>A. flavus</i>.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344232","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":"Trend of <i>Candida</i> species profiles and their susceptibility to various antifungals in Jakarta, Indonesia.","authors":"Conny Riana Tjampakasari, Yeva Rosana, Mardiastuti Wahid","doi":"10.22034/cmm.2025.345421.1672","DOIUrl":"10.22034/cmm.2025.345421.1672","url":null,"abstract":"<p><strong>Background and purpose: </strong>Fungal infections are prevalent in tropical countries, and their etiology depends on various factors, including the underlying cause and accompanying risk factors. Accurate diagnosis through culture and identification is crucial to determine the causative agent, followed by antifungal susceptibility testing to guide appropriate management. <i>Candida</i> species are the most commonly found causative agents in fungal infection cases. Given the diverse range of <i>Candida</i> causing infections, antifungal treatments vary accordingly. This study aimed to investigate <i>Candida</i> species profiles and evaluate their susceptibility to various antifungal agents, providing valuable insights for effective treatment strategies.</p><p><strong>Materials and methods: </strong>This study was conducted during 2020-2024, consisting of 2,470 samples of various specimens. Samples were inoculated onto Sabouraud Dextrose Agar for fungal culture, and isolates were subsequently identified and subjected to antifungal susceptibility testing using the Vitek 2 compact automated system.</p><p><strong>Results: </strong>A total of 799 <i>Candida</i> isolates (32.34%) were identified, comprising 21 species. The most prevalent species were <i>Candida albicans</i> (44.68%, 357/799), <i>Candida glabrata</i> (17.02%, 136/799), and <i>Candida tropicalis</i> (16.15%, 129/799). Susceptibility testing of predominant <i>Candida</i> species revealed susceptibility rates of 96.06% to fluconazole, 93.51% to voriconazole, 69.84% to caspofungin, 95.64% to micafungin, 95.07% to amphotericin B, and 97.40% to flucytosine. Several uncommon <i>Candida</i> species were successfully identified, including <i>Candida lusitaniae</i>, <i>Candida pelliculosa</i>, <i>Candida rugosa</i>, <i>Candida intermedia</i>, <i>Candida kefyr</i>, <i>Candida lipolytica</i>, and <i>Candida utilis</i>. These species demonstrated susceptibility to voriconazole, amphotericin B, and flucytosine. However, antifungal susceptibility data were not available for other uncommon species, such as <i>Candida laurentii</i>, <i>Candida famata</i>, <i>Candida colliculosa</i>, <i>Candida magnoliae</i>, <i>Candida sphaerica</i>, and <i>Candida</i> haemulonii.</p><p><strong>Conclusion: </strong>The trends in <i>Candida</i> species profiles and their susceptibility to various antifungal agents over consecutive years revealed variability in both species distribution and susceptibility rates. Understanding the profile and susceptibility of <i>Candida</i> species is essential for developing effective treatment strategies.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765234","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 <i>Chaetomium globosum</i>: an uncommon fungal nail infection.","authors":"Astha Yadav, Prashant Gupta, Gopa Banerjee, Raj Kumar Kalyan, Mohd Saqib Hasan","doi":"10.22034/cmm.2025.345421.1641","DOIUrl":"10.22034/cmm.2025.345421.1641","url":null,"abstract":"<p><strong>Background and purpose: </strong>Onychomycosis is predominantly caused by dermatophytes; however, non-dermatophytic molds are emerging as opportunistic pathogens. These infections pose diagnostic and therapeutic challenges due to their rarity, variable drug susceptibility, and frequent misidentification.</p><p><strong>Case report: </strong>This study reported a case of onychomycosis in a 46-year-old immunocompetent male caused by <i>Chaetomium globosum</i>. Diagnosis was established by direct potassium hydroxide microscopy of nail clippings, which revealed septate hyphae, and fungal culture that produced pigmented colonies with characteristic microscopic features. Antifungal susceptibility testing, performed according to CLSI M38 guidelines, showed sensitivity to itraconazole (MIC=0.25 µg/mL). The patient was treated with oral itraconazole and topical 5% nail lacquer (Nailrox, India), resulting in significant clinical improvement.</p><p><strong>Conclusion: </strong>This case highlighted the importance of accurate fungal identification, which is crucial in atypical nail infections, and occupational exposure should be considered in non-dermatophytic onychomycosis.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765171","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":"Pediatric candidemia due to <i>Candida lusitaniae</i>: A clinical and microbiological evaluation.","authors":"Nisa Nur Tapaç, Ümmühan Çay, Özlem Özgür Gündeşlioğlu, Fatma Kılınç, Emel Bakanoğlu, Fatma Tuğba Çetin, Asena Ünal, Derya Alabaz","doi":"10.22034/cmm.2025.345432.1678","DOIUrl":"10.22034/cmm.2025.345432.1678","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and purpose: &lt;/strong&gt;&lt;i&gt;Candida lusitaniae&lt;/i&gt; is a rare cause of invasive candidiasis in children. This study aimed to investigate the clinical and microbiologic characteristics, treatment, and prognosis of &lt;i&gt;C. lusitaniae&lt;/i&gt; candidemia in pediatric patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This retrospective study included pediatric patients (&lt;18 years) with bloodstream infections caused by &lt;i&gt;C. lusitaniae&lt;/i&gt; at Balcalı Hospital, Faculty of Medicine, Cukurova University, Adana, Turkey from December 2013 to December 2021. Demographics, underlying diseases, risk factors, treatment regimens, and outcomes were analyzed. Antifungal susceptibility was tested using the VITEK&lt;sup&gt;®&lt;/sup&gt; 2 Compact system. Catheter-related bloodstream infection was defined by standard criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 395 candidemia episodes, &lt;i&gt;C. lusitaniae&lt;/i&gt; accounted for 11 cases (2.7%). The median age was 16 months (range: 2-177 months). Most had underlying conditions (82%), primarily congenital heart disease (27.3%). Major risk factors included antibiotic use (100%), central venous catheter (91%), mechanical ventilation (63.6%), intensive care unit (ICU) stay (63.6%), nasogastric tube (45.4%), surgery history (45.4%), and H2 blocker use (45.4%). The median patient age was 16 months (range: 2-177 months), and all patients were male. Most patients (82%) had at least one underlying condition, with congenital heart disease being the most common (27.3%). The most frequently observed risk factors included recent antibiotic use (100%), central venous catheterization (91%), mechanical ventilation (63.6%), ICU admission (63.6%), nasogastric tube use (45.4%), surgical history (45.4%), and H2-receptor blocker administration (45.4%). Seven patients received antifungal monotherapy with fluconazole (4/7), L-AmB (1/7), caspofungin (1/7), and micafungin (1/7). Combination antifungal therapy was initiated in three patients (30%) due to persistent candidemia and delayed catheter removal. In these cases, combination regimens included fluconazole and caspofungin or L-AmB with additional agents. The mean duration of antifungal therapy was 28 days (range: 12-58 days). The median time to clearance of fungemia (negative blood culture) was 15.8 days (range: 3-45 days). Delays in catheter removal were often due to clinical instability or lack of alternative vascular access. One patient who received combination therapy died, resulting in an overall 30-day mortality rate of 9% (1/11).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;&lt;i&gt;Candida lusitaniae&lt;/i&gt; is a rare nosocomial pathogen in children with underlying conditions and risk factors. Fluconazole remains a primary treatment option, although combination therapy may be warranted in refractory cases. Given the potential resistance to L-AmB, caution is advised in its use. Timely catheter removal is associated with improved outcomes. Further studies are needed to establish optimal therapeutic st","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200447","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":"Antifungal potential of copper oxide nanoparticles against <i>Microsporum canis</i> isolates in canine and feline dermatophytosis.","authors":"Javad Malakootikhah, Donya Nikaein, Hanieh Golchini, Alireza Khosravi","doi":"10.22034/cmm.2025.345248.1604","DOIUrl":"10.22034/cmm.2025.345248.1604","url":null,"abstract":"<p><strong>Background and purpose: </strong>Dermatophytosis, or ringworm, is a highly contagious fungal infection caused by dermatophytes, like <i>Microsporum canis</i>, which primarily affects cats and dogs and poses a significant zoonotic threat. Increasing prevalence of drug-resistant strains complicates the treatment of <i>M. canis</i> infections, necessitating the exploration of new therapeutic approaches. Nanotechnology, particularly copper oxide nanoparticles (CuO NPs), has emerged as a promising solution due to its potent antimicrobial properties and potential to overcome resistance. This study aimed to evaluate the antifungal efficacy of CuO NPs against <i>M. canis</i> isolates collected from companion animals. The goal was to develop more effective treatment options for dermatophytosis, addressing the need for alternative therapies and the challenge of antifungal resistance.</p><p><strong>Materials and methods: </strong>CuO NPs were synthesized using a green chemistry approach, employing <i>Eichhornia crassipes</i> leaf extract. Concurrently, <i>M. canis</i> isolates were obtained from infected animals and cultured for purity. Antifungal activity of the CuO NPs against the isolates was assessed through disk diffusion and microdilution tests, and the results were statistically analyzed to confirm their significance. <b>Cell dens (<i>10 <b>⁵</b> </i></b>.</p><p><strong>Results: </strong> The synthesized CuO NPs exhibited high purity, small size, and cubic morphology. Statistical analysis of the disk diffusion and microdilution tests confirmed the significant antifungal efficacy of CuO NPs against <i>M. canis</i> isolates (ANOVA, <i>p</i><0.05). Minimum inhibitory concentration (MIC) values ranged from 500 to 1,000 ppm, while minimum fungicidal concentration (MFC) values were between 1,000 and 2,000 ppm. Average MFC/MIC ratio of 2.6, confirmed through paired t-test (<i>p</i>=0.003), demonstrated the fungicidal properties of the CuO NPs.</p><p><strong>Conclusion: </strong>This study highlighted the potent antifungal capabilities of CuO NPs against <i>M. canis</i>, marking them as a promising alternative to conventional treatments. With further optimization and research, CuO NPs could revolutionize the management of dermatophytosis, offering a new frontier in combating drug-resistant fungal infections.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344211","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>Scedosporium apiospermum</i>-induced brain abscess leading to rapid mortality in an immunocompetent adult male from Uttarakhand, India.","authors":"Minakshi Singh, Priyal Anand, Sowjanya Perumalla, Amber Prasad","doi":"10.22034/cmm.2025.345248.1587","DOIUrl":"10.22034/cmm.2025.345248.1587","url":null,"abstract":"<p><strong>Background and purpose: </strong><i>Scedosporium apiospermum</i>, a soil-dwelling fungus, is typically associated with localized infections, such as skin infections and osteomyelitis. However, it can also cause invasive central nervous system infections, including brain abscesses, particularly in immunocompromised individuals. Such infections are rare in immunocompetent individuals and often occur following trauma or environmental exposure. This report aimed to present a case of a fatal <i>S. apiospermum</i> brain abscess in an immunocompetent adult male, highlighting diagnostic and management challenges.</p><p><strong>Case presentation: </strong>A 48-year-old immunocompetent male presented with a three-day history of persistent holo-cranial headache and left-sided weakness. Twenty days earlier, the patient had fallen into a sewer, likely exposing him to fungal pathogens. Initial imaging revealed a large right frontal intracranial lesion. Surgical resection of the abscess was performed, and antifungal therapy with voriconazole was initiated. Intraoperative findings revealed a thick, non-vascular abscess capsule containing yellow pus. Postoperative KOH mount confirmed fungal elements (hyaline septate hyphae). Despite aggressive management in the intensive care unit, including antifungal therapy, antibiotics, and supportive care, the patient developed septic shock and succumbed to cardiac arrest within 48 h of surgery.</p><p><strong>Conclusion: </strong>This case underscores the rapid progression and severity of <i>S. apiospermum</i> infections in immunocompetent individuals, even with early surgical and medical intervention. It emphasizes the need for heightened clinical suspicion in cases involving trauma with potential environmental exposure. Prompt diagnosis, effective antifungal therapy, and multidisciplinary management are essential to improve outcomes in such cases.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200470","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":"Development and characterization of <i>Citrus limon</i> (L.) Osbeck essential oil nanoemulsions: assessment of antibacterial and antifungal activities.","authors":"Iman Haghani, Mahdi Abastabar, Mahmoud Osanloo, Ali Davoodi, Amirhossein Ghasemzadeh, Masoumeh Eslamifar, Emran Habibi, Javad Akhtari","doi":"10.22034/cmm.2025.345248.1633","DOIUrl":"10.22034/cmm.2025.345248.1633","url":null,"abstract":"<p><strong>Background and purpose: </strong>Essential oils (EO) have gained significant attention due to their natural antimicrobial and antifungal properties. However, their application is often limited due to poor solubility, volatility, and stability. Nanoemulsions, as advanced delivery systems, can overcome these limitations by enhancing the bioavailability and efficacy of EOs. Lemon EO, known for its broad-spectrum antimicrobial activity, is a promising candidate for nanoemulsion formulation. This study aimed to synthesize and characterize lemon EO nanoemulsions and evaluate their enhanced antimicrobial and antifungal potential, compared to crude oil.</p><p><strong>Materials and methods: </strong>Lemon EO was first analyzed using gas chromatography-mass spectrometry (GC-MS) to identify its chemical composition. Lemon EO nanoemulsions were prepared using the spontaneous emulsification technique. The physicochemical properties, including particle size, polydispersity index (PDI), zeta potential, and stability, were characterized using dynamic light scattering. The antimicrobial and antifungal activities were assessed against <i>Escherichia coli</i>, <i>Staphylococcus aureus</i>, <i>Staphylococcus epidermidis</i>, <i>Enterococcus faecalis</i>, <i>Candida albicans</i>, and <i>Aspergillus fumigatus</i> through minimum inhibitory concentration (MIC) and minimum bactericidal/fungicidal concentration (MBC/MFC) assays.</p><p><strong>Results: </strong>The GC-MS analysis revealed the major chemical components of lemon EO, including limonene, β-pinene, and γ-terpinene. The nanoemulsions exhibited a mean particle size of about 15 nm, a low PDI (< 0.3), and a negative zeta potential, indicating high stability and homogeneity. The antimicrobial and antifungal activities of the nanoemulsions were significantly enhanced compared to the crude lemon EO, as demonstrated by lower MIC and MFC values. The nanoemulsions also showed excellent stability under various storage conditions.</p><p><strong>Conclusion: </strong>This study demonstrated that lemon EO nanoemulsions are a stable delivery system with superior antimicrobial and antifungal properties. The GC-MS analysis provided valuable insights into the chemical composition of the EO, further supporting its efficacy. These findings suggest the potential of lemon EO nanoemulsions as a natural alternative for applications in food preservation, pharmaceuticals, and cosmetics.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344173","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":"Overview of <i>Candida parapsilosis</i> candidemia in pediatric patients with hematologic and solid organ malignancies.","authors":"Fatma Tuğba Çetin, Ümmühan Çay, Asena Ünal, Özlem Özgür Gündeşlioğlu, Derya Alabaz, Filiz Kibar, Nazlı Totik, Meriç Esen Şimşek Mullaoğlu, Gülay Sezgin, Serhan Küpeli","doi":"10.22034/cmm.2024.345299.1579","DOIUrl":"10.22034/cmm.2024.345299.1579","url":null,"abstract":"<p><strong>Background and purpose: </strong>Today, with the development of critical patient care and the increase in intravascular invasive methods, the survival rate of patients diagnosed with hematological and solid organ malignancies is increasing, and unfortunately, the incidence of <i>Candida parapsilosis</i> candidemia is also increasing due to multiple risk factors. In this study, we aimed to determine the clinical-demographic characteristics of <i>C. parapsilosis</i> candidemia and the antifungal susceptibility profile of <i>C. parapsilosis</i> in pediatric patients with hematological and solid organ malignancies.</p><p><strong>Materials and methods: </strong>The present study included pediatric patients with hematologic and solid organ malignancies presenting with signs and symptoms consistent with candidemia, in whom <i>C. parapsilosis</i> was isolated from blood and catheter cultures between January 2010 and August 2023.</p><p><strong>Results: </strong>Thirty (65.2%) of the patients had hematologic and 16 (34.8%) had solid organ malignancies. In all patients, 23 (50%) had non-catheter-related candidemia and 23 (50%) had catheter-related candidemia. At least one of the risk factors examined was detected in these patients. Catheter-related candidemia was found to be more common in patients diagnosed with hematologic malignancy. The difference was found to be statistically significant (p= 0.030). Drug resistance rates of <i>C. parapsilosis</i> were 6.5% for amphotericin B, 6.5% for fluconazole, 2.2% for voriconazole and 2.2% for micafungin. No patient with caspofungin resistance was detected. The mean treatment duration of the patients was 21 days (min 3-max 103) and it was observed that amphotericin B and caspofungin were used most frequently in the treatment regimen. The mortality rate of patients with candidemia was 6.5%.</p><p><strong>Conclusion: </strong>Our study showed that patients with hematologic malignancies exhibited a higher susceptibility to catheter-related <i>C. parapsilosis</i> candidemia compared to patients with solid organ tumors. Caspofungin resistance was not detected in our study, and we believe that each center should know its own antifungal drug sensitivity, determine the treatment regimen accordingly, and that catheters should be removed rapidly in patients with catheter-related <i>C. parapsilosis</i> candidemia in malignant patients.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"10 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636394","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":"Investigation of the relationship between fluconazole susceptibility, proteinase activity and <i>ERG11-SAP2</i> Expression in <i>Candida albicans</i> strains isolated from clinical samples.","authors":"Nagihan Ege, Şükrü Öksüz, Emel Akbaş, Emel Çalişkan, Mehmet Ali Sungur","doi":"10.22034/cmm.2024.345311.1585","DOIUrl":"10.22034/cmm.2024.345311.1585","url":null,"abstract":"<p><strong>Background and purpose: </strong><i>Candida albicans</i> is currently recognised as an opportunistic pathogen that can cause many invasive infections. Resistance mechanisms and fungal virulence factors play an important role in the effectiveness of treatment. The aim of this study was to investigate the relationship between fluconazole resistance, proteinase activity and <i>ERG11</i> (sterol 14-demethylase)- <i>SAP2</i> (secreted aspartic protease 2) gene expression levels in <i>C.albicans</i> strains.</p><p><strong>Materials and methods: </strong><i>Candida albicans</i> strains isolated from patient samples sent to Medical Microbiology laboratory of Düzce University from various clinics were included in the study. Fluconazole susceptibilities of the isolates were determined by broth microdilution method. The increase in fluconazole MIC values at 48 hours and proteinase activities of the isolates were analysed. <i>ERG11</i> and <i>SAP2</i> gene expression levels were measured by real time qPCR.</p><p><strong>Results: </strong>Fluconazole resistance rate was found to be 3.14% in 127 <i>C. albicans</i> strains. A moderate positive correlation was found between <i>ERG11</i> and <i>SAP2</i> values (p=0.029, r:0.655, p<0.001). There was no correlation between <i>SAP2/ERG11</i> expression levels and fluconazole resistance. Proteinase positivity was detected in 81.1%, of 127 strains and no statistically significant correlation was found between proteinase activities and <i>SAP2/ERG11</i> expression levels. While there was a statistically significant relationship between <i>ERG11</i> expression levels and 48th hour MIC elevation, there was no statistically significant relationship between <i>SAP2</i> levels and 48th hour MIC elevation.</p><p><strong>Conclusion: </strong>In addition to the moderate positive correlation between <i>ERG11</i> and <i>SAP2</i> values, a significant correlation was found between <i>ERG11</i> expression and fluconazole tolerance.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"10 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636393","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":"Insights into the structure, function, and impact of <i>Candida albicans UPC2</i> gene on azole resistance; a mini-review.","authors":"Akbar Hoseinnejad, Amir Hossein Mahdizade, Maryam Erfaninejad, Firoozeh Kermani, Mona Ghazanfari, Aylar Arbabi, Seyed Sobhan Bahreiny, Arezoo Bozorgomid, Mojtaba Moradi, Iman Haghani, Mahdi Abastabar","doi":"10.22034/cmm.2024.345248.1595","DOIUrl":"10.22034/cmm.2024.345248.1595","url":null,"abstract":"<p><strong>Background and purpose: </strong>Candidiasis is a prevalent fungal infection caused by various species of <i>Candida</i>, especially, <i>C. albicans</i>. The emergence of resistance to azole medications, which are frequently prescribed for the treatment of <i>Candida</i> infections, presents a significant challenge in the management of these infections.</p><p><strong>Materials and methods: </strong>The present mini-review summarizes findings from a comprehensive search of articles published between 1999 and 2024, retrieved from Scopus, PubMed, and Web of Science. Studies were selected using specific keywords based on relevance to <i>UPC2</i> gene functions, azole resistance mechanisms, and <i>C. albicans</i> biology.</p><p><strong>Results: </strong>The <i>UPC2</i> gene has become crucial in regulating drug resistance in <i>C. albicans</i>. This gene encodes a zinc (II)-Cys (6) transcription factor involved in the biosynthesis of sterols and contributes to resistance against azole antifungal drugs. When exposed to azoles, <i>UPC2</i> in <i>C. albicans</i> enhances the expression of ergosterol biosynthesis genes, such as <i>ERG2</i> and <i>ERG11</i>. Increased expression of <i>ERG11</i> leads to reduced susceptibility to azoles by boosting the production of 14α-lanosterol demethylase, the primary target of these antifungal agents. Furthermore, <i>UPC2</i> regulates sterol uptake under anaerobic conditions and manages other adaptations to environmental changes, all of which contribute to azole resistance.</p><p><strong>Conclusion: </strong>Gaining insight into how the <i>UPC2</i> gene contributes to azole resistance is essential for the development of effective strategies in the antifungal drug development process.</p>","PeriodicalId":10863,"journal":{"name":"Current Medical Mycology","volume":"10 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636391","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}